"Notes"	"VAERS ID"	"VAERS ID Code"	"Symptoms"	"Symptoms Code"	"Age"	"Age Code"	Adverse Event Description
	"0914805-1"	"0914805-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"RESIDENT CODED AND EXPIRED"
	"0914917-1"	"0914917-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death by massive heart attack.  Pfizer-BioNTech COVID-19 Vaccine EUA"
	"0914917-1"	"0914917-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"Death by massive heart attack.  Pfizer-BioNTech COVID-19 Vaccine EUA"
	"0918065-1"	"0918065-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"1/1/2020: Residents was found unresponsive. Pronounced deceased at 6:02pm"
	"0918065-1"	"0918065-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"1/1/2020: Residents was found unresponsive. Pronounced deceased at 6:02pm"
	"0923993-1"	"0923993-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient was vaccinated Dec 30, 2020. Prime dose of Moderna vaccine. Observed for full 15 minutes post-injection. No complaints when asked during observation. Released.  Subsequently, vaccine clinic staff learned from the patient's supervisor that on Jan 4, 2021 that the patient had expired on Jan 2, 2021. By report from the supervisor, the patient was found dead at his home. The patient's primary care provider was unaware of his death when contacted by this reporter today (Jan 6, 2021). Electronic Medical Record without any information since the vaccination."
	"0924464-1"	"0924464-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"coughing up blood, significant hemoptysis -- > cardiac arrest. started day after vaccine but likely related to ongoing progression of lung cancer"
	"0924464-1"	"0924464-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"coughing up blood, significant hemoptysis -- > cardiac arrest. started day after vaccine but likely related to ongoing progression of lung cancer"
	"0924464-1"	"0924464-1"	"HAEMOPTYSIS"	"10018964"	"60-64 years"	"60-64"	"coughing up blood, significant hemoptysis -- > cardiac arrest. started day after vaccine but likely related to ongoing progression of lung cancer"
	"0924464-1"	"0924464-1"	"LUNG NEOPLASM MALIGNANT"	"10058467"	"60-64 years"	"60-64"	"coughing up blood, significant hemoptysis -- > cardiac arrest. started day after vaccine but likely related to ongoing progression of lung cancer"
	"0930154-1"	"0930154-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Notified today that he passed away. No other details known at this time."
	"0932898-1"	"0932898-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"The patient had an apparent cardiac arrest on 12/23/20 and was admitted to the ICU. He was taken off of life support on 12/30/20.  He had known cardiac disease."
	"0932898-1"	"0932898-1"	"CARDIAC DISORDER"	"10061024"	"60-64 years"	"60-64"	"The patient had an apparent cardiac arrest on 12/23/20 and was admitted to the ICU. He was taken off of life support on 12/30/20.  He had known cardiac disease."
	"0932898-1"	"0932898-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"The patient had an apparent cardiac arrest on 12/23/20 and was admitted to the ICU. He was taken off of life support on 12/30/20.  He had known cardiac disease."
	"0932898-1"	"0932898-1"	"WITHDRAWAL OF LIFE SUPPORT"	"10067595"	"60-64 years"	"60-64"	"The patient had an apparent cardiac arrest on 12/23/20 and was admitted to the ICU. He was taken off of life support on 12/30/20.  He had known cardiac disease."
	"0933090-1"	"0933090-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient died, I have a copy of his vaccination card"
	"0935815-1"	"0935815-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Difficulty breathing, death."
	"0935815-1"	"0935815-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Difficulty breathing, death."
	"0937569-1"	"0937569-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"patient reported expired 1/7/2021"
	"0937818-1"	"0937818-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""This is being reported because of the incident occurring 2 days after the Moderna Covid-19 vaccination. It was reported that the patient expired on 1/9/21, 2 days after receiving  the Moderna vaccine.  Upon screening of patient prior to  administration on 1/7/21, the patient completed paperwork answering  NO to the following ""Do you currently have any active infections or acute respiratory illness or fever.""""
	"0941743-1"	"0941743-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"This person was found to be deceased on routine rounds during the night, 3am. No symptoms of reaction noted post vaccine. No injection site reaction. No reports of any allergic reaction."
	"0942085-1"	"0942085-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"No adverse effects from vaccination seen on 1/2/21.   On 1/6/21 resident was seen by Dr and her baclofen pump was refilled with 20 ml Baclofen 4,000mcg/ml. ITB Rate increased by 6% to 455.5 mcg/day simple continuous rate over 3 days.   On 1/8/21 at 0615 resident was shaking, lower extremities mottled, Sa02 70%, pulse 45. Oxygen started at 2 L/m per NC. At 0715  her primary physician was notified as well as her daughter. Oxygen increased to 4 L/min, sats at 83%. SOA noted, reported all over pain. At 0850 when they attempted to reposition the resident, she was not responsive. Licensed nurse assessed her and no heartbeat heard or pulse found."
	"0942085-1"	"0942085-1"	"LIVEDO RETICULARIS"	"10024648"	"60-64 years"	"60-64"	"No adverse effects from vaccination seen on 1/2/21.   On 1/6/21 resident was seen by Dr and her baclofen pump was refilled with 20 ml Baclofen 4,000mcg/ml. ITB Rate increased by 6% to 455.5 mcg/day simple continuous rate over 3 days.   On 1/8/21 at 0615 resident was shaking, lower extremities mottled, Sa02 70%, pulse 45. Oxygen started at 2 L/m per NC. At 0715  her primary physician was notified as well as her daughter. Oxygen increased to 4 L/min, sats at 83%. SOA noted, reported all over pain. At 0850 when they attempted to reposition the resident, she was not responsive. Licensed nurse assessed her and no heartbeat heard or pulse found."
	"0942085-1"	"0942085-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"No adverse effects from vaccination seen on 1/2/21.   On 1/6/21 resident was seen by Dr and her baclofen pump was refilled with 20 ml Baclofen 4,000mcg/ml. ITB Rate increased by 6% to 455.5 mcg/day simple continuous rate over 3 days.   On 1/8/21 at 0615 resident was shaking, lower extremities mottled, Sa02 70%, pulse 45. Oxygen started at 2 L/m per NC. At 0715  her primary physician was notified as well as her daughter. Oxygen increased to 4 L/min, sats at 83%. SOA noted, reported all over pain. At 0850 when they attempted to reposition the resident, she was not responsive. Licensed nurse assessed her and no heartbeat heard or pulse found."
	"0942085-1"	"0942085-1"	"PULSE ABSENT"	"10037469"	"60-64 years"	"60-64"	"No adverse effects from vaccination seen on 1/2/21.   On 1/6/21 resident was seen by Dr and her baclofen pump was refilled with 20 ml Baclofen 4,000mcg/ml. ITB Rate increased by 6% to 455.5 mcg/day simple continuous rate over 3 days.   On 1/8/21 at 0615 resident was shaking, lower extremities mottled, Sa02 70%, pulse 45. Oxygen started at 2 L/m per NC. At 0715  her primary physician was notified as well as her daughter. Oxygen increased to 4 L/min, sats at 83%. SOA noted, reported all over pain. At 0850 when they attempted to reposition the resident, she was not responsive. Licensed nurse assessed her and no heartbeat heard or pulse found."
	"0942085-1"	"0942085-1"	"TREMOR"	"10044565"	"60-64 years"	"60-64"	"No adverse effects from vaccination seen on 1/2/21.   On 1/6/21 resident was seen by Dr and her baclofen pump was refilled with 20 ml Baclofen 4,000mcg/ml. ITB Rate increased by 6% to 455.5 mcg/day simple continuous rate over 3 days.   On 1/8/21 at 0615 resident was shaking, lower extremities mottled, Sa02 70%, pulse 45. Oxygen started at 2 L/m per NC. At 0715  her primary physician was notified as well as her daughter. Oxygen increased to 4 L/min, sats at 83%. SOA noted, reported all over pain. At 0850 when they attempted to reposition the resident, she was not responsive. Licensed nurse assessed her and no heartbeat heard or pulse found."
	"0942085-1"	"0942085-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"No adverse effects from vaccination seen on 1/2/21.   On 1/6/21 resident was seen by Dr and her baclofen pump was refilled with 20 ml Baclofen 4,000mcg/ml. ITB Rate increased by 6% to 455.5 mcg/day simple continuous rate over 3 days.   On 1/8/21 at 0615 resident was shaking, lower extremities mottled, Sa02 70%, pulse 45. Oxygen started at 2 L/m per NC. At 0715  her primary physician was notified as well as her daughter. Oxygen increased to 4 L/min, sats at 83%. SOA noted, reported all over pain. At 0850 when they attempted to reposition the resident, she was not responsive. Licensed nurse assessed her and no heartbeat heard or pulse found."
	"0944439-1"	"0944439-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Resident expired on 1/2/21."
	"0949523-1"	"0949523-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Around 00:50am on 01/15/21, C.N.A. reported that the resident looked different and not responding. Initiated Code Blue and started CPR. 911 arrived and pronounced resident dead at 1:01 am."
	"0949523-1"	"0949523-1"	"GENERAL PHYSICAL CONDITION ABNORMAL"	"10058911"	"60-64 years"	"60-64"	"Around 00:50am on 01/15/21, C.N.A. reported that the resident looked different and not responding. Initiated Code Blue and started CPR. 911 arrived and pronounced resident dead at 1:01 am."
	"0949523-1"	"0949523-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Around 00:50am on 01/15/21, C.N.A. reported that the resident looked different and not responding. Initiated Code Blue and started CPR. 911 arrived and pronounced resident dead at 1:01 am."
	"0949523-1"	"0949523-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Around 00:50am on 01/15/21, C.N.A. reported that the resident looked different and not responding. Initiated Code Blue and started CPR. 911 arrived and pronounced resident dead at 1:01 am."
	"0950073-1"	"0950073-1"	"BODY TEMPERATURE INCREASED"	"10005911"	"60-64 years"	"60-64"	""On 1/15/2021 at 1800, resident noted to be lethargic and shaking, stating ""I don't care."" repeatedly. C/O head and neck pain. T100.6. Given Tylenol with no relief of pain. Order received for Aleve and administered.. Assisted to bed as usual in evening. Monitored during night shift and noted to be resting comfortably/sleeping.. Noted agonal breathing at 4:10 AM 1/16/2021 , T 99.4,  Absence of vital signs at 4:15AM 1/16/21 and death pronounced at 4:40AM 1/16/21.""
	"0950073-1"	"0950073-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""On 1/15/2021 at 1800, resident noted to be lethargic and shaking, stating ""I don't care."" repeatedly. C/O head and neck pain. T100.6. Given Tylenol with no relief of pain. Order received for Aleve and administered.. Assisted to bed as usual in evening. Monitored during night shift and noted to be resting comfortably/sleeping.. Noted agonal breathing at 4:10 AM 1/16/2021 , T 99.4,  Absence of vital signs at 4:15AM 1/16/21 and death pronounced at 4:40AM 1/16/21.""
	"0950073-1"	"0950073-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	""On 1/15/2021 at 1800, resident noted to be lethargic and shaking, stating ""I don't care."" repeatedly. C/O head and neck pain. T100.6. Given Tylenol with no relief of pain. Order received for Aleve and administered.. Assisted to bed as usual in evening. Monitored during night shift and noted to be resting comfortably/sleeping.. Noted agonal breathing at 4:10 AM 1/16/2021 , T 99.4,  Absence of vital signs at 4:15AM 1/16/21 and death pronounced at 4:40AM 1/16/21.""
	"0950073-1"	"0950073-1"	"LETHARGY"	"10024264"	"60-64 years"	"60-64"	""On 1/15/2021 at 1800, resident noted to be lethargic and shaking, stating ""I don't care."" repeatedly. C/O head and neck pain. T100.6. Given Tylenol with no relief of pain. Order received for Aleve and administered.. Assisted to bed as usual in evening. Monitored during night shift and noted to be resting comfortably/sleeping.. Noted agonal breathing at 4:10 AM 1/16/2021 , T 99.4,  Absence of vital signs at 4:15AM 1/16/21 and death pronounced at 4:40AM 1/16/21.""
	"0950073-1"	"0950073-1"	"MYCOBACTERIUM TUBERCULOSIS COMPLEX TEST NEGATIVE"	"10070471"	"60-64 years"	"60-64"	""On 1/15/2021 at 1800, resident noted to be lethargic and shaking, stating ""I don't care."" repeatedly. C/O head and neck pain. T100.6. Given Tylenol with no relief of pain. Order received for Aleve and administered.. Assisted to bed as usual in evening. Monitored during night shift and noted to be resting comfortably/sleeping.. Noted agonal breathing at 4:10 AM 1/16/2021 , T 99.4,  Absence of vital signs at 4:15AM 1/16/21 and death pronounced at 4:40AM 1/16/21.""
	"0950073-1"	"0950073-1"	"NECK PAIN"	"10028836"	"60-64 years"	"60-64"	""On 1/15/2021 at 1800, resident noted to be lethargic and shaking, stating ""I don't care."" repeatedly. C/O head and neck pain. T100.6. Given Tylenol with no relief of pain. Order received for Aleve and administered.. Assisted to bed as usual in evening. Monitored during night shift and noted to be resting comfortably/sleeping.. Noted agonal breathing at 4:10 AM 1/16/2021 , T 99.4,  Absence of vital signs at 4:15AM 1/16/21 and death pronounced at 4:40AM 1/16/21.""
	"0950073-1"	"0950073-1"	"RESPIRATION ABNORMAL"	"10038647"	"60-64 years"	"60-64"	""On 1/15/2021 at 1800, resident noted to be lethargic and shaking, stating ""I don't care."" repeatedly. C/O head and neck pain. T100.6. Given Tylenol with no relief of pain. Order received for Aleve and administered.. Assisted to bed as usual in evening. Monitored during night shift and noted to be resting comfortably/sleeping.. Noted agonal breathing at 4:10 AM 1/16/2021 , T 99.4,  Absence of vital signs at 4:15AM 1/16/21 and death pronounced at 4:40AM 1/16/21.""
	"0950073-1"	"0950073-1"	"TREMOR"	"10044565"	"60-64 years"	"60-64"	""On 1/15/2021 at 1800, resident noted to be lethargic and shaking, stating ""I don't care."" repeatedly. C/O head and neck pain. T100.6. Given Tylenol with no relief of pain. Order received for Aleve and administered.. Assisted to bed as usual in evening. Monitored during night shift and noted to be resting comfortably/sleeping.. Noted agonal breathing at 4:10 AM 1/16/2021 , T 99.4,  Absence of vital signs at 4:15AM 1/16/21 and death pronounced at 4:40AM 1/16/21.""
	"0950073-1"	"0950073-1"	"VITAL FUNCTIONS ABNORMAL"	"10063644"	"60-64 years"	"60-64"	""On 1/15/2021 at 1800, resident noted to be lethargic and shaking, stating ""I don't care."" repeatedly. C/O head and neck pain. T100.6. Given Tylenol with no relief of pain. Order received for Aleve and administered.. Assisted to bed as usual in evening. Monitored during night shift and noted to be resting comfortably/sleeping.. Noted agonal breathing at 4:10 AM 1/16/2021 , T 99.4,  Absence of vital signs at 4:15AM 1/16/21 and death pronounced at 4:40AM 1/16/21.""
	"0951688-1"	"0951688-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Resident expired 1/17/21"
	"0952713-1"	"0952713-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"Weakness, Low O2, death. Positive for COVID on 1/12/21, dies on 1/16/21"
	"0952713-1"	"0952713-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Weakness, Low O2, death. Positive for COVID on 1/12/21, dies on 1/16/21"
	"0952713-1"	"0952713-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"Weakness, Low O2, death. Positive for COVID on 1/12/21, dies on 1/16/21"
	"0952713-1"	"0952713-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Weakness, Low O2, death. Positive for COVID on 1/12/21, dies on 1/16/21"
	"0956458-1"	"0956458-1"	"ALANINE AMINOTRANSFERASE NORMAL"	"10001552"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"ASPARTATE AMINOTRANSFERASE INCREASED"	"10003481"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"BILIRUBIN CONJUGATED INCREASED"	"10004685"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"BLOOD ALKALINE PHOSPHATASE INCREASED"	"10059570"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"BLOOD BILIRUBIN INCREASED"	"10005364"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"BLOOD CREATININE INCREASED"	"10005483"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"ELECTROCARDIOGRAM ABNORMAL"	"10014363"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"ELECTROCARDIOGRAM QT PROLONGED"	"10014387"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"FULL BLOOD COUNT"	"10017411"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"LIVER FUNCTION TEST"	"10060105"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"LUNG INFILTRATION"	"10025102"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"METABOLIC FUNCTION TEST"	"10062191"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"METAMYELOCYTE PERCENTAGE"	"10059469"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"MYELOCYTE PERCENTAGE"	"10059470"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"NEUTROPHIL COUNT DECREASED"	"10029366"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"PLATELET COUNT DECREASED"	"10035528"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"RALES"	"10037833"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"SINUS TACHYCARDIA"	"10040752"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0956458-1"	"0956458-1"	"WHITE BLOOD CELL COUNT DECREASED"	"10047942"	"60-64 years"	"60-64"	"Patient was vaccinated for SARS-CoV-2 on 6-Jan-21 at his site of employment, a Nursing Home. Patient presented to Urgent Care on 15-Jan-21 complaining of left sided chest pain that started the evening before with an associated slight cough.  Pt was afebrile with a heart rate of 88 and an O2 sat on room air of 98% in triage.  His EKG showed a sinus tachycardia of 114 with a slightly prolonged QTc of 463 ms. Physical exam was significant for bibasilar crackles and X-ray showed bibasilar infiltrates consistent with COVID pneumonia but bacterial pneumonia could not be excluded. The patients BP was documented as 97/64.  He was treated with Zofran for nausea and tylenol. He was prescribed a five day course of Azithromycin, an Albuterol inhaler, guaifenessin with codeine cough syrup, and Zofran. Labs were drawn and he was discharged.  His lab results were reported after his departure and were significant for a white blood cell count of 1.33, platelet count of 73, 2% myelocytes, 1% metamyelocytes, an absolute neutrophil count of 0.75 K/ul, a creatinine of 1.83, total bilirubin of 1.3, with direct bilirubin of 0.8, alkaline phosphatase of 294 and AST of 112 with ALT noted to be within normal limit. His COVID nasopharyngeal swab from the visit was reported as negative and a swab performed at his employment on 13-Jan-21 was also reported to be negative.  Patient could not be reached by phone after discharge from Urgent Care about these labs. On the evening of 16-Jan-21, Police Department received a 911 call about an adult at the patient's address who was found unresponsive. Upon arrival on scene, the patient was found to be deceased and a decision was made not to attempt to resuscitate. The death was deemed to be non-suspicious and the patient's body was transported to a funeral home.  On 19-Jan-21, I contacted the State Medical Examiner's Office.  They have decided to perform an autopsy and have recovered the CBC and chemistry specimens obtained for further testing."
	"0958322-1"	"0958322-1"	"TREMOR"	"10044565"	"60-64 years"	"60-64"	"Shaking and then became unresponsive"
	"0958322-1"	"0958322-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Shaking and then became unresponsive"
	"0961705-1"	"0961705-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"approximately 3 hours prior to expiring the patient was experiencing forceful emesis.  later was found to have expired, patient was comfort care only."
	"0961705-1"	"0961705-1"	"VOMITING PROJECTILE"	"10047708"	"60-64 years"	"60-64"	"approximately 3 hours prior to expiring the patient was experiencing forceful emesis.  later was found to have expired, patient was comfort care only."
	"0962716-1"	"0962716-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient deceased"
	"0962995-1"	"0962995-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"No immediate reaction. Patient-reported deceased four days later on Jan. 19, 2021. As of this date cause of death is unknown to our clinic."
	"0963610-1"	"0963610-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient deceased on 01/17/2021"
	"0963610-1"	"0963610-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Patient deceased on 01/17/2021"
	"0964629-1"	"0964629-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death - Hospice patient with metastatic CA admitted to facility and received vaccine during stay. No adverse sequelae noted from vaccine administration, but reporting as required because pt died 7 days later. Narrative: Reporting this event because patient died 7 days after receiving vaccine in the facility where he was in hospice care for metastatic cancer. Vaccine was administered by protocol without complications. The patient had been asked and denied any prior severe reaction to this vaccine or its components and gave permission to receive it. No vaccine adverse sequelae were documented after the immunization as monitored for 15 minutes nor in facility notes for 7 days after the immunization. The patient's death was felt to be due to underlying terminal illness."
	"0964629-1"	"0964629-1"	"TERMINAL STATE"	"10048669"	"60-64 years"	"60-64"	"Death - Hospice patient with metastatic CA admitted to facility and received vaccine during stay. No adverse sequelae noted from vaccine administration, but reporting as required because pt died 7 days later. Narrative: Reporting this event because patient died 7 days after receiving vaccine in the facility where he was in hospice care for metastatic cancer. Vaccine was administered by protocol without complications. The patient had been asked and denied any prior severe reaction to this vaccine or its components and gave permission to receive it. No vaccine adverse sequelae were documented after the immunization as monitored for 15 minutes nor in facility notes for 7 days after the immunization. The patient's death was felt to be due to underlying terminal illness."
	"0965561-1"	"0965561-1"	"ANXIETY"	"10002855"	"60-64 years"	"60-64"	"respiratory distress; fever; anxiety developed requiring oxygen; Passed away; This is a spontaneous report via a Pfizer-sponsored program  from a non-contactable consumer. A 63-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot and expiry not reported), via an unspecified route of administration on 23Dec2020 at a single dose for COVID-19 immunization. Medical history included anaphylactic reaction (broad), neuroleptic malignant syndrome (broad), anticholinergic syndrome (broad), acute central respiratory depression (broad), hypersensitivity (broad), respiratory failure (narrow), drug reaction with eosinophilia and systemic symptoms (broad), hypoglycaemia (broad), COVID-19 (broad) and chronic obstructive pulmonary disease (COPD); all from an unknown date and unknown if ongoing. Concomitant medications included levothyroxine sodium and lorazepam (ATIVAN). Within 24 hours of receiving the vaccine, the patient experienced fever, respiratory distress, and anxiety developed requiring oxygen, morphine and lorazepam (ATIVAN). The patient passed away on the evening of 26Dec2020. The patient underwent lab tests and procedures which included SARS-COV-2 antibody test: negative on an unspecified date. The outcome of the event death was fatal, while of the other events was unknown. It was not reported if an autopsy was performed.  No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Passed a"
	"0965561-1"	"0965561-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"respiratory distress; fever; anxiety developed requiring oxygen; Passed away; This is a spontaneous report via a Pfizer-sponsored program  from a non-contactable consumer. A 63-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot and expiry not reported), via an unspecified route of administration on 23Dec2020 at a single dose for COVID-19 immunization. Medical history included anaphylactic reaction (broad), neuroleptic malignant syndrome (broad), anticholinergic syndrome (broad), acute central respiratory depression (broad), hypersensitivity (broad), respiratory failure (narrow), drug reaction with eosinophilia and systemic symptoms (broad), hypoglycaemia (broad), COVID-19 (broad) and chronic obstructive pulmonary disease (COPD); all from an unknown date and unknown if ongoing. Concomitant medications included levothyroxine sodium and lorazepam (ATIVAN). Within 24 hours of receiving the vaccine, the patient experienced fever, respiratory distress, and anxiety developed requiring oxygen, morphine and lorazepam (ATIVAN). The patient passed away on the evening of 26Dec2020. The patient underwent lab tests and procedures which included SARS-COV-2 antibody test: negative on an unspecified date. The outcome of the event death was fatal, while of the other events was unknown. It was not reported if an autopsy was performed.  No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Passed a"
	"0965561-1"	"0965561-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"respiratory distress; fever; anxiety developed requiring oxygen; Passed away; This is a spontaneous report via a Pfizer-sponsored program  from a non-contactable consumer. A 63-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot and expiry not reported), via an unspecified route of administration on 23Dec2020 at a single dose for COVID-19 immunization. Medical history included anaphylactic reaction (broad), neuroleptic malignant syndrome (broad), anticholinergic syndrome (broad), acute central respiratory depression (broad), hypersensitivity (broad), respiratory failure (narrow), drug reaction with eosinophilia and systemic symptoms (broad), hypoglycaemia (broad), COVID-19 (broad) and chronic obstructive pulmonary disease (COPD); all from an unknown date and unknown if ongoing. Concomitant medications included levothyroxine sodium and lorazepam (ATIVAN). Within 24 hours of receiving the vaccine, the patient experienced fever, respiratory distress, and anxiety developed requiring oxygen, morphine and lorazepam (ATIVAN). The patient passed away on the evening of 26Dec2020. The patient underwent lab tests and procedures which included SARS-COV-2 antibody test: negative on an unspecified date. The outcome of the event death was fatal, while of the other events was unknown. It was not reported if an autopsy was performed.  No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Passed a"
	"0965561-1"	"0965561-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"respiratory distress; fever; anxiety developed requiring oxygen; Passed away; This is a spontaneous report via a Pfizer-sponsored program  from a non-contactable consumer. A 63-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot and expiry not reported), via an unspecified route of administration on 23Dec2020 at a single dose for COVID-19 immunization. Medical history included anaphylactic reaction (broad), neuroleptic malignant syndrome (broad), anticholinergic syndrome (broad), acute central respiratory depression (broad), hypersensitivity (broad), respiratory failure (narrow), drug reaction with eosinophilia and systemic symptoms (broad), hypoglycaemia (broad), COVID-19 (broad) and chronic obstructive pulmonary disease (COPD); all from an unknown date and unknown if ongoing. Concomitant medications included levothyroxine sodium and lorazepam (ATIVAN). Within 24 hours of receiving the vaccine, the patient experienced fever, respiratory distress, and anxiety developed requiring oxygen, morphine and lorazepam (ATIVAN). The patient passed away on the evening of 26Dec2020. The patient underwent lab tests and procedures which included SARS-COV-2 antibody test: negative on an unspecified date. The outcome of the event death was fatal, while of the other events was unknown. It was not reported if an autopsy was performed.  No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Passed a"
	"0965561-1"	"0965561-1"	"RESPIRATORY DISTRESS"	"10038687"	"60-64 years"	"60-64"	"respiratory distress; fever; anxiety developed requiring oxygen; Passed away; This is a spontaneous report via a Pfizer-sponsored program  from a non-contactable consumer. A 63-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot and expiry not reported), via an unspecified route of administration on 23Dec2020 at a single dose for COVID-19 immunization. Medical history included anaphylactic reaction (broad), neuroleptic malignant syndrome (broad), anticholinergic syndrome (broad), acute central respiratory depression (broad), hypersensitivity (broad), respiratory failure (narrow), drug reaction with eosinophilia and systemic symptoms (broad), hypoglycaemia (broad), COVID-19 (broad) and chronic obstructive pulmonary disease (COPD); all from an unknown date and unknown if ongoing. Concomitant medications included levothyroxine sodium and lorazepam (ATIVAN). Within 24 hours of receiving the vaccine, the patient experienced fever, respiratory distress, and anxiety developed requiring oxygen, morphine and lorazepam (ATIVAN). The patient passed away on the evening of 26Dec2020. The patient underwent lab tests and procedures which included SARS-COV-2 antibody test: negative on an unspecified date. The outcome of the event death was fatal, while of the other events was unknown. It was not reported if an autopsy was performed.  No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Passed a"
	"0965561-1"	"0965561-1"	"SARS-COV-2 ANTIBODY TEST NEGATIVE"	"10084509"	"60-64 years"	"60-64"	"respiratory distress; fever; anxiety developed requiring oxygen; Passed away; This is a spontaneous report via a Pfizer-sponsored program  from a non-contactable consumer. A 63-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot and expiry not reported), via an unspecified route of administration on 23Dec2020 at a single dose for COVID-19 immunization. Medical history included anaphylactic reaction (broad), neuroleptic malignant syndrome (broad), anticholinergic syndrome (broad), acute central respiratory depression (broad), hypersensitivity (broad), respiratory failure (narrow), drug reaction with eosinophilia and systemic symptoms (broad), hypoglycaemia (broad), COVID-19 (broad) and chronic obstructive pulmonary disease (COPD); all from an unknown date and unknown if ongoing. Concomitant medications included levothyroxine sodium and lorazepam (ATIVAN). Within 24 hours of receiving the vaccine, the patient experienced fever, respiratory distress, and anxiety developed requiring oxygen, morphine and lorazepam (ATIVAN). The patient passed away on the evening of 26Dec2020. The patient underwent lab tests and procedures which included SARS-COV-2 antibody test: negative on an unspecified date. The outcome of the event death was fatal, while of the other events was unknown. It was not reported if an autopsy was performed.  No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Passed a"
	"0965561-1"	"0965561-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	"respiratory distress; fever; anxiety developed requiring oxygen; Passed away; This is a spontaneous report via a Pfizer-sponsored program  from a non-contactable consumer. A 63-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot and expiry not reported), via an unspecified route of administration on 23Dec2020 at a single dose for COVID-19 immunization. Medical history included anaphylactic reaction (broad), neuroleptic malignant syndrome (broad), anticholinergic syndrome (broad), acute central respiratory depression (broad), hypersensitivity (broad), respiratory failure (narrow), drug reaction with eosinophilia and systemic symptoms (broad), hypoglycaemia (broad), COVID-19 (broad) and chronic obstructive pulmonary disease (COPD); all from an unknown date and unknown if ongoing. Concomitant medications included levothyroxine sodium and lorazepam (ATIVAN). Within 24 hours of receiving the vaccine, the patient experienced fever, respiratory distress, and anxiety developed requiring oxygen, morphine and lorazepam (ATIVAN). The patient passed away on the evening of 26Dec2020. The patient underwent lab tests and procedures which included SARS-COV-2 antibody test: negative on an unspecified date. The outcome of the event death was fatal, while of the other events was unknown. It was not reported if an autopsy was performed.  No follow-up attempts are possible; information about lot/batch number cannot be obtained.; Reported Cause(s) of Death: Passed a"
	"0967830-1"	"0967830-1"	"BILEVEL POSITIVE AIRWAY PRESSURE"	"10064530"	"60-64 years"	"60-64"	"Patient was was brought to the ED from facility which  he received the vaccine via ambulance with BiPAP, hypoxia, and one dose of Epi of 0.3 mg. He then required intubation, and had struggled with hypoxia, even on increasing PEEP. CODE BLUE called in the ED for PEA. He was medicated for such (please see the code run sheet for details), and he came in and out of the code 5 times. After 95 minutes, with the wife at the bedside, and family conference by phone, the code was called, and he was pronounced at 18:20. He received in total 8 me of Epi, 3 shots of Atropine, 3 amps bicarb. He got lasix 40 mg, lovenox 60 mg subcutaneous once. He had a CVC into the right internal jugular, and levophed was started, then Epinephrine drip was started.  Prior to the code he got steroids (solumedrol 125 mg, then later decadron 6 mg iv), benadryl iv, antibiotics (ceftraixone / zithromax), and lasix 40 mg. All this time while in the ED, the Rt was at the bedside, and lots of secretions from the lungs were aspirated, bloody color.   Code was the result of PEA secondary to hypoxia (</= 85%), despite being on the vent, with PEEP 12, FiO2 of 100%, with acidosis.   After 95 minutes of active resuscitation, the patient was found not responsive to painful stimuli. There was no palpable pulse. No spontaneous respirations. No heart or breath sounds by auscultation. Absence of pupillary light reflex."
	"0967830-1"	"0967830-1"	"BREATH SOUNDS ABSENT"	"10062285"	"60-64 years"	"60-64"	"Patient was was brought to the ED from facility which  he received the vaccine via ambulance with BiPAP, hypoxia, and one dose of Epi of 0.3 mg. He then required intubation, and had struggled with hypoxia, even on increasing PEEP. CODE BLUE called in the ED for PEA. He was medicated for such (please see the code run sheet for details), and he came in and out of the code 5 times. After 95 minutes, with the wife at the bedside, and family conference by phone, the code was called, and he was pronounced at 18:20. He received in total 8 me of Epi, 3 shots of Atropine, 3 amps bicarb. He got lasix 40 mg, lovenox 60 mg subcutaneous once. He had a CVC into the right internal jugular, and levophed was started, then Epinephrine drip was started.  Prior to the code he got steroids (solumedrol 125 mg, then later decadron 6 mg iv), benadryl iv, antibiotics (ceftraixone / zithromax), and lasix 40 mg. All this time while in the ED, the Rt was at the bedside, and lots of secretions from the lungs were aspirated, bloody color.   Code was the result of PEA secondary to hypoxia (</= 85%), despite being on the vent, with PEEP 12, FiO2 of 100%, with acidosis.   After 95 minutes of active resuscitation, the patient was found not responsive to painful stimuli. There was no palpable pulse. No spontaneous respirations. No heart or breath sounds by auscultation. Absence of pupillary light reflex."
	"0967830-1"	"0967830-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"Patient was was brought to the ED from facility which  he received the vaccine via ambulance with BiPAP, hypoxia, and one dose of Epi of 0.3 mg. He then required intubation, and had struggled with hypoxia, even on increasing PEEP. CODE BLUE called in the ED for PEA. He was medicated for such (please see the code run sheet for details), and he came in and out of the code 5 times. After 95 minutes, with the wife at the bedside, and family conference by phone, the code was called, and he was pronounced at 18:20. He received in total 8 me of Epi, 3 shots of Atropine, 3 amps bicarb. He got lasix 40 mg, lovenox 60 mg subcutaneous once. He had a CVC into the right internal jugular, and levophed was started, then Epinephrine drip was started.  Prior to the code he got steroids (solumedrol 125 mg, then later decadron 6 mg iv), benadryl iv, antibiotics (ceftraixone / zithromax), and lasix 40 mg. All this time while in the ED, the Rt was at the bedside, and lots of secretions from the lungs were aspirated, bloody color.   Code was the result of PEA secondary to hypoxia (</= 85%), despite being on the vent, with PEEP 12, FiO2 of 100%, with acidosis.   After 95 minutes of active resuscitation, the patient was found not responsive to painful stimuli. There was no palpable pulse. No spontaneous respirations. No heart or breath sounds by auscultation. Absence of pupillary light reflex."
	"0967830-1"	"0967830-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient was was brought to the ED from facility which  he received the vaccine via ambulance with BiPAP, hypoxia, and one dose of Epi of 0.3 mg. He then required intubation, and had struggled with hypoxia, even on increasing PEEP. CODE BLUE called in the ED for PEA. He was medicated for such (please see the code run sheet for details), and he came in and out of the code 5 times. After 95 minutes, with the wife at the bedside, and family conference by phone, the code was called, and he was pronounced at 18:20. He received in total 8 me of Epi, 3 shots of Atropine, 3 amps bicarb. He got lasix 40 mg, lovenox 60 mg subcutaneous once. He had a CVC into the right internal jugular, and levophed was started, then Epinephrine drip was started.  Prior to the code he got steroids (solumedrol 125 mg, then later decadron 6 mg iv), benadryl iv, antibiotics (ceftraixone / zithromax), and lasix 40 mg. All this time while in the ED, the Rt was at the bedside, and lots of secretions from the lungs were aspirated, bloody color.   Code was the result of PEA secondary to hypoxia (</= 85%), despite being on the vent, with PEEP 12, FiO2 of 100%, with acidosis.   After 95 minutes of active resuscitation, the patient was found not responsive to painful stimuli. There was no palpable pulse. No spontaneous respirations. No heart or breath sounds by auscultation. Absence of pupillary light reflex."
	"0967830-1"	"0967830-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Patient was was brought to the ED from facility which  he received the vaccine via ambulance with BiPAP, hypoxia, and one dose of Epi of 0.3 mg. He then required intubation, and had struggled with hypoxia, even on increasing PEEP. CODE BLUE called in the ED for PEA. He was medicated for such (please see the code run sheet for details), and he came in and out of the code 5 times. After 95 minutes, with the wife at the bedside, and family conference by phone, the code was called, and he was pronounced at 18:20. He received in total 8 me of Epi, 3 shots of Atropine, 3 amps bicarb. He got lasix 40 mg, lovenox 60 mg subcutaneous once. He had a CVC into the right internal jugular, and levophed was started, then Epinephrine drip was started.  Prior to the code he got steroids (solumedrol 125 mg, then later decadron 6 mg iv), benadryl iv, antibiotics (ceftraixone / zithromax), and lasix 40 mg. All this time while in the ED, the Rt was at the bedside, and lots of secretions from the lungs were aspirated, bloody color.   Code was the result of PEA secondary to hypoxia (</= 85%), despite being on the vent, with PEEP 12, FiO2 of 100%, with acidosis.   After 95 minutes of active resuscitation, the patient was found not responsive to painful stimuli. There was no palpable pulse. No spontaneous respirations. No heart or breath sounds by auscultation. Absence of pupillary light reflex."
	"0967830-1"	"0967830-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"Patient was was brought to the ED from facility which  he received the vaccine via ambulance with BiPAP, hypoxia, and one dose of Epi of 0.3 mg. He then required intubation, and had struggled with hypoxia, even on increasing PEEP. CODE BLUE called in the ED for PEA. He was medicated for such (please see the code run sheet for details), and he came in and out of the code 5 times. After 95 minutes, with the wife at the bedside, and family conference by phone, the code was called, and he was pronounced at 18:20. He received in total 8 me of Epi, 3 shots of Atropine, 3 amps bicarb. He got lasix 40 mg, lovenox 60 mg subcutaneous once. He had a CVC into the right internal jugular, and levophed was started, then Epinephrine drip was started.  Prior to the code he got steroids (solumedrol 125 mg, then later decadron 6 mg iv), benadryl iv, antibiotics (ceftraixone / zithromax), and lasix 40 mg. All this time while in the ED, the Rt was at the bedside, and lots of secretions from the lungs were aspirated, bloody color.   Code was the result of PEA secondary to hypoxia (</= 85%), despite being on the vent, with PEEP 12, FiO2 of 100%, with acidosis.   After 95 minutes of active resuscitation, the patient was found not responsive to painful stimuli. There was no palpable pulse. No spontaneous respirations. No heart or breath sounds by auscultation. Absence of pupillary light reflex."
	"0967830-1"	"0967830-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Patient was was brought to the ED from facility which  he received the vaccine via ambulance with BiPAP, hypoxia, and one dose of Epi of 0.3 mg. He then required intubation, and had struggled with hypoxia, even on increasing PEEP. CODE BLUE called in the ED for PEA. He was medicated for such (please see the code run sheet for details), and he came in and out of the code 5 times. After 95 minutes, with the wife at the bedside, and family conference by phone, the code was called, and he was pronounced at 18:20. He received in total 8 me of Epi, 3 shots of Atropine, 3 amps bicarb. He got lasix 40 mg, lovenox 60 mg subcutaneous once. He had a CVC into the right internal jugular, and levophed was started, then Epinephrine drip was started.  Prior to the code he got steroids (solumedrol 125 mg, then later decadron 6 mg iv), benadryl iv, antibiotics (ceftraixone / zithromax), and lasix 40 mg. All this time while in the ED, the Rt was at the bedside, and lots of secretions from the lungs were aspirated, bloody color.   Code was the result of PEA secondary to hypoxia (</= 85%), despite being on the vent, with PEEP 12, FiO2 of 100%, with acidosis.   After 95 minutes of active resuscitation, the patient was found not responsive to painful stimuli. There was no palpable pulse. No spontaneous respirations. No heart or breath sounds by auscultation. Absence of pupillary light reflex."
	"0967830-1"	"0967830-1"	"PULSE ABSENT"	"10037469"	"60-64 years"	"60-64"	"Patient was was brought to the ED from facility which  he received the vaccine via ambulance with BiPAP, hypoxia, and one dose of Epi of 0.3 mg. He then required intubation, and had struggled with hypoxia, even on increasing PEEP. CODE BLUE called in the ED for PEA. He was medicated for such (please see the code run sheet for details), and he came in and out of the code 5 times. After 95 minutes, with the wife at the bedside, and family conference by phone, the code was called, and he was pronounced at 18:20. He received in total 8 me of Epi, 3 shots of Atropine, 3 amps bicarb. He got lasix 40 mg, lovenox 60 mg subcutaneous once. He had a CVC into the right internal jugular, and levophed was started, then Epinephrine drip was started.  Prior to the code he got steroids (solumedrol 125 mg, then later decadron 6 mg iv), benadryl iv, antibiotics (ceftraixone / zithromax), and lasix 40 mg. All this time while in the ED, the Rt was at the bedside, and lots of secretions from the lungs were aspirated, bloody color.   Code was the result of PEA secondary to hypoxia (</= 85%), despite being on the vent, with PEEP 12, FiO2 of 100%, with acidosis.   After 95 minutes of active resuscitation, the patient was found not responsive to painful stimuli. There was no palpable pulse. No spontaneous respirations. No heart or breath sounds by auscultation. Absence of pupillary light reflex."
	"0967830-1"	"0967830-1"	"PULSELESS ELECTRICAL ACTIVITY"	"10058151"	"60-64 years"	"60-64"	"Patient was was brought to the ED from facility which  he received the vaccine via ambulance with BiPAP, hypoxia, and one dose of Epi of 0.3 mg. He then required intubation, and had struggled with hypoxia, even on increasing PEEP. CODE BLUE called in the ED for PEA. He was medicated for such (please see the code run sheet for details), and he came in and out of the code 5 times. After 95 minutes, with the wife at the bedside, and family conference by phone, the code was called, and he was pronounced at 18:20. He received in total 8 me of Epi, 3 shots of Atropine, 3 amps bicarb. He got lasix 40 mg, lovenox 60 mg subcutaneous once. He had a CVC into the right internal jugular, and levophed was started, then Epinephrine drip was started.  Prior to the code he got steroids (solumedrol 125 mg, then later decadron 6 mg iv), benadryl iv, antibiotics (ceftraixone / zithromax), and lasix 40 mg. All this time while in the ED, the Rt was at the bedside, and lots of secretions from the lungs were aspirated, bloody color.   Code was the result of PEA secondary to hypoxia (</= 85%), despite being on the vent, with PEEP 12, FiO2 of 100%, with acidosis.   After 95 minutes of active resuscitation, the patient was found not responsive to painful stimuli. There was no palpable pulse. No spontaneous respirations. No heart or breath sounds by auscultation. Absence of pupillary light reflex."
	"0967830-1"	"0967830-1"	"PUPILLARY REFLEX IMPAIRED"	"10037532"	"60-64 years"	"60-64"	"Patient was was brought to the ED from facility which  he received the vaccine via ambulance with BiPAP, hypoxia, and one dose of Epi of 0.3 mg. He then required intubation, and had struggled with hypoxia, even on increasing PEEP. CODE BLUE called in the ED for PEA. He was medicated for such (please see the code run sheet for details), and he came in and out of the code 5 times. After 95 minutes, with the wife at the bedside, and family conference by phone, the code was called, and he was pronounced at 18:20. He received in total 8 me of Epi, 3 shots of Atropine, 3 amps bicarb. He got lasix 40 mg, lovenox 60 mg subcutaneous once. He had a CVC into the right internal jugular, and levophed was started, then Epinephrine drip was started.  Prior to the code he got steroids (solumedrol 125 mg, then later decadron 6 mg iv), benadryl iv, antibiotics (ceftraixone / zithromax), and lasix 40 mg. All this time while in the ED, the Rt was at the bedside, and lots of secretions from the lungs were aspirated, bloody color.   Code was the result of PEA secondary to hypoxia (</= 85%), despite being on the vent, with PEEP 12, FiO2 of 100%, with acidosis.   After 95 minutes of active resuscitation, the patient was found not responsive to painful stimuli. There was no palpable pulse. No spontaneous respirations. No heart or breath sounds by auscultation. Absence of pupillary light reflex."
	"0967830-1"	"0967830-1"	"RESPIRATORY ACIDOSIS"	"10038661"	"60-64 years"	"60-64"	"Patient was was brought to the ED from facility which  he received the vaccine via ambulance with BiPAP, hypoxia, and one dose of Epi of 0.3 mg. He then required intubation, and had struggled with hypoxia, even on increasing PEEP. CODE BLUE called in the ED for PEA. He was medicated for such (please see the code run sheet for details), and he came in and out of the code 5 times. After 95 minutes, with the wife at the bedside, and family conference by phone, the code was called, and he was pronounced at 18:20. He received in total 8 me of Epi, 3 shots of Atropine, 3 amps bicarb. He got lasix 40 mg, lovenox 60 mg subcutaneous once. He had a CVC into the right internal jugular, and levophed was started, then Epinephrine drip was started.  Prior to the code he got steroids (solumedrol 125 mg, then later decadron 6 mg iv), benadryl iv, antibiotics (ceftraixone / zithromax), and lasix 40 mg. All this time while in the ED, the Rt was at the bedside, and lots of secretions from the lungs were aspirated, bloody color.   Code was the result of PEA secondary to hypoxia (</= 85%), despite being on the vent, with PEEP 12, FiO2 of 100%, with acidosis.   After 95 minutes of active resuscitation, the patient was found not responsive to painful stimuli. There was no palpable pulse. No spontaneous respirations. No heart or breath sounds by auscultation. Absence of pupillary light reflex."
	"0967830-1"	"0967830-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	"Patient was was brought to the ED from facility which  he received the vaccine via ambulance with BiPAP, hypoxia, and one dose of Epi of 0.3 mg. He then required intubation, and had struggled with hypoxia, even on increasing PEEP. CODE BLUE called in the ED for PEA. He was medicated for such (please see the code run sheet for details), and he came in and out of the code 5 times. After 95 minutes, with the wife at the bedside, and family conference by phone, the code was called, and he was pronounced at 18:20. He received in total 8 me of Epi, 3 shots of Atropine, 3 amps bicarb. He got lasix 40 mg, lovenox 60 mg subcutaneous once. He had a CVC into the right internal jugular, and levophed was started, then Epinephrine drip was started.  Prior to the code he got steroids (solumedrol 125 mg, then later decadron 6 mg iv), benadryl iv, antibiotics (ceftraixone / zithromax), and lasix 40 mg. All this time while in the ED, the Rt was at the bedside, and lots of secretions from the lungs were aspirated, bloody color.   Code was the result of PEA secondary to hypoxia (</= 85%), despite being on the vent, with PEEP 12, FiO2 of 100%, with acidosis.   After 95 minutes of active resuscitation, the patient was found not responsive to painful stimuli. There was no palpable pulse. No spontaneous respirations. No heart or breath sounds by auscultation. Absence of pupillary light reflex."
	"0967830-1"	"0967830-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Patient was was brought to the ED from facility which  he received the vaccine via ambulance with BiPAP, hypoxia, and one dose of Epi of 0.3 mg. He then required intubation, and had struggled with hypoxia, even on increasing PEEP. CODE BLUE called in the ED for PEA. He was medicated for such (please see the code run sheet for details), and he came in and out of the code 5 times. After 95 minutes, with the wife at the bedside, and family conference by phone, the code was called, and he was pronounced at 18:20. He received in total 8 me of Epi, 3 shots of Atropine, 3 amps bicarb. He got lasix 40 mg, lovenox 60 mg subcutaneous once. He had a CVC into the right internal jugular, and levophed was started, then Epinephrine drip was started.  Prior to the code he got steroids (solumedrol 125 mg, then later decadron 6 mg iv), benadryl iv, antibiotics (ceftraixone / zithromax), and lasix 40 mg. All this time while in the ED, the Rt was at the bedside, and lots of secretions from the lungs were aspirated, bloody color.   Code was the result of PEA secondary to hypoxia (</= 85%), despite being on the vent, with PEEP 12, FiO2 of 100%, with acidosis.   After 95 minutes of active resuscitation, the patient was found not responsive to painful stimuli. There was no palpable pulse. No spontaneous respirations. No heart or breath sounds by auscultation. Absence of pupillary light reflex."
	"0967830-1"	"0967830-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Patient was was brought to the ED from facility which  he received the vaccine via ambulance with BiPAP, hypoxia, and one dose of Epi of 0.3 mg. He then required intubation, and had struggled with hypoxia, even on increasing PEEP. CODE BLUE called in the ED for PEA. He was medicated for such (please see the code run sheet for details), and he came in and out of the code 5 times. After 95 minutes, with the wife at the bedside, and family conference by phone, the code was called, and he was pronounced at 18:20. He received in total 8 me of Epi, 3 shots of Atropine, 3 amps bicarb. He got lasix 40 mg, lovenox 60 mg subcutaneous once. He had a CVC into the right internal jugular, and levophed was started, then Epinephrine drip was started.  Prior to the code he got steroids (solumedrol 125 mg, then later decadron 6 mg iv), benadryl iv, antibiotics (ceftraixone / zithromax), and lasix 40 mg. All this time while in the ED, the Rt was at the bedside, and lots of secretions from the lungs were aspirated, bloody color.   Code was the result of PEA secondary to hypoxia (</= 85%), despite being on the vent, with PEEP 12, FiO2 of 100%, with acidosis.   After 95 minutes of active resuscitation, the patient was found not responsive to painful stimuli. There was no palpable pulse. No spontaneous respirations. No heart or breath sounds by auscultation. Absence of pupillary light reflex."
	"0969219-1"	"0969219-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"patient received the Moderna Covid 19 vaccine on 1/23/2021 around 5:45pm  wife called management today and reported that he had collapsed and passed away today around noon"
	"0969219-1"	"0969219-1"	"SYNCOPE"	"10042772"	"60-64 years"	"60-64"	"patient received the Moderna Covid 19 vaccine on 1/23/2021 around 5:45pm  wife called management today and reported that he had collapsed and passed away today around noon"
	"0972370-1"	"0972370-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"patient received covid vaccine  and had a heart attack the next day and died"
	"0972370-1"	"0972370-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"patient received covid vaccine  and had a heart attack the next day and died"
	"0975421-1"	"0975421-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Resident was discovered deceased in his apartment on 1/23/2021. Family had"
	"0975918-1"	"0975918-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death Narrative:"
	"0979101-1"	"0979101-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"cardiac arrest - no warning signs"
	"0979841-1"	"0979841-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Pt likely presented to vaccine appt with asymptomatic/early infection of COVID-19, as he presented 2 days post-vaccination and tested positive for COVID-19 on rapid and PCR test. He was hospitalized where he eventually died of complications from COVID-19 while in ICU. Date of death was 1/15/2021."
	"0979841-1"	"0979841-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pt likely presented to vaccine appt with asymptomatic/early infection of COVID-19, as he presented 2 days post-vaccination and tested positive for COVID-19 on rapid and PCR test. He was hospitalized where he eventually died of complications from COVID-19 while in ICU. Date of death was 1/15/2021."
	"0979841-1"	"0979841-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Pt likely presented to vaccine appt with asymptomatic/early infection of COVID-19, as he presented 2 days post-vaccination and tested positive for COVID-19 on rapid and PCR test. He was hospitalized where he eventually died of complications from COVID-19 while in ICU. Date of death was 1/15/2021."
	"0979841-1"	"0979841-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Pt likely presented to vaccine appt with asymptomatic/early infection of COVID-19, as he presented 2 days post-vaccination and tested positive for COVID-19 on rapid and PCR test. He was hospitalized where he eventually died of complications from COVID-19 while in ICU. Date of death was 1/15/2021."
	"0979990-1"	"0979990-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"sudden cardiac arrest"
	"0982218-1"	"0982218-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"resident was on hospice, chronically ill w dementia, COPD, HTN, failure to thrive, passed away 1/13/21. Not certain injection related as he was declining already."
	"0982891-1"	"0982891-1"	"APNOEA"	"10002974"	"60-64 years"	"60-64"	"All residents had been in isolation due to multiple cases of COVID in the facility. Resident voiced no health related complaints. He continued to visit with staff and required moderate assist with toileting.  Resident had fall 0130 on 1-15-2021, which resulted in laceration with surgical repair.  Resident was noted to change in mental status and respirations on morning of 1-16-2021 during morning blood sugar check. Resident had O2 @1.5l/m via n/c and respirations of 10 with periods of apnea and unresponsive to verbal stimuli. Blood sugar was 583.  Resident deceased upon re-check after calling PCP to report status change."
	"0982891-1"	"0982891-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"60-64 years"	"60-64"	"All residents had been in isolation due to multiple cases of COVID in the facility. Resident voiced no health related complaints. He continued to visit with staff and required moderate assist with toileting.  Resident had fall 0130 on 1-15-2021, which resulted in laceration with surgical repair.  Resident was noted to change in mental status and respirations on morning of 1-16-2021 during morning blood sugar check. Resident had O2 @1.5l/m via n/c and respirations of 10 with periods of apnea and unresponsive to verbal stimuli. Blood sugar was 583.  Resident deceased upon re-check after calling PCP to report status change."
	"0982891-1"	"0982891-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"All residents had been in isolation due to multiple cases of COVID in the facility. Resident voiced no health related complaints. He continued to visit with staff and required moderate assist with toileting.  Resident had fall 0130 on 1-15-2021, which resulted in laceration with surgical repair.  Resident was noted to change in mental status and respirations on morning of 1-16-2021 during morning blood sugar check. Resident had O2 @1.5l/m via n/c and respirations of 10 with periods of apnea and unresponsive to verbal stimuli. Blood sugar was 583.  Resident deceased upon re-check after calling PCP to report status change."
	"0982891-1"	"0982891-1"	"EXPOSURE TO SARS-COV-2"	"10084456"	"60-64 years"	"60-64"	"All residents had been in isolation due to multiple cases of COVID in the facility. Resident voiced no health related complaints. He continued to visit with staff and required moderate assist with toileting.  Resident had fall 0130 on 1-15-2021, which resulted in laceration with surgical repair.  Resident was noted to change in mental status and respirations on morning of 1-16-2021 during morning blood sugar check. Resident had O2 @1.5l/m via n/c and respirations of 10 with periods of apnea and unresponsive to verbal stimuli. Blood sugar was 583.  Resident deceased upon re-check after calling PCP to report status change."
	"0982891-1"	"0982891-1"	"FALL"	"10016173"	"60-64 years"	"60-64"	"All residents had been in isolation due to multiple cases of COVID in the facility. Resident voiced no health related complaints. He continued to visit with staff and required moderate assist with toileting.  Resident had fall 0130 on 1-15-2021, which resulted in laceration with surgical repair.  Resident was noted to change in mental status and respirations on morning of 1-16-2021 during morning blood sugar check. Resident had O2 @1.5l/m via n/c and respirations of 10 with periods of apnea and unresponsive to verbal stimuli. Blood sugar was 583.  Resident deceased upon re-check after calling PCP to report status change."
	"0982891-1"	"0982891-1"	"MENTAL STATUS CHANGES"	"10048294"	"60-64 years"	"60-64"	"All residents had been in isolation due to multiple cases of COVID in the facility. Resident voiced no health related complaints. He continued to visit with staff and required moderate assist with toileting.  Resident had fall 0130 on 1-15-2021, which resulted in laceration with surgical repair.  Resident was noted to change in mental status and respirations on morning of 1-16-2021 during morning blood sugar check. Resident had O2 @1.5l/m via n/c and respirations of 10 with periods of apnea and unresponsive to verbal stimuli. Blood sugar was 583.  Resident deceased upon re-check after calling PCP to report status change."
	"0982891-1"	"0982891-1"	"RESPIRATION ABNORMAL"	"10038647"	"60-64 years"	"60-64"	"All residents had been in isolation due to multiple cases of COVID in the facility. Resident voiced no health related complaints. He continued to visit with staff and required moderate assist with toileting.  Resident had fall 0130 on 1-15-2021, which resulted in laceration with surgical repair.  Resident was noted to change in mental status and respirations on morning of 1-16-2021 during morning blood sugar check. Resident had O2 @1.5l/m via n/c and respirations of 10 with periods of apnea and unresponsive to verbal stimuli. Blood sugar was 583.  Resident deceased upon re-check after calling PCP to report status change."
	"0982891-1"	"0982891-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	"All residents had been in isolation due to multiple cases of COVID in the facility. Resident voiced no health related complaints. He continued to visit with staff and required moderate assist with toileting.  Resident had fall 0130 on 1-15-2021, which resulted in laceration with surgical repair.  Resident was noted to change in mental status and respirations on morning of 1-16-2021 during morning blood sugar check. Resident had O2 @1.5l/m via n/c and respirations of 10 with periods of apnea and unresponsive to verbal stimuli. Blood sugar was 583.  Resident deceased upon re-check after calling PCP to report status change."
	"0982891-1"	"0982891-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"All residents had been in isolation due to multiple cases of COVID in the facility. Resident voiced no health related complaints. He continued to visit with staff and required moderate assist with toileting.  Resident had fall 0130 on 1-15-2021, which resulted in laceration with surgical repair.  Resident was noted to change in mental status and respirations on morning of 1-16-2021 during morning blood sugar check. Resident had O2 @1.5l/m via n/c and respirations of 10 with periods of apnea and unresponsive to verbal stimuli. Blood sugar was 583.  Resident deceased upon re-check after calling PCP to report status change."
	"0982891-1"	"0982891-1"	"SKIN LACERATION"	"10058818"	"60-64 years"	"60-64"	"All residents had been in isolation due to multiple cases of COVID in the facility. Resident voiced no health related complaints. He continued to visit with staff and required moderate assist with toileting.  Resident had fall 0130 on 1-15-2021, which resulted in laceration with surgical repair.  Resident was noted to change in mental status and respirations on morning of 1-16-2021 during morning blood sugar check. Resident had O2 @1.5l/m via n/c and respirations of 10 with periods of apnea and unresponsive to verbal stimuli. Blood sugar was 583.  Resident deceased upon re-check after calling PCP to report status change."
	"0982891-1"	"0982891-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"All residents had been in isolation due to multiple cases of COVID in the facility. Resident voiced no health related complaints. He continued to visit with staff and required moderate assist with toileting.  Resident had fall 0130 on 1-15-2021, which resulted in laceration with surgical repair.  Resident was noted to change in mental status and respirations on morning of 1-16-2021 during morning blood sugar check. Resident had O2 @1.5l/m via n/c and respirations of 10 with periods of apnea and unresponsive to verbal stimuli. Blood sugar was 583.  Resident deceased upon re-check after calling PCP to report status change."
	"0982891-1"	"0982891-1"	"WOUND CLOSURE"	"10057679"	"60-64 years"	"60-64"	"All residents had been in isolation due to multiple cases of COVID in the facility. Resident voiced no health related complaints. He continued to visit with staff and required moderate assist with toileting.  Resident had fall 0130 on 1-15-2021, which resulted in laceration with surgical repair.  Resident was noted to change in mental status and respirations on morning of 1-16-2021 during morning blood sugar check. Resident had O2 @1.5l/m via n/c and respirations of 10 with periods of apnea and unresponsive to verbal stimuli. Blood sugar was 583.  Resident deceased upon re-check after calling PCP to report status change."
	"0982929-1"	"0982929-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Client was being treated with antibiotics by her PCP for diverticulitis flare up.  It had not been resolved on the date of her death which occurred 01/27/21, She was found unresponsive by staff, 911 contacted, and paramedics pronounced her deceased at 7:48 AM. After consultation with PCP manner of death was noted as cardiac arrest. PCP was to sign off on death certificate."
	"0982929-1"	"0982929-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"Client was being treated with antibiotics by her PCP for diverticulitis flare up.  It had not been resolved on the date of her death which occurred 01/27/21, She was found unresponsive by staff, 911 contacted, and paramedics pronounced her deceased at 7:48 AM. After consultation with PCP manner of death was noted as cardiac arrest. PCP was to sign off on death certificate."
	"0982929-1"	"0982929-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Client was being treated with antibiotics by her PCP for diverticulitis flare up.  It had not been resolved on the date of her death which occurred 01/27/21, She was found unresponsive by staff, 911 contacted, and paramedics pronounced her deceased at 7:48 AM. After consultation with PCP manner of death was noted as cardiac arrest. PCP was to sign off on death certificate."
	"0982929-1"	"0982929-1"	"DIVERTICULITIS"	"10013538"	"60-64 years"	"60-64"	"Client was being treated with antibiotics by her PCP for diverticulitis flare up.  It had not been resolved on the date of her death which occurred 01/27/21, She was found unresponsive by staff, 911 contacted, and paramedics pronounced her deceased at 7:48 AM. After consultation with PCP manner of death was noted as cardiac arrest. PCP was to sign off on death certificate."
	"0982929-1"	"0982929-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Client was being treated with antibiotics by her PCP for diverticulitis flare up.  It had not been resolved on the date of her death which occurred 01/27/21, She was found unresponsive by staff, 911 contacted, and paramedics pronounced her deceased at 7:48 AM. After consultation with PCP manner of death was noted as cardiac arrest. PCP was to sign off on death certificate."
	"0987513-1"	"0987513-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"Note Text: Resident oxygen was going down to 74% during change of shift 3-11, oxygen initiated 3liters via nasal canula per standing order want up to 84-86% NP notified, ordered Prednisone 20mg stat, Rocephin 1gram IM stat administered, Per NP statement if pt's condition worsening sent him to ER, continue monitoring pt and his oxygen going to 82% increasing distress. Notified Nurses supervisor, 911 was called pt left building at 1819 to Hospital alert oriented. Vs bp. 165/60, temp. 98.3,m pulse 109, res 22, 02. 82%. Resident father notified."
	"0987513-1"	"0987513-1"	"RESPIRATORY DISTRESS"	"10038687"	"60-64 years"	"60-64"	"Note Text: Resident oxygen was going down to 74% during change of shift 3-11, oxygen initiated 3liters via nasal canula per standing order want up to 84-86% NP notified, ordered Prednisone 20mg stat, Rocephin 1gram IM stat administered, Per NP statement if pt's condition worsening sent him to ER, continue monitoring pt and his oxygen going to 82% increasing distress. Notified Nurses supervisor, 911 was called pt left building at 1819 to Hospital alert oriented. Vs bp. 165/60, temp. 98.3,m pulse 109, res 22, 02. 82%. Resident father notified."
	"0991677-1"	"0991677-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"got up in the night and stated that she couldn't breath, ambulance was called, pt expired in route to hospital.  *relayed to me by Facility staff RN."
	"0991677-1"	"0991677-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"got up in the night and stated that she couldn't breath, ambulance was called, pt expired in route to hospital.  *relayed to me by Facility staff RN."
	"0992677-1"	"0992677-1"	"BACK PAIN"	"10003988"	"60-64 years"	"60-64"	"Low Grade Temp, Persistent low back pain, Projectile Vomiting."
	"0992677-1"	"0992677-1"	"BODY TEMPERATURE INCREASED"	"10005911"	"60-64 years"	"60-64"	"Low Grade Temp, Persistent low back pain, Projectile Vomiting."
	"0992677-1"	"0992677-1"	"VOMITING PROJECTILE"	"10047708"	"60-64 years"	"60-64"	"Low Grade Temp, Persistent low back pain, Projectile Vomiting."
	"0993072-1"	"0993072-1"	"ABDOMINAL PAIN"	"10000081"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"ASCITES"	"10003445"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"BLOOD ALKALINE PHOSPHATASE INCREASED"	"10059570"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"BLOOD CHLORIDE DECREASED"	"10005419"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"BLOOD CREATININE INCREASED"	"10005483"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"BLOOD CULTURE POSITIVE"	"10005488"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"BLOOD LACTIC ACID INCREASED"	"10005635"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"BLOOD POTASSIUM DECREASED"	"10005724"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"BLOOD SODIUM DECREASED"	"10005802"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"C-REACTIVE PROTEIN INCREASED"	"10006825"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"CARBON DIOXIDE DECREASED"	"10007223"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"OMENTAL NECROSIS"	"10077828"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"OVARIAN NECROSIS"	"10033270"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"PERITONEAL LAVAGE"	"10057837"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"PLATELET COUNT DECREASED"	"10035528"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"SEPTIC SHOCK"	"10040070"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"STREPTOCOCCUS TEST POSITIVE"	"10070055"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"SURGERY"	"10042609"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993072-1"	"0993072-1"	"WHITE BLOOD CELL COUNT DECREASED"	"10047942"	"60-64 years"	"60-64"	"Pt. presented to the ER with abd pain and septic shock.   Pt. reported to feel ill shortly after receiving the vaccine."
	"0993112-1"	"0993112-1"	"APHASIA"	"10002948"	"60-64 years"	"60-64"	"she was injected, sh stopped eating and talking, the doctor watched her for 2 days. had her transported to the hospital. i was told she had tested positive for COVID 2 times once at the home and once at the hospital. with in 2 DAYS at the hospital  she wa on a ventilator 2 days later she died. i talked with the rehab center and confirmed she tested negative for COVID on Dec 27th 2020 and was given the Vaccine on the 29th Dec 202 was in the hospital 4 day later, was on a ventilator 4 days after that   then died a few day later as her heart stopped beating. all the while i had POA and was not contacted by Hospital staff until after they had made the next step."
	"0993112-1"	"0993112-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"she was injected, sh stopped eating and talking, the doctor watched her for 2 days. had her transported to the hospital. i was told she had tested positive for COVID 2 times once at the home and once at the hospital. with in 2 DAYS at the hospital  she wa on a ventilator 2 days later she died. i talked with the rehab center and confirmed she tested negative for COVID on Dec 27th 2020 and was given the Vaccine on the 29th Dec 202 was in the hospital 4 day later, was on a ventilator 4 days after that   then died a few day later as her heart stopped beating. all the while i had POA and was not contacted by Hospital staff until after they had made the next step."
	"0993112-1"	"0993112-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"she was injected, sh stopped eating and talking, the doctor watched her for 2 days. had her transported to the hospital. i was told she had tested positive for COVID 2 times once at the home and once at the hospital. with in 2 DAYS at the hospital  she wa on a ventilator 2 days later she died. i talked with the rehab center and confirmed she tested negative for COVID on Dec 27th 2020 and was given the Vaccine on the 29th Dec 202 was in the hospital 4 day later, was on a ventilator 4 days after that   then died a few day later as her heart stopped beating. all the while i had POA and was not contacted by Hospital staff until after they had made the next step."
	"0993112-1"	"0993112-1"	"DECREASED APPETITE"	"10061428"	"60-64 years"	"60-64"	"she was injected, sh stopped eating and talking, the doctor watched her for 2 days. had her transported to the hospital. i was told she had tested positive for COVID 2 times once at the home and once at the hospital. with in 2 DAYS at the hospital  she wa on a ventilator 2 days later she died. i talked with the rehab center and confirmed she tested negative for COVID on Dec 27th 2020 and was given the Vaccine on the 29th Dec 202 was in the hospital 4 day later, was on a ventilator 4 days after that   then died a few day later as her heart stopped beating. all the while i had POA and was not contacted by Hospital staff until after they had made the next step."
	"0993112-1"	"0993112-1"	"DEPENDENCE ON RESPIRATOR"	"10057482"	"60-64 years"	"60-64"	"she was injected, sh stopped eating and talking, the doctor watched her for 2 days. had her transported to the hospital. i was told she had tested positive for COVID 2 times once at the home and once at the hospital. with in 2 DAYS at the hospital  she wa on a ventilator 2 days later she died. i talked with the rehab center and confirmed she tested negative for COVID on Dec 27th 2020 and was given the Vaccine on the 29th Dec 202 was in the hospital 4 day later, was on a ventilator 4 days after that   then died a few day later as her heart stopped beating. all the while i had POA and was not contacted by Hospital staff until after they had made the next step."
	"0993112-1"	"0993112-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"she was injected, sh stopped eating and talking, the doctor watched her for 2 days. had her transported to the hospital. i was told she had tested positive for COVID 2 times once at the home and once at the hospital. with in 2 DAYS at the hospital  she wa on a ventilator 2 days later she died. i talked with the rehab center and confirmed she tested negative for COVID on Dec 27th 2020 and was given the Vaccine on the 29th Dec 202 was in the hospital 4 day later, was on a ventilator 4 days after that   then died a few day later as her heart stopped beating. all the while i had POA and was not contacted by Hospital staff until after they had made the next step."
	"0997642-1"	"0997642-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"We were notified 02/02/2021 of patient's death. Unknown cause at this time."
	"1001488-1"	"1001488-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Patient died several days after receiving the second dose of the vaccine. See additional information sent. An autopsy has been performed and results are pending."
	"1001488-1"	"1001488-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient died several days after receiving the second dose of the vaccine. See additional information sent. An autopsy has been performed and results are pending."
	"1004811-1"	"1004811-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"On 1/23/21 the patient had a single-car accident, slid off icy road into snowbank. She was seen in our ER, diagnosed w/ trauma and L4 compression fracture. She was transported to Hospital for further trauma workup. We believe she was treated and released. On 1/31/21 the patient had a headache but  did not seek medical attention. In the morning of 2/1 she became unresponsive and was pronounced dead on the scene when EMS arrived. Autopsy showed a left temporal subdural hematoma."
	"1004811-1"	"1004811-1"	"BONE FRAGMENTATION"	"10064211"	"60-64 years"	"60-64"	"On 1/23/21 the patient had a single-car accident, slid off icy road into snowbank. She was seen in our ER, diagnosed w/ trauma and L4 compression fracture. She was transported to Hospital for further trauma workup. We believe she was treated and released. On 1/31/21 the patient had a headache but  did not seek medical attention. In the morning of 2/1 she became unresponsive and was pronounced dead on the scene when EMS arrived. Autopsy showed a left temporal subdural hematoma."
	"1004811-1"	"1004811-1"	"COMPUTERISED TOMOGRAM ABNORMAL"	"10010235"	"60-64 years"	"60-64"	"On 1/23/21 the patient had a single-car accident, slid off icy road into snowbank. She was seen in our ER, diagnosed w/ trauma and L4 compression fracture. She was transported to Hospital for further trauma workup. We believe she was treated and released. On 1/31/21 the patient had a headache but  did not seek medical attention. In the morning of 2/1 she became unresponsive and was pronounced dead on the scene when EMS arrived. Autopsy showed a left temporal subdural hematoma."
	"1004811-1"	"1004811-1"	"COMPUTERISED TOMOGRAM SPINE"	"10081777"	"60-64 years"	"60-64"	"On 1/23/21 the patient had a single-car accident, slid off icy road into snowbank. She was seen in our ER, diagnosed w/ trauma and L4 compression fracture. She was transported to Hospital for further trauma workup. We believe she was treated and released. On 1/31/21 the patient had a headache but  did not seek medical attention. In the morning of 2/1 she became unresponsive and was pronounced dead on the scene when EMS arrived. Autopsy showed a left temporal subdural hematoma."
	"1004811-1"	"1004811-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"On 1/23/21 the patient had a single-car accident, slid off icy road into snowbank. She was seen in our ER, diagnosed w/ trauma and L4 compression fracture. She was transported to Hospital for further trauma workup. We believe she was treated and released. On 1/31/21 the patient had a headache but  did not seek medical attention. In the morning of 2/1 she became unresponsive and was pronounced dead on the scene when EMS arrived. Autopsy showed a left temporal subdural hematoma."
	"1004811-1"	"1004811-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"On 1/23/21 the patient had a single-car accident, slid off icy road into snowbank. She was seen in our ER, diagnosed w/ trauma and L4 compression fracture. She was transported to Hospital for further trauma workup. We believe she was treated and released. On 1/31/21 the patient had a headache but  did not seek medical attention. In the morning of 2/1 she became unresponsive and was pronounced dead on the scene when EMS arrived. Autopsy showed a left temporal subdural hematoma."
	"1004811-1"	"1004811-1"	"INJURY"	"10022116"	"60-64 years"	"60-64"	"On 1/23/21 the patient had a single-car accident, slid off icy road into snowbank. She was seen in our ER, diagnosed w/ trauma and L4 compression fracture. She was transported to Hospital for further trauma workup. We believe she was treated and released. On 1/31/21 the patient had a headache but  did not seek medical attention. In the morning of 2/1 she became unresponsive and was pronounced dead on the scene when EMS arrived. Autopsy showed a left temporal subdural hematoma."
	"1004811-1"	"1004811-1"	"ROAD TRAFFIC ACCIDENT"	"10039203"	"60-64 years"	"60-64"	"On 1/23/21 the patient had a single-car accident, slid off icy road into snowbank. She was seen in our ER, diagnosed w/ trauma and L4 compression fracture. She was transported to Hospital for further trauma workup. We believe she was treated and released. On 1/31/21 the patient had a headache but  did not seek medical attention. In the morning of 2/1 she became unresponsive and was pronounced dead on the scene when EMS arrived. Autopsy showed a left temporal subdural hematoma."
	"1004811-1"	"1004811-1"	"SPINAL COMPRESSION FRACTURE"	"10041541"	"60-64 years"	"60-64"	"On 1/23/21 the patient had a single-car accident, slid off icy road into snowbank. She was seen in our ER, diagnosed w/ trauma and L4 compression fracture. She was transported to Hospital for further trauma workup. We believe she was treated and released. On 1/31/21 the patient had a headache but  did not seek medical attention. In the morning of 2/1 she became unresponsive and was pronounced dead on the scene when EMS arrived. Autopsy showed a left temporal subdural hematoma."
	"1004811-1"	"1004811-1"	"SPINAL STENOSIS"	"10082214"	"60-64 years"	"60-64"	"On 1/23/21 the patient had a single-car accident, slid off icy road into snowbank. She was seen in our ER, diagnosed w/ trauma and L4 compression fracture. She was transported to Hospital for further trauma workup. We believe she was treated and released. On 1/31/21 the patient had a headache but  did not seek medical attention. In the morning of 2/1 she became unresponsive and was pronounced dead on the scene when EMS arrived. Autopsy showed a left temporal subdural hematoma."
	"1004811-1"	"1004811-1"	"SUBDURAL HAEMATOMA"	"10042361"	"60-64 years"	"60-64"	"On 1/23/21 the patient had a single-car accident, slid off icy road into snowbank. She was seen in our ER, diagnosed w/ trauma and L4 compression fracture. She was transported to Hospital for further trauma workup. We believe she was treated and released. On 1/31/21 the patient had a headache but  did not seek medical attention. In the morning of 2/1 she became unresponsive and was pronounced dead on the scene when EMS arrived. Autopsy showed a left temporal subdural hematoma."
	"1004811-1"	"1004811-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"On 1/23/21 the patient had a single-car accident, slid off icy road into snowbank. She was seen in our ER, diagnosed w/ trauma and L4 compression fracture. She was transported to Hospital for further trauma workup. We believe she was treated and released. On 1/31/21 the patient had a headache but  did not seek medical attention. In the morning of 2/1 she became unresponsive and was pronounced dead on the scene when EMS arrived. Autopsy showed a left temporal subdural hematoma."
	"1007371-1"	"1007371-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"Called PCP, from the note: I got my shot on Jan 19. But last Friday I have been down with a horrible flu. I'm wearing diapers because of uncontrollable diarrhea. I can't leave my sofa to walk over to my desk because I'll be so out of breath. I have a cough that produces a pink or gold Phelm I have dry mouth. I have no appetite I'm so weak and have lost 15 pounds. Don't know what to do. My next Covid is shot is feb 11 Called employer on 2/3/21 but hung up. Tried calling multiple times to follow up. In triage she stated she had a COVID test scheduled and had spoken with her PCP. COVID test through PCP: 2/4/21 She passed away the night of 2/4/21"
	"1007371-1"	"1007371-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Called PCP, from the note: I got my shot on Jan 19. But last Friday I have been down with a horrible flu. I'm wearing diapers because of uncontrollable diarrhea. I can't leave my sofa to walk over to my desk because I'll be so out of breath. I have a cough that produces a pink or gold Phelm I have dry mouth. I have no appetite I'm so weak and have lost 15 pounds. Don't know what to do. My next Covid is shot is feb 11 Called employer on 2/3/21 but hung up. Tried calling multiple times to follow up. In triage she stated she had a COVID test scheduled and had spoken with her PCP. COVID test through PCP: 2/4/21 She passed away the night of 2/4/21"
	"1007371-1"	"1007371-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Called PCP, from the note: I got my shot on Jan 19. But last Friday I have been down with a horrible flu. I'm wearing diapers because of uncontrollable diarrhea. I can't leave my sofa to walk over to my desk because I'll be so out of breath. I have a cough that produces a pink or gold Phelm I have dry mouth. I have no appetite I'm so weak and have lost 15 pounds. Don't know what to do. My next Covid is shot is feb 11 Called employer on 2/3/21 but hung up. Tried calling multiple times to follow up. In triage she stated she had a COVID test scheduled and had spoken with her PCP. COVID test through PCP: 2/4/21 She passed away the night of 2/4/21"
	"1007371-1"	"1007371-1"	"DECREASED APPETITE"	"10061428"	"60-64 years"	"60-64"	"Called PCP, from the note: I got my shot on Jan 19. But last Friday I have been down with a horrible flu. I'm wearing diapers because of uncontrollable diarrhea. I can't leave my sofa to walk over to my desk because I'll be so out of breath. I have a cough that produces a pink or gold Phelm I have dry mouth. I have no appetite I'm so weak and have lost 15 pounds. Don't know what to do. My next Covid is shot is feb 11 Called employer on 2/3/21 but hung up. Tried calling multiple times to follow up. In triage she stated she had a COVID test scheduled and had spoken with her PCP. COVID test through PCP: 2/4/21 She passed away the night of 2/4/21"
	"1007371-1"	"1007371-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"Called PCP, from the note: I got my shot on Jan 19. But last Friday I have been down with a horrible flu. I'm wearing diapers because of uncontrollable diarrhea. I can't leave my sofa to walk over to my desk because I'll be so out of breath. I have a cough that produces a pink or gold Phelm I have dry mouth. I have no appetite I'm so weak and have lost 15 pounds. Don't know what to do. My next Covid is shot is feb 11 Called employer on 2/3/21 but hung up. Tried calling multiple times to follow up. In triage she stated she had a COVID test scheduled and had spoken with her PCP. COVID test through PCP: 2/4/21 She passed away the night of 2/4/21"
	"1007371-1"	"1007371-1"	"DRY MOUTH"	"10013781"	"60-64 years"	"60-64"	"Called PCP, from the note: I got my shot on Jan 19. But last Friday I have been down with a horrible flu. I'm wearing diapers because of uncontrollable diarrhea. I can't leave my sofa to walk over to my desk because I'll be so out of breath. I have a cough that produces a pink or gold Phelm I have dry mouth. I have no appetite I'm so weak and have lost 15 pounds. Don't know what to do. My next Covid is shot is feb 11 Called employer on 2/3/21 but hung up. Tried calling multiple times to follow up. In triage she stated she had a COVID test scheduled and had spoken with her PCP. COVID test through PCP: 2/4/21 She passed away the night of 2/4/21"
	"1007371-1"	"1007371-1"	"DYSPNOEA EXERTIONAL"	"10013971"	"60-64 years"	"60-64"	"Called PCP, from the note: I got my shot on Jan 19. But last Friday I have been down with a horrible flu. I'm wearing diapers because of uncontrollable diarrhea. I can't leave my sofa to walk over to my desk because I'll be so out of breath. I have a cough that produces a pink or gold Phelm I have dry mouth. I have no appetite I'm so weak and have lost 15 pounds. Don't know what to do. My next Covid is shot is feb 11 Called employer on 2/3/21 but hung up. Tried calling multiple times to follow up. In triage she stated she had a COVID test scheduled and had spoken with her PCP. COVID test through PCP: 2/4/21 She passed away the night of 2/4/21"
	"1007371-1"	"1007371-1"	"GAIT DISTURBANCE"	"10017577"	"60-64 years"	"60-64"	"Called PCP, from the note: I got my shot on Jan 19. But last Friday I have been down with a horrible flu. I'm wearing diapers because of uncontrollable diarrhea. I can't leave my sofa to walk over to my desk because I'll be so out of breath. I have a cough that produces a pink or gold Phelm I have dry mouth. I have no appetite I'm so weak and have lost 15 pounds. Don't know what to do. My next Covid is shot is feb 11 Called employer on 2/3/21 but hung up. Tried calling multiple times to follow up. In triage she stated she had a COVID test scheduled and had spoken with her PCP. COVID test through PCP: 2/4/21 She passed away the night of 2/4/21"
	"1007371-1"	"1007371-1"	"INFLUENZA"	"10022000"	"60-64 years"	"60-64"	"Called PCP, from the note: I got my shot on Jan 19. But last Friday I have been down with a horrible flu. I'm wearing diapers because of uncontrollable diarrhea. I can't leave my sofa to walk over to my desk because I'll be so out of breath. I have a cough that produces a pink or gold Phelm I have dry mouth. I have no appetite I'm so weak and have lost 15 pounds. Don't know what to do. My next Covid is shot is feb 11 Called employer on 2/3/21 but hung up. Tried calling multiple times to follow up. In triage she stated she had a COVID test scheduled and had spoken with her PCP. COVID test through PCP: 2/4/21 She passed away the night of 2/4/21"
	"1007371-1"	"1007371-1"	"PRODUCTIVE COUGH"	"10036790"	"60-64 years"	"60-64"	"Called PCP, from the note: I got my shot on Jan 19. But last Friday I have been down with a horrible flu. I'm wearing diapers because of uncontrollable diarrhea. I can't leave my sofa to walk over to my desk because I'll be so out of breath. I have a cough that produces a pink or gold Phelm I have dry mouth. I have no appetite I'm so weak and have lost 15 pounds. Don't know what to do. My next Covid is shot is feb 11 Called employer on 2/3/21 but hung up. Tried calling multiple times to follow up. In triage she stated she had a COVID test scheduled and had spoken with her PCP. COVID test through PCP: 2/4/21 She passed away the night of 2/4/21"
	"1007371-1"	"1007371-1"	"SARS-COV-2 TEST"	"10084354"	"60-64 years"	"60-64"	"Called PCP, from the note: I got my shot on Jan 19. But last Friday I have been down with a horrible flu. I'm wearing diapers because of uncontrollable diarrhea. I can't leave my sofa to walk over to my desk because I'll be so out of breath. I have a cough that produces a pink or gold Phelm I have dry mouth. I have no appetite I'm so weak and have lost 15 pounds. Don't know what to do. My next Covid is shot is feb 11 Called employer on 2/3/21 but hung up. Tried calling multiple times to follow up. In triage she stated she had a COVID test scheduled and had spoken with her PCP. COVID test through PCP: 2/4/21 She passed away the night of 2/4/21"
	"1007371-1"	"1007371-1"	"SPUTUM DISCOLOURED"	"10041807"	"60-64 years"	"60-64"	"Called PCP, from the note: I got my shot on Jan 19. But last Friday I have been down with a horrible flu. I'm wearing diapers because of uncontrollable diarrhea. I can't leave my sofa to walk over to my desk because I'll be so out of breath. I have a cough that produces a pink or gold Phelm I have dry mouth. I have no appetite I'm so weak and have lost 15 pounds. Don't know what to do. My next Covid is shot is feb 11 Called employer on 2/3/21 but hung up. Tried calling multiple times to follow up. In triage she stated she had a COVID test scheduled and had spoken with her PCP. COVID test through PCP: 2/4/21 She passed away the night of 2/4/21"
	"1007371-1"	"1007371-1"	"WEIGHT DECREASED"	"10047895"	"60-64 years"	"60-64"	"Called PCP, from the note: I got my shot on Jan 19. But last Friday I have been down with a horrible flu. I'm wearing diapers because of uncontrollable diarrhea. I can't leave my sofa to walk over to my desk because I'll be so out of breath. I have a cough that produces a pink or gold Phelm I have dry mouth. I have no appetite I'm so weak and have lost 15 pounds. Don't know what to do. My next Covid is shot is feb 11 Called employer on 2/3/21 but hung up. Tried calling multiple times to follow up. In triage she stated she had a COVID test scheduled and had spoken with her PCP. COVID test through PCP: 2/4/21 She passed away the night of 2/4/21"
	"1011834-1"	"1011834-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"patient passed away within 60 days of receiving COVID vaccine series"
	"1015687-1"	"1015687-1"	"BODY TEMPERATURE INCREASED"	"10005911"	"60-64 years"	"60-64"	"Almost immediate headache per wife. Developed fever around 4 pm. Headache all day. Took Tylenol at 4 and 10 pm.  Gradual development of SOB and cough. Temp of 101.4 at 10 pm.  pulse ox 92% at 10 pm.  Went to sleep, woke up at 0050 with increasing SOB. Pulse ox 82%. Used albuterol inhaler, wife called emergency services at 0113.  EMS arrived around 0130 to patient's home. pulse ox 86%, coughing, sob, hard time breathing. Walked to stretcher. Became unresponsive.  Found to have no pulse, stopped breathing. CPR initiated at about 0140.  King airway placed in field, I/O in left tibia. Patient from PEA to asystole, to vfib, to asystole. ACLS followed. Unrecoverable asystole and patient time of death 0213."
	"1015687-1"	"1015687-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Almost immediate headache per wife. Developed fever around 4 pm. Headache all day. Took Tylenol at 4 and 10 pm.  Gradual development of SOB and cough. Temp of 101.4 at 10 pm.  pulse ox 92% at 10 pm.  Went to sleep, woke up at 0050 with increasing SOB. Pulse ox 82%. Used albuterol inhaler, wife called emergency services at 0113.  EMS arrived around 0130 to patient's home. pulse ox 86%, coughing, sob, hard time breathing. Walked to stretcher. Became unresponsive.  Found to have no pulse, stopped breathing. CPR initiated at about 0140.  King airway placed in field, I/O in left tibia. Patient from PEA to asystole, to vfib, to asystole. ACLS followed. Unrecoverable asystole and patient time of death 0213."
	"1015687-1"	"1015687-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Almost immediate headache per wife. Developed fever around 4 pm. Headache all day. Took Tylenol at 4 and 10 pm.  Gradual development of SOB and cough. Temp of 101.4 at 10 pm.  pulse ox 92% at 10 pm.  Went to sleep, woke up at 0050 with increasing SOB. Pulse ox 82%. Used albuterol inhaler, wife called emergency services at 0113.  EMS arrived around 0130 to patient's home. pulse ox 86%, coughing, sob, hard time breathing. Walked to stretcher. Became unresponsive.  Found to have no pulse, stopped breathing. CPR initiated at about 0140.  King airway placed in field, I/O in left tibia. Patient from PEA to asystole, to vfib, to asystole. ACLS followed. Unrecoverable asystole and patient time of death 0213."
	"1015687-1"	"1015687-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Almost immediate headache per wife. Developed fever around 4 pm. Headache all day. Took Tylenol at 4 and 10 pm.  Gradual development of SOB and cough. Temp of 101.4 at 10 pm.  pulse ox 92% at 10 pm.  Went to sleep, woke up at 0050 with increasing SOB. Pulse ox 82%. Used albuterol inhaler, wife called emergency services at 0113.  EMS arrived around 0130 to patient's home. pulse ox 86%, coughing, sob, hard time breathing. Walked to stretcher. Became unresponsive.  Found to have no pulse, stopped breathing. CPR initiated at about 0140.  King airway placed in field, I/O in left tibia. Patient from PEA to asystole, to vfib, to asystole. ACLS followed. Unrecoverable asystole and patient time of death 0213."
	"1015687-1"	"1015687-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Almost immediate headache per wife. Developed fever around 4 pm. Headache all day. Took Tylenol at 4 and 10 pm.  Gradual development of SOB and cough. Temp of 101.4 at 10 pm.  pulse ox 92% at 10 pm.  Went to sleep, woke up at 0050 with increasing SOB. Pulse ox 82%. Used albuterol inhaler, wife called emergency services at 0113.  EMS arrived around 0130 to patient's home. pulse ox 86%, coughing, sob, hard time breathing. Walked to stretcher. Became unresponsive.  Found to have no pulse, stopped breathing. CPR initiated at about 0140.  King airway placed in field, I/O in left tibia. Patient from PEA to asystole, to vfib, to asystole. ACLS followed. Unrecoverable asystole and patient time of death 0213."
	"1015687-1"	"1015687-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"Almost immediate headache per wife. Developed fever around 4 pm. Headache all day. Took Tylenol at 4 and 10 pm.  Gradual development of SOB and cough. Temp of 101.4 at 10 pm.  pulse ox 92% at 10 pm.  Went to sleep, woke up at 0050 with increasing SOB. Pulse ox 82%. Used albuterol inhaler, wife called emergency services at 0113.  EMS arrived around 0130 to patient's home. pulse ox 86%, coughing, sob, hard time breathing. Walked to stretcher. Became unresponsive.  Found to have no pulse, stopped breathing. CPR initiated at about 0140.  King airway placed in field, I/O in left tibia. Patient from PEA to asystole, to vfib, to asystole. ACLS followed. Unrecoverable asystole and patient time of death 0213."
	"1015687-1"	"1015687-1"	"INTRAOSSEOUS ACCESS PLACEMENT"	"10081231"	"60-64 years"	"60-64"	"Almost immediate headache per wife. Developed fever around 4 pm. Headache all day. Took Tylenol at 4 and 10 pm.  Gradual development of SOB and cough. Temp of 101.4 at 10 pm.  pulse ox 92% at 10 pm.  Went to sleep, woke up at 0050 with increasing SOB. Pulse ox 82%. Used albuterol inhaler, wife called emergency services at 0113.  EMS arrived around 0130 to patient's home. pulse ox 86%, coughing, sob, hard time breathing. Walked to stretcher. Became unresponsive.  Found to have no pulse, stopped breathing. CPR initiated at about 0140.  King airway placed in field, I/O in left tibia. Patient from PEA to asystole, to vfib, to asystole. ACLS followed. Unrecoverable asystole and patient time of death 0213."
	"1015687-1"	"1015687-1"	"LARYNGEAL MASK AIRWAY INSERTION"	"10077088"	"60-64 years"	"60-64"	"Almost immediate headache per wife. Developed fever around 4 pm. Headache all day. Took Tylenol at 4 and 10 pm.  Gradual development of SOB and cough. Temp of 101.4 at 10 pm.  pulse ox 92% at 10 pm.  Went to sleep, woke up at 0050 with increasing SOB. Pulse ox 82%. Used albuterol inhaler, wife called emergency services at 0113.  EMS arrived around 0130 to patient's home. pulse ox 86%, coughing, sob, hard time breathing. Walked to stretcher. Became unresponsive.  Found to have no pulse, stopped breathing. CPR initiated at about 0140.  King airway placed in field, I/O in left tibia. Patient from PEA to asystole, to vfib, to asystole. ACLS followed. Unrecoverable asystole and patient time of death 0213."
	"1015687-1"	"1015687-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"Almost immediate headache per wife. Developed fever around 4 pm. Headache all day. Took Tylenol at 4 and 10 pm.  Gradual development of SOB and cough. Temp of 101.4 at 10 pm.  pulse ox 92% at 10 pm.  Went to sleep, woke up at 0050 with increasing SOB. Pulse ox 82%. Used albuterol inhaler, wife called emergency services at 0113.  EMS arrived around 0130 to patient's home. pulse ox 86%, coughing, sob, hard time breathing. Walked to stretcher. Became unresponsive.  Found to have no pulse, stopped breathing. CPR initiated at about 0140.  King airway placed in field, I/O in left tibia. Patient from PEA to asystole, to vfib, to asystole. ACLS followed. Unrecoverable asystole and patient time of death 0213."
	"1015687-1"	"1015687-1"	"PULSE ABSENT"	"10037469"	"60-64 years"	"60-64"	"Almost immediate headache per wife. Developed fever around 4 pm. Headache all day. Took Tylenol at 4 and 10 pm.  Gradual development of SOB and cough. Temp of 101.4 at 10 pm.  pulse ox 92% at 10 pm.  Went to sleep, woke up at 0050 with increasing SOB. Pulse ox 82%. Used albuterol inhaler, wife called emergency services at 0113.  EMS arrived around 0130 to patient's home. pulse ox 86%, coughing, sob, hard time breathing. Walked to stretcher. Became unresponsive.  Found to have no pulse, stopped breathing. CPR initiated at about 0140.  King airway placed in field, I/O in left tibia. Patient from PEA to asystole, to vfib, to asystole. ACLS followed. Unrecoverable asystole and patient time of death 0213."
	"1015687-1"	"1015687-1"	"PULSELESS ELECTRICAL ACTIVITY"	"10058151"	"60-64 years"	"60-64"	"Almost immediate headache per wife. Developed fever around 4 pm. Headache all day. Took Tylenol at 4 and 10 pm.  Gradual development of SOB and cough. Temp of 101.4 at 10 pm.  pulse ox 92% at 10 pm.  Went to sleep, woke up at 0050 with increasing SOB. Pulse ox 82%. Used albuterol inhaler, wife called emergency services at 0113.  EMS arrived around 0130 to patient's home. pulse ox 86%, coughing, sob, hard time breathing. Walked to stretcher. Became unresponsive.  Found to have no pulse, stopped breathing. CPR initiated at about 0140.  King airway placed in field, I/O in left tibia. Patient from PEA to asystole, to vfib, to asystole. ACLS followed. Unrecoverable asystole and patient time of death 0213."
	"1015687-1"	"1015687-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Almost immediate headache per wife. Developed fever around 4 pm. Headache all day. Took Tylenol at 4 and 10 pm.  Gradual development of SOB and cough. Temp of 101.4 at 10 pm.  pulse ox 92% at 10 pm.  Went to sleep, woke up at 0050 with increasing SOB. Pulse ox 82%. Used albuterol inhaler, wife called emergency services at 0113.  EMS arrived around 0130 to patient's home. pulse ox 86%, coughing, sob, hard time breathing. Walked to stretcher. Became unresponsive.  Found to have no pulse, stopped breathing. CPR initiated at about 0140.  King airway placed in field, I/O in left tibia. Patient from PEA to asystole, to vfib, to asystole. ACLS followed. Unrecoverable asystole and patient time of death 0213."
	"1015687-1"	"1015687-1"	"RESPIRATORY ARREST"	"10038669"	"60-64 years"	"60-64"	"Almost immediate headache per wife. Developed fever around 4 pm. Headache all day. Took Tylenol at 4 and 10 pm.  Gradual development of SOB and cough. Temp of 101.4 at 10 pm.  pulse ox 92% at 10 pm.  Went to sleep, woke up at 0050 with increasing SOB. Pulse ox 82%. Used albuterol inhaler, wife called emergency services at 0113.  EMS arrived around 0130 to patient's home. pulse ox 86%, coughing, sob, hard time breathing. Walked to stretcher. Became unresponsive.  Found to have no pulse, stopped breathing. CPR initiated at about 0140.  King airway placed in field, I/O in left tibia. Patient from PEA to asystole, to vfib, to asystole. ACLS followed. Unrecoverable asystole and patient time of death 0213."
	"1015687-1"	"1015687-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Almost immediate headache per wife. Developed fever around 4 pm. Headache all day. Took Tylenol at 4 and 10 pm.  Gradual development of SOB and cough. Temp of 101.4 at 10 pm.  pulse ox 92% at 10 pm.  Went to sleep, woke up at 0050 with increasing SOB. Pulse ox 82%. Used albuterol inhaler, wife called emergency services at 0113.  EMS arrived around 0130 to patient's home. pulse ox 86%, coughing, sob, hard time breathing. Walked to stretcher. Became unresponsive.  Found to have no pulse, stopped breathing. CPR initiated at about 0140.  King airway placed in field, I/O in left tibia. Patient from PEA to asystole, to vfib, to asystole. ACLS followed. Unrecoverable asystole and patient time of death 0213."
	"1015687-1"	"1015687-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Almost immediate headache per wife. Developed fever around 4 pm. Headache all day. Took Tylenol at 4 and 10 pm.  Gradual development of SOB and cough. Temp of 101.4 at 10 pm.  pulse ox 92% at 10 pm.  Went to sleep, woke up at 0050 with increasing SOB. Pulse ox 82%. Used albuterol inhaler, wife called emergency services at 0113.  EMS arrived around 0130 to patient's home. pulse ox 86%, coughing, sob, hard time breathing. Walked to stretcher. Became unresponsive.  Found to have no pulse, stopped breathing. CPR initiated at about 0140.  King airway placed in field, I/O in left tibia. Patient from PEA to asystole, to vfib, to asystole. ACLS followed. Unrecoverable asystole and patient time of death 0213."
	"1015687-1"	"1015687-1"	"VENTRICULAR FIBRILLATION"	"10047290"	"60-64 years"	"60-64"	"Almost immediate headache per wife. Developed fever around 4 pm. Headache all day. Took Tylenol at 4 and 10 pm.  Gradual development of SOB and cough. Temp of 101.4 at 10 pm.  pulse ox 92% at 10 pm.  Went to sleep, woke up at 0050 with increasing SOB. Pulse ox 82%. Used albuterol inhaler, wife called emergency services at 0113.  EMS arrived around 0130 to patient's home. pulse ox 86%, coughing, sob, hard time breathing. Walked to stretcher. Became unresponsive.  Found to have no pulse, stopped breathing. CPR initiated at about 0140.  King airway placed in field, I/O in left tibia. Patient from PEA to asystole, to vfib, to asystole. ACLS followed. Unrecoverable asystole and patient time of death 0213."
	"1020134-1"	"1020134-1"	"ANXIETY"	"10002855"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"ATRIAL FIBRILLATION"	"10003658"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"BLOOD CALCIUM DECREASED"	"10005395"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"BLOOD CHLORIDE NORMAL"	"10005421"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"BLOOD CREATININE INCREASED"	"10005483"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"BLOOD CULTURE"	"10005485"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"BLOOD LACTIC ACID INCREASED"	"10005635"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"BLOOD POTASSIUM NORMAL"	"10005726"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"BLOOD SODIUM NORMAL"	"10005804"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"BLOOD UREA INCREASED"	"10005851"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"CARBON DIOXIDE NORMAL"	"10007228"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"CARDIAC FAILURE CONGESTIVE"	"10007559"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"DIZZINESS"	"10013573"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"FALL"	"10016173"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"FREQUENT BOWEL MOVEMENTS"	"10017367"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"GAZE PALSY"	"10056696"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"HAEMATOCRIT DECREASED"	"10018838"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"HAEMOGLOBIN DECREASED"	"10018884"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"LUNG DISORDER"	"10025082"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"MUSCLE RIGIDITY"	"10028330"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"ORTHOPNOEA"	"10031123"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"ORTHOSTATIC HYPOTENSION"	"10031127"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"PLATELET COUNT NORMAL"	"10035530"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"POLYURIA"	"10036142"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"POSTURING"	"10036437"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"PRODUCTIVE COUGH"	"10036790"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"PULMONARY OEDEMA"	"10037423"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"PULSE ABSENT"	"10037469"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"RESPIRATORY ARREST"	"10038669"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"RESTLESSNESS"	"10038743"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"SEIZURE"	"10039906"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"SPUTUM DISCOLOURED"	"10041807"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"TACHYPNOEA"	"10043089"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"TROPONIN I INCREASED"	"10058268"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1020134-1"	"1020134-1"	"WHITE BLOOD CELL COUNT INCREASED"	"10047943"	"60-64 years"	"60-64"	""anxious, restless, weak, dizzy, felt ""horrible"". Continued to C/O symptoms,. At 01:15, patient lost consciousness , then stopped breathing and lost pulse. Narrative:  Patient was first vaccinated for COVID 19 on 1/8/21. On 1/24/21: 61 year old presents to E.R. with CC of chest pain/sob, with multiple medical conditions including hypertension, atrial fibrillation on apixaban, cardiomyopathy with poor EF, dyslipidemia, COPD, CVA, lung CA s/p radiotherapy, PTSD, depression, Churg Strauss Syndrome, Sjogren's syndrome presented with chief complaint of chest pain or shortness of breath. He has been having worsening shortness of breath the past few days, also complains of cough productive of yellowish sputum, no hemoptysis. He complains of left upper chest pain with no radiation. There is no diaphoresis, palpitations or lightheadedness. He denies fever or chills. He complains of having fallen a few times recently, thus he passed out. Could not say if there were seizures activity. Admitted to 3D Tele. On 1/27, Pt advises he had episode of substernal CP this am. RN advises pt was in afib w/ RVR at a rate >140 at time of CP. Pt CP improved w/ prn NTG. Pt HR improved after daily medications. Pt sts his CP has resolved. Pt admits to continued dyspnea. Increased trop, transferred. 1/28, struggling with orthopnea and cough. He has no peripheral edema. He does have intermittent chest pain. Patient having periods of A-Fib RVR with non-sustained rates of 140's-150's 1/29 more chest pain at 04:00, relieved with NTG. HR = AF, with RVR 145. At about 08:00, Cardiology sees patient and signs off, ""shortness of breath and cough not due to heart failure as evidenced by orthostatic hypotension and no improvement in symptoms with diuresis. Consider underlying lung disease vs acute pulmonary disease."" No pulmonary consult noted. 1/29 Patient received 2nd dose COVID19 vaccine at about 3:30-4p. No notes from staff on this event. No notes from MD that this was discussed and still part of the plan. 1/29 nurse's note: At around 2240 Pt was able to rest briefly but is now restless and anxious again. Tachypneic, stating he feels so weak and dizzy and overall just feel horrible. Continuing to get up frequently to have small soft bowel movements with assistance. Pt also stated ever since he got ""that shot"" he hasn't felt well. When asked what shot pt replied ""COVID shot."" Pt did receive 2nd dose of COVID vaccine 1/29 at 1530. Around 2250 Spoke w MOD to relay above information and overall concern for pt, asked for MOD to come to bedside to evaluate pt. MOD states he's handing off to oncoming MOD and they will come to bedside to see pt. Around 2300 oncoming MOD called and all above and previous information discussed Around 2310 MOD came to bedside to see pt. Will continue to monitor closely. 01/30/2021 ADDENDUM Around 0115 pt called for help to use bedside commode to urinate and have BM. Assisted x2 to BSC. While sitting on BSC pt's eyes rolled back and pt made postures consistent with a seizure, body became very rigid. Pt was unresponsive still with pulse. Lifted patient back to bed with 3 staff assist. Pt stopped breathing and lost pulse. Chest compressions started immediately and Code Blue called at 0120. 1/30 Hospitalist note: Called for CODE BLUE AGAIN AT 4:53. While on Vent after s/p Code blue for reasons not clear patient went into Asystole and code called second time. Patient had a prolonged CPR and was actually called off at 5:17 but he started having pulse and agonal resp. he was placed on Levophed and D5NS. He got a total of 9 amps of epi, 3 amps od Bicarb and 1amp of D50. Trope bumped from 0.12 to 0.43 prior to this he already was on ASA, Apixiban for afib. Cards are on board for his CHF for his pulmonary edema Lasix ordered. Hid lactic acid is elevated. Blood cultures pending. Started Zosyn and is on Levophed. Continue to monitor. Updated patients Mom and she requested to do everything at this point. Coded again at 5:40, survived, but AOD writes a death note(?) Coded for the 4th time at 08:18. Family at beside, Mother asks for code to be stopped.""
	"1023840-1"	"1023840-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pt was administered Moderna Covid-19 Vaccine on 2/4/2021.  Pt exhbited no symptoms of an adverse reaction of any sort.  Pt was ambulating alert and attentive.  Pt was observed for the alloted 15 mins by pharmacist and case worker who had escorted pt to vaccination clinic.  It was reported that Either on sunday 2/7/2021 or monday 2/8/2021 pt had passed away.  Circumstances revolving patient death is still unknown."
	"1023948-1"	"1023948-1"	"ABDOMINAL DISTENSION"	"10000060"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1023948-1"	"1023948-1"	"ALANINE AMINOTRANSFERASE INCREASED"	"10001551"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1023948-1"	"1023948-1"	"ASPARTATE AMINOTRANSFERASE INCREASED"	"10003481"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1023948-1"	"1023948-1"	"BACTERIAL TEST POSITIVE"	"10059421"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1023948-1"	"1023948-1"	"BLOOD SODIUM DECREASED"	"10005802"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1023948-1"	"1023948-1"	"BLOOD URINE PRESENT"	"10018870"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1023948-1"	"1023948-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1023948-1"	"1023948-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1023948-1"	"1023948-1"	"DECREASED APPETITE"	"10061428"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1023948-1"	"1023948-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1023948-1"	"1023948-1"	"FEELING ABNORMAL"	"10016322"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1023948-1"	"1023948-1"	"LYMPHOCYTE COUNT INCREASED"	"10025258"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1023948-1"	"1023948-1"	"NEUTROPHIL COUNT INCREASED"	"10029368"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1023948-1"	"1023948-1"	"PROTHROMBIN TIME PROLONGED"	"10037063"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1023948-1"	"1023948-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1023948-1"	"1023948-1"	"TROPONIN INCREASED"	"10058267"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1023948-1"	"1023948-1"	"URINE ABNORMALITY"	"10046607"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1023948-1"	"1023948-1"	"URINE ANALYSIS ABNORMAL"	"10062226"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1023948-1"	"1023948-1"	"WHITE BLOOD CELL COUNT INCREASED"	"10047943"	"60-64 years"	"60-64"	""02/08/21--2 days after vaccine--Resident stated that she ""didn't feel good"" (She is developmentally delayed and less able to communicate how she feels than those in the community) and stopped eating most foods; also had fatigue. Vitals, coloring, & behavior were normal. 02/09/21--Belly was firm and mildly distended (although she stated it didn't hurt); she coded this evening and CPR was performed before EMT could transport her to the hospital. 02/10/21--Resident passed.""
	"1024226-1"	"1024226-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"New onset dizziness with hypotension, tachycardia, and vomiting blood. Sent to ER - told he went into cardiac arrest and died."
	"1024226-1"	"1024226-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"New onset dizziness with hypotension, tachycardia, and vomiting blood. Sent to ER - told he went into cardiac arrest and died."
	"1024226-1"	"1024226-1"	"DIZZINESS"	"10013573"	"60-64 years"	"60-64"	"New onset dizziness with hypotension, tachycardia, and vomiting blood. Sent to ER - told he went into cardiac arrest and died."
	"1024226-1"	"1024226-1"	"HAEMATEMESIS"	"10018830"	"60-64 years"	"60-64"	"New onset dizziness with hypotension, tachycardia, and vomiting blood. Sent to ER - told he went into cardiac arrest and died."
	"1024226-1"	"1024226-1"	"HYPOTENSION"	"10021097"	"60-64 years"	"60-64"	"New onset dizziness with hypotension, tachycardia, and vomiting blood. Sent to ER - told he went into cardiac arrest and died."
	"1024226-1"	"1024226-1"	"TACHYCARDIA"	"10043071"	"60-64 years"	"60-64"	"New onset dizziness with hypotension, tachycardia, and vomiting blood. Sent to ER - told he went into cardiac arrest and died."
	"1025081-1"	"1025081-1"	"ARTERIOSCLEROSIS"	"10003210"	"60-64 years"	"60-64"	"No reported adverse reactions from 1st or 2nd vaccine doses Patient died on 2/6/2021 at Correctional facility- autopsy was performed at medical examiner's office. The COD was artherosclerotic cardiovascular disease"
	"1025081-1"	"1025081-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"No reported adverse reactions from 1st or 2nd vaccine doses Patient died on 2/6/2021 at Correctional facility- autopsy was performed at medical examiner's office. The COD was artherosclerotic cardiovascular disease"
	"1025081-1"	"1025081-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"No reported adverse reactions from 1st or 2nd vaccine doses Patient died on 2/6/2021 at Correctional facility- autopsy was performed at medical examiner's office. The COD was artherosclerotic cardiovascular disease"
	"1025081-1"	"1025081-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"No reported adverse reactions from 1st or 2nd vaccine doses Patient died on 2/6/2021 at Correctional facility- autopsy was performed at medical examiner's office. The COD was artherosclerotic cardiovascular disease"
	"1033155-1"	"1033155-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Vaccine given in clinic per protocol - patient monitored for 15 minutes, no adverse reactions noted at the time. Patient stated he felt fine following 15 minute monitoring time. Patient left facility- it was later reported that pt had a fall at home. Upon review of pt's medical record - Pt's wife had to initiate CPR and call EMS for transportation and life saving measures enroute to the Emergency Room. Pt was intubated as pt was in asystole upon arrival to the ER, ACLS was continued, pt was noted to have a traumatic brain injury from his fall at home, and pt was pronounced dead at 1620."
	"1033155-1"	"1033155-1"	"CRANIOCEREBRAL INJURY"	"10070976"	"60-64 years"	"60-64"	"Vaccine given in clinic per protocol - patient monitored for 15 minutes, no adverse reactions noted at the time. Patient stated he felt fine following 15 minute monitoring time. Patient left facility- it was later reported that pt had a fall at home. Upon review of pt's medical record - Pt's wife had to initiate CPR and call EMS for transportation and life saving measures enroute to the Emergency Room. Pt was intubated as pt was in asystole upon arrival to the ER, ACLS was continued, pt was noted to have a traumatic brain injury from his fall at home, and pt was pronounced dead at 1620."
	"1033155-1"	"1033155-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Vaccine given in clinic per protocol - patient monitored for 15 minutes, no adverse reactions noted at the time. Patient stated he felt fine following 15 minute monitoring time. Patient left facility- it was later reported that pt had a fall at home. Upon review of pt's medical record - Pt's wife had to initiate CPR and call EMS for transportation and life saving measures enroute to the Emergency Room. Pt was intubated as pt was in asystole upon arrival to the ER, ACLS was continued, pt was noted to have a traumatic brain injury from his fall at home, and pt was pronounced dead at 1620."
	"1033155-1"	"1033155-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Vaccine given in clinic per protocol - patient monitored for 15 minutes, no adverse reactions noted at the time. Patient stated he felt fine following 15 minute monitoring time. Patient left facility- it was later reported that pt had a fall at home. Upon review of pt's medical record - Pt's wife had to initiate CPR and call EMS for transportation and life saving measures enroute to the Emergency Room. Pt was intubated as pt was in asystole upon arrival to the ER, ACLS was continued, pt was noted to have a traumatic brain injury from his fall at home, and pt was pronounced dead at 1620."
	"1033155-1"	"1033155-1"	"FALL"	"10016173"	"60-64 years"	"60-64"	"Vaccine given in clinic per protocol - patient monitored for 15 minutes, no adverse reactions noted at the time. Patient stated he felt fine following 15 minute monitoring time. Patient left facility- it was later reported that pt had a fall at home. Upon review of pt's medical record - Pt's wife had to initiate CPR and call EMS for transportation and life saving measures enroute to the Emergency Room. Pt was intubated as pt was in asystole upon arrival to the ER, ACLS was continued, pt was noted to have a traumatic brain injury from his fall at home, and pt was pronounced dead at 1620."
	"1033155-1"	"1033155-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Vaccine given in clinic per protocol - patient monitored for 15 minutes, no adverse reactions noted at the time. Patient stated he felt fine following 15 minute monitoring time. Patient left facility- it was later reported that pt had a fall at home. Upon review of pt's medical record - Pt's wife had to initiate CPR and call EMS for transportation and life saving measures enroute to the Emergency Room. Pt was intubated as pt was in asystole upon arrival to the ER, ACLS was continued, pt was noted to have a traumatic brain injury from his fall at home, and pt was pronounced dead at 1620."
	"1033323-1"	"1033323-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"patient passed away within 60 days of receiving a COVID vaccine"
	"1036585-1"	"1036585-1"	"AORTIC ANEURYSM"	"10002882"	"60-64 years"	"60-64"	""Patient called EMS approximately 1pm on 2/15 with complaints of generalized weakness. Upon arrival EMS found her to be diaphoretic and she had a witnessed syncopal episode with question of v-fib and seizures. She became unresponsive and had no pulse. CPR was begun and she was transported to ED. She remained asystole throughout. CPR was initially continued in the ED  for approximately 30 minutes and then stopped with Time of Death noted at 13:27. ED notes noted ""suspect given history that patient experienced massive MI, PE or ruptured AAA"".  Death certificate notes indicate ""signficant conditions contributing to death after cardiac arrest; ASCVD"".""
	"1036585-1"	"1036585-1"	"ARTERIOSCLEROSIS"	"10003210"	"60-64 years"	"60-64"	""Patient called EMS approximately 1pm on 2/15 with complaints of generalized weakness. Upon arrival EMS found her to be diaphoretic and she had a witnessed syncopal episode with question of v-fib and seizures. She became unresponsive and had no pulse. CPR was begun and she was transported to ED. She remained asystole throughout. CPR was initially continued in the ED  for approximately 30 minutes and then stopped with Time of Death noted at 13:27. ED notes noted ""suspect given history that patient experienced massive MI, PE or ruptured AAA"".  Death certificate notes indicate ""signficant conditions contributing to death after cardiac arrest; ASCVD"".""
	"1036585-1"	"1036585-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	""Patient called EMS approximately 1pm on 2/15 with complaints of generalized weakness. Upon arrival EMS found her to be diaphoretic and she had a witnessed syncopal episode with question of v-fib and seizures. She became unresponsive and had no pulse. CPR was begun and she was transported to ED. She remained asystole throughout. CPR was initially continued in the ED  for approximately 30 minutes and then stopped with Time of Death noted at 13:27. ED notes noted ""suspect given history that patient experienced massive MI, PE or ruptured AAA"".  Death certificate notes indicate ""signficant conditions contributing to death after cardiac arrest; ASCVD"".""
	"1036585-1"	"1036585-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	""Patient called EMS approximately 1pm on 2/15 with complaints of generalized weakness. Upon arrival EMS found her to be diaphoretic and she had a witnessed syncopal episode with question of v-fib and seizures. She became unresponsive and had no pulse. CPR was begun and she was transported to ED. She remained asystole throughout. CPR was initially continued in the ED  for approximately 30 minutes and then stopped with Time of Death noted at 13:27. ED notes noted ""suspect given history that patient experienced massive MI, PE or ruptured AAA"".  Death certificate notes indicate ""signficant conditions contributing to death after cardiac arrest; ASCVD"".""
	"1036585-1"	"1036585-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""Patient called EMS approximately 1pm on 2/15 with complaints of generalized weakness. Upon arrival EMS found her to be diaphoretic and she had a witnessed syncopal episode with question of v-fib and seizures. She became unresponsive and had no pulse. CPR was begun and she was transported to ED. She remained asystole throughout. CPR was initially continued in the ED  for approximately 30 minutes and then stopped with Time of Death noted at 13:27. ED notes noted ""suspect given history that patient experienced massive MI, PE or ruptured AAA"".  Death certificate notes indicate ""signficant conditions contributing to death after cardiac arrest; ASCVD"".""
	"1036585-1"	"1036585-1"	"HYPERHIDROSIS"	"10020642"	"60-64 years"	"60-64"	""Patient called EMS approximately 1pm on 2/15 with complaints of generalized weakness. Upon arrival EMS found her to be diaphoretic and she had a witnessed syncopal episode with question of v-fib and seizures. She became unresponsive and had no pulse. CPR was begun and she was transported to ED. She remained asystole throughout. CPR was initially continued in the ED  for approximately 30 minutes and then stopped with Time of Death noted at 13:27. ED notes noted ""suspect given history that patient experienced massive MI, PE or ruptured AAA"".  Death certificate notes indicate ""signficant conditions contributing to death after cardiac arrest; ASCVD"".""
	"1036585-1"	"1036585-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	""Patient called EMS approximately 1pm on 2/15 with complaints of generalized weakness. Upon arrival EMS found her to be diaphoretic and she had a witnessed syncopal episode with question of v-fib and seizures. She became unresponsive and had no pulse. CPR was begun and she was transported to ED. She remained asystole throughout. CPR was initially continued in the ED  for approximately 30 minutes and then stopped with Time of Death noted at 13:27. ED notes noted ""suspect given history that patient experienced massive MI, PE or ruptured AAA"".  Death certificate notes indicate ""signficant conditions contributing to death after cardiac arrest; ASCVD"".""
	"1036585-1"	"1036585-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	""Patient called EMS approximately 1pm on 2/15 with complaints of generalized weakness. Upon arrival EMS found her to be diaphoretic and she had a witnessed syncopal episode with question of v-fib and seizures. She became unresponsive and had no pulse. CPR was begun and she was transported to ED. She remained asystole throughout. CPR was initially continued in the ED  for approximately 30 minutes and then stopped with Time of Death noted at 13:27. ED notes noted ""suspect given history that patient experienced massive MI, PE or ruptured AAA"".  Death certificate notes indicate ""signficant conditions contributing to death after cardiac arrest; ASCVD"".""
	"1036585-1"	"1036585-1"	"PULSE ABSENT"	"10037469"	"60-64 years"	"60-64"	""Patient called EMS approximately 1pm on 2/15 with complaints of generalized weakness. Upon arrival EMS found her to be diaphoretic and she had a witnessed syncopal episode with question of v-fib and seizures. She became unresponsive and had no pulse. CPR was begun and she was transported to ED. She remained asystole throughout. CPR was initially continued in the ED  for approximately 30 minutes and then stopped with Time of Death noted at 13:27. ED notes noted ""suspect given history that patient experienced massive MI, PE or ruptured AAA"".  Death certificate notes indicate ""signficant conditions contributing to death after cardiac arrest; ASCVD"".""
	"1036585-1"	"1036585-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	""Patient called EMS approximately 1pm on 2/15 with complaints of generalized weakness. Upon arrival EMS found her to be diaphoretic and she had a witnessed syncopal episode with question of v-fib and seizures. She became unresponsive and had no pulse. CPR was begun and she was transported to ED. She remained asystole throughout. CPR was initially continued in the ED  for approximately 30 minutes and then stopped with Time of Death noted at 13:27. ED notes noted ""suspect given history that patient experienced massive MI, PE or ruptured AAA"".  Death certificate notes indicate ""signficant conditions contributing to death after cardiac arrest; ASCVD"".""
	"1036585-1"	"1036585-1"	"SYNCOPE"	"10042772"	"60-64 years"	"60-64"	""Patient called EMS approximately 1pm on 2/15 with complaints of generalized weakness. Upon arrival EMS found her to be diaphoretic and she had a witnessed syncopal episode with question of v-fib and seizures. She became unresponsive and had no pulse. CPR was begun and she was transported to ED. She remained asystole throughout. CPR was initially continued in the ED  for approximately 30 minutes and then stopped with Time of Death noted at 13:27. ED notes noted ""suspect given history that patient experienced massive MI, PE or ruptured AAA"".  Death certificate notes indicate ""signficant conditions contributing to death after cardiac arrest; ASCVD"".""
	"1036585-1"	"1036585-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	""Patient called EMS approximately 1pm on 2/15 with complaints of generalized weakness. Upon arrival EMS found her to be diaphoretic and she had a witnessed syncopal episode with question of v-fib and seizures. She became unresponsive and had no pulse. CPR was begun and she was transported to ED. She remained asystole throughout. CPR was initially continued in the ED  for approximately 30 minutes and then stopped with Time of Death noted at 13:27. ED notes noted ""suspect given history that patient experienced massive MI, PE or ruptured AAA"".  Death certificate notes indicate ""signficant conditions contributing to death after cardiac arrest; ASCVD"".""
	"1036675-1"	"1036675-1"	"BLOOD CREATININE INCREASED"	"10005483"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"BLOOD CULTURE NEGATIVE"	"10005486"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"BLOOD UREA INCREASED"	"10005851"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"BRAIN NATRIURETIC PEPTIDE INCREASED"	"10053405"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"CULTURE NEGATIVE"	"10061448"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"IMMUNOGLOBULIN THERAPY"	"10069534"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"LUNG OPACITY"	"10081792"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"OESOPHAGOGASTRODUODENOSCOPY"	"10053057"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"PARALYSIS"	"10033799"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"PROCALCITONIN INCREASED"	"10067081"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"PUPILLARY DISORDER"	"10037521"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"PUPILLARY LIGHT REFLEX TESTS ABNORMAL"	"10037525"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"TROPONIN INCREASED"	"10058267"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"VENTRICULAR DRAINAGE"	"10052947"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"VIRAL TEST NEGATIVE"	"10062362"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036675-1"	"1036675-1"	"WHITE BLOOD CELL COUNT INCREASED"	"10047943"	"60-64 years"	"60-64"	"61 yo F with history of bilateral lung transplant 6/23/17 presented to ED on 2/4/21 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine (Pfizer) on 1/28/21. Upon arrival to triage she was obviously dyspneic with significantly low oxygen saturations. O2 sats on arrival were 65%, improved to mid 90's with O2 6 liters per NC. Admitting diagnosis: hypoxic respiratory failure post COVID vaccine. Lab work shows an elevation of the BUN and creatinine at 31 and 1.71 which is slightly higher than her usual baseline levels. BNP is elevated at 2 448 with a mildly elevated troponin. Procalcitonin is also elevated. Patient's white blood cell count is 11.07. Full viral panel including COVID-19 is not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, Thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 2/8/2021 and then VV ECMO cannulation on 2/13/2021. EGD done 2/14/2021 as unable to pass the TEE probe during cannulation prior day (unable to complete due to abnormal anatomy). Acute pupil exam change in the early am hours of 2/15/2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. GOL engaged and patient not an organ donation candidate. Therefore discussion with sister at bedside resulted in decision for cessation of life support. Patient expired shortly after support withdrawn and pronounced dead on 2/15/2021 at 11:11 AM."
	"1036874-1"	"1036874-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient developed pneumonia Admitted to hospital on 12/25. Determined to have pseudomonas bacteremia and passed away on 12/27."
	"1036874-1"	"1036874-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"Patient developed pneumonia Admitted to hospital on 12/25. Determined to have pseudomonas bacteremia and passed away on 12/27."
	"1036874-1"	"1036874-1"	"PSEUDOMONAL BACTERAEMIA"	"10058923"	"60-64 years"	"60-64"	"Patient developed pneumonia Admitted to hospital on 12/25. Determined to have pseudomonas bacteremia and passed away on 12/27."
	"1038257-1"	"1038257-1"	"BODY TEMPERATURE ABNORMAL"	"10075265"	"60-64 years"	"60-64"	"Passed away; tired; nonresponsive; cold; difficulty breathing; swelling; sore arm; feeling weird and funny; A spontaneous report (United States) was received from a consumer concerning a 63 year old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and the patient experienced limb discomfort, feeling abnormal, dyspnea, fatigue, swelling, unresponsive to stimuli, body temperature abnormal and the patient passed away .  Medical history included treatment for tuberculosis and dialysis. Concomitant medication included calcium acetate, Renvela, glipizide, omeprazole, aspirin, vitamin D, losartan, furosemide, rifampin, and Sensipar.  On 14 Jan 2021, the patient received the first of their first planned doses of mRNA-1273 (lot number 030L20A) for prophylaxis of COVID-19 infection.  On 13 Jan2021, the patient tested negative for COVID-19). On 16 Jan 2021, the patient experienced a sore arm, and feeling weird/funny. On 17Jan2021, the patient experienced difficulty breathing and swelling. On 18 Jan 2021, the patient declined dialysis, was tired and wanted to lay down. At 8 am, the patient was found nonresponsive and cold and is believed to have passed away around 4 am. The coroner tested the deceased for COVID-19 and the test was positive. No autopsy was reported. No death certificate was issued at the time of the report but the reporter believes it will list cause of death as COVID complications.  Action taken with the mRNA-1273 was not applicable.  The outcome of the events of limb discomfort, feeling abnormal, dyspnea, fatigue, swelling, unresponsive to stimuli, body temperature abnormal, was fatal.  On 18 Jan 2021, the patient was died. Cause of death was COVID-19. Autopsy details were not provided.; Reporter's Comments: The events developed on four days after first dose of mRNA-1372. Dyspnea, unresponsive to stimuli, and death were consistent with infection in pandemic set up confounded by age of patient and refusal of dialysis Cause of death was reported as COVID-19. Autopsy details were not provided. Based on reporter's causality the events are assessed as unlikely related to mRNA-1273.; Reported Cause(s) of Death: COVID-19"
	"1038257-1"	"1038257-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Passed away; tired; nonresponsive; cold; difficulty breathing; swelling; sore arm; feeling weird and funny; A spontaneous report (United States) was received from a consumer concerning a 63 year old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and the patient experienced limb discomfort, feeling abnormal, dyspnea, fatigue, swelling, unresponsive to stimuli, body temperature abnormal and the patient passed away .  Medical history included treatment for tuberculosis and dialysis. Concomitant medication included calcium acetate, Renvela, glipizide, omeprazole, aspirin, vitamin D, losartan, furosemide, rifampin, and Sensipar.  On 14 Jan 2021, the patient received the first of their first planned doses of mRNA-1273 (lot number 030L20A) for prophylaxis of COVID-19 infection.  On 13 Jan2021, the patient tested negative for COVID-19). On 16 Jan 2021, the patient experienced a sore arm, and feeling weird/funny. On 17Jan2021, the patient experienced difficulty breathing and swelling. On 18 Jan 2021, the patient declined dialysis, was tired and wanted to lay down. At 8 am, the patient was found nonresponsive and cold and is believed to have passed away around 4 am. The coroner tested the deceased for COVID-19 and the test was positive. No autopsy was reported. No death certificate was issued at the time of the report but the reporter believes it will list cause of death as COVID complications.  Action taken with the mRNA-1273 was not applicable.  The outcome of the events of limb discomfort, feeling abnormal, dyspnea, fatigue, swelling, unresponsive to stimuli, body temperature abnormal, was fatal.  On 18 Jan 2021, the patient was died. Cause of death was COVID-19. Autopsy details were not provided.; Reporter's Comments: The events developed on four days after first dose of mRNA-1372. Dyspnea, unresponsive to stimuli, and death were consistent with infection in pandemic set up confounded by age of patient and refusal of dialysis Cause of death was reported as COVID-19. Autopsy details were not provided. Based on reporter's causality the events are assessed as unlikely related to mRNA-1273.; Reported Cause(s) of Death: COVID-19"
	"1038257-1"	"1038257-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Passed away; tired; nonresponsive; cold; difficulty breathing; swelling; sore arm; feeling weird and funny; A spontaneous report (United States) was received from a consumer concerning a 63 year old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and the patient experienced limb discomfort, feeling abnormal, dyspnea, fatigue, swelling, unresponsive to stimuli, body temperature abnormal and the patient passed away .  Medical history included treatment for tuberculosis and dialysis. Concomitant medication included calcium acetate, Renvela, glipizide, omeprazole, aspirin, vitamin D, losartan, furosemide, rifampin, and Sensipar.  On 14 Jan 2021, the patient received the first of their first planned doses of mRNA-1273 (lot number 030L20A) for prophylaxis of COVID-19 infection.  On 13 Jan2021, the patient tested negative for COVID-19). On 16 Jan 2021, the patient experienced a sore arm, and feeling weird/funny. On 17Jan2021, the patient experienced difficulty breathing and swelling. On 18 Jan 2021, the patient declined dialysis, was tired and wanted to lay down. At 8 am, the patient was found nonresponsive and cold and is believed to have passed away around 4 am. The coroner tested the deceased for COVID-19 and the test was positive. No autopsy was reported. No death certificate was issued at the time of the report but the reporter believes it will list cause of death as COVID complications.  Action taken with the mRNA-1273 was not applicable.  The outcome of the events of limb discomfort, feeling abnormal, dyspnea, fatigue, swelling, unresponsive to stimuli, body temperature abnormal, was fatal.  On 18 Jan 2021, the patient was died. Cause of death was COVID-19. Autopsy details were not provided.; Reporter's Comments: The events developed on four days after first dose of mRNA-1372. Dyspnea, unresponsive to stimuli, and death were consistent with infection in pandemic set up confounded by age of patient and refusal of dialysis Cause of death was reported as COVID-19. Autopsy details were not provided. Based on reporter's causality the events are assessed as unlikely related to mRNA-1273.; Reported Cause(s) of Death: COVID-19"
	"1038257-1"	"1038257-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Passed away; tired; nonresponsive; cold; difficulty breathing; swelling; sore arm; feeling weird and funny; A spontaneous report (United States) was received from a consumer concerning a 63 year old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and the patient experienced limb discomfort, feeling abnormal, dyspnea, fatigue, swelling, unresponsive to stimuli, body temperature abnormal and the patient passed away .  Medical history included treatment for tuberculosis and dialysis. Concomitant medication included calcium acetate, Renvela, glipizide, omeprazole, aspirin, vitamin D, losartan, furosemide, rifampin, and Sensipar.  On 14 Jan 2021, the patient received the first of their first planned doses of mRNA-1273 (lot number 030L20A) for prophylaxis of COVID-19 infection.  On 13 Jan2021, the patient tested negative for COVID-19). On 16 Jan 2021, the patient experienced a sore arm, and feeling weird/funny. On 17Jan2021, the patient experienced difficulty breathing and swelling. On 18 Jan 2021, the patient declined dialysis, was tired and wanted to lay down. At 8 am, the patient was found nonresponsive and cold and is believed to have passed away around 4 am. The coroner tested the deceased for COVID-19 and the test was positive. No autopsy was reported. No death certificate was issued at the time of the report but the reporter believes it will list cause of death as COVID complications.  Action taken with the mRNA-1273 was not applicable.  The outcome of the events of limb discomfort, feeling abnormal, dyspnea, fatigue, swelling, unresponsive to stimuli, body temperature abnormal, was fatal.  On 18 Jan 2021, the patient was died. Cause of death was COVID-19. Autopsy details were not provided.; Reporter's Comments: The events developed on four days after first dose of mRNA-1372. Dyspnea, unresponsive to stimuli, and death were consistent with infection in pandemic set up confounded by age of patient and refusal of dialysis Cause of death was reported as COVID-19. Autopsy details were not provided. Based on reporter's causality the events are assessed as unlikely related to mRNA-1273.; Reported Cause(s) of Death: COVID-19"
	"1038257-1"	"1038257-1"	"FEELING ABNORMAL"	"10016322"	"60-64 years"	"60-64"	"Passed away; tired; nonresponsive; cold; difficulty breathing; swelling; sore arm; feeling weird and funny; A spontaneous report (United States) was received from a consumer concerning a 63 year old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and the patient experienced limb discomfort, feeling abnormal, dyspnea, fatigue, swelling, unresponsive to stimuli, body temperature abnormal and the patient passed away .  Medical history included treatment for tuberculosis and dialysis. Concomitant medication included calcium acetate, Renvela, glipizide, omeprazole, aspirin, vitamin D, losartan, furosemide, rifampin, and Sensipar.  On 14 Jan 2021, the patient received the first of their first planned doses of mRNA-1273 (lot number 030L20A) for prophylaxis of COVID-19 infection.  On 13 Jan2021, the patient tested negative for COVID-19). On 16 Jan 2021, the patient experienced a sore arm, and feeling weird/funny. On 17Jan2021, the patient experienced difficulty breathing and swelling. On 18 Jan 2021, the patient declined dialysis, was tired and wanted to lay down. At 8 am, the patient was found nonresponsive and cold and is believed to have passed away around 4 am. The coroner tested the deceased for COVID-19 and the test was positive. No autopsy was reported. No death certificate was issued at the time of the report but the reporter believes it will list cause of death as COVID complications.  Action taken with the mRNA-1273 was not applicable.  The outcome of the events of limb discomfort, feeling abnormal, dyspnea, fatigue, swelling, unresponsive to stimuli, body temperature abnormal, was fatal.  On 18 Jan 2021, the patient was died. Cause of death was COVID-19. Autopsy details were not provided.; Reporter's Comments: The events developed on four days after first dose of mRNA-1372. Dyspnea, unresponsive to stimuli, and death were consistent with infection in pandemic set up confounded by age of patient and refusal of dialysis Cause of death was reported as COVID-19. Autopsy details were not provided. Based on reporter's causality the events are assessed as unlikely related to mRNA-1273.; Reported Cause(s) of Death: COVID-19"
	"1038257-1"	"1038257-1"	"LIMB DISCOMFORT"	"10061224"	"60-64 years"	"60-64"	"Passed away; tired; nonresponsive; cold; difficulty breathing; swelling; sore arm; feeling weird and funny; A spontaneous report (United States) was received from a consumer concerning a 63 year old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and the patient experienced limb discomfort, feeling abnormal, dyspnea, fatigue, swelling, unresponsive to stimuli, body temperature abnormal and the patient passed away .  Medical history included treatment for tuberculosis and dialysis. Concomitant medication included calcium acetate, Renvela, glipizide, omeprazole, aspirin, vitamin D, losartan, furosemide, rifampin, and Sensipar.  On 14 Jan 2021, the patient received the first of their first planned doses of mRNA-1273 (lot number 030L20A) for prophylaxis of COVID-19 infection.  On 13 Jan2021, the patient tested negative for COVID-19). On 16 Jan 2021, the patient experienced a sore arm, and feeling weird/funny. On 17Jan2021, the patient experienced difficulty breathing and swelling. On 18 Jan 2021, the patient declined dialysis, was tired and wanted to lay down. At 8 am, the patient was found nonresponsive and cold and is believed to have passed away around 4 am. The coroner tested the deceased for COVID-19 and the test was positive. No autopsy was reported. No death certificate was issued at the time of the report but the reporter believes it will list cause of death as COVID complications.  Action taken with the mRNA-1273 was not applicable.  The outcome of the events of limb discomfort, feeling abnormal, dyspnea, fatigue, swelling, unresponsive to stimuli, body temperature abnormal, was fatal.  On 18 Jan 2021, the patient was died. Cause of death was COVID-19. Autopsy details were not provided.; Reporter's Comments: The events developed on four days after first dose of mRNA-1372. Dyspnea, unresponsive to stimuli, and death were consistent with infection in pandemic set up confounded by age of patient and refusal of dialysis Cause of death was reported as COVID-19. Autopsy details were not provided. Based on reporter's causality the events are assessed as unlikely related to mRNA-1273.; Reported Cause(s) of Death: COVID-19"
	"1038257-1"	"1038257-1"	"SARS-COV-2 TEST"	"10084354"	"60-64 years"	"60-64"	"Passed away; tired; nonresponsive; cold; difficulty breathing; swelling; sore arm; feeling weird and funny; A spontaneous report (United States) was received from a consumer concerning a 63 year old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and the patient experienced limb discomfort, feeling abnormal, dyspnea, fatigue, swelling, unresponsive to stimuli, body temperature abnormal and the patient passed away .  Medical history included treatment for tuberculosis and dialysis. Concomitant medication included calcium acetate, Renvela, glipizide, omeprazole, aspirin, vitamin D, losartan, furosemide, rifampin, and Sensipar.  On 14 Jan 2021, the patient received the first of their first planned doses of mRNA-1273 (lot number 030L20A) for prophylaxis of COVID-19 infection.  On 13 Jan2021, the patient tested negative for COVID-19). On 16 Jan 2021, the patient experienced a sore arm, and feeling weird/funny. On 17Jan2021, the patient experienced difficulty breathing and swelling. On 18 Jan 2021, the patient declined dialysis, was tired and wanted to lay down. At 8 am, the patient was found nonresponsive and cold and is believed to have passed away around 4 am. The coroner tested the deceased for COVID-19 and the test was positive. No autopsy was reported. No death certificate was issued at the time of the report but the reporter believes it will list cause of death as COVID complications.  Action taken with the mRNA-1273 was not applicable.  The outcome of the events of limb discomfort, feeling abnormal, dyspnea, fatigue, swelling, unresponsive to stimuli, body temperature abnormal, was fatal.  On 18 Jan 2021, the patient was died. Cause of death was COVID-19. Autopsy details were not provided.; Reporter's Comments: The events developed on four days after first dose of mRNA-1372. Dyspnea, unresponsive to stimuli, and death were consistent with infection in pandemic set up confounded by age of patient and refusal of dialysis Cause of death was reported as COVID-19. Autopsy details were not provided. Based on reporter's causality the events are assessed as unlikely related to mRNA-1273.; Reported Cause(s) of Death: COVID-19"
	"1038257-1"	"1038257-1"	"SWELLING"	"10042674"	"60-64 years"	"60-64"	"Passed away; tired; nonresponsive; cold; difficulty breathing; swelling; sore arm; feeling weird and funny; A spontaneous report (United States) was received from a consumer concerning a 63 year old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and the patient experienced limb discomfort, feeling abnormal, dyspnea, fatigue, swelling, unresponsive to stimuli, body temperature abnormal and the patient passed away .  Medical history included treatment for tuberculosis and dialysis. Concomitant medication included calcium acetate, Renvela, glipizide, omeprazole, aspirin, vitamin D, losartan, furosemide, rifampin, and Sensipar.  On 14 Jan 2021, the patient received the first of their first planned doses of mRNA-1273 (lot number 030L20A) for prophylaxis of COVID-19 infection.  On 13 Jan2021, the patient tested negative for COVID-19). On 16 Jan 2021, the patient experienced a sore arm, and feeling weird/funny. On 17Jan2021, the patient experienced difficulty breathing and swelling. On 18 Jan 2021, the patient declined dialysis, was tired and wanted to lay down. At 8 am, the patient was found nonresponsive and cold and is believed to have passed away around 4 am. The coroner tested the deceased for COVID-19 and the test was positive. No autopsy was reported. No death certificate was issued at the time of the report but the reporter believes it will list cause of death as COVID complications.  Action taken with the mRNA-1273 was not applicable.  The outcome of the events of limb discomfort, feeling abnormal, dyspnea, fatigue, swelling, unresponsive to stimuli, body temperature abnormal, was fatal.  On 18 Jan 2021, the patient was died. Cause of death was COVID-19. Autopsy details were not provided.; Reporter's Comments: The events developed on four days after first dose of mRNA-1372. Dyspnea, unresponsive to stimuli, and death were consistent with infection in pandemic set up confounded by age of patient and refusal of dialysis Cause of death was reported as COVID-19. Autopsy details were not provided. Based on reporter's causality the events are assessed as unlikely related to mRNA-1273.; Reported Cause(s) of Death: COVID-19"
	"1038257-1"	"1038257-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Passed away; tired; nonresponsive; cold; difficulty breathing; swelling; sore arm; feeling weird and funny; A spontaneous report (United States) was received from a consumer concerning a 63 year old male patient who received Moderna's COVID-19 vaccine (mRNA-1273) and the patient experienced limb discomfort, feeling abnormal, dyspnea, fatigue, swelling, unresponsive to stimuli, body temperature abnormal and the patient passed away .  Medical history included treatment for tuberculosis and dialysis. Concomitant medication included calcium acetate, Renvela, glipizide, omeprazole, aspirin, vitamin D, losartan, furosemide, rifampin, and Sensipar.  On 14 Jan 2021, the patient received the first of their first planned doses of mRNA-1273 (lot number 030L20A) for prophylaxis of COVID-19 infection.  On 13 Jan2021, the patient tested negative for COVID-19). On 16 Jan 2021, the patient experienced a sore arm, and feeling weird/funny. On 17Jan2021, the patient experienced difficulty breathing and swelling. On 18 Jan 2021, the patient declined dialysis, was tired and wanted to lay down. At 8 am, the patient was found nonresponsive and cold and is believed to have passed away around 4 am. The coroner tested the deceased for COVID-19 and the test was positive. No autopsy was reported. No death certificate was issued at the time of the report but the reporter believes it will list cause of death as COVID complications.  Action taken with the mRNA-1273 was not applicable.  The outcome of the events of limb discomfort, feeling abnormal, dyspnea, fatigue, swelling, unresponsive to stimuli, body temperature abnormal, was fatal.  On 18 Jan 2021, the patient was died. Cause of death was COVID-19. Autopsy details were not provided.; Reporter's Comments: The events developed on four days after first dose of mRNA-1372. Dyspnea, unresponsive to stimuli, and death were consistent with infection in pandemic set up confounded by age of patient and refusal of dialysis Cause of death was reported as COVID-19. Autopsy details were not provided. Based on reporter's causality the events are assessed as unlikely related to mRNA-1273.; Reported Cause(s) of Death: COVID-19"
	"1039597-1"	"1039597-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""Death Narrative:  Patient received first dose of COVID vaccine on 1/30/21. Reported by his wife to agency that he passed away at an outside hospital on 2/14/21. By report of his wife: ""due to sepsis (related to bed sores) and aspiration pneumonia""""
	"1039597-1"	"1039597-1"	"DECUBITUS ULCER"	"10011985"	"60-64 years"	"60-64"	""Death Narrative:  Patient received first dose of COVID vaccine on 1/30/21. Reported by his wife to agency that he passed away at an outside hospital on 2/14/21. By report of his wife: ""due to sepsis (related to bed sores) and aspiration pneumonia""""
	"1039597-1"	"1039597-1"	"PNEUMONIA ASPIRATION"	"10035669"	"60-64 years"	"60-64"	""Death Narrative:  Patient received first dose of COVID vaccine on 1/30/21. Reported by his wife to agency that he passed away at an outside hospital on 2/14/21. By report of his wife: ""due to sepsis (related to bed sores) and aspiration pneumonia""""
	"1039597-1"	"1039597-1"	"SEPSIS"	"10040047"	"60-64 years"	"60-64"	""Death Narrative:  Patient received first dose of COVID vaccine on 1/30/21. Reported by his wife to agency that he passed away at an outside hospital on 2/14/21. By report of his wife: ""due to sepsis (related to bed sores) and aspiration pneumonia""""
	"1044352-1"	"1044352-1"	"ABDOMINAL DISCOMFORT"	"10000059"	"60-64 years"	"60-64"	"Stomach upset, sudden heart failure, death"
	"1044352-1"	"1044352-1"	"CARDIAC FAILURE"	"10007554"	"60-64 years"	"60-64"	"Stomach upset, sudden heart failure, death"
	"1044352-1"	"1044352-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Stomach upset, sudden heart failure, death"
	"1046698-1"	"1046698-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"patient passed away within 60 days of receiving a COVID vaccine"
	"1046795-1"	"1046795-1"	"BILEVEL POSITIVE AIRWAY PRESSURE"	"10064530"	"60-64 years"	"60-64"	"Per ED note: Brought in ED by EMS at 1945 for acute shortness of breath and hypotension. Patient was placed on supplemental oxygen and covid test completed. Patient was placed on BiPAP to maintain oxygen greater than 90%. Found to be in metabolic acidosis. Patient became unresponsive and pulse could not be palpated. Chest compressions were initiated. ACLS medications given and pulses regained. Patient lost pulse 30 mins later and never regained pulse. Per ED noted; likely developed a PE. Passed away at 2127"
	"1046795-1"	"1046795-1"	"BLOOD GASES"	"10005537"	"60-64 years"	"60-64"	"Per ED note: Brought in ED by EMS at 1945 for acute shortness of breath and hypotension. Patient was placed on supplemental oxygen and covid test completed. Patient was placed on BiPAP to maintain oxygen greater than 90%. Found to be in metabolic acidosis. Patient became unresponsive and pulse could not be palpated. Chest compressions were initiated. ACLS medications given and pulses regained. Patient lost pulse 30 mins later and never regained pulse. Per ED noted; likely developed a PE. Passed away at 2127"
	"1046795-1"	"1046795-1"	"BLOOD LACTIC ACID"	"10005632"	"60-64 years"	"60-64"	"Per ED note: Brought in ED by EMS at 1945 for acute shortness of breath and hypotension. Patient was placed on supplemental oxygen and covid test completed. Patient was placed on BiPAP to maintain oxygen greater than 90%. Found to be in metabolic acidosis. Patient became unresponsive and pulse could not be palpated. Chest compressions were initiated. ACLS medications given and pulses regained. Patient lost pulse 30 mins later and never regained pulse. Per ED noted; likely developed a PE. Passed away at 2127"
	"1046795-1"	"1046795-1"	"CHEST X-RAY"	"10008498"	"60-64 years"	"60-64"	"Per ED note: Brought in ED by EMS at 1945 for acute shortness of breath and hypotension. Patient was placed on supplemental oxygen and covid test completed. Patient was placed on BiPAP to maintain oxygen greater than 90%. Found to be in metabolic acidosis. Patient became unresponsive and pulse could not be palpated. Chest compressions were initiated. ACLS medications given and pulses regained. Patient lost pulse 30 mins later and never regained pulse. Per ED noted; likely developed a PE. Passed away at 2127"
	"1046795-1"	"1046795-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Per ED note: Brought in ED by EMS at 1945 for acute shortness of breath and hypotension. Patient was placed on supplemental oxygen and covid test completed. Patient was placed on BiPAP to maintain oxygen greater than 90%. Found to be in metabolic acidosis. Patient became unresponsive and pulse could not be palpated. Chest compressions were initiated. ACLS medications given and pulses regained. Patient lost pulse 30 mins later and never regained pulse. Per ED noted; likely developed a PE. Passed away at 2127"
	"1046795-1"	"1046795-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Per ED note: Brought in ED by EMS at 1945 for acute shortness of breath and hypotension. Patient was placed on supplemental oxygen and covid test completed. Patient was placed on BiPAP to maintain oxygen greater than 90%. Found to be in metabolic acidosis. Patient became unresponsive and pulse could not be palpated. Chest compressions were initiated. ACLS medications given and pulses regained. Patient lost pulse 30 mins later and never regained pulse. Per ED noted; likely developed a PE. Passed away at 2127"
	"1046795-1"	"1046795-1"	"FULL BLOOD COUNT"	"10017411"	"60-64 years"	"60-64"	"Per ED note: Brought in ED by EMS at 1945 for acute shortness of breath and hypotension. Patient was placed on supplemental oxygen and covid test completed. Patient was placed on BiPAP to maintain oxygen greater than 90%. Found to be in metabolic acidosis. Patient became unresponsive and pulse could not be palpated. Chest compressions were initiated. ACLS medications given and pulses regained. Patient lost pulse 30 mins later and never regained pulse. Per ED noted; likely developed a PE. Passed away at 2127"
	"1046795-1"	"1046795-1"	"HYPOTENSION"	"10021097"	"60-64 years"	"60-64"	"Per ED note: Brought in ED by EMS at 1945 for acute shortness of breath and hypotension. Patient was placed on supplemental oxygen and covid test completed. Patient was placed on BiPAP to maintain oxygen greater than 90%. Found to be in metabolic acidosis. Patient became unresponsive and pulse could not be palpated. Chest compressions were initiated. ACLS medications given and pulses regained. Patient lost pulse 30 mins later and never regained pulse. Per ED noted; likely developed a PE. Passed away at 2127"
	"1046795-1"	"1046795-1"	"METABOLIC ACIDOSIS"	"10027417"	"60-64 years"	"60-64"	"Per ED note: Brought in ED by EMS at 1945 for acute shortness of breath and hypotension. Patient was placed on supplemental oxygen and covid test completed. Patient was placed on BiPAP to maintain oxygen greater than 90%. Found to be in metabolic acidosis. Patient became unresponsive and pulse could not be palpated. Chest compressions were initiated. ACLS medications given and pulses regained. Patient lost pulse 30 mins later and never regained pulse. Per ED noted; likely developed a PE. Passed away at 2127"
	"1046795-1"	"1046795-1"	"METABOLIC FUNCTION TEST"	"10062191"	"60-64 years"	"60-64"	"Per ED note: Brought in ED by EMS at 1945 for acute shortness of breath and hypotension. Patient was placed on supplemental oxygen and covid test completed. Patient was placed on BiPAP to maintain oxygen greater than 90%. Found to be in metabolic acidosis. Patient became unresponsive and pulse could not be palpated. Chest compressions were initiated. ACLS medications given and pulses regained. Patient lost pulse 30 mins later and never regained pulse. Per ED noted; likely developed a PE. Passed away at 2127"
	"1046795-1"	"1046795-1"	"OXYGEN THERAPY"	"10078798"	"60-64 years"	"60-64"	"Per ED note: Brought in ED by EMS at 1945 for acute shortness of breath and hypotension. Patient was placed on supplemental oxygen and covid test completed. Patient was placed on BiPAP to maintain oxygen greater than 90%. Found to be in metabolic acidosis. Patient became unresponsive and pulse could not be palpated. Chest compressions were initiated. ACLS medications given and pulses regained. Patient lost pulse 30 mins later and never regained pulse. Per ED noted; likely developed a PE. Passed away at 2127"
	"1046795-1"	"1046795-1"	"PULSE ABSENT"	"10037469"	"60-64 years"	"60-64"	"Per ED note: Brought in ED by EMS at 1945 for acute shortness of breath and hypotension. Patient was placed on supplemental oxygen and covid test completed. Patient was placed on BiPAP to maintain oxygen greater than 90%. Found to be in metabolic acidosis. Patient became unresponsive and pulse could not be palpated. Chest compressions were initiated. ACLS medications given and pulses regained. Patient lost pulse 30 mins later and never regained pulse. Per ED noted; likely developed a PE. Passed away at 2127"
	"1046795-1"	"1046795-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Per ED note: Brought in ED by EMS at 1945 for acute shortness of breath and hypotension. Patient was placed on supplemental oxygen and covid test completed. Patient was placed on BiPAP to maintain oxygen greater than 90%. Found to be in metabolic acidosis. Patient became unresponsive and pulse could not be palpated. Chest compressions were initiated. ACLS medications given and pulses regained. Patient lost pulse 30 mins later and never regained pulse. Per ED noted; likely developed a PE. Passed away at 2127"
	"1046795-1"	"1046795-1"	"SARS-COV-2 TEST"	"10084354"	"60-64 years"	"60-64"	"Per ED note: Brought in ED by EMS at 1945 for acute shortness of breath and hypotension. Patient was placed on supplemental oxygen and covid test completed. Patient was placed on BiPAP to maintain oxygen greater than 90%. Found to be in metabolic acidosis. Patient became unresponsive and pulse could not be palpated. Chest compressions were initiated. ACLS medications given and pulses regained. Patient lost pulse 30 mins later and never regained pulse. Per ED noted; likely developed a PE. Passed away at 2127"
	"1046795-1"	"1046795-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Per ED note: Brought in ED by EMS at 1945 for acute shortness of breath and hypotension. Patient was placed on supplemental oxygen and covid test completed. Patient was placed on BiPAP to maintain oxygen greater than 90%. Found to be in metabolic acidosis. Patient became unresponsive and pulse could not be palpated. Chest compressions were initiated. ACLS medications given and pulses regained. Patient lost pulse 30 mins later and never regained pulse. Per ED noted; likely developed a PE. Passed away at 2127"
	"1047072-1"	"1047072-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient had sore arm on the day of vaccination. Per patient's nephew , the next morning patient experienced body pains, aches, headache . Onn Tuesday patient had fever.  Patient's condition  progressively got worse. He had difficulty breathing by Wednesday night. He had low oxygen levels at 80 per pulse ox reading. Patient was coughing up blood. Family took him to hospital on Thursday morning due to breathing difficulty and patient died 2.18.21 at 10 am"
	"1047072-1"	"1047072-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Patient had sore arm on the day of vaccination. Per patient's nephew , the next morning patient experienced body pains, aches, headache . Onn Tuesday patient had fever.  Patient's condition  progressively got worse. He had difficulty breathing by Wednesday night. He had low oxygen levels at 80 per pulse ox reading. Patient was coughing up blood. Family took him to hospital on Thursday morning due to breathing difficulty and patient died 2.18.21 at 10 am"
	"1047072-1"	"1047072-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"60-64 years"	"60-64"	"Patient had sore arm on the day of vaccination. Per patient's nephew , the next morning patient experienced body pains, aches, headache . Onn Tuesday patient had fever.  Patient's condition  progressively got worse. He had difficulty breathing by Wednesday night. He had low oxygen levels at 80 per pulse ox reading. Patient was coughing up blood. Family took him to hospital on Thursday morning due to breathing difficulty and patient died 2.18.21 at 10 am"
	"1047072-1"	"1047072-1"	"HAEMOPTYSIS"	"10018964"	"60-64 years"	"60-64"	"Patient had sore arm on the day of vaccination. Per patient's nephew , the next morning patient experienced body pains, aches, headache . Onn Tuesday patient had fever.  Patient's condition  progressively got worse. He had difficulty breathing by Wednesday night. He had low oxygen levels at 80 per pulse ox reading. Patient was coughing up blood. Family took him to hospital on Thursday morning due to breathing difficulty and patient died 2.18.21 at 10 am"
	"1047072-1"	"1047072-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"Patient had sore arm on the day of vaccination. Per patient's nephew , the next morning patient experienced body pains, aches, headache . Onn Tuesday patient had fever.  Patient's condition  progressively got worse. He had difficulty breathing by Wednesday night. He had low oxygen levels at 80 per pulse ox reading. Patient was coughing up blood. Family took him to hospital on Thursday morning due to breathing difficulty and patient died 2.18.21 at 10 am"
	"1047072-1"	"1047072-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"Patient had sore arm on the day of vaccination. Per patient's nephew , the next morning patient experienced body pains, aches, headache . Onn Tuesday patient had fever.  Patient's condition  progressively got worse. He had difficulty breathing by Wednesday night. He had low oxygen levels at 80 per pulse ox reading. Patient was coughing up blood. Family took him to hospital on Thursday morning due to breathing difficulty and patient died 2.18.21 at 10 am"
	"1047072-1"	"1047072-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"Patient had sore arm on the day of vaccination. Per patient's nephew , the next morning patient experienced body pains, aches, headache . Onn Tuesday patient had fever.  Patient's condition  progressively got worse. He had difficulty breathing by Wednesday night. He had low oxygen levels at 80 per pulse ox reading. Patient was coughing up blood. Family took him to hospital on Thursday morning due to breathing difficulty and patient died 2.18.21 at 10 am"
	"1047072-1"	"1047072-1"	"PAIN IN EXTREMITY"	"10033425"	"60-64 years"	"60-64"	"Patient had sore arm on the day of vaccination. Per patient's nephew , the next morning patient experienced body pains, aches, headache . Onn Tuesday patient had fever.  Patient's condition  progressively got worse. He had difficulty breathing by Wednesday night. He had low oxygen levels at 80 per pulse ox reading. Patient was coughing up blood. Family took him to hospital on Thursday morning due to breathing difficulty and patient died 2.18.21 at 10 am"
	"1047072-1"	"1047072-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Patient had sore arm on the day of vaccination. Per patient's nephew , the next morning patient experienced body pains, aches, headache . Onn Tuesday patient had fever.  Patient's condition  progressively got worse. He had difficulty breathing by Wednesday night. He had low oxygen levels at 80 per pulse ox reading. Patient was coughing up blood. Family took him to hospital on Thursday morning due to breathing difficulty and patient died 2.18.21 at 10 am"
	"1051445-1"	"1051445-1"	"BLOOD CULTURE"	"10005485"	"60-64 years"	"60-64"	"chest x-ray shows numerous bilateral patchy opacities; catastrophic brain bleed; Brainstem reflexes were lost; Patient died; shortness of breath; nausea; diarrhea; worsening shortness of breath/numerous bilateral patchy opacities; immunosuppressed status; This is a spontaneous report from a contactable pharmacist and a contactable other health professional.  A 61-year-old female patient (not pregnant) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL9261), intramuscular at arm right on 28Jan2021 (at the age of 61 years) at single dose for COVID-19 immunization.  The patient medical history included bilateral lung transplant on 23Jun2017, lymphangioleiomyomatosis, hepatocellular carcinoma, antibody mediated rejection of lung transplant , bronchiolitis obliterans syndrome, grade 0P, major depressive disorder, RLS (restless legs syndrome), chronic insomnia, long term current use of systemic steroids OSA (obstructive sleep apnea), iron deficiency anemia, bilateral sciatica, hoarseness of voice, memory change, laryngeal stridor, pure hypercholesterolemia senile nuclear cataract, bilateral myopia of both eyes, osteoporosis without current pathological fracture, alopecia, immunosuppressed status, all from an unknown date and unknown if ongoing.  Concomitant medication included acyclovir (formulation: capsule, strength: 200 mg) oral at 200 mg twice daily, salbutamol (ALBUTEROL HFA) as needed (MCG/ACT inhaler take 2 puffs by inhalation every 4 hours as needed) for wheezing (shortness of breath), atorvastatin (LIPITOR, formulation: tablet) oral at 80 mg once a day, azithromycin (ZITHROMAX, formulation: tablet)oral at 250 mg (every Monday, Wednesday, Friday), bupropion hydrochloride (WELLBUTRIN XL, formulation: tablet, strength: 150 mg) oral at 150 mg once a day, calcium citrate/cholecalciferol (CALCIUM + VITAMIN D, formulation: tablet) oral at 2 dose form once a day (every morning), everolimus (ZORTRESS, formulation: tablet, strength: 1 mg) oral at 2 mg twice a day, fluticasone propionate/salmeterol xinafoate (ADVAIR, strength: 500 ug/ 20 ug) twice daily (1 puff by inhalation), gabapentin (NEURONTIN, formulation: capsule, strength:100 mg) oral at 300 mg daily (by mouth nightly), loratadine (CLARITIN, formulation: tablet, strength: 10 mg) oral at 10 mg as needed, metoprolol tartrate (LOPRESSOR, formulation: tablet, strength: 25 mg)oral at 50 mg twice daily, minoxidil (ROGAN, strength: 5%) topical apply 1 cap full every other day to affected area on scalp for alopecia, ondansetron (ZOFRAN, formulation: tablet, strength: 4 mg) oral at 4 mg as needed for nausea, pantoprazole sodium sesquihydrate (PROTONIX, formulation: tablet, strength: 40 mg) oral at 40 mg once a day, prednisone (DELTASONE, formulation: tablet, strength: 5 mg) oral at 5 mg daily (every morning), sertraline hydrochloride (ZOLOFT, formulation: tablet, strength: 100 mg) oral at 100 mg twice a day (every morning), sulfamethoxazole/trimethoprim (BACTRIM) 400-80 mg per tablet (1 tablet by mouth every Monday, Wednesday, Friday), tacrolimus (formulation: capsule) at 3 mg daily (2 mg every morning and 1 mg at night), salbutamol sulfate (PROVENTIL HFA) as needed for wheezing (shortness of breath), salbutamol sulfate (VENTOLIN HFA) as needed for wheezing (shortness of breath) , salbutamol sulfate (PROAIR HFA) as needed for wheezing (shortness of breath), ascorbic acid/ferrous fumarate/folic acid/ retinol (PRENATAL, formulation: tablet) oral daily.  The patient previously took NSAIDs and voriconazole and experienced drug allergies. It was reported that the patient presented to emergency department (ED) on 04Feb2021 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine. Full viral panel including COVID-19 was not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 08Feb2021 and then VV ECMO cannulation on 13Feb2021. Acute pupil exam changes in the early am hours of 15Feb2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. The events were all serious. The patient outcome of the events was fatal. The patient died on 15Feb2021.  It was not reported if an autopsy was performed.; Sender's Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events due to temporal relationship. However, the reported event may possibly represent intercurrent medical conditions in this patient.  There is limited information provided in this report.  Additional information is needed to better assess the case, including complete medical history, diagnostics, counteractive treatment measures and concomitant medications. This case will be reassessed once additional information is available.  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: Chest x-ray shows numerous bilateral patchy opacities; Catastrophic brain bleed; Brainstem reflexes were lost; shortness of breath; nausea; Diarrhea; Worsening shortness of breath/numerous bilateral patchy opacities"
	"1051445-1"	"1051445-1"	"BRAIN STEM HAEMORRHAGE"	"10006145"	"60-64 years"	"60-64"	"chest x-ray shows numerous bilateral patchy opacities; catastrophic brain bleed; Brainstem reflexes were lost; Patient died; shortness of breath; nausea; diarrhea; worsening shortness of breath/numerous bilateral patchy opacities; immunosuppressed status; This is a spontaneous report from a contactable pharmacist and a contactable other health professional.  A 61-year-old female patient (not pregnant) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL9261), intramuscular at arm right on 28Jan2021 (at the age of 61 years) at single dose for COVID-19 immunization.  The patient medical history included bilateral lung transplant on 23Jun2017, lymphangioleiomyomatosis, hepatocellular carcinoma, antibody mediated rejection of lung transplant , bronchiolitis obliterans syndrome, grade 0P, major depressive disorder, RLS (restless legs syndrome), chronic insomnia, long term current use of systemic steroids OSA (obstructive sleep apnea), iron deficiency anemia, bilateral sciatica, hoarseness of voice, memory change, laryngeal stridor, pure hypercholesterolemia senile nuclear cataract, bilateral myopia of both eyes, osteoporosis without current pathological fracture, alopecia, immunosuppressed status, all from an unknown date and unknown if ongoing.  Concomitant medication included acyclovir (formulation: capsule, strength: 200 mg) oral at 200 mg twice daily, salbutamol (ALBUTEROL HFA) as needed (MCG/ACT inhaler take 2 puffs by inhalation every 4 hours as needed) for wheezing (shortness of breath), atorvastatin (LIPITOR, formulation: tablet) oral at 80 mg once a day, azithromycin (ZITHROMAX, formulation: tablet)oral at 250 mg (every Monday, Wednesday, Friday), bupropion hydrochloride (WELLBUTRIN XL, formulation: tablet, strength: 150 mg) oral at 150 mg once a day, calcium citrate/cholecalciferol (CALCIUM + VITAMIN D, formulation: tablet) oral at 2 dose form once a day (every morning), everolimus (ZORTRESS, formulation: tablet, strength: 1 mg) oral at 2 mg twice a day, fluticasone propionate/salmeterol xinafoate (ADVAIR, strength: 500 ug/ 20 ug) twice daily (1 puff by inhalation), gabapentin (NEURONTIN, formulation: capsule, strength:100 mg) oral at 300 mg daily (by mouth nightly), loratadine (CLARITIN, formulation: tablet, strength: 10 mg) oral at 10 mg as needed, metoprolol tartrate (LOPRESSOR, formulation: tablet, strength: 25 mg)oral at 50 mg twice daily, minoxidil (ROGAN, strength: 5%) topical apply 1 cap full every other day to affected area on scalp for alopecia, ondansetron (ZOFRAN, formulation: tablet, strength: 4 mg) oral at 4 mg as needed for nausea, pantoprazole sodium sesquihydrate (PROTONIX, formulation: tablet, strength: 40 mg) oral at 40 mg once a day, prednisone (DELTASONE, formulation: tablet, strength: 5 mg) oral at 5 mg daily (every morning), sertraline hydrochloride (ZOLOFT, formulation: tablet, strength: 100 mg) oral at 100 mg twice a day (every morning), sulfamethoxazole/trimethoprim (BACTRIM) 400-80 mg per tablet (1 tablet by mouth every Monday, Wednesday, Friday), tacrolimus (formulation: capsule) at 3 mg daily (2 mg every morning and 1 mg at night), salbutamol sulfate (PROVENTIL HFA) as needed for wheezing (shortness of breath), salbutamol sulfate (VENTOLIN HFA) as needed for wheezing (shortness of breath) , salbutamol sulfate (PROAIR HFA) as needed for wheezing (shortness of breath), ascorbic acid/ferrous fumarate/folic acid/ retinol (PRENATAL, formulation: tablet) oral daily.  The patient previously took NSAIDs and voriconazole and experienced drug allergies. It was reported that the patient presented to emergency department (ED) on 04Feb2021 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine. Full viral panel including COVID-19 was not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 08Feb2021 and then VV ECMO cannulation on 13Feb2021. Acute pupil exam changes in the early am hours of 15Feb2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. The events were all serious. The patient outcome of the events was fatal. The patient died on 15Feb2021.  It was not reported if an autopsy was performed.; Sender's Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events due to temporal relationship. However, the reported event may possibly represent intercurrent medical conditions in this patient.  There is limited information provided in this report.  Additional information is needed to better assess the case, including complete medical history, diagnostics, counteractive treatment measures and concomitant medications. This case will be reassessed once additional information is available.  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: Chest x-ray shows numerous bilateral patchy opacities; Catastrophic brain bleed; Brainstem reflexes were lost; shortness of breath; nausea; Diarrhea; Worsening shortness of breath/numerous bilateral patchy opacities"
	"1051445-1"	"1051445-1"	"BRAIN STEM SYNDROME"	"10063292"	"60-64 years"	"60-64"	"chest x-ray shows numerous bilateral patchy opacities; catastrophic brain bleed; Brainstem reflexes were lost; Patient died; shortness of breath; nausea; diarrhea; worsening shortness of breath/numerous bilateral patchy opacities; immunosuppressed status; This is a spontaneous report from a contactable pharmacist and a contactable other health professional.  A 61-year-old female patient (not pregnant) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL9261), intramuscular at arm right on 28Jan2021 (at the age of 61 years) at single dose for COVID-19 immunization.  The patient medical history included bilateral lung transplant on 23Jun2017, lymphangioleiomyomatosis, hepatocellular carcinoma, antibody mediated rejection of lung transplant , bronchiolitis obliterans syndrome, grade 0P, major depressive disorder, RLS (restless legs syndrome), chronic insomnia, long term current use of systemic steroids OSA (obstructive sleep apnea), iron deficiency anemia, bilateral sciatica, hoarseness of voice, memory change, laryngeal stridor, pure hypercholesterolemia senile nuclear cataract, bilateral myopia of both eyes, osteoporosis without current pathological fracture, alopecia, immunosuppressed status, all from an unknown date and unknown if ongoing.  Concomitant medication included acyclovir (formulation: capsule, strength: 200 mg) oral at 200 mg twice daily, salbutamol (ALBUTEROL HFA) as needed (MCG/ACT inhaler take 2 puffs by inhalation every 4 hours as needed) for wheezing (shortness of breath), atorvastatin (LIPITOR, formulation: tablet) oral at 80 mg once a day, azithromycin (ZITHROMAX, formulation: tablet)oral at 250 mg (every Monday, Wednesday, Friday), bupropion hydrochloride (WELLBUTRIN XL, formulation: tablet, strength: 150 mg) oral at 150 mg once a day, calcium citrate/cholecalciferol (CALCIUM + VITAMIN D, formulation: tablet) oral at 2 dose form once a day (every morning), everolimus (ZORTRESS, formulation: tablet, strength: 1 mg) oral at 2 mg twice a day, fluticasone propionate/salmeterol xinafoate (ADVAIR, strength: 500 ug/ 20 ug) twice daily (1 puff by inhalation), gabapentin (NEURONTIN, formulation: capsule, strength:100 mg) oral at 300 mg daily (by mouth nightly), loratadine (CLARITIN, formulation: tablet, strength: 10 mg) oral at 10 mg as needed, metoprolol tartrate (LOPRESSOR, formulation: tablet, strength: 25 mg)oral at 50 mg twice daily, minoxidil (ROGAN, strength: 5%) topical apply 1 cap full every other day to affected area on scalp for alopecia, ondansetron (ZOFRAN, formulation: tablet, strength: 4 mg) oral at 4 mg as needed for nausea, pantoprazole sodium sesquihydrate (PROTONIX, formulation: tablet, strength: 40 mg) oral at 40 mg once a day, prednisone (DELTASONE, formulation: tablet, strength: 5 mg) oral at 5 mg daily (every morning), sertraline hydrochloride (ZOLOFT, formulation: tablet, strength: 100 mg) oral at 100 mg twice a day (every morning), sulfamethoxazole/trimethoprim (BACTRIM) 400-80 mg per tablet (1 tablet by mouth every Monday, Wednesday, Friday), tacrolimus (formulation: capsule) at 3 mg daily (2 mg every morning and 1 mg at night), salbutamol sulfate (PROVENTIL HFA) as needed for wheezing (shortness of breath), salbutamol sulfate (VENTOLIN HFA) as needed for wheezing (shortness of breath) , salbutamol sulfate (PROAIR HFA) as needed for wheezing (shortness of breath), ascorbic acid/ferrous fumarate/folic acid/ retinol (PRENATAL, formulation: tablet) oral daily.  The patient previously took NSAIDs and voriconazole and experienced drug allergies. It was reported that the patient presented to emergency department (ED) on 04Feb2021 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine. Full viral panel including COVID-19 was not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 08Feb2021 and then VV ECMO cannulation on 13Feb2021. Acute pupil exam changes in the early am hours of 15Feb2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. The events were all serious. The patient outcome of the events was fatal. The patient died on 15Feb2021.  It was not reported if an autopsy was performed.; Sender's Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events due to temporal relationship. However, the reported event may possibly represent intercurrent medical conditions in this patient.  There is limited information provided in this report.  Additional information is needed to better assess the case, including complete medical history, diagnostics, counteractive treatment measures and concomitant medications. This case will be reassessed once additional information is available.  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: Chest x-ray shows numerous bilateral patchy opacities; Catastrophic brain bleed; Brainstem reflexes were lost; shortness of breath; nausea; Diarrhea; Worsening shortness of breath/numerous bilateral patchy opacities"
	"1051445-1"	"1051445-1"	"CHEST X-RAY"	"10008498"	"60-64 years"	"60-64"	"chest x-ray shows numerous bilateral patchy opacities; catastrophic brain bleed; Brainstem reflexes were lost; Patient died; shortness of breath; nausea; diarrhea; worsening shortness of breath/numerous bilateral patchy opacities; immunosuppressed status; This is a spontaneous report from a contactable pharmacist and a contactable other health professional.  A 61-year-old female patient (not pregnant) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL9261), intramuscular at arm right on 28Jan2021 (at the age of 61 years) at single dose for COVID-19 immunization.  The patient medical history included bilateral lung transplant on 23Jun2017, lymphangioleiomyomatosis, hepatocellular carcinoma, antibody mediated rejection of lung transplant , bronchiolitis obliterans syndrome, grade 0P, major depressive disorder, RLS (restless legs syndrome), chronic insomnia, long term current use of systemic steroids OSA (obstructive sleep apnea), iron deficiency anemia, bilateral sciatica, hoarseness of voice, memory change, laryngeal stridor, pure hypercholesterolemia senile nuclear cataract, bilateral myopia of both eyes, osteoporosis without current pathological fracture, alopecia, immunosuppressed status, all from an unknown date and unknown if ongoing.  Concomitant medication included acyclovir (formulation: capsule, strength: 200 mg) oral at 200 mg twice daily, salbutamol (ALBUTEROL HFA) as needed (MCG/ACT inhaler take 2 puffs by inhalation every 4 hours as needed) for wheezing (shortness of breath), atorvastatin (LIPITOR, formulation: tablet) oral at 80 mg once a day, azithromycin (ZITHROMAX, formulation: tablet)oral at 250 mg (every Monday, Wednesday, Friday), bupropion hydrochloride (WELLBUTRIN XL, formulation: tablet, strength: 150 mg) oral at 150 mg once a day, calcium citrate/cholecalciferol (CALCIUM + VITAMIN D, formulation: tablet) oral at 2 dose form once a day (every morning), everolimus (ZORTRESS, formulation: tablet, strength: 1 mg) oral at 2 mg twice a day, fluticasone propionate/salmeterol xinafoate (ADVAIR, strength: 500 ug/ 20 ug) twice daily (1 puff by inhalation), gabapentin (NEURONTIN, formulation: capsule, strength:100 mg) oral at 300 mg daily (by mouth nightly), loratadine (CLARITIN, formulation: tablet, strength: 10 mg) oral at 10 mg as needed, metoprolol tartrate (LOPRESSOR, formulation: tablet, strength: 25 mg)oral at 50 mg twice daily, minoxidil (ROGAN, strength: 5%) topical apply 1 cap full every other day to affected area on scalp for alopecia, ondansetron (ZOFRAN, formulation: tablet, strength: 4 mg) oral at 4 mg as needed for nausea, pantoprazole sodium sesquihydrate (PROTONIX, formulation: tablet, strength: 40 mg) oral at 40 mg once a day, prednisone (DELTASONE, formulation: tablet, strength: 5 mg) oral at 5 mg daily (every morning), sertraline hydrochloride (ZOLOFT, formulation: tablet, strength: 100 mg) oral at 100 mg twice a day (every morning), sulfamethoxazole/trimethoprim (BACTRIM) 400-80 mg per tablet (1 tablet by mouth every Monday, Wednesday, Friday), tacrolimus (formulation: capsule) at 3 mg daily (2 mg every morning and 1 mg at night), salbutamol sulfate (PROVENTIL HFA) as needed for wheezing (shortness of breath), salbutamol sulfate (VENTOLIN HFA) as needed for wheezing (shortness of breath) , salbutamol sulfate (PROAIR HFA) as needed for wheezing (shortness of breath), ascorbic acid/ferrous fumarate/folic acid/ retinol (PRENATAL, formulation: tablet) oral daily.  The patient previously took NSAIDs and voriconazole and experienced drug allergies. It was reported that the patient presented to emergency department (ED) on 04Feb2021 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine. Full viral panel including COVID-19 was not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 08Feb2021 and then VV ECMO cannulation on 13Feb2021. Acute pupil exam changes in the early am hours of 15Feb2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. The events were all serious. The patient outcome of the events was fatal. The patient died on 15Feb2021.  It was not reported if an autopsy was performed.; Sender's Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events due to temporal relationship. However, the reported event may possibly represent intercurrent medical conditions in this patient.  There is limited information provided in this report.  Additional information is needed to better assess the case, including complete medical history, diagnostics, counteractive treatment measures and concomitant medications. This case will be reassessed once additional information is available.  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: Chest x-ray shows numerous bilateral patchy opacities; Catastrophic brain bleed; Brainstem reflexes were lost; shortness of breath; nausea; Diarrhea; Worsening shortness of breath/numerous bilateral patchy opacities"
	"1051445-1"	"1051445-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"chest x-ray shows numerous bilateral patchy opacities; catastrophic brain bleed; Brainstem reflexes were lost; Patient died; shortness of breath; nausea; diarrhea; worsening shortness of breath/numerous bilateral patchy opacities; immunosuppressed status; This is a spontaneous report from a contactable pharmacist and a contactable other health professional.  A 61-year-old female patient (not pregnant) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL9261), intramuscular at arm right on 28Jan2021 (at the age of 61 years) at single dose for COVID-19 immunization.  The patient medical history included bilateral lung transplant on 23Jun2017, lymphangioleiomyomatosis, hepatocellular carcinoma, antibody mediated rejection of lung transplant , bronchiolitis obliterans syndrome, grade 0P, major depressive disorder, RLS (restless legs syndrome), chronic insomnia, long term current use of systemic steroids OSA (obstructive sleep apnea), iron deficiency anemia, bilateral sciatica, hoarseness of voice, memory change, laryngeal stridor, pure hypercholesterolemia senile nuclear cataract, bilateral myopia of both eyes, osteoporosis without current pathological fracture, alopecia, immunosuppressed status, all from an unknown date and unknown if ongoing.  Concomitant medication included acyclovir (formulation: capsule, strength: 200 mg) oral at 200 mg twice daily, salbutamol (ALBUTEROL HFA) as needed (MCG/ACT inhaler take 2 puffs by inhalation every 4 hours as needed) for wheezing (shortness of breath), atorvastatin (LIPITOR, formulation: tablet) oral at 80 mg once a day, azithromycin (ZITHROMAX, formulation: tablet)oral at 250 mg (every Monday, Wednesday, Friday), bupropion hydrochloride (WELLBUTRIN XL, formulation: tablet, strength: 150 mg) oral at 150 mg once a day, calcium citrate/cholecalciferol (CALCIUM + VITAMIN D, formulation: tablet) oral at 2 dose form once a day (every morning), everolimus (ZORTRESS, formulation: tablet, strength: 1 mg) oral at 2 mg twice a day, fluticasone propionate/salmeterol xinafoate (ADVAIR, strength: 500 ug/ 20 ug) twice daily (1 puff by inhalation), gabapentin (NEURONTIN, formulation: capsule, strength:100 mg) oral at 300 mg daily (by mouth nightly), loratadine (CLARITIN, formulation: tablet, strength: 10 mg) oral at 10 mg as needed, metoprolol tartrate (LOPRESSOR, formulation: tablet, strength: 25 mg)oral at 50 mg twice daily, minoxidil (ROGAN, strength: 5%) topical apply 1 cap full every other day to affected area on scalp for alopecia, ondansetron (ZOFRAN, formulation: tablet, strength: 4 mg) oral at 4 mg as needed for nausea, pantoprazole sodium sesquihydrate (PROTONIX, formulation: tablet, strength: 40 mg) oral at 40 mg once a day, prednisone (DELTASONE, formulation: tablet, strength: 5 mg) oral at 5 mg daily (every morning), sertraline hydrochloride (ZOLOFT, formulation: tablet, strength: 100 mg) oral at 100 mg twice a day (every morning), sulfamethoxazole/trimethoprim (BACTRIM) 400-80 mg per tablet (1 tablet by mouth every Monday, Wednesday, Friday), tacrolimus (formulation: capsule) at 3 mg daily (2 mg every morning and 1 mg at night), salbutamol sulfate (PROVENTIL HFA) as needed for wheezing (shortness of breath), salbutamol sulfate (VENTOLIN HFA) as needed for wheezing (shortness of breath) , salbutamol sulfate (PROAIR HFA) as needed for wheezing (shortness of breath), ascorbic acid/ferrous fumarate/folic acid/ retinol (PRENATAL, formulation: tablet) oral daily.  The patient previously took NSAIDs and voriconazole and experienced drug allergies. It was reported that the patient presented to emergency department (ED) on 04Feb2021 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine. Full viral panel including COVID-19 was not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 08Feb2021 and then VV ECMO cannulation on 13Feb2021. Acute pupil exam changes in the early am hours of 15Feb2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. The events were all serious. The patient outcome of the events was fatal. The patient died on 15Feb2021.  It was not reported if an autopsy was performed.; Sender's Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events due to temporal relationship. However, the reported event may possibly represent intercurrent medical conditions in this patient.  There is limited information provided in this report.  Additional information is needed to better assess the case, including complete medical history, diagnostics, counteractive treatment measures and concomitant medications. This case will be reassessed once additional information is available.  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: Chest x-ray shows numerous bilateral patchy opacities; Catastrophic brain bleed; Brainstem reflexes were lost; shortness of breath; nausea; Diarrhea; Worsening shortness of breath/numerous bilateral patchy opacities"
	"1051445-1"	"1051445-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"chest x-ray shows numerous bilateral patchy opacities; catastrophic brain bleed; Brainstem reflexes were lost; Patient died; shortness of breath; nausea; diarrhea; worsening shortness of breath/numerous bilateral patchy opacities; immunosuppressed status; This is a spontaneous report from a contactable pharmacist and a contactable other health professional.  A 61-year-old female patient (not pregnant) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL9261), intramuscular at arm right on 28Jan2021 (at the age of 61 years) at single dose for COVID-19 immunization.  The patient medical history included bilateral lung transplant on 23Jun2017, lymphangioleiomyomatosis, hepatocellular carcinoma, antibody mediated rejection of lung transplant , bronchiolitis obliterans syndrome, grade 0P, major depressive disorder, RLS (restless legs syndrome), chronic insomnia, long term current use of systemic steroids OSA (obstructive sleep apnea), iron deficiency anemia, bilateral sciatica, hoarseness of voice, memory change, laryngeal stridor, pure hypercholesterolemia senile nuclear cataract, bilateral myopia of both eyes, osteoporosis without current pathological fracture, alopecia, immunosuppressed status, all from an unknown date and unknown if ongoing.  Concomitant medication included acyclovir (formulation: capsule, strength: 200 mg) oral at 200 mg twice daily, salbutamol (ALBUTEROL HFA) as needed (MCG/ACT inhaler take 2 puffs by inhalation every 4 hours as needed) for wheezing (shortness of breath), atorvastatin (LIPITOR, formulation: tablet) oral at 80 mg once a day, azithromycin (ZITHROMAX, formulation: tablet)oral at 250 mg (every Monday, Wednesday, Friday), bupropion hydrochloride (WELLBUTRIN XL, formulation: tablet, strength: 150 mg) oral at 150 mg once a day, calcium citrate/cholecalciferol (CALCIUM + VITAMIN D, formulation: tablet) oral at 2 dose form once a day (every morning), everolimus (ZORTRESS, formulation: tablet, strength: 1 mg) oral at 2 mg twice a day, fluticasone propionate/salmeterol xinafoate (ADVAIR, strength: 500 ug/ 20 ug) twice daily (1 puff by inhalation), gabapentin (NEURONTIN, formulation: capsule, strength:100 mg) oral at 300 mg daily (by mouth nightly), loratadine (CLARITIN, formulation: tablet, strength: 10 mg) oral at 10 mg as needed, metoprolol tartrate (LOPRESSOR, formulation: tablet, strength: 25 mg)oral at 50 mg twice daily, minoxidil (ROGAN, strength: 5%) topical apply 1 cap full every other day to affected area on scalp for alopecia, ondansetron (ZOFRAN, formulation: tablet, strength: 4 mg) oral at 4 mg as needed for nausea, pantoprazole sodium sesquihydrate (PROTONIX, formulation: tablet, strength: 40 mg) oral at 40 mg once a day, prednisone (DELTASONE, formulation: tablet, strength: 5 mg) oral at 5 mg daily (every morning), sertraline hydrochloride (ZOLOFT, formulation: tablet, strength: 100 mg) oral at 100 mg twice a day (every morning), sulfamethoxazole/trimethoprim (BACTRIM) 400-80 mg per tablet (1 tablet by mouth every Monday, Wednesday, Friday), tacrolimus (formulation: capsule) at 3 mg daily (2 mg every morning and 1 mg at night), salbutamol sulfate (PROVENTIL HFA) as needed for wheezing (shortness of breath), salbutamol sulfate (VENTOLIN HFA) as needed for wheezing (shortness of breath) , salbutamol sulfate (PROAIR HFA) as needed for wheezing (shortness of breath), ascorbic acid/ferrous fumarate/folic acid/ retinol (PRENATAL, formulation: tablet) oral daily.  The patient previously took NSAIDs and voriconazole and experienced drug allergies. It was reported that the patient presented to emergency department (ED) on 04Feb2021 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine. Full viral panel including COVID-19 was not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 08Feb2021 and then VV ECMO cannulation on 13Feb2021. Acute pupil exam changes in the early am hours of 15Feb2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. The events were all serious. The patient outcome of the events was fatal. The patient died on 15Feb2021.  It was not reported if an autopsy was performed.; Sender's Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events due to temporal relationship. However, the reported event may possibly represent intercurrent medical conditions in this patient.  There is limited information provided in this report.  Additional information is needed to better assess the case, including complete medical history, diagnostics, counteractive treatment measures and concomitant medications. This case will be reassessed once additional information is available.  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: Chest x-ray shows numerous bilateral patchy opacities; Catastrophic brain bleed; Brainstem reflexes were lost; shortness of breath; nausea; Diarrhea; Worsening shortness of breath/numerous bilateral patchy opacities"
	"1051445-1"	"1051445-1"	"CULTURE"	"10061447"	"60-64 years"	"60-64"	"chest x-ray shows numerous bilateral patchy opacities; catastrophic brain bleed; Brainstem reflexes were lost; Patient died; shortness of breath; nausea; diarrhea; worsening shortness of breath/numerous bilateral patchy opacities; immunosuppressed status; This is a spontaneous report from a contactable pharmacist and a contactable other health professional.  A 61-year-old female patient (not pregnant) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL9261), intramuscular at arm right on 28Jan2021 (at the age of 61 years) at single dose for COVID-19 immunization.  The patient medical history included bilateral lung transplant on 23Jun2017, lymphangioleiomyomatosis, hepatocellular carcinoma, antibody mediated rejection of lung transplant , bronchiolitis obliterans syndrome, grade 0P, major depressive disorder, RLS (restless legs syndrome), chronic insomnia, long term current use of systemic steroids OSA (obstructive sleep apnea), iron deficiency anemia, bilateral sciatica, hoarseness of voice, memory change, laryngeal stridor, pure hypercholesterolemia senile nuclear cataract, bilateral myopia of both eyes, osteoporosis without current pathological fracture, alopecia, immunosuppressed status, all from an unknown date and unknown if ongoing.  Concomitant medication included acyclovir (formulation: capsule, strength: 200 mg) oral at 200 mg twice daily, salbutamol (ALBUTEROL HFA) as needed (MCG/ACT inhaler take 2 puffs by inhalation every 4 hours as needed) for wheezing (shortness of breath), atorvastatin (LIPITOR, formulation: tablet) oral at 80 mg once a day, azithromycin (ZITHROMAX, formulation: tablet)oral at 250 mg (every Monday, Wednesday, Friday), bupropion hydrochloride (WELLBUTRIN XL, formulation: tablet, strength: 150 mg) oral at 150 mg once a day, calcium citrate/cholecalciferol (CALCIUM + VITAMIN D, formulation: tablet) oral at 2 dose form once a day (every morning), everolimus (ZORTRESS, formulation: tablet, strength: 1 mg) oral at 2 mg twice a day, fluticasone propionate/salmeterol xinafoate (ADVAIR, strength: 500 ug/ 20 ug) twice daily (1 puff by inhalation), gabapentin (NEURONTIN, formulation: capsule, strength:100 mg) oral at 300 mg daily (by mouth nightly), loratadine (CLARITIN, formulation: tablet, strength: 10 mg) oral at 10 mg as needed, metoprolol tartrate (LOPRESSOR, formulation: tablet, strength: 25 mg)oral at 50 mg twice daily, minoxidil (ROGAN, strength: 5%) topical apply 1 cap full every other day to affected area on scalp for alopecia, ondansetron (ZOFRAN, formulation: tablet, strength: 4 mg) oral at 4 mg as needed for nausea, pantoprazole sodium sesquihydrate (PROTONIX, formulation: tablet, strength: 40 mg) oral at 40 mg once a day, prednisone (DELTASONE, formulation: tablet, strength: 5 mg) oral at 5 mg daily (every morning), sertraline hydrochloride (ZOLOFT, formulation: tablet, strength: 100 mg) oral at 100 mg twice a day (every morning), sulfamethoxazole/trimethoprim (BACTRIM) 400-80 mg per tablet (1 tablet by mouth every Monday, Wednesday, Friday), tacrolimus (formulation: capsule) at 3 mg daily (2 mg every morning and 1 mg at night), salbutamol sulfate (PROVENTIL HFA) as needed for wheezing (shortness of breath), salbutamol sulfate (VENTOLIN HFA) as needed for wheezing (shortness of breath) , salbutamol sulfate (PROAIR HFA) as needed for wheezing (shortness of breath), ascorbic acid/ferrous fumarate/folic acid/ retinol (PRENATAL, formulation: tablet) oral daily.  The patient previously took NSAIDs and voriconazole and experienced drug allergies. It was reported that the patient presented to emergency department (ED) on 04Feb2021 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine. Full viral panel including COVID-19 was not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 08Feb2021 and then VV ECMO cannulation on 13Feb2021. Acute pupil exam changes in the early am hours of 15Feb2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. The events were all serious. The patient outcome of the events was fatal. The patient died on 15Feb2021.  It was not reported if an autopsy was performed.; Sender's Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events due to temporal relationship. However, the reported event may possibly represent intercurrent medical conditions in this patient.  There is limited information provided in this report.  Additional information is needed to better assess the case, including complete medical history, diagnostics, counteractive treatment measures and concomitant medications. This case will be reassessed once additional information is available.  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: Chest x-ray shows numerous bilateral patchy opacities; Catastrophic brain bleed; Brainstem reflexes were lost; shortness of breath; nausea; Diarrhea; Worsening shortness of breath/numerous bilateral patchy opacities"
	"1051445-1"	"1051445-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"chest x-ray shows numerous bilateral patchy opacities; catastrophic brain bleed; Brainstem reflexes were lost; Patient died; shortness of breath; nausea; diarrhea; worsening shortness of breath/numerous bilateral patchy opacities; immunosuppressed status; This is a spontaneous report from a contactable pharmacist and a contactable other health professional.  A 61-year-old female patient (not pregnant) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL9261), intramuscular at arm right on 28Jan2021 (at the age of 61 years) at single dose for COVID-19 immunization.  The patient medical history included bilateral lung transplant on 23Jun2017, lymphangioleiomyomatosis, hepatocellular carcinoma, antibody mediated rejection of lung transplant , bronchiolitis obliterans syndrome, grade 0P, major depressive disorder, RLS (restless legs syndrome), chronic insomnia, long term current use of systemic steroids OSA (obstructive sleep apnea), iron deficiency anemia, bilateral sciatica, hoarseness of voice, memory change, laryngeal stridor, pure hypercholesterolemia senile nuclear cataract, bilateral myopia of both eyes, osteoporosis without current pathological fracture, alopecia, immunosuppressed status, all from an unknown date and unknown if ongoing.  Concomitant medication included acyclovir (formulation: capsule, strength: 200 mg) oral at 200 mg twice daily, salbutamol (ALBUTEROL HFA) as needed (MCG/ACT inhaler take 2 puffs by inhalation every 4 hours as needed) for wheezing (shortness of breath), atorvastatin (LIPITOR, formulation: tablet) oral at 80 mg once a day, azithromycin (ZITHROMAX, formulation: tablet)oral at 250 mg (every Monday, Wednesday, Friday), bupropion hydrochloride (WELLBUTRIN XL, formulation: tablet, strength: 150 mg) oral at 150 mg once a day, calcium citrate/cholecalciferol (CALCIUM + VITAMIN D, formulation: tablet) oral at 2 dose form once a day (every morning), everolimus (ZORTRESS, formulation: tablet, strength: 1 mg) oral at 2 mg twice a day, fluticasone propionate/salmeterol xinafoate (ADVAIR, strength: 500 ug/ 20 ug) twice daily (1 puff by inhalation), gabapentin (NEURONTIN, formulation: capsule, strength:100 mg) oral at 300 mg daily (by mouth nightly), loratadine (CLARITIN, formulation: tablet, strength: 10 mg) oral at 10 mg as needed, metoprolol tartrate (LOPRESSOR, formulation: tablet, strength: 25 mg)oral at 50 mg twice daily, minoxidil (ROGAN, strength: 5%) topical apply 1 cap full every other day to affected area on scalp for alopecia, ondansetron (ZOFRAN, formulation: tablet, strength: 4 mg) oral at 4 mg as needed for nausea, pantoprazole sodium sesquihydrate (PROTONIX, formulation: tablet, strength: 40 mg) oral at 40 mg once a day, prednisone (DELTASONE, formulation: tablet, strength: 5 mg) oral at 5 mg daily (every morning), sertraline hydrochloride (ZOLOFT, formulation: tablet, strength: 100 mg) oral at 100 mg twice a day (every morning), sulfamethoxazole/trimethoprim (BACTRIM) 400-80 mg per tablet (1 tablet by mouth every Monday, Wednesday, Friday), tacrolimus (formulation: capsule) at 3 mg daily (2 mg every morning and 1 mg at night), salbutamol sulfate (PROVENTIL HFA) as needed for wheezing (shortness of breath), salbutamol sulfate (VENTOLIN HFA) as needed for wheezing (shortness of breath) , salbutamol sulfate (PROAIR HFA) as needed for wheezing (shortness of breath), ascorbic acid/ferrous fumarate/folic acid/ retinol (PRENATAL, formulation: tablet) oral daily.  The patient previously took NSAIDs and voriconazole and experienced drug allergies. It was reported that the patient presented to emergency department (ED) on 04Feb2021 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine. Full viral panel including COVID-19 was not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 08Feb2021 and then VV ECMO cannulation on 13Feb2021. Acute pupil exam changes in the early am hours of 15Feb2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. The events were all serious. The patient outcome of the events was fatal. The patient died on 15Feb2021.  It was not reported if an autopsy was performed.; Sender's Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events due to temporal relationship. However, the reported event may possibly represent intercurrent medical conditions in this patient.  There is limited information provided in this report.  Additional information is needed to better assess the case, including complete medical history, diagnostics, counteractive treatment measures and concomitant medications. This case will be reassessed once additional information is available.  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: Chest x-ray shows numerous bilateral patchy opacities; Catastrophic brain bleed; Brainstem reflexes were lost; shortness of breath; nausea; Diarrhea; Worsening shortness of breath/numerous bilateral patchy opacities"
	"1051445-1"	"1051445-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"chest x-ray shows numerous bilateral patchy opacities; catastrophic brain bleed; Brainstem reflexes were lost; Patient died; shortness of breath; nausea; diarrhea; worsening shortness of breath/numerous bilateral patchy opacities; immunosuppressed status; This is a spontaneous report from a contactable pharmacist and a contactable other health professional.  A 61-year-old female patient (not pregnant) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL9261), intramuscular at arm right on 28Jan2021 (at the age of 61 years) at single dose for COVID-19 immunization.  The patient medical history included bilateral lung transplant on 23Jun2017, lymphangioleiomyomatosis, hepatocellular carcinoma, antibody mediated rejection of lung transplant , bronchiolitis obliterans syndrome, grade 0P, major depressive disorder, RLS (restless legs syndrome), chronic insomnia, long term current use of systemic steroids OSA (obstructive sleep apnea), iron deficiency anemia, bilateral sciatica, hoarseness of voice, memory change, laryngeal stridor, pure hypercholesterolemia senile nuclear cataract, bilateral myopia of both eyes, osteoporosis without current pathological fracture, alopecia, immunosuppressed status, all from an unknown date and unknown if ongoing.  Concomitant medication included acyclovir (formulation: capsule, strength: 200 mg) oral at 200 mg twice daily, salbutamol (ALBUTEROL HFA) as needed (MCG/ACT inhaler take 2 puffs by inhalation every 4 hours as needed) for wheezing (shortness of breath), atorvastatin (LIPITOR, formulation: tablet) oral at 80 mg once a day, azithromycin (ZITHROMAX, formulation: tablet)oral at 250 mg (every Monday, Wednesday, Friday), bupropion hydrochloride (WELLBUTRIN XL, formulation: tablet, strength: 150 mg) oral at 150 mg once a day, calcium citrate/cholecalciferol (CALCIUM + VITAMIN D, formulation: tablet) oral at 2 dose form once a day (every morning), everolimus (ZORTRESS, formulation: tablet, strength: 1 mg) oral at 2 mg twice a day, fluticasone propionate/salmeterol xinafoate (ADVAIR, strength: 500 ug/ 20 ug) twice daily (1 puff by inhalation), gabapentin (NEURONTIN, formulation: capsule, strength:100 mg) oral at 300 mg daily (by mouth nightly), loratadine (CLARITIN, formulation: tablet, strength: 10 mg) oral at 10 mg as needed, metoprolol tartrate (LOPRESSOR, formulation: tablet, strength: 25 mg)oral at 50 mg twice daily, minoxidil (ROGAN, strength: 5%) topical apply 1 cap full every other day to affected area on scalp for alopecia, ondansetron (ZOFRAN, formulation: tablet, strength: 4 mg) oral at 4 mg as needed for nausea, pantoprazole sodium sesquihydrate (PROTONIX, formulation: tablet, strength: 40 mg) oral at 40 mg once a day, prednisone (DELTASONE, formulation: tablet, strength: 5 mg) oral at 5 mg daily (every morning), sertraline hydrochloride (ZOLOFT, formulation: tablet, strength: 100 mg) oral at 100 mg twice a day (every morning), sulfamethoxazole/trimethoprim (BACTRIM) 400-80 mg per tablet (1 tablet by mouth every Monday, Wednesday, Friday), tacrolimus (formulation: capsule) at 3 mg daily (2 mg every morning and 1 mg at night), salbutamol sulfate (PROVENTIL HFA) as needed for wheezing (shortness of breath), salbutamol sulfate (VENTOLIN HFA) as needed for wheezing (shortness of breath) , salbutamol sulfate (PROAIR HFA) as needed for wheezing (shortness of breath), ascorbic acid/ferrous fumarate/folic acid/ retinol (PRENATAL, formulation: tablet) oral daily.  The patient previously took NSAIDs and voriconazole and experienced drug allergies. It was reported that the patient presented to emergency department (ED) on 04Feb2021 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine. Full viral panel including COVID-19 was not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 08Feb2021 and then VV ECMO cannulation on 13Feb2021. Acute pupil exam changes in the early am hours of 15Feb2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. The events were all serious. The patient outcome of the events was fatal. The patient died on 15Feb2021.  It was not reported if an autopsy was performed.; Sender's Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events due to temporal relationship. However, the reported event may possibly represent intercurrent medical conditions in this patient.  There is limited information provided in this report.  Additional information is needed to better assess the case, including complete medical history, diagnostics, counteractive treatment measures and concomitant medications. This case will be reassessed once additional information is available.  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: Chest x-ray shows numerous bilateral patchy opacities; Catastrophic brain bleed; Brainstem reflexes were lost; shortness of breath; nausea; Diarrhea; Worsening shortness of breath/numerous bilateral patchy opacities"
	"1051445-1"	"1051445-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"chest x-ray shows numerous bilateral patchy opacities; catastrophic brain bleed; Brainstem reflexes were lost; Patient died; shortness of breath; nausea; diarrhea; worsening shortness of breath/numerous bilateral patchy opacities; immunosuppressed status; This is a spontaneous report from a contactable pharmacist and a contactable other health professional.  A 61-year-old female patient (not pregnant) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL9261), intramuscular at arm right on 28Jan2021 (at the age of 61 years) at single dose for COVID-19 immunization.  The patient medical history included bilateral lung transplant on 23Jun2017, lymphangioleiomyomatosis, hepatocellular carcinoma, antibody mediated rejection of lung transplant , bronchiolitis obliterans syndrome, grade 0P, major depressive disorder, RLS (restless legs syndrome), chronic insomnia, long term current use of systemic steroids OSA (obstructive sleep apnea), iron deficiency anemia, bilateral sciatica, hoarseness of voice, memory change, laryngeal stridor, pure hypercholesterolemia senile nuclear cataract, bilateral myopia of both eyes, osteoporosis without current pathological fracture, alopecia, immunosuppressed status, all from an unknown date and unknown if ongoing.  Concomitant medication included acyclovir (formulation: capsule, strength: 200 mg) oral at 200 mg twice daily, salbutamol (ALBUTEROL HFA) as needed (MCG/ACT inhaler take 2 puffs by inhalation every 4 hours as needed) for wheezing (shortness of breath), atorvastatin (LIPITOR, formulation: tablet) oral at 80 mg once a day, azithromycin (ZITHROMAX, formulation: tablet)oral at 250 mg (every Monday, Wednesday, Friday), bupropion hydrochloride (WELLBUTRIN XL, formulation: tablet, strength: 150 mg) oral at 150 mg once a day, calcium citrate/cholecalciferol (CALCIUM + VITAMIN D, formulation: tablet) oral at 2 dose form once a day (every morning), everolimus (ZORTRESS, formulation: tablet, strength: 1 mg) oral at 2 mg twice a day, fluticasone propionate/salmeterol xinafoate (ADVAIR, strength: 500 ug/ 20 ug) twice daily (1 puff by inhalation), gabapentin (NEURONTIN, formulation: capsule, strength:100 mg) oral at 300 mg daily (by mouth nightly), loratadine (CLARITIN, formulation: tablet, strength: 10 mg) oral at 10 mg as needed, metoprolol tartrate (LOPRESSOR, formulation: tablet, strength: 25 mg)oral at 50 mg twice daily, minoxidil (ROGAN, strength: 5%) topical apply 1 cap full every other day to affected area on scalp for alopecia, ondansetron (ZOFRAN, formulation: tablet, strength: 4 mg) oral at 4 mg as needed for nausea, pantoprazole sodium sesquihydrate (PROTONIX, formulation: tablet, strength: 40 mg) oral at 40 mg once a day, prednisone (DELTASONE, formulation: tablet, strength: 5 mg) oral at 5 mg daily (every morning), sertraline hydrochloride (ZOLOFT, formulation: tablet, strength: 100 mg) oral at 100 mg twice a day (every morning), sulfamethoxazole/trimethoprim (BACTRIM) 400-80 mg per tablet (1 tablet by mouth every Monday, Wednesday, Friday), tacrolimus (formulation: capsule) at 3 mg daily (2 mg every morning and 1 mg at night), salbutamol sulfate (PROVENTIL HFA) as needed for wheezing (shortness of breath), salbutamol sulfate (VENTOLIN HFA) as needed for wheezing (shortness of breath) , salbutamol sulfate (PROAIR HFA) as needed for wheezing (shortness of breath), ascorbic acid/ferrous fumarate/folic acid/ retinol (PRENATAL, formulation: tablet) oral daily.  The patient previously took NSAIDs and voriconazole and experienced drug allergies. It was reported that the patient presented to emergency department (ED) on 04Feb2021 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine. Full viral panel including COVID-19 was not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 08Feb2021 and then VV ECMO cannulation on 13Feb2021. Acute pupil exam changes in the early am hours of 15Feb2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. The events were all serious. The patient outcome of the events was fatal. The patient died on 15Feb2021.  It was not reported if an autopsy was performed.; Sender's Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events due to temporal relationship. However, the reported event may possibly represent intercurrent medical conditions in this patient.  There is limited information provided in this report.  Additional information is needed to better assess the case, including complete medical history, diagnostics, counteractive treatment measures and concomitant medications. This case will be reassessed once additional information is available.  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: Chest x-ray shows numerous bilateral patchy opacities; Catastrophic brain bleed; Brainstem reflexes were lost; shortness of breath; nausea; Diarrhea; Worsening shortness of breath/numerous bilateral patchy opacities"
	"1051445-1"	"1051445-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"chest x-ray shows numerous bilateral patchy opacities; catastrophic brain bleed; Brainstem reflexes were lost; Patient died; shortness of breath; nausea; diarrhea; worsening shortness of breath/numerous bilateral patchy opacities; immunosuppressed status; This is a spontaneous report from a contactable pharmacist and a contactable other health professional.  A 61-year-old female patient (not pregnant) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL9261), intramuscular at arm right on 28Jan2021 (at the age of 61 years) at single dose for COVID-19 immunization.  The patient medical history included bilateral lung transplant on 23Jun2017, lymphangioleiomyomatosis, hepatocellular carcinoma, antibody mediated rejection of lung transplant , bronchiolitis obliterans syndrome, grade 0P, major depressive disorder, RLS (restless legs syndrome), chronic insomnia, long term current use of systemic steroids OSA (obstructive sleep apnea), iron deficiency anemia, bilateral sciatica, hoarseness of voice, memory change, laryngeal stridor, pure hypercholesterolemia senile nuclear cataract, bilateral myopia of both eyes, osteoporosis without current pathological fracture, alopecia, immunosuppressed status, all from an unknown date and unknown if ongoing.  Concomitant medication included acyclovir (formulation: capsule, strength: 200 mg) oral at 200 mg twice daily, salbutamol (ALBUTEROL HFA) as needed (MCG/ACT inhaler take 2 puffs by inhalation every 4 hours as needed) for wheezing (shortness of breath), atorvastatin (LIPITOR, formulation: tablet) oral at 80 mg once a day, azithromycin (ZITHROMAX, formulation: tablet)oral at 250 mg (every Monday, Wednesday, Friday), bupropion hydrochloride (WELLBUTRIN XL, formulation: tablet, strength: 150 mg) oral at 150 mg once a day, calcium citrate/cholecalciferol (CALCIUM + VITAMIN D, formulation: tablet) oral at 2 dose form once a day (every morning), everolimus (ZORTRESS, formulation: tablet, strength: 1 mg) oral at 2 mg twice a day, fluticasone propionate/salmeterol xinafoate (ADVAIR, strength: 500 ug/ 20 ug) twice daily (1 puff by inhalation), gabapentin (NEURONTIN, formulation: capsule, strength:100 mg) oral at 300 mg daily (by mouth nightly), loratadine (CLARITIN, formulation: tablet, strength: 10 mg) oral at 10 mg as needed, metoprolol tartrate (LOPRESSOR, formulation: tablet, strength: 25 mg)oral at 50 mg twice daily, minoxidil (ROGAN, strength: 5%) topical apply 1 cap full every other day to affected area on scalp for alopecia, ondansetron (ZOFRAN, formulation: tablet, strength: 4 mg) oral at 4 mg as needed for nausea, pantoprazole sodium sesquihydrate (PROTONIX, formulation: tablet, strength: 40 mg) oral at 40 mg once a day, prednisone (DELTASONE, formulation: tablet, strength: 5 mg) oral at 5 mg daily (every morning), sertraline hydrochloride (ZOLOFT, formulation: tablet, strength: 100 mg) oral at 100 mg twice a day (every morning), sulfamethoxazole/trimethoprim (BACTRIM) 400-80 mg per tablet (1 tablet by mouth every Monday, Wednesday, Friday), tacrolimus (formulation: capsule) at 3 mg daily (2 mg every morning and 1 mg at night), salbutamol sulfate (PROVENTIL HFA) as needed for wheezing (shortness of breath), salbutamol sulfate (VENTOLIN HFA) as needed for wheezing (shortness of breath) , salbutamol sulfate (PROAIR HFA) as needed for wheezing (shortness of breath), ascorbic acid/ferrous fumarate/folic acid/ retinol (PRENATAL, formulation: tablet) oral daily.  The patient previously took NSAIDs and voriconazole and experienced drug allergies. It was reported that the patient presented to emergency department (ED) on 04Feb2021 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine. Full viral panel including COVID-19 was not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 08Feb2021 and then VV ECMO cannulation on 13Feb2021. Acute pupil exam changes in the early am hours of 15Feb2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. The events were all serious. The patient outcome of the events was fatal. The patient died on 15Feb2021.  It was not reported if an autopsy was performed.; Sender's Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events due to temporal relationship. However, the reported event may possibly represent intercurrent medical conditions in this patient.  There is limited information provided in this report.  Additional information is needed to better assess the case, including complete medical history, diagnostics, counteractive treatment measures and concomitant medications. This case will be reassessed once additional information is available.  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: Chest x-ray shows numerous bilateral patchy opacities; Catastrophic brain bleed; Brainstem reflexes were lost; shortness of breath; nausea; Diarrhea; Worsening shortness of breath/numerous bilateral patchy opacities"
	"1051445-1"	"1051445-1"	"PRODUCT USE ISSUE"	"10076309"	"60-64 years"	"60-64"	"chest x-ray shows numerous bilateral patchy opacities; catastrophic brain bleed; Brainstem reflexes were lost; Patient died; shortness of breath; nausea; diarrhea; worsening shortness of breath/numerous bilateral patchy opacities; immunosuppressed status; This is a spontaneous report from a contactable pharmacist and a contactable other health professional.  A 61-year-old female patient (not pregnant) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL9261), intramuscular at arm right on 28Jan2021 (at the age of 61 years) at single dose for COVID-19 immunization.  The patient medical history included bilateral lung transplant on 23Jun2017, lymphangioleiomyomatosis, hepatocellular carcinoma, antibody mediated rejection of lung transplant , bronchiolitis obliterans syndrome, grade 0P, major depressive disorder, RLS (restless legs syndrome), chronic insomnia, long term current use of systemic steroids OSA (obstructive sleep apnea), iron deficiency anemia, bilateral sciatica, hoarseness of voice, memory change, laryngeal stridor, pure hypercholesterolemia senile nuclear cataract, bilateral myopia of both eyes, osteoporosis without current pathological fracture, alopecia, immunosuppressed status, all from an unknown date and unknown if ongoing.  Concomitant medication included acyclovir (formulation: capsule, strength: 200 mg) oral at 200 mg twice daily, salbutamol (ALBUTEROL HFA) as needed (MCG/ACT inhaler take 2 puffs by inhalation every 4 hours as needed) for wheezing (shortness of breath), atorvastatin (LIPITOR, formulation: tablet) oral at 80 mg once a day, azithromycin (ZITHROMAX, formulation: tablet)oral at 250 mg (every Monday, Wednesday, Friday), bupropion hydrochloride (WELLBUTRIN XL, formulation: tablet, strength: 150 mg) oral at 150 mg once a day, calcium citrate/cholecalciferol (CALCIUM + VITAMIN D, formulation: tablet) oral at 2 dose form once a day (every morning), everolimus (ZORTRESS, formulation: tablet, strength: 1 mg) oral at 2 mg twice a day, fluticasone propionate/salmeterol xinafoate (ADVAIR, strength: 500 ug/ 20 ug) twice daily (1 puff by inhalation), gabapentin (NEURONTIN, formulation: capsule, strength:100 mg) oral at 300 mg daily (by mouth nightly), loratadine (CLARITIN, formulation: tablet, strength: 10 mg) oral at 10 mg as needed, metoprolol tartrate (LOPRESSOR, formulation: tablet, strength: 25 mg)oral at 50 mg twice daily, minoxidil (ROGAN, strength: 5%) topical apply 1 cap full every other day to affected area on scalp for alopecia, ondansetron (ZOFRAN, formulation: tablet, strength: 4 mg) oral at 4 mg as needed for nausea, pantoprazole sodium sesquihydrate (PROTONIX, formulation: tablet, strength: 40 mg) oral at 40 mg once a day, prednisone (DELTASONE, formulation: tablet, strength: 5 mg) oral at 5 mg daily (every morning), sertraline hydrochloride (ZOLOFT, formulation: tablet, strength: 100 mg) oral at 100 mg twice a day (every morning), sulfamethoxazole/trimethoprim (BACTRIM) 400-80 mg per tablet (1 tablet by mouth every Monday, Wednesday, Friday), tacrolimus (formulation: capsule) at 3 mg daily (2 mg every morning and 1 mg at night), salbutamol sulfate (PROVENTIL HFA) as needed for wheezing (shortness of breath), salbutamol sulfate (VENTOLIN HFA) as needed for wheezing (shortness of breath) , salbutamol sulfate (PROAIR HFA) as needed for wheezing (shortness of breath), ascorbic acid/ferrous fumarate/folic acid/ retinol (PRENATAL, formulation: tablet) oral daily.  The patient previously took NSAIDs and voriconazole and experienced drug allergies. It was reported that the patient presented to emergency department (ED) on 04Feb2021 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine. Full viral panel including COVID-19 was not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 08Feb2021 and then VV ECMO cannulation on 13Feb2021. Acute pupil exam changes in the early am hours of 15Feb2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. The events were all serious. The patient outcome of the events was fatal. The patient died on 15Feb2021.  It was not reported if an autopsy was performed.; Sender's Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events due to temporal relationship. However, the reported event may possibly represent intercurrent medical conditions in this patient.  There is limited information provided in this report.  Additional information is needed to better assess the case, including complete medical history, diagnostics, counteractive treatment measures and concomitant medications. This case will be reassessed once additional information is available.  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: Chest x-ray shows numerous bilateral patchy opacities; Catastrophic brain bleed; Brainstem reflexes were lost; shortness of breath; nausea; Diarrhea; Worsening shortness of breath/numerous bilateral patchy opacities"
	"1051445-1"	"1051445-1"	"SARS-COV-2 TEST"	"10084354"	"60-64 years"	"60-64"	"chest x-ray shows numerous bilateral patchy opacities; catastrophic brain bleed; Brainstem reflexes were lost; Patient died; shortness of breath; nausea; diarrhea; worsening shortness of breath/numerous bilateral patchy opacities; immunosuppressed status; This is a spontaneous report from a contactable pharmacist and a contactable other health professional.  A 61-year-old female patient (not pregnant) received first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, lot number: EL9261), intramuscular at arm right on 28Jan2021 (at the age of 61 years) at single dose for COVID-19 immunization.  The patient medical history included bilateral lung transplant on 23Jun2017, lymphangioleiomyomatosis, hepatocellular carcinoma, antibody mediated rejection of lung transplant , bronchiolitis obliterans syndrome, grade 0P, major depressive disorder, RLS (restless legs syndrome), chronic insomnia, long term current use of systemic steroids OSA (obstructive sleep apnea), iron deficiency anemia, bilateral sciatica, hoarseness of voice, memory change, laryngeal stridor, pure hypercholesterolemia senile nuclear cataract, bilateral myopia of both eyes, osteoporosis without current pathological fracture, alopecia, immunosuppressed status, all from an unknown date and unknown if ongoing.  Concomitant medication included acyclovir (formulation: capsule, strength: 200 mg) oral at 200 mg twice daily, salbutamol (ALBUTEROL HFA) as needed (MCG/ACT inhaler take 2 puffs by inhalation every 4 hours as needed) for wheezing (shortness of breath), atorvastatin (LIPITOR, formulation: tablet) oral at 80 mg once a day, azithromycin (ZITHROMAX, formulation: tablet)oral at 250 mg (every Monday, Wednesday, Friday), bupropion hydrochloride (WELLBUTRIN XL, formulation: tablet, strength: 150 mg) oral at 150 mg once a day, calcium citrate/cholecalciferol (CALCIUM + VITAMIN D, formulation: tablet) oral at 2 dose form once a day (every morning), everolimus (ZORTRESS, formulation: tablet, strength: 1 mg) oral at 2 mg twice a day, fluticasone propionate/salmeterol xinafoate (ADVAIR, strength: 500 ug/ 20 ug) twice daily (1 puff by inhalation), gabapentin (NEURONTIN, formulation: capsule, strength:100 mg) oral at 300 mg daily (by mouth nightly), loratadine (CLARITIN, formulation: tablet, strength: 10 mg) oral at 10 mg as needed, metoprolol tartrate (LOPRESSOR, formulation: tablet, strength: 25 mg)oral at 50 mg twice daily, minoxidil (ROGAN, strength: 5%) topical apply 1 cap full every other day to affected area on scalp for alopecia, ondansetron (ZOFRAN, formulation: tablet, strength: 4 mg) oral at 4 mg as needed for nausea, pantoprazole sodium sesquihydrate (PROTONIX, formulation: tablet, strength: 40 mg) oral at 40 mg once a day, prednisone (DELTASONE, formulation: tablet, strength: 5 mg) oral at 5 mg daily (every morning), sertraline hydrochloride (ZOLOFT, formulation: tablet, strength: 100 mg) oral at 100 mg twice a day (every morning), sulfamethoxazole/trimethoprim (BACTRIM) 400-80 mg per tablet (1 tablet by mouth every Monday, Wednesday, Friday), tacrolimus (formulation: capsule) at 3 mg daily (2 mg every morning and 1 mg at night), salbutamol sulfate (PROVENTIL HFA) as needed for wheezing (shortness of breath), salbutamol sulfate (VENTOLIN HFA) as needed for wheezing (shortness of breath) , salbutamol sulfate (PROAIR HFA) as needed for wheezing (shortness of breath), ascorbic acid/ferrous fumarate/folic acid/ retinol (PRENATAL, formulation: tablet) oral daily.  The patient previously took NSAIDs and voriconazole and experienced drug allergies. It was reported that the patient presented to emergency department (ED) on 04Feb2021 with chief complaint of worsening shortness of breath, nausea and diarrhea for past week since receiving since receiving COVID-19 vaccine. Full viral panel including COVID-19 was not detected. All blood cultures and respiratory cultures were negative. Patient chest x-ray shows numerous bilateral patchy opacities which is significantly different from her previous chest x-ray here. Empiric rejection treatment initiated including high dose methylprednisolone, plasmapheresis, IVIG, thymoglobulin. She continued to decline and ultimately required intubation, proning and paralyzing on 08Feb2021 and then VV ECMO cannulation on 13Feb2021. Acute pupil exam changes in the early am hours of 15Feb2021 prompted urgent head CT which revealed catastrophic brain bleed. Brainstem reflexes were lost soon after. Despite placing an EVD emergently at bedside, brain stem reflexes were not recovered. The events were all serious. The patient outcome of the events was fatal. The patient died on 15Feb2021.  It was not reported if an autopsy was performed.; Sender's Comments: Based on available information, a possible contributory role of the subject product, BNT162B2 vaccine, cannot be excluded for the reported events due to temporal relationship. However, the reported event may possibly represent intercurrent medical conditions in this patient.  There is limited information provided in this report.  Additional information is needed to better assess the case, including complete medical history, diagnostics, counteractive treatment measures and concomitant medications. This case will be reassessed once additional information is available.  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: Chest x-ray shows numerous bilateral patchy opacities; Catastrophic brain bleed; Brainstem reflexes were lost; shortness of breath; nausea; Diarrhea; Worsening shortness of breath/numerous bilateral patchy opacities"
	"1052226-1"	"1052226-1"	"CYANOSIS"	"10011703"	"60-64 years"	"60-64"	"Patient discovered unresponsive in cell, blue coloration to skin, vital signs, undetectable.  CPR initiated, Ambulance summoned.  Following EMS arrival with additional unsuccessful attempts to revive patient, patient was determined to have expired."
	"1052226-1"	"1052226-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient discovered unresponsive in cell, blue coloration to skin, vital signs, undetectable.  CPR initiated, Ambulance summoned.  Following EMS arrival with additional unsuccessful attempts to revive patient, patient was determined to have expired."
	"1052226-1"	"1052226-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Patient discovered unresponsive in cell, blue coloration to skin, vital signs, undetectable.  CPR initiated, Ambulance summoned.  Following EMS arrival with additional unsuccessful attempts to revive patient, patient was determined to have expired."
	"1052226-1"	"1052226-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Patient discovered unresponsive in cell, blue coloration to skin, vital signs, undetectable.  CPR initiated, Ambulance summoned.  Following EMS arrival with additional unsuccessful attempts to revive patient, patient was determined to have expired."
	"1053694-1"	"1053694-1"	"SUDDEN DEATH"	"10042434"	"60-64 years"	"60-64"	"Sudden Death on 2/17/2021"
	"1057853-1"	"1057853-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"on 2/218/2021 the patient was at home and developed chest pain. Patient was transported by family to urgent care then to the ED where the patient later died."
	"1057853-1"	"1057853-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"on 2/218/2021 the patient was at home and developed chest pain. Patient was transported by family to urgent care then to the ED where the patient later died."
	"1060858-1"	"1060858-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"had lack of appetite before second dose. When received the second dose, he started vomiting on the way home. Was sick on and off for the next few days. Died suddenly on 2/23/2021"
	"1060858-1"	"1060858-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"had lack of appetite before second dose. When received the second dose, he started vomiting on the way home. Was sick on and off for the next few days. Died suddenly on 2/23/2021"
	"1060858-1"	"1060858-1"	"DECREASED APPETITE"	"10061428"	"60-64 years"	"60-64"	"had lack of appetite before second dose. When received the second dose, he started vomiting on the way home. Was sick on and off for the next few days. Died suddenly on 2/23/2021"
	"1060858-1"	"1060858-1"	"SUDDEN DEATH"	"10042434"	"60-64 years"	"60-64"	"had lack of appetite before second dose. When received the second dose, he started vomiting on the way home. Was sick on and off for the next few days. Died suddenly on 2/23/2021"
	"1060858-1"	"1060858-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"had lack of appetite before second dose. When received the second dose, he started vomiting on the way home. Was sick on and off for the next few days. Died suddenly on 2/23/2021"
	"1062550-1"	"1062550-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient's daughter called to report that about 30 hours after receiving the vaccine he passed away at home. She said she didn't know the cause of death but she felt like she should let us know about it."
	"1062962-1"	"1062962-1"	"BLOOD CREATININE INCREASED"	"10005483"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"BLOOD CULTURE NEGATIVE"	"10005486"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"BLOOD UREA INCREASED"	"10005851"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"BRAIN NATRIURETIC PEPTIDE INCREASED"	"10053405"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"CULTURE THROAT NEGATIVE"	"10011633"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"IMMUNOGLOBULIN THERAPY"	"10069534"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"LUNG OPACITY"	"10081792"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"OESOPHAGOGASTRODUODENOSCOPY"	"10053057"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"PARALYSIS"	"10033799"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"PROCALCITONIN INCREASED"	"10067081"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"PUPILLARY LIGHT REFLEX TESTS"	"10037524"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"TROPONIN INCREASED"	"10058267"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"VENTRICULAR DRAINAGE"	"10052947"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1062962-1"	"1062962-1"	"WHITE BLOOD CELL COUNT INCREASED"	"10047943"	"60-64 years"	"60-64"	"[COVID-19 mRNA vaccine (Pfizer-BioNtech] treatment under Emergency Use Authorization (EUA)"
	"1063201-1"	"1063201-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"The recipient was feeling well immediately after the vaccination,  all day on 2.8 and in the morning of 2.9.  His daughter in law text him at 0930 and he did not respond to the text (atypical) and then he missed a morning meeting.  His wife was downstairs in a meeting herself and after the meeting was over she called to him and he did not respond.  She found him with no pulse and was not breathing.  She called 911 and attempted CPR.  They did not complete an autopsy, they stated that they believe the cause of death was either an embolism, Heart attack or aneurism.   The wife stated that she does not believe the death was due to the vaccination; however, there were no tests completed to prove or disprove."
	"1063201-1"	"1063201-1"	"PULSE ABSENT"	"10037469"	"60-64 years"	"60-64"	"The recipient was feeling well immediately after the vaccination,  all day on 2.8 and in the morning of 2.9.  His daughter in law text him at 0930 and he did not respond to the text (atypical) and then he missed a morning meeting.  His wife was downstairs in a meeting herself and after the meeting was over she called to him and he did not respond.  She found him with no pulse and was not breathing.  She called 911 and attempted CPR.  They did not complete an autopsy, they stated that they believe the cause of death was either an embolism, Heart attack or aneurism.   The wife stated that she does not believe the death was due to the vaccination; however, there were no tests completed to prove or disprove."
	"1063201-1"	"1063201-1"	"RESPIRATORY ARREST"	"10038669"	"60-64 years"	"60-64"	"The recipient was feeling well immediately after the vaccination,  all day on 2.8 and in the morning of 2.9.  His daughter in law text him at 0930 and he did not respond to the text (atypical) and then he missed a morning meeting.  His wife was downstairs in a meeting herself and after the meeting was over she called to him and he did not respond.  She found him with no pulse and was not breathing.  She called 911 and attempted CPR.  They did not complete an autopsy, they stated that they believe the cause of death was either an embolism, Heart attack or aneurism.   The wife stated that she does not believe the death was due to the vaccination; however, there were no tests completed to prove or disprove."
	"1063457-1"	"1063457-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"On date on second dose, 2/27/2021,  the pt began have fatigue and diarrhea at around 10:30 am.  This continued to the following day.  On 2/28/2021, the patient was last seen around 4:20 pm by his wife in their residence.  She found him unresponsive at 5:30 pm in their bedroom.  EMS was called and the decedent was declared deceased.    The pt had his first dose on 2/9/2021.  Both doses were given at the hospital. Per family, the pt had no adverse affects following the first dose."
	"1063457-1"	"1063457-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"On date on second dose, 2/27/2021,  the pt began have fatigue and diarrhea at around 10:30 am.  This continued to the following day.  On 2/28/2021, the patient was last seen around 4:20 pm by his wife in their residence.  She found him unresponsive at 5:30 pm in their bedroom.  EMS was called and the decedent was declared deceased.    The pt had his first dose on 2/9/2021.  Both doses were given at the hospital. Per family, the pt had no adverse affects following the first dose."
	"1063457-1"	"1063457-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"On date on second dose, 2/27/2021,  the pt began have fatigue and diarrhea at around 10:30 am.  This continued to the following day.  On 2/28/2021, the patient was last seen around 4:20 pm by his wife in their residence.  She found him unresponsive at 5:30 pm in their bedroom.  EMS was called and the decedent was declared deceased.    The pt had his first dose on 2/9/2021.  Both doses were given at the hospital. Per family, the pt had no adverse affects following the first dose."
	"1063457-1"	"1063457-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"On date on second dose, 2/27/2021,  the pt began have fatigue and diarrhea at around 10:30 am.  This continued to the following day.  On 2/28/2021, the patient was last seen around 4:20 pm by his wife in their residence.  She found him unresponsive at 5:30 pm in their bedroom.  EMS was called and the decedent was declared deceased.    The pt had his first dose on 2/9/2021.  Both doses were given at the hospital. Per family, the pt had no adverse affects following the first dose."
	"1063758-1"	"1063758-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""Patient died on 2/25/21 in the AM after receiving his COVID-19 Moderna vaccine #1 at approximately 2:30P on 2/24/21. I do not have a time of death. I contacted the County Medical Examiner's office who stated that they received his body after he was determined to be deceased at the shelter.  No autopsy was performed and his body was released to a funeral home on 2/26. The ME's office said that ""permit for burial/cremation is pending"" and no other information on COD was available. Per staff, he was also tested for COVID as part of shelter protocol on 2/24 and PCR was negative. He arrived to the shelter on 2/19/21.""
	"1063758-1"	"1063758-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	""Patient died on 2/25/21 in the AM after receiving his COVID-19 Moderna vaccine #1 at approximately 2:30P on 2/24/21. I do not have a time of death. I contacted the County Medical Examiner's office who stated that they received his body after he was determined to be deceased at the shelter.  No autopsy was performed and his body was released to a funeral home on 2/26. The ME's office said that ""permit for burial/cremation is pending"" and no other information on COD was available. Per staff, he was also tested for COVID as part of shelter protocol on 2/24 and PCR was negative. He arrived to the shelter on 2/19/21.""
	"1066093-1"	"1066093-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"No known side effects; however, on 1/20 the decedent suffered lethargy.  On 2/12/2021, the decedent had a possible seizure and was transported to emergency department where shortly after arrival, he was pronounced dead."
	"1066093-1"	"1066093-1"	"LETHARGY"	"10024264"	"60-64 years"	"60-64"	"No known side effects; however, on 1/20 the decedent suffered lethargy.  On 2/12/2021, the decedent had a possible seizure and was transported to emergency department where shortly after arrival, he was pronounced dead."
	"1066093-1"	"1066093-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	"No known side effects; however, on 1/20 the decedent suffered lethargy.  On 2/12/2021, the decedent had a possible seizure and was transported to emergency department where shortly after arrival, he was pronounced dead."
	"1067358-1"	"1067358-1"	"BODY TEMPERATURE INCREASED"	"10005911"	"60-64 years"	"60-64"	"1-25-2021- Phone call: pt had cold and cough prior to vaccine. cough worsened 1-28-2021 Phone call: pt requesting provider visit, cough is same and taking tessalon pearls  1-29-2021 Provider in office  visit: pt complain of cough and SOB for 6 days. Getting worse. Temp 101.2, pulse ox 87%, BP 128/70. level of distress- leaning forward to breath. appeared ill. diffuse rales throughout both lung fields, more at bases. Diagnosis Pneumonia due to COVID 19 virus. Sent to ER"
	"1067358-1"	"1067358-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"1-25-2021- Phone call: pt had cold and cough prior to vaccine. cough worsened 1-28-2021 Phone call: pt requesting provider visit, cough is same and taking tessalon pearls  1-29-2021 Provider in office  visit: pt complain of cough and SOB for 6 days. Getting worse. Temp 101.2, pulse ox 87%, BP 128/70. level of distress- leaning forward to breath. appeared ill. diffuse rales throughout both lung fields, more at bases. Diagnosis Pneumonia due to COVID 19 virus. Sent to ER"
	"1067358-1"	"1067358-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"1-25-2021- Phone call: pt had cold and cough prior to vaccine. cough worsened 1-28-2021 Phone call: pt requesting provider visit, cough is same and taking tessalon pearls  1-29-2021 Provider in office  visit: pt complain of cough and SOB for 6 days. Getting worse. Temp 101.2, pulse ox 87%, BP 128/70. level of distress- leaning forward to breath. appeared ill. diffuse rales throughout both lung fields, more at bases. Diagnosis Pneumonia due to COVID 19 virus. Sent to ER"
	"1067358-1"	"1067358-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"1-25-2021- Phone call: pt had cold and cough prior to vaccine. cough worsened 1-28-2021 Phone call: pt requesting provider visit, cough is same and taking tessalon pearls  1-29-2021 Provider in office  visit: pt complain of cough and SOB for 6 days. Getting worse. Temp 101.2, pulse ox 87%, BP 128/70. level of distress- leaning forward to breath. appeared ill. diffuse rales throughout both lung fields, more at bases. Diagnosis Pneumonia due to COVID 19 virus. Sent to ER"
	"1067358-1"	"1067358-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"1-25-2021- Phone call: pt had cold and cough prior to vaccine. cough worsened 1-28-2021 Phone call: pt requesting provider visit, cough is same and taking tessalon pearls  1-29-2021 Provider in office  visit: pt complain of cough and SOB for 6 days. Getting worse. Temp 101.2, pulse ox 87%, BP 128/70. level of distress- leaning forward to breath. appeared ill. diffuse rales throughout both lung fields, more at bases. Diagnosis Pneumonia due to COVID 19 virus. Sent to ER"
	"1067358-1"	"1067358-1"	"EMOTIONAL DISTRESS"	"10049119"	"60-64 years"	"60-64"	"1-25-2021- Phone call: pt had cold and cough prior to vaccine. cough worsened 1-28-2021 Phone call: pt requesting provider visit, cough is same and taking tessalon pearls  1-29-2021 Provider in office  visit: pt complain of cough and SOB for 6 days. Getting worse. Temp 101.2, pulse ox 87%, BP 128/70. level of distress- leaning forward to breath. appeared ill. diffuse rales throughout both lung fields, more at bases. Diagnosis Pneumonia due to COVID 19 virus. Sent to ER"
	"1067358-1"	"1067358-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"1-25-2021- Phone call: pt had cold and cough prior to vaccine. cough worsened 1-28-2021 Phone call: pt requesting provider visit, cough is same and taking tessalon pearls  1-29-2021 Provider in office  visit: pt complain of cough and SOB for 6 days. Getting worse. Temp 101.2, pulse ox 87%, BP 128/70. level of distress- leaning forward to breath. appeared ill. diffuse rales throughout both lung fields, more at bases. Diagnosis Pneumonia due to COVID 19 virus. Sent to ER"
	"1067358-1"	"1067358-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"1-25-2021- Phone call: pt had cold and cough prior to vaccine. cough worsened 1-28-2021 Phone call: pt requesting provider visit, cough is same and taking tessalon pearls  1-29-2021 Provider in office  visit: pt complain of cough and SOB for 6 days. Getting worse. Temp 101.2, pulse ox 87%, BP 128/70. level of distress- leaning forward to breath. appeared ill. diffuse rales throughout both lung fields, more at bases. Diagnosis Pneumonia due to COVID 19 virus. Sent to ER"
	"1067358-1"	"1067358-1"	"RALES"	"10037833"	"60-64 years"	"60-64"	"1-25-2021- Phone call: pt had cold and cough prior to vaccine. cough worsened 1-28-2021 Phone call: pt requesting provider visit, cough is same and taking tessalon pearls  1-29-2021 Provider in office  visit: pt complain of cough and SOB for 6 days. Getting worse. Temp 101.2, pulse ox 87%, BP 128/70. level of distress- leaning forward to breath. appeared ill. diffuse rales throughout both lung fields, more at bases. Diagnosis Pneumonia due to COVID 19 virus. Sent to ER"
	"1067358-1"	"1067358-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"1-25-2021- Phone call: pt had cold and cough prior to vaccine. cough worsened 1-28-2021 Phone call: pt requesting provider visit, cough is same and taking tessalon pearls  1-29-2021 Provider in office  visit: pt complain of cough and SOB for 6 days. Getting worse. Temp 101.2, pulse ox 87%, BP 128/70. level of distress- leaning forward to breath. appeared ill. diffuse rales throughout both lung fields, more at bases. Diagnosis Pneumonia due to COVID 19 virus. Sent to ER"
	"1069560-1"	"1069560-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"BLOOD LACTIC ACID INCREASED"	"10005635"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"CARDIAC FAILURE"	"10007554"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"CYANOSIS"	"10011703"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"ELECTROCARDIOGRAM ABNORMAL"	"10014363"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"ELECTROCARDIOGRAM NORMAL"	"10014373"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"FIBRIN D DIMER INCREASED"	"10016581"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"LUNG INFILTRATION"	"10025102"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"MYOCARDIAL ISCHAEMIA"	"10028600"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"RESPIRATORY ARREST"	"10038669"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"SKIN DISCOLOURATION"	"10040829"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"TROPONIN INCREASED"	"10058267"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1069560-1"	"1069560-1"	"URINE ELECTROLYTES NORMAL"	"10062230"	"60-64 years"	"60-64"	"Hospital course 1/31 ? 2/20/21 1/31 in ED pt was at home when children noticed his lips were blue, ems arrived and found him to be 50% on RA, on Non-rebreather pt got to 78%, covid on 01/26   Shortness of Breath   61-year-old male presents with EMS for evaluation of shortness of breath hypoxia.  History is limited due to the patient's current clinical condition and so is primarily obtained from EMS.  EMS reports that he tested positive for COVID-19 5 days ago.  He began developing shortness of breath yesterday and his family called because his lips and fingers were blue today and he appeared short of breath.  On EMS arrival he had a room air saturation of less than 50% so he was placed on nonrebreather with improvement in his saturation to 70% and he was transported to the emergency department.  Patient does admit to shortness of breath.  He denies any chest pain.  He is noted to have a cast on his left ankle and said that he broke his left ankle on 23 December but has not had surgery.  He denies any new pain or swelling of the leg.  In the ED he was placed on 15L nasal cannula and NRB mask with improvement in SPO2 to low 90s. Additional work up revealed troponin of 1.35, lactic acid 5.8, and d-dimer 14.4.  He received dexamethasone and was placed on heparin gtt.   1/31 admitted to ICU Acute hypoxic respiratory failure due to COVID-19 vs heart failure vs PE.  CXR with bilateral hazy infiltrates more pronounced in the bases and left periphery and suspected multifocal pneumonia.   At risk for PE given LLE immobility in the setting of COVID-19 with significantly elevated d-dimer. RISK of CTA outweighs benefit given AKI and iodine allergy. Continue with empiric treatment with heparin gtt.   Admitted to ICU with SO2 in 60s-70s on 15L and NRB. Attempted 50L 95% FIO2 high flow and nasal cannula. Given lasix 40mg IV with good diuresis however SPO2 still remained low 80s with RR 40s and PO2 42 so the decision was made to intubate.  Oxygenation improved following intubation, with further improvement following recruitment maneuver and increase in PEEP. FIO2 weaned to 90% with SPO2 remaining in mid 90s. Will continue to wean FIO2 as able.  ARDS net protocol as much as possible. Consider prone ventilation and/or epoprostenol if unable to improve .  VAP Bundle: HOB >30 degrees; Oral care per nursing standard and on DVT/PPI prophylaxis Sedation: Target Richmond Agitation and Sedation Scale (RASS) of 0 to -2 with propofol and fentanyl. Check baseline TG levels.    COVID - 19: Convalescent plasma: Not indicated  Steroids: Dexamethasone 6 mg / day for 10 days Remdesivir: Not indicated d/t AKI   IL-6 inhibitor: Meets criteria for tocilizumab Systemic AC: Heparin gtt. No signs of bleeding (Platelets and Hb stable).  Antibiotics: Start 3 and 7 day course of azithromycin and ceftriaxone, respectively.  Elevated troponin  Suspect demand ischemia d/t hypoxia; EKG does not show any ischemic changes    AKI: Suspect d/t hypoxia in the setting of COVID infection. Urine output and electrolytes acceptable.  Closed fracture of left ankle Suffered fracture following a fall on ice in December. Cast was placed on 12/30 by SOS. He was due to be re-evaluated this week for possible cast removal.    Inhaled epoprostenol started  Considered for ECMO but not initiated due to not a candidate  Vasopressors required at times  Antihypertensive infusion required at times  severe hypoxia with position changes  switched from heparin drip to enoxaparin prophylaxis  2/20 discharge summary 61 y/o male admitted to Hospital on 1/31 with hypoxia.  He was diagnosed with COVID 19 5 days prior to admission, and had worsening respiratory status.  He was intubated after arrival, and was on ventilator for the entire intervening time, until he was extubated on 2/20 at the time of transition to Comfort measures only.    Prior to developing COVID 19, he had received his first dose of the Pfizer vaccine, as a member of the school system.  He had a fractured L ankle after a fall on 12/31/20, and had a cast in place at the time of admission.  He received Tocilizumab on 1/31, and underwent several cycles of prone positioning, beginning on 2/2.  He completed a course of Decadron, he received  Ceftriaxone and azithromycin beginning on admission, and completed a course of these.  Anticoagulation with enoxaparin was utilized due to coagulopathy associated with COVID 19.  Vasopressor support was required at times, as well as diuresis for fluid management.    He required high levels of sedation to maintain ventilator synchrony, and high levels of ventilator support with high oxygen levels throughout his stay.  Tracheostomy was being considered, but family decided that since he was not going to have good recovery, withdrawal of support, and allowing death was the appropriate choice for the patient and for them.   He was extubated at 2100 on 2/20/2021.   Death was pronounced at 2123 on 2/20/2021.  Children were at bedside."
	"1071120-1"	"1071120-1"	"ATRIAL FIBRILLATION"	"10003658"	"60-64 years"	"60-64"	"Atrial fibrillation; Feeling fluttery; Heart rate was racing and was increasing, went up to 175 just sitting; A spontaneous report was received from a consumer concerning a 64-year-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced atrial fibrillation, feeling fluttery, and heart rate was racing and was increasing, went up to 175 just sitting.  The patient's medical history was not provided. Concomitant medications included Travatan for glaucoma.    On 12 Feb 2021, prior to the onset of the events, the patient received the first of two planned doses of mRNA-1273 (lot/batch: 030M20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection.  On 12 Feb 2021, five hours after vaccination, the patient experienced a fluttery feeling, heart rate was racing and was increasing, heart rate went up to 175 just sitting. She took an EKG on her watch and it was atrial fibrillation. When she was sleeping, her heart rate was at 102 or the 90s, normally it would be in the 60s.    No treatment information was provided.   Action taken with mRNA-1273 in response to the events was not reported.  At the time of this report, the outcome of the events, atrial fibrillation, feeling fluttery, and heart rate was racing and was increasing, went up to 175 just sitting, was unknown.; Reporter's Comments: This case concerns a 64 year old female patient, who was on hospice care experienced a fatal event of death, 1 day after receiving second dose of mRNA- 1273 (Lot# 030M20A). Very limited information regarding this event has been provided at this time. Further information has been requested."
	"1071120-1"	"1071120-1"	"ATRIAL FLUTTER"	"10003662"	"60-64 years"	"60-64"	"Atrial fibrillation; Feeling fluttery; Heart rate was racing and was increasing, went up to 175 just sitting; A spontaneous report was received from a consumer concerning a 64-year-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced atrial fibrillation, feeling fluttery, and heart rate was racing and was increasing, went up to 175 just sitting.  The patient's medical history was not provided. Concomitant medications included Travatan for glaucoma.    On 12 Feb 2021, prior to the onset of the events, the patient received the first of two planned doses of mRNA-1273 (lot/batch: 030M20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection.  On 12 Feb 2021, five hours after vaccination, the patient experienced a fluttery feeling, heart rate was racing and was increasing, heart rate went up to 175 just sitting. She took an EKG on her watch and it was atrial fibrillation. When she was sleeping, her heart rate was at 102 or the 90s, normally it would be in the 60s.    No treatment information was provided.   Action taken with mRNA-1273 in response to the events was not reported.  At the time of this report, the outcome of the events, atrial fibrillation, feeling fluttery, and heart rate was racing and was increasing, went up to 175 just sitting, was unknown.; Reporter's Comments: This case concerns a 64 year old female patient, who was on hospice care experienced a fatal event of death, 1 day after receiving second dose of mRNA- 1273 (Lot# 030M20A). Very limited information regarding this event has been provided at this time. Further information has been requested."
	"1071120-1"	"1071120-1"	"HEART RATE INCREASED"	"10019303"	"60-64 years"	"60-64"	"Atrial fibrillation; Feeling fluttery; Heart rate was racing and was increasing, went up to 175 just sitting; A spontaneous report was received from a consumer concerning a 64-year-old female patient who received Moderna's COVID-19 vaccine (mRNA-1273) and experienced atrial fibrillation, feeling fluttery, and heart rate was racing and was increasing, went up to 175 just sitting.  The patient's medical history was not provided. Concomitant medications included Travatan for glaucoma.    On 12 Feb 2021, prior to the onset of the events, the patient received the first of two planned doses of mRNA-1273 (lot/batch: 030M20A) intramuscularly in the left arm for prophylaxis of COVID-19 infection.  On 12 Feb 2021, five hours after vaccination, the patient experienced a fluttery feeling, heart rate was racing and was increasing, heart rate went up to 175 just sitting. She took an EKG on her watch and it was atrial fibrillation. When she was sleeping, her heart rate was at 102 or the 90s, normally it would be in the 60s.    No treatment information was provided.   Action taken with mRNA-1273 in response to the events was not reported.  At the time of this report, the outcome of the events, atrial fibrillation, feeling fluttery, and heart rate was racing and was increasing, went up to 175 just sitting, was unknown.; Reporter's Comments: This case concerns a 64 year old female patient, who was on hospice care experienced a fatal event of death, 1 day after receiving second dose of mRNA- 1273 (Lot# 030M20A). Very limited information regarding this event has been provided at this time. Further information has been requested."
	"1071903-1"	"1071903-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"No reported adverse effects after vaccine was administered. Someone reported to our clinic that patient was found dead at home on Sunday"
	"1075407-1"	"1075407-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient passed away within 60 days of receiving the COVID vaccine series"
	"1077148-1"	"1077148-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"It was reported to us that at @1822 the patient sustained a Seizure at home.  EMS was called and arrived to initiate CPR.  CPR was performed but the patient was declared deceased by EMS at his home."
	"1077148-1"	"1077148-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"It was reported to us that at @1822 the patient sustained a Seizure at home.  EMS was called and arrived to initiate CPR.  CPR was performed but the patient was declared deceased by EMS at his home."
	"1077148-1"	"1077148-1"	"SEIZURE"	"10039906"	"60-64 years"	"60-64"	"It was reported to us that at @1822 the patient sustained a Seizure at home.  EMS was called and arrived to initiate CPR.  CPR was performed but the patient was declared deceased by EMS at his home."
	"1079904-1"	"1079904-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"SUBJECT WAS FOUND DECEASED ON 22 FEB 2021 AT AROUND 11:30 PM"
	"1080075-1"	"1080075-1"	"COMPUTERISED TOMOGRAM HEAD"	"10054003"	"60-64 years"	"60-64"	"Hemorrhagic stroke. = Death"
	"1080075-1"	"1080075-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Hemorrhagic stroke. = Death"
	"1080075-1"	"1080075-1"	"HAEMORRHAGIC STROKE"	"10019016"	"60-64 years"	"60-64"	"Hemorrhagic stroke. = Death"
	"1080432-1"	"1080432-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Death Narrative: On 3/3/21 an MSA from the Decedent Affairs Office received a call from the Office of the Chief Medical Examiner. The ME office informed the MSA that an autopsy was conducted on 3/2/21 and is pending results. No further information was given. A clinical review was conducted by the PCP but no conclusions could be made until autopsy results are received. The Office of Decedent Affairs will be reaching out periodically to the ME's office to retrieve these results. This Issue Brief will be updated by 3/17/21."
	"1080432-1"	"1080432-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death Narrative: On 3/3/21 an MSA from the Decedent Affairs Office received a call from the Office of the Chief Medical Examiner. The ME office informed the MSA that an autopsy was conducted on 3/2/21 and is pending results. No further information was given. A clinical review was conducted by the PCP but no conclusions could be made until autopsy results are received. The Office of Decedent Affairs will be reaching out periodically to the ME's office to retrieve these results. This Issue Brief will be updated by 3/17/21."
	"1080435-1"	"1080435-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"DEATH Narrative: 61 y.o. male with pmh afib, substance dependance, renal failure, recent admissions in the community for acute hypotension and acute kidney injury (11/2020 & 2/2021). Was found deceased in his apartment on the afternoon of 03/01/2021. Request sent to ME office for report if one exists. Patient was listed as having no known allergies."
	"1082467-1"	"1082467-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pt passed away on 3/6/21."
	"1084419-1"	"1084419-1"	"AIRWAY PATENCY DEVICE INSERTION"	"10081227"	"60-64 years"	"60-64"	"EMS reported sudden onset of shortness of breath, patient grabbed his chest and collapsed. He stopped breathing. Wife began CPR with chest compressions at 5:00. Fire dept. arrived resumed CPR and attached AED but there was no shock advise. They placed an OPA as well (inserted an airway) and started ventilation. Asystole was confirmed, they continued CPR. After 5:25 they gave 3 rounds Epineferin and ended CPR at 5:46. They also checked his blood sugar and it was 136. Possible reaction to covid vaccine. Possible death due to history of cardiac issues. His PCP is requesting an autopsy"
	"1084419-1"	"1084419-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"60-64 years"	"60-64"	"EMS reported sudden onset of shortness of breath, patient grabbed his chest and collapsed. He stopped breathing. Wife began CPR with chest compressions at 5:00. Fire dept. arrived resumed CPR and attached AED but there was no shock advise. They placed an OPA as well (inserted an airway) and started ventilation. Asystole was confirmed, they continued CPR. After 5:25 they gave 3 rounds Epineferin and ended CPR at 5:46. They also checked his blood sugar and it was 136. Possible reaction to covid vaccine. Possible death due to history of cardiac issues. His PCP is requesting an autopsy"
	"1084419-1"	"1084419-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"EMS reported sudden onset of shortness of breath, patient grabbed his chest and collapsed. He stopped breathing. Wife began CPR with chest compressions at 5:00. Fire dept. arrived resumed CPR and attached AED but there was no shock advise. They placed an OPA as well (inserted an airway) and started ventilation. Asystole was confirmed, they continued CPR. After 5:25 they gave 3 rounds Epineferin and ended CPR at 5:46. They also checked his blood sugar and it was 136. Possible reaction to covid vaccine. Possible death due to history of cardiac issues. His PCP is requesting an autopsy"
	"1084419-1"	"1084419-1"	"CARDIAC ASSISTANCE DEVICE USER"	"10053686"	"60-64 years"	"60-64"	"EMS reported sudden onset of shortness of breath, patient grabbed his chest and collapsed. He stopped breathing. Wife began CPR with chest compressions at 5:00. Fire dept. arrived resumed CPR and attached AED but there was no shock advise. They placed an OPA as well (inserted an airway) and started ventilation. Asystole was confirmed, they continued CPR. After 5:25 they gave 3 rounds Epineferin and ended CPR at 5:46. They also checked his blood sugar and it was 136. Possible reaction to covid vaccine. Possible death due to history of cardiac issues. His PCP is requesting an autopsy"
	"1084419-1"	"1084419-1"	"CARDIAC DISORDER"	"10061024"	"60-64 years"	"60-64"	"EMS reported sudden onset of shortness of breath, patient grabbed his chest and collapsed. He stopped breathing. Wife began CPR with chest compressions at 5:00. Fire dept. arrived resumed CPR and attached AED but there was no shock advise. They placed an OPA as well (inserted an airway) and started ventilation. Asystole was confirmed, they continued CPR. After 5:25 they gave 3 rounds Epineferin and ended CPR at 5:46. They also checked his blood sugar and it was 136. Possible reaction to covid vaccine. Possible death due to history of cardiac issues. His PCP is requesting an autopsy"
	"1084419-1"	"1084419-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"EMS reported sudden onset of shortness of breath, patient grabbed his chest and collapsed. He stopped breathing. Wife began CPR with chest compressions at 5:00. Fire dept. arrived resumed CPR and attached AED but there was no shock advise. They placed an OPA as well (inserted an airway) and started ventilation. Asystole was confirmed, they continued CPR. After 5:25 they gave 3 rounds Epineferin and ended CPR at 5:46. They also checked his blood sugar and it was 136. Possible reaction to covid vaccine. Possible death due to history of cardiac issues. His PCP is requesting an autopsy"
	"1084419-1"	"1084419-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"EMS reported sudden onset of shortness of breath, patient grabbed his chest and collapsed. He stopped breathing. Wife began CPR with chest compressions at 5:00. Fire dept. arrived resumed CPR and attached AED but there was no shock advise. They placed an OPA as well (inserted an airway) and started ventilation. Asystole was confirmed, they continued CPR. After 5:25 they gave 3 rounds Epineferin and ended CPR at 5:46. They also checked his blood sugar and it was 136. Possible reaction to covid vaccine. Possible death due to history of cardiac issues. His PCP is requesting an autopsy"
	"1084419-1"	"1084419-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"EMS reported sudden onset of shortness of breath, patient grabbed his chest and collapsed. He stopped breathing. Wife began CPR with chest compressions at 5:00. Fire dept. arrived resumed CPR and attached AED but there was no shock advise. They placed an OPA as well (inserted an airway) and started ventilation. Asystole was confirmed, they continued CPR. After 5:25 they gave 3 rounds Epineferin and ended CPR at 5:46. They also checked his blood sugar and it was 136. Possible reaction to covid vaccine. Possible death due to history of cardiac issues. His PCP is requesting an autopsy"
	"1084419-1"	"1084419-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"EMS reported sudden onset of shortness of breath, patient grabbed his chest and collapsed. He stopped breathing. Wife began CPR with chest compressions at 5:00. Fire dept. arrived resumed CPR and attached AED but there was no shock advise. They placed an OPA as well (inserted an airway) and started ventilation. Asystole was confirmed, they continued CPR. After 5:25 they gave 3 rounds Epineferin and ended CPR at 5:46. They also checked his blood sugar and it was 136. Possible reaction to covid vaccine. Possible death due to history of cardiac issues. His PCP is requesting an autopsy"
	"1084419-1"	"1084419-1"	"RESPIRATORY ARREST"	"10038669"	"60-64 years"	"60-64"	"EMS reported sudden onset of shortness of breath, patient grabbed his chest and collapsed. He stopped breathing. Wife began CPR with chest compressions at 5:00. Fire dept. arrived resumed CPR and attached AED but there was no shock advise. They placed an OPA as well (inserted an airway) and started ventilation. Asystole was confirmed, they continued CPR. After 5:25 they gave 3 rounds Epineferin and ended CPR at 5:46. They also checked his blood sugar and it was 136. Possible reaction to covid vaccine. Possible death due to history of cardiac issues. His PCP is requesting an autopsy"
	"1084419-1"	"1084419-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"EMS reported sudden onset of shortness of breath, patient grabbed his chest and collapsed. He stopped breathing. Wife began CPR with chest compressions at 5:00. Fire dept. arrived resumed CPR and attached AED but there was no shock advise. They placed an OPA as well (inserted an airway) and started ventilation. Asystole was confirmed, they continued CPR. After 5:25 they gave 3 rounds Epineferin and ended CPR at 5:46. They also checked his blood sugar and it was 136. Possible reaction to covid vaccine. Possible death due to history of cardiac issues. His PCP is requesting an autopsy"
	"1084419-1"	"1084419-1"	"SYNCOPE"	"10042772"	"60-64 years"	"60-64"	"EMS reported sudden onset of shortness of breath, patient grabbed his chest and collapsed. He stopped breathing. Wife began CPR with chest compressions at 5:00. Fire dept. arrived resumed CPR and attached AED but there was no shock advise. They placed an OPA as well (inserted an airway) and started ventilation. Asystole was confirmed, they continued CPR. After 5:25 they gave 3 rounds Epineferin and ended CPR at 5:46. They also checked his blood sugar and it was 136. Possible reaction to covid vaccine. Possible death due to history of cardiac issues. His PCP is requesting an autopsy"
	"1084793-1"	"1084793-1"	"ACUTE ABDOMEN"	"10000647"	"60-64 years"	"60-64"	"Hypotension in the 70s/40s despite IV fluid replenishment.   Per our MD DC/transfer note:  PEG displacement, ongoing sepsis, hypoglycemia.  Assess for other reason for hypotension including sepsis, cardiogenic shock, acute abdominal processes. patient was transferred to the Hospital ER where she expired"
	"1084793-1"	"1084793-1"	"CARDIOGENIC SHOCK"	"10007625"	"60-64 years"	"60-64"	"Hypotension in the 70s/40s despite IV fluid replenishment.   Per our MD DC/transfer note:  PEG displacement, ongoing sepsis, hypoglycemia.  Assess for other reason for hypotension including sepsis, cardiogenic shock, acute abdominal processes. patient was transferred to the Hospital ER where she expired"
	"1084793-1"	"1084793-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Hypotension in the 70s/40s despite IV fluid replenishment.   Per our MD DC/transfer note:  PEG displacement, ongoing sepsis, hypoglycemia.  Assess for other reason for hypotension including sepsis, cardiogenic shock, acute abdominal processes. patient was transferred to the Hospital ER where she expired"
	"1084793-1"	"1084793-1"	"FLUID REPLACEMENT"	"10061858"	"60-64 years"	"60-64"	"Hypotension in the 70s/40s despite IV fluid replenishment.   Per our MD DC/transfer note:  PEG displacement, ongoing sepsis, hypoglycemia.  Assess for other reason for hypotension including sepsis, cardiogenic shock, acute abdominal processes. patient was transferred to the Hospital ER where she expired"
	"1084793-1"	"1084793-1"	"GASTROSTOMY"	"10048978"	"60-64 years"	"60-64"	"Hypotension in the 70s/40s despite IV fluid replenishment.   Per our MD DC/transfer note:  PEG displacement, ongoing sepsis, hypoglycemia.  Assess for other reason for hypotension including sepsis, cardiogenic shock, acute abdominal processes. patient was transferred to the Hospital ER where she expired"
	"1084793-1"	"1084793-1"	"HYPOGLYCAEMIA"	"10020993"	"60-64 years"	"60-64"	"Hypotension in the 70s/40s despite IV fluid replenishment.   Per our MD DC/transfer note:  PEG displacement, ongoing sepsis, hypoglycemia.  Assess for other reason for hypotension including sepsis, cardiogenic shock, acute abdominal processes. patient was transferred to the Hospital ER where she expired"
	"1084793-1"	"1084793-1"	"HYPOTENSION"	"10021097"	"60-64 years"	"60-64"	"Hypotension in the 70s/40s despite IV fluid replenishment.   Per our MD DC/transfer note:  PEG displacement, ongoing sepsis, hypoglycemia.  Assess for other reason for hypotension including sepsis, cardiogenic shock, acute abdominal processes. patient was transferred to the Hospital ER where she expired"
	"1084793-1"	"1084793-1"	"SEPSIS"	"10040047"	"60-64 years"	"60-64"	"Hypotension in the 70s/40s despite IV fluid replenishment.   Per our MD DC/transfer note:  PEG displacement, ongoing sepsis, hypoglycemia.  Assess for other reason for hypotension including sepsis, cardiogenic shock, acute abdominal processes. patient was transferred to the Hospital ER where she expired"
	"1087763-1"	"1087763-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Difficulty breathing leading to organ failure and death"
	"1087763-1"	"1087763-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Difficulty breathing leading to organ failure and death"
	"1087763-1"	"1087763-1"	"LABORATORY TEST"	"10059938"	"60-64 years"	"60-64"	"Difficulty breathing leading to organ failure and death"
	"1087763-1"	"1087763-1"	"ORGAN FAILURE"	"10053159"	"60-64 years"	"60-64"	"Difficulty breathing leading to organ failure and death"
	"1088837-1"	"1088837-1"	"ALANINE AMINOTRANSFERASE NORMAL"	"10001552"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"ASPARTATE AMINOTRANSFERASE NORMAL"	"10003482"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"BLOOD BICARBONATE DECREASED"	"10005359"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"BLOOD CALCIUM NORMAL"	"10005397"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"BLOOD CHLORIDE NORMAL"	"10005421"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"BLOOD CREATININE INCREASED"	"10005483"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"BLOOD MAGNESIUM INCREASED"	"10005655"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"BLOOD PH DECREASED"	"10005706"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"BLOOD POTASSIUM NORMAL"	"10005726"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"BLOOD SODIUM NORMAL"	"10005804"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"BLOOD UREA INCREASED"	"10005851"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"CARBON DIOXIDE DECREASED"	"10007223"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"CONTINUOUS POSITIVE AIRWAY PRESSURE"	"10052934"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"FOAMING AT MOUTH"	"10062654"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"HAEMATOCRIT DECREASED"	"10018838"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"HAEMOGLOBIN DECREASED"	"10018884"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"HAEMOPTYSIS"	"10018964"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"PCO2 INCREASED"	"10034183"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"PLATELET COUNT INCREASED"	"10051608"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"PNEUMOTHORAX"	"10035759"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"PO2 DECREASED"	"10035768"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"PROTEIN TOTAL NORMAL"	"10037017"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"PULMONARY OEDEMA"	"10037423"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"RESPIRATORY DISTRESS"	"10038687"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1088837-1"	"1088837-1"	"WHITE BLOOD CELL COUNT NORMAL"	"10047944"	"60-64 years"	"60-64"	"Patient received first vaccine dose on 3/10/21, waited for approximately 1 hour in Pharmacy after.  Was walking to her vehicle and became short of breath.  Patient got to her vehicle and called 911 due to severe shortness of breath.  Rescue arrived on scene at approximately 11:00am, found patient in distress and administered epinephrine, methylprednisolone, and diphenhydramine.  Patient placed on CPAP in rescue en route to ER, became unresponsive, frothing pink sputum.  Intubated by paramedics en route with iGel device.  Patient arrived to ER at 11:22am, went into cardiac arrest at 11:24am.  Patient continued to be unstable, had multiple rounds of cardiac arrest and ROSC.  Patient ultimately did not survive arrests, and pronounced dead at 2:37pm.    Medications received during course in the ER - epinephrine 1mg x18 doses, sodium bicarbonate 50mEq x4 doses, calcium chloride 1g, insulin regular 10 units x1, furosemide 80mg x1, epinephrine titrated infusion, sodium bicarbonate infusion."
	"1089349-1"	"1089349-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient had an adverse reaction to her first shot, unreported, mostly local to the injection.  For this 2nd dose, she was not feeling well the day after the shot, but was at work.  She did not show up for work on Friday and was found dead.  Time of death was undetermined.  She lived alone. An autopsy was not performed."
	"1089349-1"	"1089349-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"Patient had an adverse reaction to her first shot, unreported, mostly local to the injection.  For this 2nd dose, she was not feeling well the day after the shot, but was at work.  She did not show up for work on Friday and was found dead.  Time of death was undetermined.  She lived alone. An autopsy was not performed."
	"1091327-1"	"1091327-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death"
	"1091799-1"	"1091799-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"ALANINE AMINOTRANSFERASE NORMAL"	"10001552"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"ANION GAP"	"10002522"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"ANISOCYTOSIS"	"10002536"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"ASPARTATE AMINOTRANSFERASE INCREASED"	"10003481"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BAND NEUTROPHIL PERCENTAGE INCREASED"	"10059129"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BASE EXCESS INCREASED"	"10059993"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BASOPHIL COUNT DECREASED"	"10004167"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BASOPHIL PERCENTAGE DECREASED"	"10052219"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BLOOD ALBUMIN DECREASED"	"10005287"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BLOOD ALKALINE PHOSPHATASE INCREASED"	"10059570"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BLOOD BICARBONATE INCREASED"	"10005360"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BLOOD BILIRUBIN NORMAL"	"10005367"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BLOOD CALCIUM DECREASED"	"10005395"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BLOOD CHLORIDE NORMAL"	"10005421"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BLOOD CREATININE INCREASED"	"10005483"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BLOOD GLUCOSE NORMAL"	"10005558"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BLOOD LACTATE DEHYDROGENASE INCREASED"	"10005630"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BLOOD LACTIC ACID"	"10005632"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BLOOD MAGNESIUM NORMAL"	"10005656"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BLOOD PARATHYROID HORMONE INCREASED"	"10005703"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BLOOD PH NORMAL"	"10005709"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BLOOD PHOSPHORUS INCREASED"	"10050196"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BLOOD POTASSIUM NORMAL"	"10005726"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BLOOD SODIUM NORMAL"	"10005804"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BLOOD UREA INCREASED"	"10005851"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"BLOOD UREA NITROGEN/CREATININE RATIO"	"10059899"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"C-REACTIVE PROTEIN INCREASED"	"10006825"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"CARBON DIOXIDE NORMAL"	"10007228"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"EOSINOPHIL COUNT DECREASED"	"10014943"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"EOSINOPHIL PERCENTAGE DECREASED"	"10052221"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"FIBRIN D DIMER INCREASED"	"10016581"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"FRACTION OF INSPIRED OXYGEN"	"10059883"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"GLOMERULAR FILTRATION RATE DECREASED"	"10018358"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"HAEMATOCRIT DECREASED"	"10018838"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"HAEMOGLOBIN DECREASED"	"10018884"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"HEPATITIS A ANTIBODY NEGATIVE"	"10019723"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"HEPATITIS B CORE ANTIBODY NEGATIVE"	"10071345"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"HEPATITIS B SURFACE ANTIGEN NEGATIVE"	"10050542"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"HEPATITIS C ANTIBODY NEGATIVE"	"10019746"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"HYPOCHROMASIA"	"10050789"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"IMMATURE GRANULOCYTE COUNT"	"10085122"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"LABORATORY TEST"	"10059938"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"LYMPHOCYTE COUNT DECREASED"	"10025256"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"LYMPHOCYTE PERCENTAGE DECREASED"	"10052231"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"MEAN CELL HAEMOGLOBIN CONCENTRATION DECREASED"	"10026991"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"MEAN CELL HAEMOGLOBIN DECREASED"	"10026995"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"MEAN CELL VOLUME NORMAL"	"10027006"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"MEAN PLATELET VOLUME NORMAL"	"10055070"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"MONOCYTE COUNT NORMAL"	"10027882"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"MONOCYTE PERCENTAGE DECREASED"	"10052229"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"N-TERMINAL PROHORMONE BRAIN NATRIURETIC PEPTIDE INCREASED"	"10071662"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"NEUTROPHIL COUNT INCREASED"	"10029368"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"NEUTROPHIL PERCENTAGE INCREASED"	"10052224"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"OXYGEN SATURATION"	"10033316"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"PCO2 INCREASED"	"10034183"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"PLATELET COUNT NORMAL"	"10035530"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"PO2 DECREASED"	"10035768"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"POLYCHROMASIA"	"10036040"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"PROCALCITONIN INCREASED"	"10067081"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"PROTEIN TOTAL INCREASED"	"10037016"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"PUNCTATE BASOPHILIA"	"10037507"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"RED BLOOD CELL COUNT DECREASED"	"10038153"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"RED BLOOD CELL NUCLEATED MORPHOLOGY PRESENT"	"10038165"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"RED CELL DISTRIBUTION WIDTH INCREASED"	"10053920"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"SERUM FERRITIN INCREASED"	"10040250"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"TROPONIN I NORMAL"	"10073406"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1091799-1"	"1091799-1"	"WHITE BLOOD CELL COUNT NORMAL"	"10047944"	"60-64 years"	"60-64"	"Became COVID-positive, pneumonia, ARDS, hospitalized for hypoxia 2/21/2021, death 2/25/2021"
	"1094300-1"	"1094300-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death"
	"1095668-1"	"1095668-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	""62 yo M with no known medical history awoke 12:15 am on 3/11/2021 and told his wife he had ""pain all over"". When she asked if it was chest pain, he said he didn't know.  He went downstairs, vomited, slumped over against the wall behind the couch, and became unresponsive.  Wife called 911 and was instructed to begin CPR.  EMS crew arrived shortly after that and performed prolonged resuscitation efforts as per ACLS protocol.  Pt pronounced at 3:15 am.  Patient had not seen a physician in many years, had not had any vaccines in over 20 years, took no medications, and had no known medical history.  He did have a strong family history of heart disease and had told his wife the week prior to his death that he had suffered a several-hour bout of chest pain that resolved spontaneously 2-3 days prior to his telling her about it.  He refused to seek medical evaluation despite her urging.""
	"1095668-1"	"1095668-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""62 yo M with no known medical history awoke 12:15 am on 3/11/2021 and told his wife he had ""pain all over"". When she asked if it was chest pain, he said he didn't know.  He went downstairs, vomited, slumped over against the wall behind the couch, and became unresponsive.  Wife called 911 and was instructed to begin CPR.  EMS crew arrived shortly after that and performed prolonged resuscitation efforts as per ACLS protocol.  Pt pronounced at 3:15 am.  Patient had not seen a physician in many years, had not had any vaccines in over 20 years, took no medications, and had no known medical history.  He did have a strong family history of heart disease and had told his wife the week prior to his death that he had suffered a several-hour bout of chest pain that resolved spontaneously 2-3 days prior to his telling her about it.  He refused to seek medical evaluation despite her urging.""
	"1095668-1"	"1095668-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	""62 yo M with no known medical history awoke 12:15 am on 3/11/2021 and told his wife he had ""pain all over"". When she asked if it was chest pain, he said he didn't know.  He went downstairs, vomited, slumped over against the wall behind the couch, and became unresponsive.  Wife called 911 and was instructed to begin CPR.  EMS crew arrived shortly after that and performed prolonged resuscitation efforts as per ACLS protocol.  Pt pronounced at 3:15 am.  Patient had not seen a physician in many years, had not had any vaccines in over 20 years, took no medications, and had no known medical history.  He did have a strong family history of heart disease and had told his wife the week prior to his death that he had suffered a several-hour bout of chest pain that resolved spontaneously 2-3 days prior to his telling her about it.  He refused to seek medical evaluation despite her urging.""
	"1095668-1"	"1095668-1"	"POSTURE ABNORMAL"	"10036436"	"60-64 years"	"60-64"	""62 yo M with no known medical history awoke 12:15 am on 3/11/2021 and told his wife he had ""pain all over"". When she asked if it was chest pain, he said he didn't know.  He went downstairs, vomited, slumped over against the wall behind the couch, and became unresponsive.  Wife called 911 and was instructed to begin CPR.  EMS crew arrived shortly after that and performed prolonged resuscitation efforts as per ACLS protocol.  Pt pronounced at 3:15 am.  Patient had not seen a physician in many years, had not had any vaccines in over 20 years, took no medications, and had no known medical history.  He did have a strong family history of heart disease and had told his wife the week prior to his death that he had suffered a several-hour bout of chest pain that resolved spontaneously 2-3 days prior to his telling her about it.  He refused to seek medical evaluation despite her urging.""
	"1095668-1"	"1095668-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	""62 yo M with no known medical history awoke 12:15 am on 3/11/2021 and told his wife he had ""pain all over"". When she asked if it was chest pain, he said he didn't know.  He went downstairs, vomited, slumped over against the wall behind the couch, and became unresponsive.  Wife called 911 and was instructed to begin CPR.  EMS crew arrived shortly after that and performed prolonged resuscitation efforts as per ACLS protocol.  Pt pronounced at 3:15 am.  Patient had not seen a physician in many years, had not had any vaccines in over 20 years, took no medications, and had no known medical history.  He did have a strong family history of heart disease and had told his wife the week prior to his death that he had suffered a several-hour bout of chest pain that resolved spontaneously 2-3 days prior to his telling her about it.  He refused to seek medical evaluation despite her urging.""
	"1095668-1"	"1095668-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	""62 yo M with no known medical history awoke 12:15 am on 3/11/2021 and told his wife he had ""pain all over"". When she asked if it was chest pain, he said he didn't know.  He went downstairs, vomited, slumped over against the wall behind the couch, and became unresponsive.  Wife called 911 and was instructed to begin CPR.  EMS crew arrived shortly after that and performed prolonged resuscitation efforts as per ACLS protocol.  Pt pronounced at 3:15 am.  Patient had not seen a physician in many years, had not had any vaccines in over 20 years, took no medications, and had no known medical history.  He did have a strong family history of heart disease and had told his wife the week prior to his death that he had suffered a several-hour bout of chest pain that resolved spontaneously 2-3 days prior to his telling her about it.  He refused to seek medical evaluation despite her urging.""
	"1095668-1"	"1095668-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	""62 yo M with no known medical history awoke 12:15 am on 3/11/2021 and told his wife he had ""pain all over"". When she asked if it was chest pain, he said he didn't know.  He went downstairs, vomited, slumped over against the wall behind the couch, and became unresponsive.  Wife called 911 and was instructed to begin CPR.  EMS crew arrived shortly after that and performed prolonged resuscitation efforts as per ACLS protocol.  Pt pronounced at 3:15 am.  Patient had not seen a physician in many years, had not had any vaccines in over 20 years, took no medications, and had no known medical history.  He did have a strong family history of heart disease and had told his wife the week prior to his death that he had suffered a several-hour bout of chest pain that resolved spontaneously 2-3 days prior to his telling her about it.  He refused to seek medical evaluation despite her urging.""
	"1100963-1"	"1100963-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"High temperature second day after vacination.  Tylenol treatment to drop the high temperature. Passed away by pulmonary embolism suddenly."
	"1100963-1"	"1100963-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"High temperature second day after vacination.  Tylenol treatment to drop the high temperature. Passed away by pulmonary embolism suddenly."
	"1100963-1"	"1100963-1"	"SUDDEN DEATH"	"10042434"	"60-64 years"	"60-64"	"High temperature second day after vacination.  Tylenol treatment to drop the high temperature. Passed away by pulmonary embolism suddenly."
	"1103955-1"	"1103955-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"No adverse reactions at the time of vaccine.  Was admitted to hospital 5 days later with BLL pneumonia and passed away on 03/10/2021"
	"1103955-1"	"1103955-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"No adverse reactions at the time of vaccine.  Was admitted to hospital 5 days later with BLL pneumonia and passed away on 03/10/2021"
	"1104845-1"	"1104845-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"60-64 years"	"60-64"	"Deceased received second Moderna dose on 3/11/2021 at unknown location and unknown time. Complained of 'side effects' which are unclear at this time. Had a sudden witnessed cardiac event on 3/14/2021 and was rushed to a local emergency department. Diagnosed with ST elevation MI and could not be fully resuscitated."
	"1104845-1"	"1104845-1"	"AMPHETAMINES POSITIVE"	"10063228"	"60-64 years"	"60-64"	"Deceased received second Moderna dose on 3/11/2021 at unknown location and unknown time. Complained of 'side effects' which are unclear at this time. Had a sudden witnessed cardiac event on 3/14/2021 and was rushed to a local emergency department. Diagnosed with ST elevation MI and could not be fully resuscitated."
	"1104845-1"	"1104845-1"	"ARTERIOSCLEROSIS"	"10003210"	"60-64 years"	"60-64"	"Deceased received second Moderna dose on 3/11/2021 at unknown location and unknown time. Complained of 'side effects' which are unclear at this time. Had a sudden witnessed cardiac event on 3/14/2021 and was rushed to a local emergency department. Diagnosed with ST elevation MI and could not be fully resuscitated."
	"1104845-1"	"1104845-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Deceased received second Moderna dose on 3/11/2021 at unknown location and unknown time. Complained of 'side effects' which are unclear at this time. Had a sudden witnessed cardiac event on 3/14/2021 and was rushed to a local emergency department. Diagnosed with ST elevation MI and could not be fully resuscitated."
	"1104845-1"	"1104845-1"	"CARDIAC DISORDER"	"10061024"	"60-64 years"	"60-64"	"Deceased received second Moderna dose on 3/11/2021 at unknown location and unknown time. Complained of 'side effects' which are unclear at this time. Had a sudden witnessed cardiac event on 3/14/2021 and was rushed to a local emergency department. Diagnosed with ST elevation MI and could not be fully resuscitated."
	"1104845-1"	"1104845-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Deceased received second Moderna dose on 3/11/2021 at unknown location and unknown time. Complained of 'side effects' which are unclear at this time. Had a sudden witnessed cardiac event on 3/14/2021 and was rushed to a local emergency department. Diagnosed with ST elevation MI and could not be fully resuscitated."
	"1104845-1"	"1104845-1"	"DRUG SCREEN POSITIVE"	"10049177"	"60-64 years"	"60-64"	"Deceased received second Moderna dose on 3/11/2021 at unknown location and unknown time. Complained of 'side effects' which are unclear at this time. Had a sudden witnessed cardiac event on 3/14/2021 and was rushed to a local emergency department. Diagnosed with ST elevation MI and could not be fully resuscitated."
	"1104845-1"	"1104845-1"	"VACCINATION COMPLICATION"	"10046861"	"60-64 years"	"60-64"	"Deceased received second Moderna dose on 3/11/2021 at unknown location and unknown time. Complained of 'side effects' which are unclear at this time. Had a sudden witnessed cardiac event on 3/14/2021 and was rushed to a local emergency department. Diagnosed with ST elevation MI and could not be fully resuscitated."
	"1106554-1"	"1106554-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""She received vaccine on 12.28.21.  On 12.30.21 she went to the ER and was subsequently sent to Hospital.  Not sure what the findings were, but she was discharged after several hours.  I spoke with her on the phone on 1.1.21,, She wasn't feeling well.  I asked her what was going on because she had been doing really well for a few months. She stated ""Every since I took the vaccine, I have felt really bad.""  She died on 1.5.21. Timeline: 12.28.20 Vaccine 12.30.20 ER 1.1.21 Continues to feel bad and reports feeling worse and worse since vaccine. 1.5.21 Died at home.""
	"1106554-1"	"1106554-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	""She received vaccine on 12.28.21.  On 12.30.21 she went to the ER and was subsequently sent to Hospital.  Not sure what the findings were, but she was discharged after several hours.  I spoke with her on the phone on 1.1.21,, She wasn't feeling well.  I asked her what was going on because she had been doing really well for a few months. She stated ""Every since I took the vaccine, I have felt really bad.""  She died on 1.5.21. Timeline: 12.28.20 Vaccine 12.30.20 ER 1.1.21 Continues to feel bad and reports feeling worse and worse since vaccine. 1.5.21 Died at home.""
	"1109418-1"	"1109418-1"	"RESPIRATORY ARREST"	"10038669"	"60-64 years"	"60-64"	"sudden death, while sleeping 2 days after injection Vaccine 3/12/21 last seen conversant and comfortable at 3a 3/14/21 Found nonresponsive and not breathing at 8:30a 3/14/21"
	"1109418-1"	"1109418-1"	"SUDDEN DEATH"	"10042434"	"60-64 years"	"60-64"	"sudden death, while sleeping 2 days after injection Vaccine 3/12/21 last seen conversant and comfortable at 3a 3/14/21 Found nonresponsive and not breathing at 8:30a 3/14/21"
	"1109418-1"	"1109418-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"sudden death, while sleeping 2 days after injection Vaccine 3/12/21 last seen conversant and comfortable at 3a 3/14/21 Found nonresponsive and not breathing at 8:30a 3/14/21"
	"1109696-1"	"1109696-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"60-64 years"	"60-64"	"Pt presented to the ER on 1/4 2021 with worsening sob, found to have  acute ST elevation MI  and new rapid atrial fib with RVR. He tested positive for covid 19 requiring new oxygen and received his first pfizer vaccine on 12/31. He was acutely transferred to rochester general hospital. He progressed to multiorgan failure, sepsis, mrsa bacteremia and died on 1/14/2021"
	"1109696-1"	"1109696-1"	"ATRIAL FIBRILLATION"	"10003658"	"60-64 years"	"60-64"	"Pt presented to the ER on 1/4 2021 with worsening sob, found to have  acute ST elevation MI  and new rapid atrial fib with RVR. He tested positive for covid 19 requiring new oxygen and received his first pfizer vaccine on 12/31. He was acutely transferred to rochester general hospital. He progressed to multiorgan failure, sepsis, mrsa bacteremia and died on 1/14/2021"
	"1109696-1"	"1109696-1"	"BLOOD LACTATE DEHYDROGENASE INCREASED"	"10005630"	"60-64 years"	"60-64"	"Pt presented to the ER on 1/4 2021 with worsening sob, found to have  acute ST elevation MI  and new rapid atrial fib with RVR. He tested positive for covid 19 requiring new oxygen and received his first pfizer vaccine on 12/31. He was acutely transferred to rochester general hospital. He progressed to multiorgan failure, sepsis, mrsa bacteremia and died on 1/14/2021"
	"1109696-1"	"1109696-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Pt presented to the ER on 1/4 2021 with worsening sob, found to have  acute ST elevation MI  and new rapid atrial fib with RVR. He tested positive for covid 19 requiring new oxygen and received his first pfizer vaccine on 12/31. He was acutely transferred to rochester general hospital. He progressed to multiorgan failure, sepsis, mrsa bacteremia and died on 1/14/2021"
	"1109696-1"	"1109696-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pt presented to the ER on 1/4 2021 with worsening sob, found to have  acute ST elevation MI  and new rapid atrial fib with RVR. He tested positive for covid 19 requiring new oxygen and received his first pfizer vaccine on 12/31. He was acutely transferred to rochester general hospital. He progressed to multiorgan failure, sepsis, mrsa bacteremia and died on 1/14/2021"
	"1109696-1"	"1109696-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Pt presented to the ER on 1/4 2021 with worsening sob, found to have  acute ST elevation MI  and new rapid atrial fib with RVR. He tested positive for covid 19 requiring new oxygen and received his first pfizer vaccine on 12/31. He was acutely transferred to rochester general hospital. He progressed to multiorgan failure, sepsis, mrsa bacteremia and died on 1/14/2021"
	"1109696-1"	"1109696-1"	"METABOLIC FUNCTION TEST NORMAL"	"10062192"	"60-64 years"	"60-64"	"Pt presented to the ER on 1/4 2021 with worsening sob, found to have  acute ST elevation MI  and new rapid atrial fib with RVR. He tested positive for covid 19 requiring new oxygen and received his first pfizer vaccine on 12/31. He was acutely transferred to rochester general hospital. He progressed to multiorgan failure, sepsis, mrsa bacteremia and died on 1/14/2021"
	"1109696-1"	"1109696-1"	"MULTIPLE ORGAN DYSFUNCTION SYNDROME"	"10077361"	"60-64 years"	"60-64"	"Pt presented to the ER on 1/4 2021 with worsening sob, found to have  acute ST elevation MI  and new rapid atrial fib with RVR. He tested positive for covid 19 requiring new oxygen and received his first pfizer vaccine on 12/31. He was acutely transferred to rochester general hospital. He progressed to multiorgan failure, sepsis, mrsa bacteremia and died on 1/14/2021"
	"1109696-1"	"1109696-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Pt presented to the ER on 1/4 2021 with worsening sob, found to have  acute ST elevation MI  and new rapid atrial fib with RVR. He tested positive for covid 19 requiring new oxygen and received his first pfizer vaccine on 12/31. He was acutely transferred to rochester general hospital. He progressed to multiorgan failure, sepsis, mrsa bacteremia and died on 1/14/2021"
	"1109696-1"	"1109696-1"	"SEPSIS"	"10040047"	"60-64 years"	"60-64"	"Pt presented to the ER on 1/4 2021 with worsening sob, found to have  acute ST elevation MI  and new rapid atrial fib with RVR. He tested positive for covid 19 requiring new oxygen and received his first pfizer vaccine on 12/31. He was acutely transferred to rochester general hospital. He progressed to multiorgan failure, sepsis, mrsa bacteremia and died on 1/14/2021"
	"1109696-1"	"1109696-1"	"SERUM FERRITIN INCREASED"	"10040250"	"60-64 years"	"60-64"	"Pt presented to the ER on 1/4 2021 with worsening sob, found to have  acute ST elevation MI  and new rapid atrial fib with RVR. He tested positive for covid 19 requiring new oxygen and received his first pfizer vaccine on 12/31. He was acutely transferred to rochester general hospital. He progressed to multiorgan failure, sepsis, mrsa bacteremia and died on 1/14/2021"
	"1109696-1"	"1109696-1"	"STAPHYLOCOCCAL BACTERAEMIA"	"10051017"	"60-64 years"	"60-64"	"Pt presented to the ER on 1/4 2021 with worsening sob, found to have  acute ST elevation MI  and new rapid atrial fib with RVR. He tested positive for covid 19 requiring new oxygen and received his first pfizer vaccine on 12/31. He was acutely transferred to rochester general hospital. He progressed to multiorgan failure, sepsis, mrsa bacteremia and died on 1/14/2021"
	"1110152-1"	"1110152-1"	"ABDOMINAL PAIN UPPER"	"10000087"	"60-64 years"	"60-64"	"This is a 60 year old female was brought into emergency department as cardiac arrest.  Patient was seen at care now urgent care with the complain of epigastric pain associated with nausea vomiting and intermittent diarrhea.  Patient received her initial COVID vaccine 2 days ago.  History is obtained from urgent care chart.  As per notes patient started nausea vomiting 6 hours post COVID vaccine administration.  Patient was seen in urgent care for epigastric pain and nausea vomiting.  Patient was found unresponsive at 0902 by tech.  No carotid pulses palpated.  CPR was started.  Patient was brought into the emergency department with Lucas on.  Patient was given 5 epinephrine prior to arrival.  CPR was in progress.  Patient was asystole.  Resuscitation was continued in the ED.  Patient was intubated in the ED by physician assistant 5 epinephrine 2 bicarb and 1 calcium chloride was given in the ED.  Cardiac Ultrasound didn't show any cardiac activity.  Asystole on the monitor.  No corneal reflex people are fixed and dilated.  Patient was pronounced at 1007 am"
	"1110152-1"	"1110152-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"This is a 60 year old female was brought into emergency department as cardiac arrest.  Patient was seen at care now urgent care with the complain of epigastric pain associated with nausea vomiting and intermittent diarrhea.  Patient received her initial COVID vaccine 2 days ago.  History is obtained from urgent care chart.  As per notes patient started nausea vomiting 6 hours post COVID vaccine administration.  Patient was seen in urgent care for epigastric pain and nausea vomiting.  Patient was found unresponsive at 0902 by tech.  No carotid pulses palpated.  CPR was started.  Patient was brought into the emergency department with Lucas on.  Patient was given 5 epinephrine prior to arrival.  CPR was in progress.  Patient was asystole.  Resuscitation was continued in the ED.  Patient was intubated in the ED by physician assistant 5 epinephrine 2 bicarb and 1 calcium chloride was given in the ED.  Cardiac Ultrasound didn't show any cardiac activity.  Asystole on the monitor.  No corneal reflex people are fixed and dilated.  Patient was pronounced at 1007 am"
	"1110152-1"	"1110152-1"	"CORNEAL REFLEX DECREASED"	"10011042"	"60-64 years"	"60-64"	"This is a 60 year old female was brought into emergency department as cardiac arrest.  Patient was seen at care now urgent care with the complain of epigastric pain associated with nausea vomiting and intermittent diarrhea.  Patient received her initial COVID vaccine 2 days ago.  History is obtained from urgent care chart.  As per notes patient started nausea vomiting 6 hours post COVID vaccine administration.  Patient was seen in urgent care for epigastric pain and nausea vomiting.  Patient was found unresponsive at 0902 by tech.  No carotid pulses palpated.  CPR was started.  Patient was brought into the emergency department with Lucas on.  Patient was given 5 epinephrine prior to arrival.  CPR was in progress.  Patient was asystole.  Resuscitation was continued in the ED.  Patient was intubated in the ED by physician assistant 5 epinephrine 2 bicarb and 1 calcium chloride was given in the ED.  Cardiac Ultrasound didn't show any cardiac activity.  Asystole on the monitor.  No corneal reflex people are fixed and dilated.  Patient was pronounced at 1007 am"
	"1110152-1"	"1110152-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"This is a 60 year old female was brought into emergency department as cardiac arrest.  Patient was seen at care now urgent care with the complain of epigastric pain associated with nausea vomiting and intermittent diarrhea.  Patient received her initial COVID vaccine 2 days ago.  History is obtained from urgent care chart.  As per notes patient started nausea vomiting 6 hours post COVID vaccine administration.  Patient was seen in urgent care for epigastric pain and nausea vomiting.  Patient was found unresponsive at 0902 by tech.  No carotid pulses palpated.  CPR was started.  Patient was brought into the emergency department with Lucas on.  Patient was given 5 epinephrine prior to arrival.  CPR was in progress.  Patient was asystole.  Resuscitation was continued in the ED.  Patient was intubated in the ED by physician assistant 5 epinephrine 2 bicarb and 1 calcium chloride was given in the ED.  Cardiac Ultrasound didn't show any cardiac activity.  Asystole on the monitor.  No corneal reflex people are fixed and dilated.  Patient was pronounced at 1007 am"
	"1110152-1"	"1110152-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"This is a 60 year old female was brought into emergency department as cardiac arrest.  Patient was seen at care now urgent care with the complain of epigastric pain associated with nausea vomiting and intermittent diarrhea.  Patient received her initial COVID vaccine 2 days ago.  History is obtained from urgent care chart.  As per notes patient started nausea vomiting 6 hours post COVID vaccine administration.  Patient was seen in urgent care for epigastric pain and nausea vomiting.  Patient was found unresponsive at 0902 by tech.  No carotid pulses palpated.  CPR was started.  Patient was brought into the emergency department with Lucas on.  Patient was given 5 epinephrine prior to arrival.  CPR was in progress.  Patient was asystole.  Resuscitation was continued in the ED.  Patient was intubated in the ED by physician assistant 5 epinephrine 2 bicarb and 1 calcium chloride was given in the ED.  Cardiac Ultrasound didn't show any cardiac activity.  Asystole on the monitor.  No corneal reflex people are fixed and dilated.  Patient was pronounced at 1007 am"
	"1110152-1"	"1110152-1"	"ECHOCARDIOGRAM"	"10014113"	"60-64 years"	"60-64"	"This is a 60 year old female was brought into emergency department as cardiac arrest.  Patient was seen at care now urgent care with the complain of epigastric pain associated with nausea vomiting and intermittent diarrhea.  Patient received her initial COVID vaccine 2 days ago.  History is obtained from urgent care chart.  As per notes patient started nausea vomiting 6 hours post COVID vaccine administration.  Patient was seen in urgent care for epigastric pain and nausea vomiting.  Patient was found unresponsive at 0902 by tech.  No carotid pulses palpated.  CPR was started.  Patient was brought into the emergency department with Lucas on.  Patient was given 5 epinephrine prior to arrival.  CPR was in progress.  Patient was asystole.  Resuscitation was continued in the ED.  Patient was intubated in the ED by physician assistant 5 epinephrine 2 bicarb and 1 calcium chloride was given in the ED.  Cardiac Ultrasound didn't show any cardiac activity.  Asystole on the monitor.  No corneal reflex people are fixed and dilated.  Patient was pronounced at 1007 am"
	"1110152-1"	"1110152-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"This is a 60 year old female was brought into emergency department as cardiac arrest.  Patient was seen at care now urgent care with the complain of epigastric pain associated with nausea vomiting and intermittent diarrhea.  Patient received her initial COVID vaccine 2 days ago.  History is obtained from urgent care chart.  As per notes patient started nausea vomiting 6 hours post COVID vaccine administration.  Patient was seen in urgent care for epigastric pain and nausea vomiting.  Patient was found unresponsive at 0902 by tech.  No carotid pulses palpated.  CPR was started.  Patient was brought into the emergency department with Lucas on.  Patient was given 5 epinephrine prior to arrival.  CPR was in progress.  Patient was asystole.  Resuscitation was continued in the ED.  Patient was intubated in the ED by physician assistant 5 epinephrine 2 bicarb and 1 calcium chloride was given in the ED.  Cardiac Ultrasound didn't show any cardiac activity.  Asystole on the monitor.  No corneal reflex people are fixed and dilated.  Patient was pronounced at 1007 am"
	"1110152-1"	"1110152-1"	"LIFE SUPPORT"	"10024447"	"60-64 years"	"60-64"	"This is a 60 year old female was brought into emergency department as cardiac arrest.  Patient was seen at care now urgent care with the complain of epigastric pain associated with nausea vomiting and intermittent diarrhea.  Patient received her initial COVID vaccine 2 days ago.  History is obtained from urgent care chart.  As per notes patient started nausea vomiting 6 hours post COVID vaccine administration.  Patient was seen in urgent care for epigastric pain and nausea vomiting.  Patient was found unresponsive at 0902 by tech.  No carotid pulses palpated.  CPR was started.  Patient was brought into the emergency department with Lucas on.  Patient was given 5 epinephrine prior to arrival.  CPR was in progress.  Patient was asystole.  Resuscitation was continued in the ED.  Patient was intubated in the ED by physician assistant 5 epinephrine 2 bicarb and 1 calcium chloride was given in the ED.  Cardiac Ultrasound didn't show any cardiac activity.  Asystole on the monitor.  No corneal reflex people are fixed and dilated.  Patient was pronounced at 1007 am"
	"1110152-1"	"1110152-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"This is a 60 year old female was brought into emergency department as cardiac arrest.  Patient was seen at care now urgent care with the complain of epigastric pain associated with nausea vomiting and intermittent diarrhea.  Patient received her initial COVID vaccine 2 days ago.  History is obtained from urgent care chart.  As per notes patient started nausea vomiting 6 hours post COVID vaccine administration.  Patient was seen in urgent care for epigastric pain and nausea vomiting.  Patient was found unresponsive at 0902 by tech.  No carotid pulses palpated.  CPR was started.  Patient was brought into the emergency department with Lucas on.  Patient was given 5 epinephrine prior to arrival.  CPR was in progress.  Patient was asystole.  Resuscitation was continued in the ED.  Patient was intubated in the ED by physician assistant 5 epinephrine 2 bicarb and 1 calcium chloride was given in the ED.  Cardiac Ultrasound didn't show any cardiac activity.  Asystole on the monitor.  No corneal reflex people are fixed and dilated.  Patient was pronounced at 1007 am"
	"1110152-1"	"1110152-1"	"PULSE ABSENT"	"10037469"	"60-64 years"	"60-64"	"This is a 60 year old female was brought into emergency department as cardiac arrest.  Patient was seen at care now urgent care with the complain of epigastric pain associated with nausea vomiting and intermittent diarrhea.  Patient received her initial COVID vaccine 2 days ago.  History is obtained from urgent care chart.  As per notes patient started nausea vomiting 6 hours post COVID vaccine administration.  Patient was seen in urgent care for epigastric pain and nausea vomiting.  Patient was found unresponsive at 0902 by tech.  No carotid pulses palpated.  CPR was started.  Patient was brought into the emergency department with Lucas on.  Patient was given 5 epinephrine prior to arrival.  CPR was in progress.  Patient was asystole.  Resuscitation was continued in the ED.  Patient was intubated in the ED by physician assistant 5 epinephrine 2 bicarb and 1 calcium chloride was given in the ED.  Cardiac Ultrasound didn't show any cardiac activity.  Asystole on the monitor.  No corneal reflex people are fixed and dilated.  Patient was pronounced at 1007 am"
	"1110152-1"	"1110152-1"	"PULSELESS ELECTRICAL ACTIVITY"	"10058151"	"60-64 years"	"60-64"	"This is a 60 year old female was brought into emergency department as cardiac arrest.  Patient was seen at care now urgent care with the complain of epigastric pain associated with nausea vomiting and intermittent diarrhea.  Patient received her initial COVID vaccine 2 days ago.  History is obtained from urgent care chart.  As per notes patient started nausea vomiting 6 hours post COVID vaccine administration.  Patient was seen in urgent care for epigastric pain and nausea vomiting.  Patient was found unresponsive at 0902 by tech.  No carotid pulses palpated.  CPR was started.  Patient was brought into the emergency department with Lucas on.  Patient was given 5 epinephrine prior to arrival.  CPR was in progress.  Patient was asystole.  Resuscitation was continued in the ED.  Patient was intubated in the ED by physician assistant 5 epinephrine 2 bicarb and 1 calcium chloride was given in the ED.  Cardiac Ultrasound didn't show any cardiac activity.  Asystole on the monitor.  No corneal reflex people are fixed and dilated.  Patient was pronounced at 1007 am"
	"1110152-1"	"1110152-1"	"PUPIL FIXED"	"10037515"	"60-64 years"	"60-64"	"This is a 60 year old female was brought into emergency department as cardiac arrest.  Patient was seen at care now urgent care with the complain of epigastric pain associated with nausea vomiting and intermittent diarrhea.  Patient received her initial COVID vaccine 2 days ago.  History is obtained from urgent care chart.  As per notes patient started nausea vomiting 6 hours post COVID vaccine administration.  Patient was seen in urgent care for epigastric pain and nausea vomiting.  Patient was found unresponsive at 0902 by tech.  No carotid pulses palpated.  CPR was started.  Patient was brought into the emergency department with Lucas on.  Patient was given 5 epinephrine prior to arrival.  CPR was in progress.  Patient was asystole.  Resuscitation was continued in the ED.  Patient was intubated in the ED by physician assistant 5 epinephrine 2 bicarb and 1 calcium chloride was given in the ED.  Cardiac Ultrasound didn't show any cardiac activity.  Asystole on the monitor.  No corneal reflex people are fixed and dilated.  Patient was pronounced at 1007 am"
	"1110152-1"	"1110152-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"This is a 60 year old female was brought into emergency department as cardiac arrest.  Patient was seen at care now urgent care with the complain of epigastric pain associated with nausea vomiting and intermittent diarrhea.  Patient received her initial COVID vaccine 2 days ago.  History is obtained from urgent care chart.  As per notes patient started nausea vomiting 6 hours post COVID vaccine administration.  Patient was seen in urgent care for epigastric pain and nausea vomiting.  Patient was found unresponsive at 0902 by tech.  No carotid pulses palpated.  CPR was started.  Patient was brought into the emergency department with Lucas on.  Patient was given 5 epinephrine prior to arrival.  CPR was in progress.  Patient was asystole.  Resuscitation was continued in the ED.  Patient was intubated in the ED by physician assistant 5 epinephrine 2 bicarb and 1 calcium chloride was given in the ED.  Cardiac Ultrasound didn't show any cardiac activity.  Asystole on the monitor.  No corneal reflex people are fixed and dilated.  Patient was pronounced at 1007 am"
	"1110152-1"	"1110152-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"This is a 60 year old female was brought into emergency department as cardiac arrest.  Patient was seen at care now urgent care with the complain of epigastric pain associated with nausea vomiting and intermittent diarrhea.  Patient received her initial COVID vaccine 2 days ago.  History is obtained from urgent care chart.  As per notes patient started nausea vomiting 6 hours post COVID vaccine administration.  Patient was seen in urgent care for epigastric pain and nausea vomiting.  Patient was found unresponsive at 0902 by tech.  No carotid pulses palpated.  CPR was started.  Patient was brought into the emergency department with Lucas on.  Patient was given 5 epinephrine prior to arrival.  CPR was in progress.  Patient was asystole.  Resuscitation was continued in the ED.  Patient was intubated in the ED by physician assistant 5 epinephrine 2 bicarb and 1 calcium chloride was given in the ED.  Cardiac Ultrasound didn't show any cardiac activity.  Asystole on the monitor.  No corneal reflex people are fixed and dilated.  Patient was pronounced at 1007 am"
	"1110152-1"	"1110152-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"This is a 60 year old female was brought into emergency department as cardiac arrest.  Patient was seen at care now urgent care with the complain of epigastric pain associated with nausea vomiting and intermittent diarrhea.  Patient received her initial COVID vaccine 2 days ago.  History is obtained from urgent care chart.  As per notes patient started nausea vomiting 6 hours post COVID vaccine administration.  Patient was seen in urgent care for epigastric pain and nausea vomiting.  Patient was found unresponsive at 0902 by tech.  No carotid pulses palpated.  CPR was started.  Patient was brought into the emergency department with Lucas on.  Patient was given 5 epinephrine prior to arrival.  CPR was in progress.  Patient was asystole.  Resuscitation was continued in the ED.  Patient was intubated in the ED by physician assistant 5 epinephrine 2 bicarb and 1 calcium chloride was given in the ED.  Cardiac Ultrasound didn't show any cardiac activity.  Asystole on the monitor.  No corneal reflex people are fixed and dilated.  Patient was pronounced at 1007 am"
	"1110329-1"	"1110329-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient passed away within 60 days of receiving the COVID vaccine series"
	"1110388-1"	"1110388-1"	"AUSCULTATION"	"10076270"	"60-64 years"	"60-64"	"On 2/1/2021 they performed CBC, the result was aseptic bacteria so it came out and she was taken to the hospital. They removed the tube in the hospital, (she remained in the hospital) First she was hospitalized and then she was transferred to the Medical Center Hospital to auscultate bleeding in the stool and to be evaluated by the Gastroenterologist. This specialist performs the necessary studies, they do not give a diagnosis and in the process she dies. The hospital indicated that she had a blood drain and heart failure."
	"1110388-1"	"1110388-1"	"BACTERIAL INFECTION"	"10060945"	"60-64 years"	"60-64"	"On 2/1/2021 they performed CBC, the result was aseptic bacteria so it came out and she was taken to the hospital. They removed the tube in the hospital, (she remained in the hospital) First she was hospitalized and then she was transferred to the Medical Center Hospital to auscultate bleeding in the stool and to be evaluated by the Gastroenterologist. This specialist performs the necessary studies, they do not give a diagnosis and in the process she dies. The hospital indicated that she had a blood drain and heart failure."
	"1110388-1"	"1110388-1"	"BLOODY DISCHARGE"	"10057687"	"60-64 years"	"60-64"	"On 2/1/2021 they performed CBC, the result was aseptic bacteria so it came out and she was taken to the hospital. They removed the tube in the hospital, (she remained in the hospital) First she was hospitalized and then she was transferred to the Medical Center Hospital to auscultate bleeding in the stool and to be evaluated by the Gastroenterologist. This specialist performs the necessary studies, they do not give a diagnosis and in the process she dies. The hospital indicated that she had a blood drain and heart failure."
	"1110388-1"	"1110388-1"	"CARDIAC FAILURE"	"10007554"	"60-64 years"	"60-64"	"On 2/1/2021 they performed CBC, the result was aseptic bacteria so it came out and she was taken to the hospital. They removed the tube in the hospital, (she remained in the hospital) First she was hospitalized and then she was transferred to the Medical Center Hospital to auscultate bleeding in the stool and to be evaluated by the Gastroenterologist. This specialist performs the necessary studies, they do not give a diagnosis and in the process she dies. The hospital indicated that she had a blood drain and heart failure."
	"1110388-1"	"1110388-1"	"COLOSTOMY INFECTION"	"10010046"	"60-64 years"	"60-64"	"On 2/1/2021 they performed CBC, the result was aseptic bacteria so it came out and she was taken to the hospital. They removed the tube in the hospital, (she remained in the hospital) First she was hospitalized and then she was transferred to the Medical Center Hospital to auscultate bleeding in the stool and to be evaluated by the Gastroenterologist. This specialist performs the necessary studies, they do not give a diagnosis and in the process she dies. The hospital indicated that she had a blood drain and heart failure."
	"1110388-1"	"1110388-1"	"CULTURE STOOL POSITIVE"	"10011631"	"60-64 years"	"60-64"	"On 2/1/2021 they performed CBC, the result was aseptic bacteria so it came out and she was taken to the hospital. They removed the tube in the hospital, (she remained in the hospital) First she was hospitalized and then she was transferred to the Medical Center Hospital to auscultate bleeding in the stool and to be evaluated by the Gastroenterologist. This specialist performs the necessary studies, they do not give a diagnosis and in the process she dies. The hospital indicated that she had a blood drain and heart failure."
	"1110388-1"	"1110388-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"On 2/1/2021 they performed CBC, the result was aseptic bacteria so it came out and she was taken to the hospital. They removed the tube in the hospital, (she remained in the hospital) First she was hospitalized and then she was transferred to the Medical Center Hospital to auscultate bleeding in the stool and to be evaluated by the Gastroenterologist. This specialist performs the necessary studies, they do not give a diagnosis and in the process she dies. The hospital indicated that she had a blood drain and heart failure."
	"1110388-1"	"1110388-1"	"FULL BLOOD COUNT ABNORMAL"	"10017412"	"60-64 years"	"60-64"	"On 2/1/2021 they performed CBC, the result was aseptic bacteria so it came out and she was taken to the hospital. They removed the tube in the hospital, (she remained in the hospital) First she was hospitalized and then she was transferred to the Medical Center Hospital to auscultate bleeding in the stool and to be evaluated by the Gastroenterologist. This specialist performs the necessary studies, they do not give a diagnosis and in the process she dies. The hospital indicated that she had a blood drain and heart failure."
	"1110388-1"	"1110388-1"	"GASTROSTOMY TUBE REMOVAL"	"10072964"	"60-64 years"	"60-64"	"On 2/1/2021 they performed CBC, the result was aseptic bacteria so it came out and she was taken to the hospital. They removed the tube in the hospital, (she remained in the hospital) First she was hospitalized and then she was transferred to the Medical Center Hospital to auscultate bleeding in the stool and to be evaluated by the Gastroenterologist. This specialist performs the necessary studies, they do not give a diagnosis and in the process she dies. The hospital indicated that she had a blood drain and heart failure."
	"1111831-1"	"1111831-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Died 3-2-21"
	"1116098-1"	"1116098-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death Narrative:"
	"1116236-1"	"1116236-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Hospice patient passed away within 60 days of receiving a COVID vaccine"
	"1118963-1"	"1118963-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death Narrative:"
	"1124121-1"	"1124121-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"DECEDENT WAS NOTED TO BE COUGHING FOLLOWING THE ADMINISTERING OF THE VACCINE. FAMILY INTERVIEWED COULD NOT RECALL WHETHER THE DECEDENT WAS COUGHING PRIOR TO RECEIVING THE VACCINE."
	"1124121-1"	"1124121-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"DECEDENT WAS NOTED TO BE COUGHING FOLLOWING THE ADMINISTERING OF THE VACCINE. FAMILY INTERVIEWED COULD NOT RECALL WHETHER THE DECEDENT WAS COUGHING PRIOR TO RECEIVING THE VACCINE."
	"1125778-1"	"1125778-1"	"ABDOMINAL DISTENSION"	"10000060"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"ALBUMIN GLOBULIN RATIO DECREASED"	"10001565"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"ANION GAP DECREASED"	"10002526"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"BLOOD ALBUMIN DECREASED"	"10005287"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"BLOOD CALCIUM DECREASED"	"10005395"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"BLOOD CREATINE INCREASED"	"10005464"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"BLOOD GLUCOSE NORMAL"	"10005558"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"BLOOD UREA INCREASED"	"10005851"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"BLOOD UREA NITROGEN/CREATININE RATIO"	"10059899"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"CARBON DIOXIDE INCREASED"	"10007225"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"FULL BLOOD COUNT ABNORMAL"	"10017412"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"HAEMATOCRIT DECREASED"	"10018838"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"HAEMOGLOBIN DECREASED"	"10018884"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"HYPOPNOEA"	"10021079"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"MEAN CELL HAEMOGLOBIN CONCENTRATION DECREASED"	"10026991"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"MEAN CELL HAEMOGLOBIN DECREASED"	"10026995"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"MEAN PLATELET VOLUME DECREASED"	"10055053"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"METABOLIC FUNCTION TEST ABNORMAL"	"10061286"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"PROTEIN TOTAL DECREASED"	"10037014"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"PULSE ABNORMAL"	"10037466"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"PULSE ABSENT"	"10037469"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"RED BLOOD CELL COUNT DECREASED"	"10038153"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125778-1"	"1125778-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"3/20/21 06:22 pm Resident c/o Nausea and feeling full- Tube feeding placed on Hold- Resident started vomiting- Zofran 4 mg  given- Positive outcomes. 03/21/2021- 0430 Resident found unresponsive on morning rounds- w/ weak pulse, shallow breathing. O2 via NC increased to 5 L, NP, Family  ( Code Status DNR)- Power of attorney ordered to send out- MR notified- Upon arrival no rhythm detected- Death pronounced at 0445"
	"1125891-1"	"1125891-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient died with an unknown cause. He was found on the kitchen floor with no blood present. We requested an autopsy but because the County Coroner said there was no foul play suspected, that they would not perform an autopsy on the body to determine the cause of death even though the family had requested an autopsy. The Funeral Home stated to us that it had the looks of a heart attack, but he was not qualified to make that determination. He stated that the way the blood had stopped and purpled in his neck, gave him the indication that the heart was unable to pump all the way."
	"1126012-1"	"1126012-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death within 60 days of vaccination"
	"1126060-1"	"1126060-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death 2 and half hours after receiving the first Moderna vaccine; A Spontaneous report was received from  a health care professional concerning a 61 year old male patient,who received Moderna's COVID-19 vaccine (mRNA-1273) and reported death.  The patient's medical history as provided by the reporter included diabetes, history of shortness of breath, cardiac history. Concomitant medications included metoprolol, metformin and glipizide.  On 05 Mar 2021, prior to the onset of events the patient received his first dose of their two planned doses of mRNA-1273 (Batch N0: 030a21a) intramuscularly for prophylaxis of covid 19 infection.  On 05 Mar 2021,it was reported that the patient died 2 and half hours after receiving the first Moderna vaccine. The patient had no symptoms during observation 15 minutes after receiving fist Moderna vaccine.The patient's PCP ordered an autopsy.  Treatment information not included.   Action taken with mRNA-1273 in response to the events was not applicable.  On 05 Mar 2021, it was reported that the patient died.; Reporter's Comments: This is a case of sudden death in a 61-year-old male subject with hx of diabetes, history of shortness of breath and cardiac history, who died 2 1/2 hours after receiving first dose of vaccine. Very limited information has been provided at this time.; Reported Cause(s) of Death: unknown cause of death"
	"1126609-1"	"1126609-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"CARDIOPULMONARY ARREST 2 DAYS AFTER RECIEVING SECOND MODERNA DOSE"
	"1126609-1"	"1126609-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"CARDIOPULMONARY ARREST 2 DAYS AFTER RECIEVING SECOND MODERNA DOSE"
	"1126609-1"	"1126609-1"	"DRUG SCREEN NEGATIVE"	"10050895"	"60-64 years"	"60-64"	"CARDIOPULMONARY ARREST 2 DAYS AFTER RECIEVING SECOND MODERNA DOSE"
	"1126609-1"	"1126609-1"	"HAEMOGLOBIN NORMAL"	"10018890"	"60-64 years"	"60-64"	"CARDIOPULMONARY ARREST 2 DAYS AFTER RECIEVING SECOND MODERNA DOSE"
	"1126609-1"	"1126609-1"	"PLATELET COUNT DECREASED"	"10035528"	"60-64 years"	"60-64"	"CARDIOPULMONARY ARREST 2 DAYS AFTER RECIEVING SECOND MODERNA DOSE"
	"1126609-1"	"1126609-1"	"RED BLOOD CELL COUNT NORMAL"	"10038157"	"60-64 years"	"60-64"	"CARDIOPULMONARY ARREST 2 DAYS AFTER RECIEVING SECOND MODERNA DOSE"
	"1126609-1"	"1126609-1"	"THROMBOSIS"	"10043607"	"60-64 years"	"60-64"	"CARDIOPULMONARY ARREST 2 DAYS AFTER RECIEVING SECOND MODERNA DOSE"
	"1126609-1"	"1126609-1"	"WHITE BLOOD CELL COUNT INCREASED"	"10047943"	"60-64 years"	"60-64"	"CARDIOPULMONARY ARREST 2 DAYS AFTER RECIEVING SECOND MODERNA DOSE"
	"1126681-1"	"1126681-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Family notified facility of death when we contacted to confirm second dose appointment"
	"1126917-1"	"1126917-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"N/a"
	"1127466-1"	"1127466-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"Received call from his exwife that patient had passed away.  Death Certificate states date of death as March 14, 2021.  Causes of death are listed a. Cardiac Pulmonary Arrest. b. Myocardial Infarction"
	"1127466-1"	"1127466-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Received call from his exwife that patient had passed away.  Death Certificate states date of death as March 14, 2021.  Causes of death are listed a. Cardiac Pulmonary Arrest. b. Myocardial Infarction"
	"1127466-1"	"1127466-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"Received call from his exwife that patient had passed away.  Death Certificate states date of death as March 14, 2021.  Causes of death are listed a. Cardiac Pulmonary Arrest. b. Myocardial Infarction"
	"1130340-1"	"1130340-1"	"ASPIRATION"	"10003504"	"60-64 years"	"60-64"	"2/25/2021 She was taken to the hospital for aspiration. 03/09/2021 was discharged, but relatives were informed that she was unwell. 3/13/2021 When they went to take the rounds she was without signs, she was sleeping. He refers that the patient died of Aspiration Pneumonia and was tested at the Hospital with negative results. They certify death due to cardiovascular arrest"
	"1130340-1"	"1130340-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"2/25/2021 She was taken to the hospital for aspiration. 03/09/2021 was discharged, but relatives were informed that she was unwell. 3/13/2021 When they went to take the rounds she was without signs, she was sleeping. He refers that the patient died of Aspiration Pneumonia and was tested at the Hospital with negative results. They certify death due to cardiovascular arrest"
	"1130340-1"	"1130340-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"2/25/2021 She was taken to the hospital for aspiration. 03/09/2021 was discharged, but relatives were informed that she was unwell. 3/13/2021 When they went to take the rounds she was without signs, she was sleeping. He refers that the patient died of Aspiration Pneumonia and was tested at the Hospital with negative results. They certify death due to cardiovascular arrest"
	"1130340-1"	"1130340-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"2/25/2021 She was taken to the hospital for aspiration. 03/09/2021 was discharged, but relatives were informed that she was unwell. 3/13/2021 When they went to take the rounds she was without signs, she was sleeping. He refers that the patient died of Aspiration Pneumonia and was tested at the Hospital with negative results. They certify death due to cardiovascular arrest"
	"1130340-1"	"1130340-1"	"PNEUMONIA ASPIRATION"	"10035669"	"60-64 years"	"60-64"	"2/25/2021 She was taken to the hospital for aspiration. 03/09/2021 was discharged, but relatives were informed that she was unwell. 3/13/2021 When they went to take the rounds she was without signs, she was sleeping. He refers that the patient died of Aspiration Pneumonia and was tested at the Hospital with negative results. They certify death due to cardiovascular arrest"
	"1132752-1"	"1132752-1"	"ARTHRALGIA"	"10003239"	"60-64 years"	"60-64"	"Decedent began noticing symptoms on 3/17/2021.  He c/o worsening back pain, joint pain, headache and stiffness last Sunday (3/21/2021).  Today (3/25/2021), he c/o chest pain.  The decedent received his COVID-19 vaccine on 3/16/2021."
	"1132752-1"	"1132752-1"	"BACK PAIN"	"10003988"	"60-64 years"	"60-64"	"Decedent began noticing symptoms on 3/17/2021.  He c/o worsening back pain, joint pain, headache and stiffness last Sunday (3/21/2021).  Today (3/25/2021), he c/o chest pain.  The decedent received his COVID-19 vaccine on 3/16/2021."
	"1132752-1"	"1132752-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"Decedent began noticing symptoms on 3/17/2021.  He c/o worsening back pain, joint pain, headache and stiffness last Sunday (3/21/2021).  Today (3/25/2021), he c/o chest pain.  The decedent received his COVID-19 vaccine on 3/16/2021."
	"1132752-1"	"1132752-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"Decedent began noticing symptoms on 3/17/2021.  He c/o worsening back pain, joint pain, headache and stiffness last Sunday (3/21/2021).  Today (3/25/2021), he c/o chest pain.  The decedent received his COVID-19 vaccine on 3/16/2021."
	"1132752-1"	"1132752-1"	"MUSCULOSKELETAL STIFFNESS"	"10052904"	"60-64 years"	"60-64"	"Decedent began noticing symptoms on 3/17/2021.  He c/o worsening back pain, joint pain, headache and stiffness last Sunday (3/21/2021).  Today (3/25/2021), he c/o chest pain.  The decedent received his COVID-19 vaccine on 3/16/2021."
	"1132752-1"	"1132752-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	"Decedent began noticing symptoms on 3/17/2021.  He c/o worsening back pain, joint pain, headache and stiffness last Sunday (3/21/2021).  Today (3/25/2021), he c/o chest pain.  The decedent received his COVID-19 vaccine on 3/16/2021."
	"1132786-1"	"1132786-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death"
	"1133564-1"	"1133564-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"It was sent for low pressure on 02/12/2021 to the Hospital Medical Center. He died of respiratory arrest."
	"1133564-1"	"1133564-1"	"HYPOTENSION"	"10021097"	"60-64 years"	"60-64"	"It was sent for low pressure on 02/12/2021 to the Hospital Medical Center. He died of respiratory arrest."
	"1133564-1"	"1133564-1"	"RESPIRATORY ARREST"	"10038669"	"60-64 years"	"60-64"	"It was sent for low pressure on 02/12/2021 to the Hospital Medical Center. He died of respiratory arrest."
	"1134432-1"	"1134432-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pt went unresponsive at home per wife, was transported to hospital by EMS and died after getting to the hospital. This is not a suspected allergic reaction to the COVID Moderna vaccine at this time."
	"1134432-1"	"1134432-1"	"HYPERSENSITIVITY"	"10020751"	"60-64 years"	"60-64"	"Pt went unresponsive at home per wife, was transported to hospital by EMS and died after getting to the hospital. This is not a suspected allergic reaction to the COVID Moderna vaccine at this time."
	"1134432-1"	"1134432-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Pt went unresponsive at home per wife, was transported to hospital by EMS and died after getting to the hospital. This is not a suspected allergic reaction to the COVID Moderna vaccine at this time."
	"1134651-1"	"1134651-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"The patient had a hemorrhagic stroke approximately 3 days after receiving the vaccine and died."
	"1134651-1"	"1134651-1"	"HAEMORRHAGIC STROKE"	"10019016"	"60-64 years"	"60-64"	"The patient had a hemorrhagic stroke approximately 3 days after receiving the vaccine and died."
	"1137579-1"	"1137579-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"? Maderna vaccine #1 on 3/16 at clinic ? Provider visit 3/22 dx bronchitis due to COVID-19, z pak and steroids ? ED 3/25 syncopy, full arrest and patient expired patient states she had COVID in February"
	"1137579-1"	"1137579-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"? Maderna vaccine #1 on 3/16 at clinic ? Provider visit 3/22 dx bronchitis due to COVID-19, z pak and steroids ? ED 3/25 syncopy, full arrest and patient expired patient states she had COVID in February"
	"1137579-1"	"1137579-1"	"SYNCOPE"	"10042772"	"60-64 years"	"60-64"	"? Maderna vaccine #1 on 3/16 at clinic ? Provider visit 3/22 dx bronchitis due to COVID-19, z pak and steroids ? ED 3/25 syncopy, full arrest and patient expired patient states she had COVID in February"
	"1138291-1"	"1138291-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"60-64 years"	"60-64"	"Severe headache, fatigue, very sleepy about two hours after injection.  Woke about 1:00 a.m. with severe headache.  Gave two Tylenol and cold wash cloth for forehead.  Started tossing and turning about five minutes later.  Sat up in bed, fell over and struck bedside table.  EMT said he suffered stroke around 1:30 am.  He passed away on the 5th."
	"1138291-1"	"1138291-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"60-64 years"	"60-64"	"Severe headache, fatigue, very sleepy about two hours after injection.  Woke about 1:00 a.m. with severe headache.  Gave two Tylenol and cold wash cloth for forehead.  Started tossing and turning about five minutes later.  Sat up in bed, fell over and struck bedside table.  EMT said he suffered stroke around 1:30 am.  He passed away on the 5th."
	"1138291-1"	"1138291-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Severe headache, fatigue, very sleepy about two hours after injection.  Woke about 1:00 a.m. with severe headache.  Gave two Tylenol and cold wash cloth for forehead.  Started tossing and turning about five minutes later.  Sat up in bed, fell over and struck bedside table.  EMT said he suffered stroke around 1:30 am.  He passed away on the 5th."
	"1138291-1"	"1138291-1"	"FALL"	"10016173"	"60-64 years"	"60-64"	"Severe headache, fatigue, very sleepy about two hours after injection.  Woke about 1:00 a.m. with severe headache.  Gave two Tylenol and cold wash cloth for forehead.  Started tossing and turning about five minutes later.  Sat up in bed, fell over and struck bedside table.  EMT said he suffered stroke around 1:30 am.  He passed away on the 5th."
	"1138291-1"	"1138291-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Severe headache, fatigue, very sleepy about two hours after injection.  Woke about 1:00 a.m. with severe headache.  Gave two Tylenol and cold wash cloth for forehead.  Started tossing and turning about five minutes later.  Sat up in bed, fell over and struck bedside table.  EMT said he suffered stroke around 1:30 am.  He passed away on the 5th."
	"1138291-1"	"1138291-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"Severe headache, fatigue, very sleepy about two hours after injection.  Woke about 1:00 a.m. with severe headache.  Gave two Tylenol and cold wash cloth for forehead.  Started tossing and turning about five minutes later.  Sat up in bed, fell over and struck bedside table.  EMT said he suffered stroke around 1:30 am.  He passed away on the 5th."
	"1138291-1"	"1138291-1"	"RESTLESSNESS"	"10038743"	"60-64 years"	"60-64"	"Severe headache, fatigue, very sleepy about two hours after injection.  Woke about 1:00 a.m. with severe headache.  Gave two Tylenol and cold wash cloth for forehead.  Started tossing and turning about five minutes later.  Sat up in bed, fell over and struck bedside table.  EMT said he suffered stroke around 1:30 am.  He passed away on the 5th."
	"1138291-1"	"1138291-1"	"SOMNOLENCE"	"10041349"	"60-64 years"	"60-64"	"Severe headache, fatigue, very sleepy about two hours after injection.  Woke about 1:00 a.m. with severe headache.  Gave two Tylenol and cold wash cloth for forehead.  Started tossing and turning about five minutes later.  Sat up in bed, fell over and struck bedside table.  EMT said he suffered stroke around 1:30 am.  He passed away on the 5th."
	"1139056-1"	"1139056-1"	"CELLULITIS"	"10007882"	"60-64 years"	"60-64"	"****I want to note that I am submitting on behave of my mother who passed away yesterday. The medical examiner has declined 2x for an autopsy to be done.  My mother was healthy and was absolutely fine besides the rash (dr diagnosed her with cellulitis week of March 14). I do not agree with the rule of death being  ?natural causes? neither does her doctor."
	"1139056-1"	"1139056-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"****I want to note that I am submitting on behave of my mother who passed away yesterday. The medical examiner has declined 2x for an autopsy to be done.  My mother was healthy and was absolutely fine besides the rash (dr diagnosed her with cellulitis week of March 14). I do not agree with the rule of death being  ?natural causes? neither does her doctor."
	"1139056-1"	"1139056-1"	"RASH"	"10037844"	"60-64 years"	"60-64"	"****I want to note that I am submitting on behave of my mother who passed away yesterday. The medical examiner has declined 2x for an autopsy to be done.  My mother was healthy and was absolutely fine besides the rash (dr diagnosed her with cellulitis week of March 14). I do not agree with the rule of death being  ?natural causes? neither does her doctor."
	"1139812-1"	"1139812-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient was found expired in his home on 3/20/2021."
	"1141569-1"	"1141569-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"patient experienced heart attack and subsequently passed away approximately 2 weeks following vaccination. it is not believed to be related to the vaccination."
	"1141569-1"	"1141569-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"patient experienced heart attack and subsequently passed away approximately 2 weeks following vaccination. it is not believed to be related to the vaccination."
	"1142995-1"	"1142995-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death"
	"1147210-1"	"1147210-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Massive heart attack, yelled for help to wife, 10 seconds later no pulse, called EMT, could not revive, DOA at hospital"
	"1147210-1"	"1147210-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"Massive heart attack, yelled for help to wife, 10 seconds later no pulse, called EMT, could not revive, DOA at hospital"
	"1147210-1"	"1147210-1"	"PULSE ABSENT"	"10037469"	"60-64 years"	"60-64"	"Massive heart attack, yelled for help to wife, 10 seconds later no pulse, called EMT, could not revive, DOA at hospital"
	"1147354-1"	"1147354-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient death within 60 days of receiving a COVID vaccine"
	"1147591-1"	"1147591-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Patient received vaccine on 3/26/2021. Was found deceased on 03/27/2021"
	"1147591-1"	"1147591-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient received vaccine on 3/26/2021. Was found deceased on 03/27/2021"
	"1147758-1"	"1147758-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"headaches, coughing, fatigue, fever, chills, nonapeptide, vomiting"
	"1147758-1"	"1147758-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"headaches, coughing, fatigue, fever, chills, nonapeptide, vomiting"
	"1147758-1"	"1147758-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"headaches, coughing, fatigue, fever, chills, nonapeptide, vomiting"
	"1147758-1"	"1147758-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"headaches, coughing, fatigue, fever, chills, nonapeptide, vomiting"
	"1147758-1"	"1147758-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"headaches, coughing, fatigue, fever, chills, nonapeptide, vomiting"
	"1147758-1"	"1147758-1"	"SARS-COV-2 TEST"	"10084354"	"60-64 years"	"60-64"	"headaches, coughing, fatigue, fever, chills, nonapeptide, vomiting"
	"1147758-1"	"1147758-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"headaches, coughing, fatigue, fever, chills, nonapeptide, vomiting"
	"1149813-1"	"1149813-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"PT RECEIVED MODERNA #1 ON 3/26 AND PASSED AWAY ON 3/28 AT HOME."
	"1152164-1"	"1152164-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Deceased 2/26/21"
	"1152421-1"	"1152421-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"hospice patietn passed away"
	"1152513-1"	"1152513-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Employee had a heart attack and past away around 3/17/21."
	"1152513-1"	"1152513-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"Employee had a heart attack and past away around 3/17/21."
	"1152757-1"	"1152757-1"	"CARDIAC DEATH"	"10049993"	"60-64 years"	"60-64"	"vaccine recieved 3/29/21, on 3/30/21 patient expired in his home.  cause of death assumed to be cardiac related.  Pt. was not feeling well after covid vaccination, therefore refused to go to dialysis (3/30/21).  Collapsed in basement and was found by spouse 30 minutes later.  Patient was DNR.  spouse stated she feels death was not directly related to vaccine because he had several health conditions in which he has been noncompliant with and has not been following his medical providers treatment plans."
	"1152757-1"	"1152757-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"vaccine recieved 3/29/21, on 3/30/21 patient expired in his home.  cause of death assumed to be cardiac related.  Pt. was not feeling well after covid vaccination, therefore refused to go to dialysis (3/30/21).  Collapsed in basement and was found by spouse 30 minutes later.  Patient was DNR.  spouse stated she feels death was not directly related to vaccine because he had several health conditions in which he has been noncompliant with and has not been following his medical providers treatment plans."
	"1152757-1"	"1152757-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"vaccine recieved 3/29/21, on 3/30/21 patient expired in his home.  cause of death assumed to be cardiac related.  Pt. was not feeling well after covid vaccination, therefore refused to go to dialysis (3/30/21).  Collapsed in basement and was found by spouse 30 minutes later.  Patient was DNR.  spouse stated she feels death was not directly related to vaccine because he had several health conditions in which he has been noncompliant with and has not been following his medical providers treatment plans."
	"1152757-1"	"1152757-1"	"REFUSAL OF TREATMENT BY PATIENT"	"10056407"	"60-64 years"	"60-64"	"vaccine recieved 3/29/21, on 3/30/21 patient expired in his home.  cause of death assumed to be cardiac related.  Pt. was not feeling well after covid vaccination, therefore refused to go to dialysis (3/30/21).  Collapsed in basement and was found by spouse 30 minutes later.  Patient was DNR.  spouse stated she feels death was not directly related to vaccine because he had several health conditions in which he has been noncompliant with and has not been following his medical providers treatment plans."
	"1152757-1"	"1152757-1"	"SYNCOPE"	"10042772"	"60-64 years"	"60-64"	"vaccine recieved 3/29/21, on 3/30/21 patient expired in his home.  cause of death assumed to be cardiac related.  Pt. was not feeling well after covid vaccination, therefore refused to go to dialysis (3/30/21).  Collapsed in basement and was found by spouse 30 minutes later.  Patient was DNR.  spouse stated she feels death was not directly related to vaccine because he had several health conditions in which he has been noncompliant with and has not been following his medical providers treatment plans."
	"1153969-1"	"1153969-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"60-64 years"	"60-64"	"Brain bleed; Platelet count droppped to 40; Bruises all over the body; Organs shut down; A spontaneous report  was received from a consumer concerning a 64-year-old female patient, who experienced bruises all over the body (contusion) , brain bleed (cerebral haemorrhage), platelet count dropped below 40 (platelet count decreased) and organs shutdown (multi organ failure).   The patient's medical history included bacterial infection 2 days prior to receiving vaccine dose. Product known to have been used by the patient, within two weeks prior to the event, included antibiotics (not specified).  On 02 Mar 2021, the patient received her first of the two planned vaccine doses of mRNA-1237 (Lot # unknown) for prophylaxis of Covid-19 infection.  On 03-Mar-2021, the patient developed severe bruises all over her body.  On 04 Mar 2021, within 2 days after receiving the vaccination, the patient was rushed to the hospital where it was determined that she had sustained a brain bleed. She had all her organs shutdown and her platelet count had dropped below 40.  On 04 Mar 2021, it was reported that the patient died.  The cause of death was reported as organ failure. Plans for autopsy were not provided.   Action taken with the mRNA-1273 in response to the events was not applicable.  The outcome of the events, bruises all over the body(contusion), brain bleed(cerebral haemorrhage), platelet count dropped below 40(platelet count decreased) were unknown.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.  However, the patient's underlying history of bacterial infection could be a contributory factor.  Awaiting further clarification.; Reported Cause(s) of Death: Organ Failure"
	"1153969-1"	"1153969-1"	"CONTUSION"	"10050584"	"60-64 years"	"60-64"	"Brain bleed; Platelet count droppped to 40; Bruises all over the body; Organs shut down; A spontaneous report  was received from a consumer concerning a 64-year-old female patient, who experienced bruises all over the body (contusion) , brain bleed (cerebral haemorrhage), platelet count dropped below 40 (platelet count decreased) and organs shutdown (multi organ failure).   The patient's medical history included bacterial infection 2 days prior to receiving vaccine dose. Product known to have been used by the patient, within two weeks prior to the event, included antibiotics (not specified).  On 02 Mar 2021, the patient received her first of the two planned vaccine doses of mRNA-1237 (Lot # unknown) for prophylaxis of Covid-19 infection.  On 03-Mar-2021, the patient developed severe bruises all over her body.  On 04 Mar 2021, within 2 days after receiving the vaccination, the patient was rushed to the hospital where it was determined that she had sustained a brain bleed. She had all her organs shutdown and her platelet count had dropped below 40.  On 04 Mar 2021, it was reported that the patient died.  The cause of death was reported as organ failure. Plans for autopsy were not provided.   Action taken with the mRNA-1273 in response to the events was not applicable.  The outcome of the events, bruises all over the body(contusion), brain bleed(cerebral haemorrhage), platelet count dropped below 40(platelet count decreased) were unknown.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.  However, the patient's underlying history of bacterial infection could be a contributory factor.  Awaiting further clarification.; Reported Cause(s) of Death: Organ Failure"
	"1153969-1"	"1153969-1"	"MULTIPLE ORGAN DYSFUNCTION SYNDROME"	"10077361"	"60-64 years"	"60-64"	"Brain bleed; Platelet count droppped to 40; Bruises all over the body; Organs shut down; A spontaneous report  was received from a consumer concerning a 64-year-old female patient, who experienced bruises all over the body (contusion) , brain bleed (cerebral haemorrhage), platelet count dropped below 40 (platelet count decreased) and organs shutdown (multi organ failure).   The patient's medical history included bacterial infection 2 days prior to receiving vaccine dose. Product known to have been used by the patient, within two weeks prior to the event, included antibiotics (not specified).  On 02 Mar 2021, the patient received her first of the two planned vaccine doses of mRNA-1237 (Lot # unknown) for prophylaxis of Covid-19 infection.  On 03-Mar-2021, the patient developed severe bruises all over her body.  On 04 Mar 2021, within 2 days after receiving the vaccination, the patient was rushed to the hospital where it was determined that she had sustained a brain bleed. She had all her organs shutdown and her platelet count had dropped below 40.  On 04 Mar 2021, it was reported that the patient died.  The cause of death was reported as organ failure. Plans for autopsy were not provided.   Action taken with the mRNA-1273 in response to the events was not applicable.  The outcome of the events, bruises all over the body(contusion), brain bleed(cerebral haemorrhage), platelet count dropped below 40(platelet count decreased) were unknown.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.  However, the patient's underlying history of bacterial infection could be a contributory factor.  Awaiting further clarification.; Reported Cause(s) of Death: Organ Failure"
	"1153969-1"	"1153969-1"	"PLATELET COUNT"	"10035525"	"60-64 years"	"60-64"	"Brain bleed; Platelet count droppped to 40; Bruises all over the body; Organs shut down; A spontaneous report  was received from a consumer concerning a 64-year-old female patient, who experienced bruises all over the body (contusion) , brain bleed (cerebral haemorrhage), platelet count dropped below 40 (platelet count decreased) and organs shutdown (multi organ failure).   The patient's medical history included bacterial infection 2 days prior to receiving vaccine dose. Product known to have been used by the patient, within two weeks prior to the event, included antibiotics (not specified).  On 02 Mar 2021, the patient received her first of the two planned vaccine doses of mRNA-1237 (Lot # unknown) for prophylaxis of Covid-19 infection.  On 03-Mar-2021, the patient developed severe bruises all over her body.  On 04 Mar 2021, within 2 days after receiving the vaccination, the patient was rushed to the hospital where it was determined that she had sustained a brain bleed. She had all her organs shutdown and her platelet count had dropped below 40.  On 04 Mar 2021, it was reported that the patient died.  The cause of death was reported as organ failure. Plans for autopsy were not provided.   Action taken with the mRNA-1273 in response to the events was not applicable.  The outcome of the events, bruises all over the body(contusion), brain bleed(cerebral haemorrhage), platelet count dropped below 40(platelet count decreased) were unknown.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.  However, the patient's underlying history of bacterial infection could be a contributory factor.  Awaiting further clarification.; Reported Cause(s) of Death: Organ Failure"
	"1153969-1"	"1153969-1"	"PLATELET COUNT DECREASED"	"10035528"	"60-64 years"	"60-64"	"Brain bleed; Platelet count droppped to 40; Bruises all over the body; Organs shut down; A spontaneous report  was received from a consumer concerning a 64-year-old female patient, who experienced bruises all over the body (contusion) , brain bleed (cerebral haemorrhage), platelet count dropped below 40 (platelet count decreased) and organs shutdown (multi organ failure).   The patient's medical history included bacterial infection 2 days prior to receiving vaccine dose. Product known to have been used by the patient, within two weeks prior to the event, included antibiotics (not specified).  On 02 Mar 2021, the patient received her first of the two planned vaccine doses of mRNA-1237 (Lot # unknown) for prophylaxis of Covid-19 infection.  On 03-Mar-2021, the patient developed severe bruises all over her body.  On 04 Mar 2021, within 2 days after receiving the vaccination, the patient was rushed to the hospital where it was determined that she had sustained a brain bleed. She had all her organs shutdown and her platelet count had dropped below 40.  On 04 Mar 2021, it was reported that the patient died.  The cause of death was reported as organ failure. Plans for autopsy were not provided.   Action taken with the mRNA-1273 in response to the events was not applicable.  The outcome of the events, bruises all over the body(contusion), brain bleed(cerebral haemorrhage), platelet count dropped below 40(platelet count decreased) were unknown.; Reporter's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.  However, the patient's underlying history of bacterial infection could be a contributory factor.  Awaiting further clarification.; Reported Cause(s) of Death: Organ Failure"
	"1155594-1"	"1155594-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient death within 60 days of receiving a COVID vaccine"
	"1155893-1"	"1155893-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"pt was at his normal baseline of health the Monday of vaccine. Per sister, he had a fever of 104F, chills and myalgias hte following Saturday. he was not heard from on Sunday therefore on Monday his sister did a forced entry and found him on the ground."
	"1155893-1"	"1155893-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"pt was at his normal baseline of health the Monday of vaccine. Per sister, he had a fever of 104F, chills and myalgias hte following Saturday. he was not heard from on Sunday therefore on Monday his sister did a forced entry and found him on the ground."
	"1155893-1"	"1155893-1"	"MYALGIA"	"10028411"	"60-64 years"	"60-64"	"pt was at his normal baseline of health the Monday of vaccine. Per sister, he had a fever of 104F, chills and myalgias hte following Saturday. he was not heard from on Sunday therefore on Monday his sister did a forced entry and found him on the ground."
	"1155893-1"	"1155893-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"pt was at his normal baseline of health the Monday of vaccine. Per sister, he had a fever of 104F, chills and myalgias hte following Saturday. he was not heard from on Sunday therefore on Monday his sister did a forced entry and found him on the ground."
	"1157133-1"	"1157133-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"pt deceased approx 36 hours after vaccination"
	"1157733-1"	"1157733-1"	"BRAIN STEM HAEMORRHAGE"	"10006145"	"60-64 years"	"60-64"	"Patient experienced a brain hemorrhage and was hospitalized on Monday, March 15. Despite numerous tests, doctors could not find the source or cause of the bleeding. Over time, the bleeding spread to other areas of her brain including her brain stem. Damage from the bleeding was so severe that she would not recover. She passed away on March 24 after being removed from life support."
	"1157733-1"	"1157733-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"60-64 years"	"60-64"	"Patient experienced a brain hemorrhage and was hospitalized on Monday, March 15. Despite numerous tests, doctors could not find the source or cause of the bleeding. Over time, the bleeding spread to other areas of her brain including her brain stem. Damage from the bleeding was so severe that she would not recover. She passed away on March 24 after being removed from life support."
	"1157733-1"	"1157733-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient experienced a brain hemorrhage and was hospitalized on Monday, March 15. Despite numerous tests, doctors could not find the source or cause of the bleeding. Over time, the bleeding spread to other areas of her brain including her brain stem. Damage from the bleeding was so severe that she would not recover. She passed away on March 24 after being removed from life support."
	"1160180-1"	"1160180-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Long term care patient death within 60 days of receiving a COVID vaccine"
	"1160365-1"	"1160365-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death"
	"1166300-1"	"1166300-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Note: I AM reporting this because I strongly believe that patient's death was caused by his second COvid-19 vaccine. The exact date of the vaccine is unknown. His girlfriend told me he got his second Vaccine at the end of February. I also don't know what vaccine (Moderna or Pfizer) he got, so the Pfizer is just a guess. Patient started feeling bad and looking bad after his second vaccine. He complained that he wasn't feeling well and missed appointments saying he wasn't feeling well during the two weeks or so between the time of his second vaccine and his death."
	"1166300-1"	"1166300-1"	"FEELING ABNORMAL"	"10016322"	"60-64 years"	"60-64"	"Note: I AM reporting this because I strongly believe that patient's death was caused by his second COvid-19 vaccine. The exact date of the vaccine is unknown. His girlfriend told me he got his second Vaccine at the end of February. I also don't know what vaccine (Moderna or Pfizer) he got, so the Pfizer is just a guess. Patient started feeling bad and looking bad after his second vaccine. He complained that he wasn't feeling well and missed appointments saying he wasn't feeling well during the two weeks or so between the time of his second vaccine and his death."
	"1166300-1"	"1166300-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"Note: I AM reporting this because I strongly believe that patient's death was caused by his second COvid-19 vaccine. The exact date of the vaccine is unknown. His girlfriend told me he got his second Vaccine at the end of February. I also don't know what vaccine (Moderna or Pfizer) he got, so the Pfizer is just a guess. Patient started feeling bad and looking bad after his second vaccine. He complained that he wasn't feeling well and missed appointments saying he wasn't feeling well during the two weeks or so between the time of his second vaccine and his death."
	"1168352-1"	"1168352-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Started feeling ill a few hours after vaccination. Became increasingly ill over the next few days with nausea and vomiting, severe diarrhea, leg cramps that progressed to where he was not able to ambulate, flushed, confused."
	"1168352-1"	"1168352-1"	"CONFUSIONAL STATE"	"10010305"	"60-64 years"	"60-64"	"Started feeling ill a few hours after vaccination. Became increasingly ill over the next few days with nausea and vomiting, severe diarrhea, leg cramps that progressed to where he was not able to ambulate, flushed, confused."
	"1168352-1"	"1168352-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"Started feeling ill a few hours after vaccination. Became increasingly ill over the next few days with nausea and vomiting, severe diarrhea, leg cramps that progressed to where he was not able to ambulate, flushed, confused."
	"1168352-1"	"1168352-1"	"FLUSHING"	"10016825"	"60-64 years"	"60-64"	"Started feeling ill a few hours after vaccination. Became increasingly ill over the next few days with nausea and vomiting, severe diarrhea, leg cramps that progressed to where he was not able to ambulate, flushed, confused."
	"1168352-1"	"1168352-1"	"GAIT INABILITY"	"10017581"	"60-64 years"	"60-64"	"Started feeling ill a few hours after vaccination. Became increasingly ill over the next few days with nausea and vomiting, severe diarrhea, leg cramps that progressed to where he was not able to ambulate, flushed, confused."
	"1168352-1"	"1168352-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"Started feeling ill a few hours after vaccination. Became increasingly ill over the next few days with nausea and vomiting, severe diarrhea, leg cramps that progressed to where he was not able to ambulate, flushed, confused."
	"1168352-1"	"1168352-1"	"MUSCLE SPASMS"	"10028334"	"60-64 years"	"60-64"	"Started feeling ill a few hours after vaccination. Became increasingly ill over the next few days with nausea and vomiting, severe diarrhea, leg cramps that progressed to where he was not able to ambulate, flushed, confused."
	"1168352-1"	"1168352-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Started feeling ill a few hours after vaccination. Became increasingly ill over the next few days with nausea and vomiting, severe diarrhea, leg cramps that progressed to where he was not able to ambulate, flushed, confused."
	"1168352-1"	"1168352-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	"Started feeling ill a few hours after vaccination. Became increasingly ill over the next few days with nausea and vomiting, severe diarrhea, leg cramps that progressed to where he was not able to ambulate, flushed, confused."
	"1168352-1"	"1168352-1"	"TOXICOLOGIC TEST"	"10061384"	"60-64 years"	"60-64"	"Started feeling ill a few hours after vaccination. Became increasingly ill over the next few days with nausea and vomiting, severe diarrhea, leg cramps that progressed to where he was not able to ambulate, flushed, confused."
	"1168352-1"	"1168352-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"Started feeling ill a few hours after vaccination. Became increasingly ill over the next few days with nausea and vomiting, severe diarrhea, leg cramps that progressed to where he was not able to ambulate, flushed, confused."
	"1168598-1"	"1168598-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient passed away the morning after receiving her second COVID vaccine."
	"1168833-1"	"1168833-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death Narrative:  Death on 12/27/20. 1st dose 10 days before serious event. Patient was admitted for hospice care at the facility with bladder cancer with mets to liver, lung, and bone. There are no indications that death was related to the vaccine."
	"1171204-1"	"1171204-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient fell while on the job on Friday March 26th, slurred talking. Later slumped over in the car while driving and had to be taken to the Emergency room where he later passed away. Cause of death on the death certificate per the coroner is Pulmonary Embolus. Patient was just seen my his family physician in January and was in good health no medications taken other than eye drops."
	"1171204-1"	"1171204-1"	"DYSARTHRIA"	"10013887"	"60-64 years"	"60-64"	"Patient fell while on the job on Friday March 26th, slurred talking. Later slumped over in the car while driving and had to be taken to the Emergency room where he later passed away. Cause of death on the death certificate per the coroner is Pulmonary Embolus. Patient was just seen my his family physician in January and was in good health no medications taken other than eye drops."
	"1171204-1"	"1171204-1"	"FALL"	"10016173"	"60-64 years"	"60-64"	"Patient fell while on the job on Friday March 26th, slurred talking. Later slumped over in the car while driving and had to be taken to the Emergency room where he later passed away. Cause of death on the death certificate per the coroner is Pulmonary Embolus. Patient was just seen my his family physician in January and was in good health no medications taken other than eye drops."
	"1171204-1"	"1171204-1"	"IMPAIRED DRIVING ABILITY"	"10049564"	"60-64 years"	"60-64"	"Patient fell while on the job on Friday March 26th, slurred talking. Later slumped over in the car while driving and had to be taken to the Emergency room where he later passed away. Cause of death on the death certificate per the coroner is Pulmonary Embolus. Patient was just seen my his family physician in January and was in good health no medications taken other than eye drops."
	"1171204-1"	"1171204-1"	"POSTURE ABNORMAL"	"10036436"	"60-64 years"	"60-64"	"Patient fell while on the job on Friday March 26th, slurred talking. Later slumped over in the car while driving and had to be taken to the Emergency room where he later passed away. Cause of death on the death certificate per the coroner is Pulmonary Embolus. Patient was just seen my his family physician in January and was in good health no medications taken other than eye drops."
	"1171204-1"	"1171204-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"Patient fell while on the job on Friday March 26th, slurred talking. Later slumped over in the car while driving and had to be taken to the Emergency room where he later passed away. Cause of death on the death certificate per the coroner is Pulmonary Embolus. Patient was just seen my his family physician in January and was in good health no medications taken other than eye drops."
	"1171391-1"	"1171391-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death on 3/24/21 reported to vaccination clinic by family member. No additional details given."
	"1172708-1"	"1172708-1"	"CARDIOMEGALY"	"10007632"	"60-64 years"	"60-64"	"No acute symptoms after vaccine except a mildly sore arm.  Patient died 4 days later"
	"1172708-1"	"1172708-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"No acute symptoms after vaccine except a mildly sore arm.  Patient died 4 days later"
	"1172708-1"	"1172708-1"	"HYPERTENSION"	"10020772"	"60-64 years"	"60-64"	"No acute symptoms after vaccine except a mildly sore arm.  Patient died 4 days later"
	"1172708-1"	"1172708-1"	"PAIN IN EXTREMITY"	"10033425"	"60-64 years"	"60-64"	"No acute symptoms after vaccine except a mildly sore arm.  Patient died 4 days later"
	"1173746-1"	"1173746-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Received first dose 2/27/21 and received second dose 3/20/21 and died 3/26/21."
	"1176373-1"	"1176373-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death Narrative: Patient with gastric cancer received COVID-19 vaccine, first dose on 2/8/2021 and second dose on 3/9/2021. Chart note indicates that patient passed away on 3/26/2021 while on home hospice. Patient has never tested positive for COVID. Patient had metastatic cancer and was referred to hospice on 3/5/2021, note from provider indicates patient likely had only weeks to live. Patient had no documented reaction from COVID vaccine administration. Patient had no hospitalization around time of COVID vaccination. The patients most likely cause of death was the metastatic cancer, with date of death closely aligning with cancer providers' estimations of remaining life span on 3/5."
	"1176373-1"	"1176373-1"	"METASTATIC NEOPLASM"	"10061289"	"60-64 years"	"60-64"	"Death Narrative: Patient with gastric cancer received COVID-19 vaccine, first dose on 2/8/2021 and second dose on 3/9/2021. Chart note indicates that patient passed away on 3/26/2021 while on home hospice. Patient has never tested positive for COVID. Patient had metastatic cancer and was referred to hospice on 3/5/2021, note from provider indicates patient likely had only weeks to live. Patient had no documented reaction from COVID vaccine administration. Patient had no hospitalization around time of COVID vaccination. The patients most likely cause of death was the metastatic cancer, with date of death closely aligning with cancer providers' estimations of remaining life span on 3/5."
	"1176896-1"	"1176896-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Patient died of an apparent Cardiac Arrest."
	"1176896-1"	"1176896-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient died of an apparent Cardiac Arrest."
	"1178158-1"	"1178158-1"	"AGGRESSION"	"10001488"	"60-64 years"	"60-64"	"Pt came to the ER via ambulance with SOB, difficulty breathing, confusion and combativeness which had gotten worse over the day 4/3/21. He had a rash all over his body..  After the respiratory  treatments failed, pt was intubated and transferred to a higher level of care and expired on 4/4/21"
	"1178158-1"	"1178158-1"	"BLOOD GASES"	"10005537"	"60-64 years"	"60-64"	"Pt came to the ER via ambulance with SOB, difficulty breathing, confusion and combativeness which had gotten worse over the day 4/3/21. He had a rash all over his body..  After the respiratory  treatments failed, pt was intubated and transferred to a higher level of care and expired on 4/4/21"
	"1178158-1"	"1178158-1"	"COAGULATION TEST"	"10063556"	"60-64 years"	"60-64"	"Pt came to the ER via ambulance with SOB, difficulty breathing, confusion and combativeness which had gotten worse over the day 4/3/21. He had a rash all over his body..  After the respiratory  treatments failed, pt was intubated and transferred to a higher level of care and expired on 4/4/21"
	"1178158-1"	"1178158-1"	"CONFUSIONAL STATE"	"10010305"	"60-64 years"	"60-64"	"Pt came to the ER via ambulance with SOB, difficulty breathing, confusion and combativeness which had gotten worse over the day 4/3/21. He had a rash all over his body..  After the respiratory  treatments failed, pt was intubated and transferred to a higher level of care and expired on 4/4/21"
	"1178158-1"	"1178158-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pt came to the ER via ambulance with SOB, difficulty breathing, confusion and combativeness which had gotten worse over the day 4/3/21. He had a rash all over his body..  After the respiratory  treatments failed, pt was intubated and transferred to a higher level of care and expired on 4/4/21"
	"1178158-1"	"1178158-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Pt came to the ER via ambulance with SOB, difficulty breathing, confusion and combativeness which had gotten worse over the day 4/3/21. He had a rash all over his body..  After the respiratory  treatments failed, pt was intubated and transferred to a higher level of care and expired on 4/4/21"
	"1178158-1"	"1178158-1"	"ENDOCRINE TEST"	"10059689"	"60-64 years"	"60-64"	"Pt came to the ER via ambulance with SOB, difficulty breathing, confusion and combativeness which had gotten worse over the day 4/3/21. He had a rash all over his body..  After the respiratory  treatments failed, pt was intubated and transferred to a higher level of care and expired on 4/4/21"
	"1178158-1"	"1178158-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Pt came to the ER via ambulance with SOB, difficulty breathing, confusion and combativeness which had gotten worse over the day 4/3/21. He had a rash all over his body..  After the respiratory  treatments failed, pt was intubated and transferred to a higher level of care and expired on 4/4/21"
	"1178158-1"	"1178158-1"	"FULL BLOOD COUNT"	"10017411"	"60-64 years"	"60-64"	"Pt came to the ER via ambulance with SOB, difficulty breathing, confusion and combativeness which had gotten worse over the day 4/3/21. He had a rash all over his body..  After the respiratory  treatments failed, pt was intubated and transferred to a higher level of care and expired on 4/4/21"
	"1178158-1"	"1178158-1"	"LABORATORY TEST"	"10059938"	"60-64 years"	"60-64"	"Pt came to the ER via ambulance with SOB, difficulty breathing, confusion and combativeness which had gotten worse over the day 4/3/21. He had a rash all over his body..  After the respiratory  treatments failed, pt was intubated and transferred to a higher level of care and expired on 4/4/21"
	"1178158-1"	"1178158-1"	"MYOCARDIAL NECROSIS MARKER"	"10075210"	"60-64 years"	"60-64"	"Pt came to the ER via ambulance with SOB, difficulty breathing, confusion and combativeness which had gotten worse over the day 4/3/21. He had a rash all over his body..  After the respiratory  treatments failed, pt was intubated and transferred to a higher level of care and expired on 4/4/21"
	"1178158-1"	"1178158-1"	"RASH"	"10037844"	"60-64 years"	"60-64"	"Pt came to the ER via ambulance with SOB, difficulty breathing, confusion and combativeness which had gotten worse over the day 4/3/21. He had a rash all over his body..  After the respiratory  treatments failed, pt was intubated and transferred to a higher level of care and expired on 4/4/21"
	"1178158-1"	"1178158-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	"Pt came to the ER via ambulance with SOB, difficulty breathing, confusion and combativeness which had gotten worse over the day 4/3/21. He had a rash all over his body..  After the respiratory  treatments failed, pt was intubated and transferred to a higher level of care and expired on 4/4/21"
	"1178158-1"	"1178158-1"	"URINE ANALYSIS"	"10046614"	"60-64 years"	"60-64"	"Pt came to the ER via ambulance with SOB, difficulty breathing, confusion and combativeness which had gotten worse over the day 4/3/21. He had a rash all over his body..  After the respiratory  treatments failed, pt was intubated and transferred to a higher level of care and expired on 4/4/21"
	"1180533-1"	"1180533-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"wife of the patient called came in for her COVID-19 vaccine appointment on 4/8/2021 and explained that her husband passed away in his sleep suddenly after a wonderful evening on 3/25/2021.  She expressed that physician said it was not COVID related.  Wife did not want to discuss  the death of her husband at this time so the information is limited for this report."
	"1184531-1"	"1184531-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"Weakness Confusion Falling down Vision impairment  Legs really weak All of the  above symptoms started on March 14, 2021 On March 18,2021 she was not out of bed except for just a few minutes.  On March 19, 2021 she was on the floor laying beside of the bed and my father noticed blood looking stuff on her shirt and bed covers. She was really confused and lethargic. She was really weak and could not stand. She was extremely fatigued. At around 10:30 she fell again on the floor and my father and sister in law was able to get her back up and put her in a chair and she went to sleep. At 12:55 my father noticed she was not breathing and called 911. When they did CPR blood was coming from her mouth and nose. When the ambulance arrived they immediately took her to the hospital where she was pronounced dead at around 3:30 pm."
	"1184531-1"	"1184531-1"	"CONFUSIONAL STATE"	"10010305"	"60-64 years"	"60-64"	"Weakness Confusion Falling down Vision impairment  Legs really weak All of the  above symptoms started on March 14, 2021 On March 18,2021 she was not out of bed except for just a few minutes.  On March 19, 2021 she was on the floor laying beside of the bed and my father noticed blood looking stuff on her shirt and bed covers. She was really confused and lethargic. She was really weak and could not stand. She was extremely fatigued. At around 10:30 she fell again on the floor and my father and sister in law was able to get her back up and put her in a chair and she went to sleep. At 12:55 my father noticed she was not breathing and called 911. When they did CPR blood was coming from her mouth and nose. When the ambulance arrived they immediately took her to the hospital where she was pronounced dead at around 3:30 pm."
	"1184531-1"	"1184531-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Weakness Confusion Falling down Vision impairment  Legs really weak All of the  above symptoms started on March 14, 2021 On March 18,2021 she was not out of bed except for just a few minutes.  On March 19, 2021 she was on the floor laying beside of the bed and my father noticed blood looking stuff on her shirt and bed covers. She was really confused and lethargic. She was really weak and could not stand. She was extremely fatigued. At around 10:30 she fell again on the floor and my father and sister in law was able to get her back up and put her in a chair and she went to sleep. At 12:55 my father noticed she was not breathing and called 911. When they did CPR blood was coming from her mouth and nose. When the ambulance arrived they immediately took her to the hospital where she was pronounced dead at around 3:30 pm."
	"1184531-1"	"1184531-1"	"DYSSTASIA"	"10050256"	"60-64 years"	"60-64"	"Weakness Confusion Falling down Vision impairment  Legs really weak All of the  above symptoms started on March 14, 2021 On March 18,2021 she was not out of bed except for just a few minutes.  On March 19, 2021 she was on the floor laying beside of the bed and my father noticed blood looking stuff on her shirt and bed covers. She was really confused and lethargic. She was really weak and could not stand. She was extremely fatigued. At around 10:30 she fell again on the floor and my father and sister in law was able to get her back up and put her in a chair and she went to sleep. At 12:55 my father noticed she was not breathing and called 911. When they did CPR blood was coming from her mouth and nose. When the ambulance arrived they immediately took her to the hospital where she was pronounced dead at around 3:30 pm."
	"1184531-1"	"1184531-1"	"EPISTAXIS"	"10015090"	"60-64 years"	"60-64"	"Weakness Confusion Falling down Vision impairment  Legs really weak All of the  above symptoms started on March 14, 2021 On March 18,2021 she was not out of bed except for just a few minutes.  On March 19, 2021 she was on the floor laying beside of the bed and my father noticed blood looking stuff on her shirt and bed covers. She was really confused and lethargic. She was really weak and could not stand. She was extremely fatigued. At around 10:30 she fell again on the floor and my father and sister in law was able to get her back up and put her in a chair and she went to sleep. At 12:55 my father noticed she was not breathing and called 911. When they did CPR blood was coming from her mouth and nose. When the ambulance arrived they immediately took her to the hospital where she was pronounced dead at around 3:30 pm."
	"1184531-1"	"1184531-1"	"FALL"	"10016173"	"60-64 years"	"60-64"	"Weakness Confusion Falling down Vision impairment  Legs really weak All of the  above symptoms started on March 14, 2021 On March 18,2021 she was not out of bed except for just a few minutes.  On March 19, 2021 she was on the floor laying beside of the bed and my father noticed blood looking stuff on her shirt and bed covers. She was really confused and lethargic. She was really weak and could not stand. She was extremely fatigued. At around 10:30 she fell again on the floor and my father and sister in law was able to get her back up and put her in a chair and she went to sleep. At 12:55 my father noticed she was not breathing and called 911. When they did CPR blood was coming from her mouth and nose. When the ambulance arrived they immediately took her to the hospital where she was pronounced dead at around 3:30 pm."
	"1184531-1"	"1184531-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Weakness Confusion Falling down Vision impairment  Legs really weak All of the  above symptoms started on March 14, 2021 On March 18,2021 she was not out of bed except for just a few minutes.  On March 19, 2021 she was on the floor laying beside of the bed and my father noticed blood looking stuff on her shirt and bed covers. She was really confused and lethargic. She was really weak and could not stand. She was extremely fatigued. At around 10:30 she fell again on the floor and my father and sister in law was able to get her back up and put her in a chair and she went to sleep. At 12:55 my father noticed she was not breathing and called 911. When they did CPR blood was coming from her mouth and nose. When the ambulance arrived they immediately took her to the hospital where she was pronounced dead at around 3:30 pm."
	"1184531-1"	"1184531-1"	"LETHARGY"	"10024264"	"60-64 years"	"60-64"	"Weakness Confusion Falling down Vision impairment  Legs really weak All of the  above symptoms started on March 14, 2021 On March 18,2021 she was not out of bed except for just a few minutes.  On March 19, 2021 she was on the floor laying beside of the bed and my father noticed blood looking stuff on her shirt and bed covers. She was really confused and lethargic. She was really weak and could not stand. She was extremely fatigued. At around 10:30 she fell again on the floor and my father and sister in law was able to get her back up and put her in a chair and she went to sleep. At 12:55 my father noticed she was not breathing and called 911. When they did CPR blood was coming from her mouth and nose. When the ambulance arrived they immediately took her to the hospital where she was pronounced dead at around 3:30 pm."
	"1184531-1"	"1184531-1"	"MOUTH HAEMORRHAGE"	"10028024"	"60-64 years"	"60-64"	"Weakness Confusion Falling down Vision impairment  Legs really weak All of the  above symptoms started on March 14, 2021 On March 18,2021 she was not out of bed except for just a few minutes.  On March 19, 2021 she was on the floor laying beside of the bed and my father noticed blood looking stuff on her shirt and bed covers. She was really confused and lethargic. She was really weak and could not stand. She was extremely fatigued. At around 10:30 she fell again on the floor and my father and sister in law was able to get her back up and put her in a chair and she went to sleep. At 12:55 my father noticed she was not breathing and called 911. When they did CPR blood was coming from her mouth and nose. When the ambulance arrived they immediately took her to the hospital where she was pronounced dead at around 3:30 pm."
	"1184531-1"	"1184531-1"	"MUSCULAR WEAKNESS"	"10028372"	"60-64 years"	"60-64"	"Weakness Confusion Falling down Vision impairment  Legs really weak All of the  above symptoms started on March 14, 2021 On March 18,2021 she was not out of bed except for just a few minutes.  On March 19, 2021 she was on the floor laying beside of the bed and my father noticed blood looking stuff on her shirt and bed covers. She was really confused and lethargic. She was really weak and could not stand. She was extremely fatigued. At around 10:30 she fell again on the floor and my father and sister in law was able to get her back up and put her in a chair and she went to sleep. At 12:55 my father noticed she was not breathing and called 911. When they did CPR blood was coming from her mouth and nose. When the ambulance arrived they immediately took her to the hospital where she was pronounced dead at around 3:30 pm."
	"1184531-1"	"1184531-1"	"RESPIRATORY ARREST"	"10038669"	"60-64 years"	"60-64"	"Weakness Confusion Falling down Vision impairment  Legs really weak All of the  above symptoms started on March 14, 2021 On March 18,2021 she was not out of bed except for just a few minutes.  On March 19, 2021 she was on the floor laying beside of the bed and my father noticed blood looking stuff on her shirt and bed covers. She was really confused and lethargic. She was really weak and could not stand. She was extremely fatigued. At around 10:30 she fell again on the floor and my father and sister in law was able to get her back up and put her in a chair and she went to sleep. At 12:55 my father noticed she was not breathing and called 911. When they did CPR blood was coming from her mouth and nose. When the ambulance arrived they immediately took her to the hospital where she was pronounced dead at around 3:30 pm."
	"1184531-1"	"1184531-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Weakness Confusion Falling down Vision impairment  Legs really weak All of the  above symptoms started on March 14, 2021 On March 18,2021 she was not out of bed except for just a few minutes.  On March 19, 2021 she was on the floor laying beside of the bed and my father noticed blood looking stuff on her shirt and bed covers. She was really confused and lethargic. She was really weak and could not stand. She was extremely fatigued. At around 10:30 she fell again on the floor and my father and sister in law was able to get her back up and put her in a chair and she went to sleep. At 12:55 my father noticed she was not breathing and called 911. When they did CPR blood was coming from her mouth and nose. When the ambulance arrived they immediately took her to the hospital where she was pronounced dead at around 3:30 pm."
	"1184531-1"	"1184531-1"	"VISUAL IMPAIRMENT"	"10047571"	"60-64 years"	"60-64"	"Weakness Confusion Falling down Vision impairment  Legs really weak All of the  above symptoms started on March 14, 2021 On March 18,2021 she was not out of bed except for just a few minutes.  On March 19, 2021 she was on the floor laying beside of the bed and my father noticed blood looking stuff on her shirt and bed covers. She was really confused and lethargic. She was really weak and could not stand. She was extremely fatigued. At around 10:30 she fell again on the floor and my father and sister in law was able to get her back up and put her in a chair and she went to sleep. At 12:55 my father noticed she was not breathing and called 911. When they did CPR blood was coming from her mouth and nose. When the ambulance arrived they immediately took her to the hospital where she was pronounced dead at around 3:30 pm."
	"1194540-1"	"1194540-1"	"BLOOD GASES"	"10005537"	"60-64 years"	"60-64"	"on 2/8 developed cough  on 2/13 to Hospital Emergency Room, diagnosed viral pneumonia on  2/15 back to ER, admitted, diagnosed with pulmonary embolism  on 2/20 to ICU, intubated and put on ventilator on 3/3 died from pneumonia due to COVID-19 per death certificate"
	"1194540-1"	"1194540-1"	"BLOOD TEST"	"10061726"	"60-64 years"	"60-64"	"on 2/8 developed cough  on 2/13 to Hospital Emergency Room, diagnosed viral pneumonia on  2/15 back to ER, admitted, diagnosed with pulmonary embolism  on 2/20 to ICU, intubated and put on ventilator on 3/3 died from pneumonia due to COVID-19 per death certificate"
	"1194540-1"	"1194540-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"on 2/8 developed cough  on 2/13 to Hospital Emergency Room, diagnosed viral pneumonia on  2/15 back to ER, admitted, diagnosed with pulmonary embolism  on 2/20 to ICU, intubated and put on ventilator on 3/3 died from pneumonia due to COVID-19 per death certificate"
	"1194540-1"	"1194540-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"on 2/8 developed cough  on 2/13 to Hospital Emergency Room, diagnosed viral pneumonia on  2/15 back to ER, admitted, diagnosed with pulmonary embolism  on 2/20 to ICU, intubated and put on ventilator on 3/3 died from pneumonia due to COVID-19 per death certificate"
	"1194540-1"	"1194540-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"on 2/8 developed cough  on 2/13 to Hospital Emergency Room, diagnosed viral pneumonia on  2/15 back to ER, admitted, diagnosed with pulmonary embolism  on 2/20 to ICU, intubated and put on ventilator on 3/3 died from pneumonia due to COVID-19 per death certificate"
	"1194540-1"	"1194540-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"on 2/8 developed cough  on 2/13 to Hospital Emergency Room, diagnosed viral pneumonia on  2/15 back to ER, admitted, diagnosed with pulmonary embolism  on 2/20 to ICU, intubated and put on ventilator on 3/3 died from pneumonia due to COVID-19 per death certificate"
	"1194540-1"	"1194540-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"on 2/8 developed cough  on 2/13 to Hospital Emergency Room, diagnosed viral pneumonia on  2/15 back to ER, admitted, diagnosed with pulmonary embolism  on 2/20 to ICU, intubated and put on ventilator on 3/3 died from pneumonia due to COVID-19 per death certificate"
	"1194540-1"	"1194540-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"on 2/8 developed cough  on 2/13 to Hospital Emergency Room, diagnosed viral pneumonia on  2/15 back to ER, admitted, diagnosed with pulmonary embolism  on 2/20 to ICU, intubated and put on ventilator on 3/3 died from pneumonia due to COVID-19 per death certificate"
	"1194540-1"	"1194540-1"	"PNEUMONIA VIRAL"	"10035737"	"60-64 years"	"60-64"	"on 2/8 developed cough  on 2/13 to Hospital Emergency Room, diagnosed viral pneumonia on  2/15 back to ER, admitted, diagnosed with pulmonary embolism  on 2/20 to ICU, intubated and put on ventilator on 3/3 died from pneumonia due to COVID-19 per death certificate"
	"1194540-1"	"1194540-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"on 2/8 developed cough  on 2/13 to Hospital Emergency Room, diagnosed viral pneumonia on  2/15 back to ER, admitted, diagnosed with pulmonary embolism  on 2/20 to ICU, intubated and put on ventilator on 3/3 died from pneumonia due to COVID-19 per death certificate"
	"1194540-1"	"1194540-1"	"X-RAY"	"10048064"	"60-64 years"	"60-64"	"on 2/8 developed cough  on 2/13 to Hospital Emergency Room, diagnosed viral pneumonia on  2/15 back to ER, admitted, diagnosed with pulmonary embolism  on 2/20 to ICU, intubated and put on ventilator on 3/3 died from pneumonia due to COVID-19 per death certificate"
	"1196099-1"	"1196099-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"DEATH  OF PATIENT REPORTED ON 04/07/2021 AT 11:25PM"
	"1198199-1"	"1198199-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"62-year-old male with number of medical problems that include history of hepatitis-C, history of cirrhosis, history of alcohol abuse, cocaine abuse, history of diabetes hypertension who has initially presented to EMS with increasing shortness of breath.  Patient suffered cardiac arrest during his transportation to the emergency room.  A CPR was initiated and was given 3 rounds of epinephrine.  Most of the history is taken from the ER physician chart review.   ACUTE RESPIRATORY FAILURE SECONDARY TO HYPOXEMIA, COVID-19 , cardiac arrest, possible anoxic brain damage  : Patient is 62-year-old male with complicated history with history of hepatitis-C, cirrhosis, alcohol use, cocaine abuse diabetes who presented after having cardiac arrest and possible anoxic brain damage.  Patient was intubated after the arrest.  Patient stayed in the hospital for number of days.  Patient was found to have COVID-19 positive.  Patient was found to have diffuse bilateral infiltrate.  Patient was started on broad-spectrum antibiotics including cefepime Flagyl and Decadron.  Due to patient's cardiac arrest patient was started on hypothermia protocol.  Patient was rewarming after that.  There was no purposeful movement or neurological recovery.  After long discussion with the family, patient has been made comfort care.  Patient was extubated.  Patient expired promptly after that.  Family is notified."
	"1198199-1"	"1198199-1"	"BLOOD GASES"	"10005537"	"60-64 years"	"60-64"	"62-year-old male with number of medical problems that include history of hepatitis-C, history of cirrhosis, history of alcohol abuse, cocaine abuse, history of diabetes hypertension who has initially presented to EMS with increasing shortness of breath.  Patient suffered cardiac arrest during his transportation to the emergency room.  A CPR was initiated and was given 3 rounds of epinephrine.  Most of the history is taken from the ER physician chart review.   ACUTE RESPIRATORY FAILURE SECONDARY TO HYPOXEMIA, COVID-19 , cardiac arrest, possible anoxic brain damage  : Patient is 62-year-old male with complicated history with history of hepatitis-C, cirrhosis, alcohol use, cocaine abuse diabetes who presented after having cardiac arrest and possible anoxic brain damage.  Patient was intubated after the arrest.  Patient stayed in the hospital for number of days.  Patient was found to have COVID-19 positive.  Patient was found to have diffuse bilateral infiltrate.  Patient was started on broad-spectrum antibiotics including cefepime Flagyl and Decadron.  Due to patient's cardiac arrest patient was started on hypothermia protocol.  Patient was rewarming after that.  There was no purposeful movement or neurological recovery.  After long discussion with the family, patient has been made comfort care.  Patient was extubated.  Patient expired promptly after that.  Family is notified."
	"1198199-1"	"1198199-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"62-year-old male with number of medical problems that include history of hepatitis-C, history of cirrhosis, history of alcohol abuse, cocaine abuse, history of diabetes hypertension who has initially presented to EMS with increasing shortness of breath.  Patient suffered cardiac arrest during his transportation to the emergency room.  A CPR was initiated and was given 3 rounds of epinephrine.  Most of the history is taken from the ER physician chart review.   ACUTE RESPIRATORY FAILURE SECONDARY TO HYPOXEMIA, COVID-19 , cardiac arrest, possible anoxic brain damage  : Patient is 62-year-old male with complicated history with history of hepatitis-C, cirrhosis, alcohol use, cocaine abuse diabetes who presented after having cardiac arrest and possible anoxic brain damage.  Patient was intubated after the arrest.  Patient stayed in the hospital for number of days.  Patient was found to have COVID-19 positive.  Patient was found to have diffuse bilateral infiltrate.  Patient was started on broad-spectrum antibiotics including cefepime Flagyl and Decadron.  Due to patient's cardiac arrest patient was started on hypothermia protocol.  Patient was rewarming after that.  There was no purposeful movement or neurological recovery.  After long discussion with the family, patient has been made comfort care.  Patient was extubated.  Patient expired promptly after that.  Family is notified."
	"1198199-1"	"1198199-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"62-year-old male with number of medical problems that include history of hepatitis-C, history of cirrhosis, history of alcohol abuse, cocaine abuse, history of diabetes hypertension who has initially presented to EMS with increasing shortness of breath.  Patient suffered cardiac arrest during his transportation to the emergency room.  A CPR was initiated and was given 3 rounds of epinephrine.  Most of the history is taken from the ER physician chart review.   ACUTE RESPIRATORY FAILURE SECONDARY TO HYPOXEMIA, COVID-19 , cardiac arrest, possible anoxic brain damage  : Patient is 62-year-old male with complicated history with history of hepatitis-C, cirrhosis, alcohol use, cocaine abuse diabetes who presented after having cardiac arrest and possible anoxic brain damage.  Patient was intubated after the arrest.  Patient stayed in the hospital for number of days.  Patient was found to have COVID-19 positive.  Patient was found to have diffuse bilateral infiltrate.  Patient was started on broad-spectrum antibiotics including cefepime Flagyl and Decadron.  Due to patient's cardiac arrest patient was started on hypothermia protocol.  Patient was rewarming after that.  There was no purposeful movement or neurological recovery.  After long discussion with the family, patient has been made comfort care.  Patient was extubated.  Patient expired promptly after that.  Family is notified."
	"1198199-1"	"1198199-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"62-year-old male with number of medical problems that include history of hepatitis-C, history of cirrhosis, history of alcohol abuse, cocaine abuse, history of diabetes hypertension who has initially presented to EMS with increasing shortness of breath.  Patient suffered cardiac arrest during his transportation to the emergency room.  A CPR was initiated and was given 3 rounds of epinephrine.  Most of the history is taken from the ER physician chart review.   ACUTE RESPIRATORY FAILURE SECONDARY TO HYPOXEMIA, COVID-19 , cardiac arrest, possible anoxic brain damage  : Patient is 62-year-old male with complicated history with history of hepatitis-C, cirrhosis, alcohol use, cocaine abuse diabetes who presented after having cardiac arrest and possible anoxic brain damage.  Patient was intubated after the arrest.  Patient stayed in the hospital for number of days.  Patient was found to have COVID-19 positive.  Patient was found to have diffuse bilateral infiltrate.  Patient was started on broad-spectrum antibiotics including cefepime Flagyl and Decadron.  Due to patient's cardiac arrest patient was started on hypothermia protocol.  Patient was rewarming after that.  There was no purposeful movement or neurological recovery.  After long discussion with the family, patient has been made comfort care.  Patient was extubated.  Patient expired promptly after that.  Family is notified."
	"1198199-1"	"1198199-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"62-year-old male with number of medical problems that include history of hepatitis-C, history of cirrhosis, history of alcohol abuse, cocaine abuse, history of diabetes hypertension who has initially presented to EMS with increasing shortness of breath.  Patient suffered cardiac arrest during his transportation to the emergency room.  A CPR was initiated and was given 3 rounds of epinephrine.  Most of the history is taken from the ER physician chart review.   ACUTE RESPIRATORY FAILURE SECONDARY TO HYPOXEMIA, COVID-19 , cardiac arrest, possible anoxic brain damage  : Patient is 62-year-old male with complicated history with history of hepatitis-C, cirrhosis, alcohol use, cocaine abuse diabetes who presented after having cardiac arrest and possible anoxic brain damage.  Patient was intubated after the arrest.  Patient stayed in the hospital for number of days.  Patient was found to have COVID-19 positive.  Patient was found to have diffuse bilateral infiltrate.  Patient was started on broad-spectrum antibiotics including cefepime Flagyl and Decadron.  Due to patient's cardiac arrest patient was started on hypothermia protocol.  Patient was rewarming after that.  There was no purposeful movement or neurological recovery.  After long discussion with the family, patient has been made comfort care.  Patient was extubated.  Patient expired promptly after that.  Family is notified."
	"1198199-1"	"1198199-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"62-year-old male with number of medical problems that include history of hepatitis-C, history of cirrhosis, history of alcohol abuse, cocaine abuse, history of diabetes hypertension who has initially presented to EMS with increasing shortness of breath.  Patient suffered cardiac arrest during his transportation to the emergency room.  A CPR was initiated and was given 3 rounds of epinephrine.  Most of the history is taken from the ER physician chart review.   ACUTE RESPIRATORY FAILURE SECONDARY TO HYPOXEMIA, COVID-19 , cardiac arrest, possible anoxic brain damage  : Patient is 62-year-old male with complicated history with history of hepatitis-C, cirrhosis, alcohol use, cocaine abuse diabetes who presented after having cardiac arrest and possible anoxic brain damage.  Patient was intubated after the arrest.  Patient stayed in the hospital for number of days.  Patient was found to have COVID-19 positive.  Patient was found to have diffuse bilateral infiltrate.  Patient was started on broad-spectrum antibiotics including cefepime Flagyl and Decadron.  Due to patient's cardiac arrest patient was started on hypothermia protocol.  Patient was rewarming after that.  There was no purposeful movement or neurological recovery.  After long discussion with the family, patient has been made comfort care.  Patient was extubated.  Patient expired promptly after that.  Family is notified."
	"1198199-1"	"1198199-1"	"FIBRIN D DIMER"	"10016577"	"60-64 years"	"60-64"	"62-year-old male with number of medical problems that include history of hepatitis-C, history of cirrhosis, history of alcohol abuse, cocaine abuse, history of diabetes hypertension who has initially presented to EMS with increasing shortness of breath.  Patient suffered cardiac arrest during his transportation to the emergency room.  A CPR was initiated and was given 3 rounds of epinephrine.  Most of the history is taken from the ER physician chart review.   ACUTE RESPIRATORY FAILURE SECONDARY TO HYPOXEMIA, COVID-19 , cardiac arrest, possible anoxic brain damage  : Patient is 62-year-old male with complicated history with history of hepatitis-C, cirrhosis, alcohol use, cocaine abuse diabetes who presented after having cardiac arrest and possible anoxic brain damage.  Patient was intubated after the arrest.  Patient stayed in the hospital for number of days.  Patient was found to have COVID-19 positive.  Patient was found to have diffuse bilateral infiltrate.  Patient was started on broad-spectrum antibiotics including cefepime Flagyl and Decadron.  Due to patient's cardiac arrest patient was started on hypothermia protocol.  Patient was rewarming after that.  There was no purposeful movement or neurological recovery.  After long discussion with the family, patient has been made comfort care.  Patient was extubated.  Patient expired promptly after that.  Family is notified."
	"1198199-1"	"1198199-1"	"FULL BLOOD COUNT"	"10017411"	"60-64 years"	"60-64"	"62-year-old male with number of medical problems that include history of hepatitis-C, history of cirrhosis, history of alcohol abuse, cocaine abuse, history of diabetes hypertension who has initially presented to EMS with increasing shortness of breath.  Patient suffered cardiac arrest during his transportation to the emergency room.  A CPR was initiated and was given 3 rounds of epinephrine.  Most of the history is taken from the ER physician chart review.   ACUTE RESPIRATORY FAILURE SECONDARY TO HYPOXEMIA, COVID-19 , cardiac arrest, possible anoxic brain damage  : Patient is 62-year-old male with complicated history with history of hepatitis-C, cirrhosis, alcohol use, cocaine abuse diabetes who presented after having cardiac arrest and possible anoxic brain damage.  Patient was intubated after the arrest.  Patient stayed in the hospital for number of days.  Patient was found to have COVID-19 positive.  Patient was found to have diffuse bilateral infiltrate.  Patient was started on broad-spectrum antibiotics including cefepime Flagyl and Decadron.  Due to patient's cardiac arrest patient was started on hypothermia protocol.  Patient was rewarming after that.  There was no purposeful movement or neurological recovery.  After long discussion with the family, patient has been made comfort care.  Patient was extubated.  Patient expired promptly after that.  Family is notified."
	"1198199-1"	"1198199-1"	"INFLUENZA VIRUS TEST"	"10070715"	"60-64 years"	"60-64"	"62-year-old male with number of medical problems that include history of hepatitis-C, history of cirrhosis, history of alcohol abuse, cocaine abuse, history of diabetes hypertension who has initially presented to EMS with increasing shortness of breath.  Patient suffered cardiac arrest during his transportation to the emergency room.  A CPR was initiated and was given 3 rounds of epinephrine.  Most of the history is taken from the ER physician chart review.   ACUTE RESPIRATORY FAILURE SECONDARY TO HYPOXEMIA, COVID-19 , cardiac arrest, possible anoxic brain damage  : Patient is 62-year-old male with complicated history with history of hepatitis-C, cirrhosis, alcohol use, cocaine abuse diabetes who presented after having cardiac arrest and possible anoxic brain damage.  Patient was intubated after the arrest.  Patient stayed in the hospital for number of days.  Patient was found to have COVID-19 positive.  Patient was found to have diffuse bilateral infiltrate.  Patient was started on broad-spectrum antibiotics including cefepime Flagyl and Decadron.  Due to patient's cardiac arrest patient was started on hypothermia protocol.  Patient was rewarming after that.  There was no purposeful movement or neurological recovery.  After long discussion with the family, patient has been made comfort care.  Patient was extubated.  Patient expired promptly after that.  Family is notified."
	"1198199-1"	"1198199-1"	"INTERNATIONAL NORMALISED RATIO"	"10022591"	"60-64 years"	"60-64"	"62-year-old male with number of medical problems that include history of hepatitis-C, history of cirrhosis, history of alcohol abuse, cocaine abuse, history of diabetes hypertension who has initially presented to EMS with increasing shortness of breath.  Patient suffered cardiac arrest during his transportation to the emergency room.  A CPR was initiated and was given 3 rounds of epinephrine.  Most of the history is taken from the ER physician chart review.   ACUTE RESPIRATORY FAILURE SECONDARY TO HYPOXEMIA, COVID-19 , cardiac arrest, possible anoxic brain damage  : Patient is 62-year-old male with complicated history with history of hepatitis-C, cirrhosis, alcohol use, cocaine abuse diabetes who presented after having cardiac arrest and possible anoxic brain damage.  Patient was intubated after the arrest.  Patient stayed in the hospital for number of days.  Patient was found to have COVID-19 positive.  Patient was found to have diffuse bilateral infiltrate.  Patient was started on broad-spectrum antibiotics including cefepime Flagyl and Decadron.  Due to patient's cardiac arrest patient was started on hypothermia protocol.  Patient was rewarming after that.  There was no purposeful movement or neurological recovery.  After long discussion with the family, patient has been made comfort care.  Patient was extubated.  Patient expired promptly after that.  Family is notified."
	"1198199-1"	"1198199-1"	"LUNG INFILTRATION"	"10025102"	"60-64 years"	"60-64"	"62-year-old male with number of medical problems that include history of hepatitis-C, history of cirrhosis, history of alcohol abuse, cocaine abuse, history of diabetes hypertension who has initially presented to EMS with increasing shortness of breath.  Patient suffered cardiac arrest during his transportation to the emergency room.  A CPR was initiated and was given 3 rounds of epinephrine.  Most of the history is taken from the ER physician chart review.   ACUTE RESPIRATORY FAILURE SECONDARY TO HYPOXEMIA, COVID-19 , cardiac arrest, possible anoxic brain damage  : Patient is 62-year-old male with complicated history with history of hepatitis-C, cirrhosis, alcohol use, cocaine abuse diabetes who presented after having cardiac arrest and possible anoxic brain damage.  Patient was intubated after the arrest.  Patient stayed in the hospital for number of days.  Patient was found to have COVID-19 positive.  Patient was found to have diffuse bilateral infiltrate.  Patient was started on broad-spectrum antibiotics including cefepime Flagyl and Decadron.  Due to patient's cardiac arrest patient was started on hypothermia protocol.  Patient was rewarming after that.  There was no purposeful movement or neurological recovery.  After long discussion with the family, patient has been made comfort care.  Patient was extubated.  Patient expired promptly after that.  Family is notified."
	"1198199-1"	"1198199-1"	"METABOLIC FUNCTION TEST"	"10062191"	"60-64 years"	"60-64"	"62-year-old male with number of medical problems that include history of hepatitis-C, history of cirrhosis, history of alcohol abuse, cocaine abuse, history of diabetes hypertension who has initially presented to EMS with increasing shortness of breath.  Patient suffered cardiac arrest during his transportation to the emergency room.  A CPR was initiated and was given 3 rounds of epinephrine.  Most of the history is taken from the ER physician chart review.   ACUTE RESPIRATORY FAILURE SECONDARY TO HYPOXEMIA, COVID-19 , cardiac arrest, possible anoxic brain damage  : Patient is 62-year-old male with complicated history with history of hepatitis-C, cirrhosis, alcohol use, cocaine abuse diabetes who presented after having cardiac arrest and possible anoxic brain damage.  Patient was intubated after the arrest.  Patient stayed in the hospital for number of days.  Patient was found to have COVID-19 positive.  Patient was found to have diffuse bilateral infiltrate.  Patient was started on broad-spectrum antibiotics including cefepime Flagyl and Decadron.  Due to patient's cardiac arrest patient was started on hypothermia protocol.  Patient was rewarming after that.  There was no purposeful movement or neurological recovery.  After long discussion with the family, patient has been made comfort care.  Patient was extubated.  Patient expired promptly after that.  Family is notified."
	"1198199-1"	"1198199-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"62-year-old male with number of medical problems that include history of hepatitis-C, history of cirrhosis, history of alcohol abuse, cocaine abuse, history of diabetes hypertension who has initially presented to EMS with increasing shortness of breath.  Patient suffered cardiac arrest during his transportation to the emergency room.  A CPR was initiated and was given 3 rounds of epinephrine.  Most of the history is taken from the ER physician chart review.   ACUTE RESPIRATORY FAILURE SECONDARY TO HYPOXEMIA, COVID-19 , cardiac arrest, possible anoxic brain damage  : Patient is 62-year-old male with complicated history with history of hepatitis-C, cirrhosis, alcohol use, cocaine abuse diabetes who presented after having cardiac arrest and possible anoxic brain damage.  Patient was intubated after the arrest.  Patient stayed in the hospital for number of days.  Patient was found to have COVID-19 positive.  Patient was found to have diffuse bilateral infiltrate.  Patient was started on broad-spectrum antibiotics including cefepime Flagyl and Decadron.  Due to patient's cardiac arrest patient was started on hypothermia protocol.  Patient was rewarming after that.  There was no purposeful movement or neurological recovery.  After long discussion with the family, patient has been made comfort care.  Patient was extubated.  Patient expired promptly after that.  Family is notified."
	"1198199-1"	"1198199-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"62-year-old male with number of medical problems that include history of hepatitis-C, history of cirrhosis, history of alcohol abuse, cocaine abuse, history of diabetes hypertension who has initially presented to EMS with increasing shortness of breath.  Patient suffered cardiac arrest during his transportation to the emergency room.  A CPR was initiated and was given 3 rounds of epinephrine.  Most of the history is taken from the ER physician chart review.   ACUTE RESPIRATORY FAILURE SECONDARY TO HYPOXEMIA, COVID-19 , cardiac arrest, possible anoxic brain damage  : Patient is 62-year-old male with complicated history with history of hepatitis-C, cirrhosis, alcohol use, cocaine abuse diabetes who presented after having cardiac arrest and possible anoxic brain damage.  Patient was intubated after the arrest.  Patient stayed in the hospital for number of days.  Patient was found to have COVID-19 positive.  Patient was found to have diffuse bilateral infiltrate.  Patient was started on broad-spectrum antibiotics including cefepime Flagyl and Decadron.  Due to patient's cardiac arrest patient was started on hypothermia protocol.  Patient was rewarming after that.  There was no purposeful movement or neurological recovery.  After long discussion with the family, patient has been made comfort care.  Patient was extubated.  Patient expired promptly after that.  Family is notified."
	"1198199-1"	"1198199-1"	"TOXICOLOGIC TEST"	"10061384"	"60-64 years"	"60-64"	"62-year-old male with number of medical problems that include history of hepatitis-C, history of cirrhosis, history of alcohol abuse, cocaine abuse, history of diabetes hypertension who has initially presented to EMS with increasing shortness of breath.  Patient suffered cardiac arrest during his transportation to the emergency room.  A CPR was initiated and was given 3 rounds of epinephrine.  Most of the history is taken from the ER physician chart review.   ACUTE RESPIRATORY FAILURE SECONDARY TO HYPOXEMIA, COVID-19 , cardiac arrest, possible anoxic brain damage  : Patient is 62-year-old male with complicated history with history of hepatitis-C, cirrhosis, alcohol use, cocaine abuse diabetes who presented after having cardiac arrest and possible anoxic brain damage.  Patient was intubated after the arrest.  Patient stayed in the hospital for number of days.  Patient was found to have COVID-19 positive.  Patient was found to have diffuse bilateral infiltrate.  Patient was started on broad-spectrum antibiotics including cefepime Flagyl and Decadron.  Due to patient's cardiac arrest patient was started on hypothermia protocol.  Patient was rewarming after that.  There was no purposeful movement or neurological recovery.  After long discussion with the family, patient has been made comfort care.  Patient was extubated.  Patient expired promptly after that.  Family is notified."
	"1198199-1"	"1198199-1"	"TROPONIN"	"10061576"	"60-64 years"	"60-64"	"62-year-old male with number of medical problems that include history of hepatitis-C, history of cirrhosis, history of alcohol abuse, cocaine abuse, history of diabetes hypertension who has initially presented to EMS with increasing shortness of breath.  Patient suffered cardiac arrest during his transportation to the emergency room.  A CPR was initiated and was given 3 rounds of epinephrine.  Most of the history is taken from the ER physician chart review.   ACUTE RESPIRATORY FAILURE SECONDARY TO HYPOXEMIA, COVID-19 , cardiac arrest, possible anoxic brain damage  : Patient is 62-year-old male with complicated history with history of hepatitis-C, cirrhosis, alcohol use, cocaine abuse diabetes who presented after having cardiac arrest and possible anoxic brain damage.  Patient was intubated after the arrest.  Patient stayed in the hospital for number of days.  Patient was found to have COVID-19 positive.  Patient was found to have diffuse bilateral infiltrate.  Patient was started on broad-spectrum antibiotics including cefepime Flagyl and Decadron.  Due to patient's cardiac arrest patient was started on hypothermia protocol.  Patient was rewarming after that.  There was no purposeful movement or neurological recovery.  After long discussion with the family, patient has been made comfort care.  Patient was extubated.  Patient expired promptly after that.  Family is notified."
	"1198387-1"	"1198387-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Found dead in her home on Saturday morning"
	"1198798-1"	"1198798-1"	"ANGIOGRAM PULMONARY ABNORMAL"	"10002441"	"60-64 years"	"60-64"	"Began feeling unwell, had urinary urgency, and was itching shortly after 2nd dose of Pfizer COVID-19,  then found obtunded due to pulmonary embolus resulting in death within 24 hours of receiving 2nd dose"
	"1198798-1"	"1198798-1"	"BLOOD FIBRINOGEN DECREASED"	"10005520"	"60-64 years"	"60-64"	"Began feeling unwell, had urinary urgency, and was itching shortly after 2nd dose of Pfizer COVID-19,  then found obtunded due to pulmonary embolus resulting in death within 24 hours of receiving 2nd dose"
	"1198798-1"	"1198798-1"	"COAGULATION TIME PROLONGED"	"10009799"	"60-64 years"	"60-64"	"Began feeling unwell, had urinary urgency, and was itching shortly after 2nd dose of Pfizer COVID-19,  then found obtunded due to pulmonary embolus resulting in death within 24 hours of receiving 2nd dose"
	"1198798-1"	"1198798-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Began feeling unwell, had urinary urgency, and was itching shortly after 2nd dose of Pfizer COVID-19,  then found obtunded due to pulmonary embolus resulting in death within 24 hours of receiving 2nd dose"
	"1198798-1"	"1198798-1"	"DEPRESSED LEVEL OF CONSCIOUSNESS"	"10012373"	"60-64 years"	"60-64"	"Began feeling unwell, had urinary urgency, and was itching shortly after 2nd dose of Pfizer COVID-19,  then found obtunded due to pulmonary embolus resulting in death within 24 hours of receiving 2nd dose"
	"1198798-1"	"1198798-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"Began feeling unwell, had urinary urgency, and was itching shortly after 2nd dose of Pfizer COVID-19,  then found obtunded due to pulmonary embolus resulting in death within 24 hours of receiving 2nd dose"
	"1198798-1"	"1198798-1"	"MICTURITION URGENCY"	"10027566"	"60-64 years"	"60-64"	"Began feeling unwell, had urinary urgency, and was itching shortly after 2nd dose of Pfizer COVID-19,  then found obtunded due to pulmonary embolus resulting in death within 24 hours of receiving 2nd dose"
	"1198798-1"	"1198798-1"	"PROTHROMBIN TIME PROLONGED"	"10037063"	"60-64 years"	"60-64"	"Began feeling unwell, had urinary urgency, and was itching shortly after 2nd dose of Pfizer COVID-19,  then found obtunded due to pulmonary embolus resulting in death within 24 hours of receiving 2nd dose"
	"1198798-1"	"1198798-1"	"PRURITUS"	"10037087"	"60-64 years"	"60-64"	"Began feeling unwell, had urinary urgency, and was itching shortly after 2nd dose of Pfizer COVID-19,  then found obtunded due to pulmonary embolus resulting in death within 24 hours of receiving 2nd dose"
	"1198798-1"	"1198798-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"Began feeling unwell, had urinary urgency, and was itching shortly after 2nd dose of Pfizer COVID-19,  then found obtunded due to pulmonary embolus resulting in death within 24 hours of receiving 2nd dose"
	"1198798-1"	"1198798-1"	"TROPONIN INCREASED"	"10058267"	"60-64 years"	"60-64"	"Began feeling unwell, had urinary urgency, and was itching shortly after 2nd dose of Pfizer COVID-19,  then found obtunded due to pulmonary embolus resulting in death within 24 hours of receiving 2nd dose"
	"1199446-1"	"1199446-1"	"CHEST X-RAY"	"10008498"	"60-64 years"	"60-64"	"admitted to the hospital with recurrent hypoxemic and hypercarbic respiratory failure.  discharged home.  passed away at home after discharge."
	"1199446-1"	"1199446-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"admitted to the hospital with recurrent hypoxemic and hypercarbic respiratory failure.  discharged home.  passed away at home after discharge."
	"1199446-1"	"1199446-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"admitted to the hospital with recurrent hypoxemic and hypercarbic respiratory failure.  discharged home.  passed away at home after discharge."
	"1199446-1"	"1199446-1"	"LABORATORY TEST"	"10059938"	"60-64 years"	"60-64"	"admitted to the hospital with recurrent hypoxemic and hypercarbic respiratory failure.  discharged home.  passed away at home after discharge."
	"1199446-1"	"1199446-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	"admitted to the hospital with recurrent hypoxemic and hypercarbic respiratory failure.  discharged home.  passed away at home after discharge."
	"1200514-1"	"1200514-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death on 4-5-21 the day after the shot.  Bloody nose during that day"
	"1200514-1"	"1200514-1"	"EPISTAXIS"	"10015090"	"60-64 years"	"60-64"	"Death on 4-5-21 the day after the shot.  Bloody nose during that day"
	"1202478-1"	"1202478-1"	"BLOOD GLUCOSE NORMAL"	"10005558"	"60-64 years"	"60-64"	"This is a 61 year old female, with history of hypertension, who presents to the ED via EMS for evaluation of cardiac arrest prior to arrival. Patient's husband came from anouther [sic] room and found patient take a big gasp then suddenly became unresponsive. EMS gave patient a total of 4 rounds of Epi, 1 Narcan, and 2 shocks en route. EMS reports with glucose level of 92. Unknown if patient is on any anticoagulation.  Patient presents in asystole. Epi and bicarb given. Compressions performed. Lungs equal with bagging. Bedside US performed which did not reveal any meaningful cardiac activity. Code called. Discussed with family, they state she had been having some cardiac issues and her daughter died of cardiac problems in her 30s."
	"1202478-1"	"1202478-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"This is a 61 year old female, with history of hypertension, who presents to the ED via EMS for evaluation of cardiac arrest prior to arrival. Patient's husband came from anouther [sic] room and found patient take a big gasp then suddenly became unresponsive. EMS gave patient a total of 4 rounds of Epi, 1 Narcan, and 2 shocks en route. EMS reports with glucose level of 92. Unknown if patient is on any anticoagulation.  Patient presents in asystole. Epi and bicarb given. Compressions performed. Lungs equal with bagging. Bedside US performed which did not reveal any meaningful cardiac activity. Code called. Discussed with family, they state she had been having some cardiac issues and her daughter died of cardiac problems in her 30s."
	"1202478-1"	"1202478-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"This is a 61 year old female, with history of hypertension, who presents to the ED via EMS for evaluation of cardiac arrest prior to arrival. Patient's husband came from anouther [sic] room and found patient take a big gasp then suddenly became unresponsive. EMS gave patient a total of 4 rounds of Epi, 1 Narcan, and 2 shocks en route. EMS reports with glucose level of 92. Unknown if patient is on any anticoagulation.  Patient presents in asystole. Epi and bicarb given. Compressions performed. Lungs equal with bagging. Bedside US performed which did not reveal any meaningful cardiac activity. Code called. Discussed with family, they state she had been having some cardiac issues and her daughter died of cardiac problems in her 30s."
	"1202478-1"	"1202478-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"This is a 61 year old female, with history of hypertension, who presents to the ED via EMS for evaluation of cardiac arrest prior to arrival. Patient's husband came from anouther [sic] room and found patient take a big gasp then suddenly became unresponsive. EMS gave patient a total of 4 rounds of Epi, 1 Narcan, and 2 shocks en route. EMS reports with glucose level of 92. Unknown if patient is on any anticoagulation.  Patient presents in asystole. Epi and bicarb given. Compressions performed. Lungs equal with bagging. Bedside US performed which did not reveal any meaningful cardiac activity. Code called. Discussed with family, they state she had been having some cardiac issues and her daughter died of cardiac problems in her 30s."
	"1202478-1"	"1202478-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"This is a 61 year old female, with history of hypertension, who presents to the ED via EMS for evaluation of cardiac arrest prior to arrival. Patient's husband came from anouther [sic] room and found patient take a big gasp then suddenly became unresponsive. EMS gave patient a total of 4 rounds of Epi, 1 Narcan, and 2 shocks en route. EMS reports with glucose level of 92. Unknown if patient is on any anticoagulation.  Patient presents in asystole. Epi and bicarb given. Compressions performed. Lungs equal with bagging. Bedside US performed which did not reveal any meaningful cardiac activity. Code called. Discussed with family, they state she had been having some cardiac issues and her daughter died of cardiac problems in her 30s."
	"1202478-1"	"1202478-1"	"ULTRASOUND SCAN ABNORMAL"	"10061606"	"60-64 years"	"60-64"	"This is a 61 year old female, with history of hypertension, who presents to the ED via EMS for evaluation of cardiac arrest prior to arrival. Patient's husband came from anouther [sic] room and found patient take a big gasp then suddenly became unresponsive. EMS gave patient a total of 4 rounds of Epi, 1 Narcan, and 2 shocks en route. EMS reports with glucose level of 92. Unknown if patient is on any anticoagulation.  Patient presents in asystole. Epi and bicarb given. Compressions performed. Lungs equal with bagging. Bedside US performed which did not reveal any meaningful cardiac activity. Code called. Discussed with family, they state she had been having some cardiac issues and her daughter died of cardiac problems in her 30s."
	"1202478-1"	"1202478-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"This is a 61 year old female, with history of hypertension, who presents to the ED via EMS for evaluation of cardiac arrest prior to arrival. Patient's husband came from anouther [sic] room and found patient take a big gasp then suddenly became unresponsive. EMS gave patient a total of 4 rounds of Epi, 1 Narcan, and 2 shocks en route. EMS reports with glucose level of 92. Unknown if patient is on any anticoagulation.  Patient presents in asystole. Epi and bicarb given. Compressions performed. Lungs equal with bagging. Bedside US performed which did not reveal any meaningful cardiac activity. Code called. Discussed with family, they state she had been having some cardiac issues and her daughter died of cardiac problems in her 30s."
	"1203732-1"	"1203732-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient had history of COPD, MS. Treated for pneumonia in February. Recently discharged from the hospital 2/24/2021 for pneumonia. Seen in the office on 3/1/2021 as a follow up. Given Covid vaccine on 3/15/2021. Patient was reportedly feeling well the day of vaccine. Patient collapsed on 3/19/2021 and died."
	"1203732-1"	"1203732-1"	"SYNCOPE"	"10042772"	"60-64 years"	"60-64"	"Patient had history of COPD, MS. Treated for pneumonia in February. Recently discharged from the hospital 2/24/2021 for pneumonia. Seen in the office on 3/1/2021 as a follow up. Given Covid vaccine on 3/15/2021. Patient was reportedly feeling well the day of vaccine. Patient collapsed on 3/19/2021 and died."
	"1204726-1"	"1204726-1"	"BRAIN STEM THROMBOSIS"	"10062573"	"60-64 years"	"60-64"	"Patient vaccinated on 3/7/21, on 4/2 presented pain in left leg and some redness, on 4/3 some dizziness,  lightheadedness, difficulty with vision in right eye, some slurred speech; on 4/5 his health agravated and EMS was called and taken to hospital; spouse informed that patient had a blood clot in stem of brain; on 4/6 patient died. No autopsy performed"
	"1204726-1"	"1204726-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient vaccinated on 3/7/21, on 4/2 presented pain in left leg and some redness, on 4/3 some dizziness,  lightheadedness, difficulty with vision in right eye, some slurred speech; on 4/5 his health agravated and EMS was called and taken to hospital; spouse informed that patient had a blood clot in stem of brain; on 4/6 patient died. No autopsy performed"
	"1204726-1"	"1204726-1"	"DIZZINESS"	"10013573"	"60-64 years"	"60-64"	"Patient vaccinated on 3/7/21, on 4/2 presented pain in left leg and some redness, on 4/3 some dizziness,  lightheadedness, difficulty with vision in right eye, some slurred speech; on 4/5 his health agravated and EMS was called and taken to hospital; spouse informed that patient had a blood clot in stem of brain; on 4/6 patient died. No autopsy performed"
	"1204726-1"	"1204726-1"	"DYSARTHRIA"	"10013887"	"60-64 years"	"60-64"	"Patient vaccinated on 3/7/21, on 4/2 presented pain in left leg and some redness, on 4/3 some dizziness,  lightheadedness, difficulty with vision in right eye, some slurred speech; on 4/5 his health agravated and EMS was called and taken to hospital; spouse informed that patient had a blood clot in stem of brain; on 4/6 patient died. No autopsy performed"
	"1204726-1"	"1204726-1"	"ERYTHEMA"	"10015150"	"60-64 years"	"60-64"	"Patient vaccinated on 3/7/21, on 4/2 presented pain in left leg and some redness, on 4/3 some dizziness,  lightheadedness, difficulty with vision in right eye, some slurred speech; on 4/5 his health agravated and EMS was called and taken to hospital; spouse informed that patient had a blood clot in stem of brain; on 4/6 patient died. No autopsy performed"
	"1204726-1"	"1204726-1"	"PAIN IN EXTREMITY"	"10033425"	"60-64 years"	"60-64"	"Patient vaccinated on 3/7/21, on 4/2 presented pain in left leg and some redness, on 4/3 some dizziness,  lightheadedness, difficulty with vision in right eye, some slurred speech; on 4/5 his health agravated and EMS was called and taken to hospital; spouse informed that patient had a blood clot in stem of brain; on 4/6 patient died. No autopsy performed"
	"1204726-1"	"1204726-1"	"VISUAL IMPAIRMENT"	"10047571"	"60-64 years"	"60-64"	"Patient vaccinated on 3/7/21, on 4/2 presented pain in left leg and some redness, on 4/3 some dizziness,  lightheadedness, difficulty with vision in right eye, some slurred speech; on 4/5 his health agravated and EMS was called and taken to hospital; spouse informed that patient had a blood clot in stem of brain; on 4/6 patient died. No autopsy performed"
	"1205124-1"	"1205124-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Witnessed cardiac arrest with death as the outcome"
	"1205124-1"	"1205124-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Witnessed cardiac arrest with death as the outcome"
	"1205249-1"	"1205249-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Died from cardiac arrest; This is a spontaneous report from a contactable consumer. A 63-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, solution for injection, Lot number was not reported), via an unspecified route of administration, administered in left arm on 24Mar2021 as single dose for COVID-19 immunization. Medical history included heart disease, kidney issues, and physical disability from an unknown date. Prior to vaccination, the patient was not diagnosed with COVID-19. Since the vaccination, the patient has not been tested for COVID-19. Concomitant medication included atorvastatin; spironolactone; lisinopril; and ubidecarenone, vitamin e NOS (COQ10 COMPLEX) taken for an unspecified indication. The patient previously received the first dose of BNT162B2 on 03Mar2021 11:00 AM, on Left arm, for COVID-19 immunization. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. The patient was reported to have died from cardiac arrest on 26Mar2021. The reporter did not know if it was related to vaccine. The patient died on 26Mar2021. It was not reported if an autopsy was performed.; Reported Cause(s) of Death: It appears he died from cardiac arrest."
	"1205392-1"	"1205392-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"blood clots in left leg and both lungs diagnosed on 2/22, died 2/24"
	"1205392-1"	"1205392-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"blood clots in left leg and both lungs diagnosed on 2/22, died 2/24"
	"1205392-1"	"1205392-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"blood clots in left leg and both lungs diagnosed on 2/22, died 2/24"
	"1205392-1"	"1205392-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"blood clots in left leg and both lungs diagnosed on 2/22, died 2/24"
	"1205392-1"	"1205392-1"	"THROMBOSIS"	"10043607"	"60-64 years"	"60-64"	"blood clots in left leg and both lungs diagnosed on 2/22, died 2/24"
	"1205421-1"	"1205421-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"On April 8, 2021 patient received his second dose of Moderna COVID-19 vaccine at pharmacy at 1:08pm.  Patient waited the appropriate 15 minutes, and then left pharmacy.  He reported no adverse reactions to our staff during that time, and did not call afterward to report any adverse reactions.  At approximately 4:30pm on April 10, 2021, I received notification that patient was found DOA at his residence.  No other information is available at this time."
	"1205421-1"	"1205421-1"	"NO ADVERSE EVENT"	"10067482"	"60-64 years"	"60-64"	"On April 8, 2021 patient received his second dose of Moderna COVID-19 vaccine at pharmacy at 1:08pm.  Patient waited the appropriate 15 minutes, and then left pharmacy.  He reported no adverse reactions to our staff during that time, and did not call afterward to report any adverse reactions.  At approximately 4:30pm on April 10, 2021, I received notification that patient was found DOA at his residence.  No other information is available at this time."
	"1207254-1"	"1207254-1"	"ABDOMINAL PAIN"	"10000081"	"60-64 years"	"60-64"	"Deceased complained of abdominal pain and was taking aspirin for a headache.  He died within less than a day of initial complaints."
	"1207254-1"	"1207254-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Deceased complained of abdominal pain and was taking aspirin for a headache.  He died within less than a day of initial complaints."
	"1207254-1"	"1207254-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"Deceased complained of abdominal pain and was taking aspirin for a headache.  He died within less than a day of initial complaints."
	"1207401-1"	"1207401-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"SUDDEN DEATH - PULMONARY EMBOLUS DUE TO DEEP VEIN THROMBOSIS RIGHT POPLITEAL VEIN"
	"1207401-1"	"1207401-1"	"DEEP VEIN THROMBOSIS"	"10051055"	"60-64 years"	"60-64"	"SUDDEN DEATH - PULMONARY EMBOLUS DUE TO DEEP VEIN THROMBOSIS RIGHT POPLITEAL VEIN"
	"1207401-1"	"1207401-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"SUDDEN DEATH - PULMONARY EMBOLUS DUE TO DEEP VEIN THROMBOSIS RIGHT POPLITEAL VEIN"
	"1207401-1"	"1207401-1"	"SUDDEN DEATH"	"10042434"	"60-64 years"	"60-64"	"SUDDEN DEATH - PULMONARY EMBOLUS DUE TO DEEP VEIN THROMBOSIS RIGHT POPLITEAL VEIN"
	"1208583-1"	"1208583-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"Chills, Fever,fatigue.  Tested positive for COVID on 3/22 and died on 3/29"
	"1208583-1"	"1208583-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Chills, Fever,fatigue.  Tested positive for COVID on 3/22 and died on 3/29"
	"1208583-1"	"1208583-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Chills, Fever,fatigue.  Tested positive for COVID on 3/22 and died on 3/29"
	"1208583-1"	"1208583-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Chills, Fever,fatigue.  Tested positive for COVID on 3/22 and died on 3/29"
	"1208583-1"	"1208583-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Chills, Fever,fatigue.  Tested positive for COVID on 3/22 and died on 3/29"
	"1208583-1"	"1208583-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Chills, Fever,fatigue.  Tested positive for COVID on 3/22 and died on 3/29"
	"1209096-1"	"1209096-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death"
	"1209415-1"	"1209415-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"60-64 years"	"60-64"	"Patient experience flu like symptoms and body aches the same evening after receiving vaccine.  On 4/1/21 the patient experienced nausea, high blood pressure, and a headache. Around 7:00 pm that night the patient threw up and became unresponsive. The patient was then transported to the hospital by ambulance. A CT scan showed a brain bleed and the patient was intubated and transferred to another hospital."
	"1209415-1"	"1209415-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"60-64 years"	"60-64"	"Patient experience flu like symptoms and body aches the same evening after receiving vaccine.  On 4/1/21 the patient experienced nausea, high blood pressure, and a headache. Around 7:00 pm that night the patient threw up and became unresponsive. The patient was then transported to the hospital by ambulance. A CT scan showed a brain bleed and the patient was intubated and transferred to another hospital."
	"1209415-1"	"1209415-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Patient experience flu like symptoms and body aches the same evening after receiving vaccine.  On 4/1/21 the patient experienced nausea, high blood pressure, and a headache. Around 7:00 pm that night the patient threw up and became unresponsive. The patient was then transported to the hospital by ambulance. A CT scan showed a brain bleed and the patient was intubated and transferred to another hospital."
	"1209415-1"	"1209415-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"Patient experience flu like symptoms and body aches the same evening after receiving vaccine.  On 4/1/21 the patient experienced nausea, high blood pressure, and a headache. Around 7:00 pm that night the patient threw up and became unresponsive. The patient was then transported to the hospital by ambulance. A CT scan showed a brain bleed and the patient was intubated and transferred to another hospital."
	"1209415-1"	"1209415-1"	"HYPERTENSION"	"10020772"	"60-64 years"	"60-64"	"Patient experience flu like symptoms and body aches the same evening after receiving vaccine.  On 4/1/21 the patient experienced nausea, high blood pressure, and a headache. Around 7:00 pm that night the patient threw up and became unresponsive. The patient was then transported to the hospital by ambulance. A CT scan showed a brain bleed and the patient was intubated and transferred to another hospital."
	"1209415-1"	"1209415-1"	"INFLUENZA LIKE ILLNESS"	"10022004"	"60-64 years"	"60-64"	"Patient experience flu like symptoms and body aches the same evening after receiving vaccine.  On 4/1/21 the patient experienced nausea, high blood pressure, and a headache. Around 7:00 pm that night the patient threw up and became unresponsive. The patient was then transported to the hospital by ambulance. A CT scan showed a brain bleed and the patient was intubated and transferred to another hospital."
	"1209415-1"	"1209415-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Patient experience flu like symptoms and body aches the same evening after receiving vaccine.  On 4/1/21 the patient experienced nausea, high blood pressure, and a headache. Around 7:00 pm that night the patient threw up and became unresponsive. The patient was then transported to the hospital by ambulance. A CT scan showed a brain bleed and the patient was intubated and transferred to another hospital."
	"1209415-1"	"1209415-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"Patient experience flu like symptoms and body aches the same evening after receiving vaccine.  On 4/1/21 the patient experienced nausea, high blood pressure, and a headache. Around 7:00 pm that night the patient threw up and became unresponsive. The patient was then transported to the hospital by ambulance. A CT scan showed a brain bleed and the patient was intubated and transferred to another hospital."
	"1209415-1"	"1209415-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Patient experience flu like symptoms and body aches the same evening after receiving vaccine.  On 4/1/21 the patient experienced nausea, high blood pressure, and a headache. Around 7:00 pm that night the patient threw up and became unresponsive. The patient was then transported to the hospital by ambulance. A CT scan showed a brain bleed and the patient was intubated and transferred to another hospital."
	"1209415-1"	"1209415-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"Patient experience flu like symptoms and body aches the same evening after receiving vaccine.  On 4/1/21 the patient experienced nausea, high blood pressure, and a headache. Around 7:00 pm that night the patient threw up and became unresponsive. The patient was then transported to the hospital by ambulance. A CT scan showed a brain bleed and the patient was intubated and transferred to another hospital."
	"1209422-1"	"1209422-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"Per the patient's husband, on 03/26/2021, the day after vaccination, the decedent complained of nausea with vomiting, and had difficulty driving. On 03/27/2021, her nausea continued and she complained of shortness of breath while walking. On 03/28/2021, she was short of breath before vomiting a small amount. She then became unresponsive. Death was pronounced a short time later.  Per her treating physician who signed the death certificate, the cause of death is felt to be probable myocardial infarction due to electrolyte abnormalities due to complications of her diabetes mellitus."
	"1209422-1"	"1209422-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Per the patient's husband, on 03/26/2021, the day after vaccination, the decedent complained of nausea with vomiting, and had difficulty driving. On 03/27/2021, her nausea continued and she complained of shortness of breath while walking. On 03/28/2021, she was short of breath before vomiting a small amount. She then became unresponsive. Death was pronounced a short time later.  Per her treating physician who signed the death certificate, the cause of death is felt to be probable myocardial infarction due to electrolyte abnormalities due to complications of her diabetes mellitus."
	"1209422-1"	"1209422-1"	"DIABETES MELLITUS"	"10012601"	"60-64 years"	"60-64"	"Per the patient's husband, on 03/26/2021, the day after vaccination, the decedent complained of nausea with vomiting, and had difficulty driving. On 03/27/2021, her nausea continued and she complained of shortness of breath while walking. On 03/28/2021, she was short of breath before vomiting a small amount. She then became unresponsive. Death was pronounced a short time later.  Per her treating physician who signed the death certificate, the cause of death is felt to be probable myocardial infarction due to electrolyte abnormalities due to complications of her diabetes mellitus."
	"1209422-1"	"1209422-1"	"DIABETIC COMPLICATION"	"10061104"	"60-64 years"	"60-64"	"Per the patient's husband, on 03/26/2021, the day after vaccination, the decedent complained of nausea with vomiting, and had difficulty driving. On 03/27/2021, her nausea continued and she complained of shortness of breath while walking. On 03/28/2021, she was short of breath before vomiting a small amount. She then became unresponsive. Death was pronounced a short time later.  Per her treating physician who signed the death certificate, the cause of death is felt to be probable myocardial infarction due to electrolyte abnormalities due to complications of her diabetes mellitus."
	"1209422-1"	"1209422-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Per the patient's husband, on 03/26/2021, the day after vaccination, the decedent complained of nausea with vomiting, and had difficulty driving. On 03/27/2021, her nausea continued and she complained of shortness of breath while walking. On 03/28/2021, she was short of breath before vomiting a small amount. She then became unresponsive. Death was pronounced a short time later.  Per her treating physician who signed the death certificate, the cause of death is felt to be probable myocardial infarction due to electrolyte abnormalities due to complications of her diabetes mellitus."
	"1209422-1"	"1209422-1"	"ELECTROLYTE IMBALANCE"	"10014418"	"60-64 years"	"60-64"	"Per the patient's husband, on 03/26/2021, the day after vaccination, the decedent complained of nausea with vomiting, and had difficulty driving. On 03/27/2021, her nausea continued and she complained of shortness of breath while walking. On 03/28/2021, she was short of breath before vomiting a small amount. She then became unresponsive. Death was pronounced a short time later.  Per her treating physician who signed the death certificate, the cause of death is felt to be probable myocardial infarction due to electrolyte abnormalities due to complications of her diabetes mellitus."
	"1209422-1"	"1209422-1"	"IMPAIRED DRIVING ABILITY"	"10049564"	"60-64 years"	"60-64"	"Per the patient's husband, on 03/26/2021, the day after vaccination, the decedent complained of nausea with vomiting, and had difficulty driving. On 03/27/2021, her nausea continued and she complained of shortness of breath while walking. On 03/28/2021, she was short of breath before vomiting a small amount. She then became unresponsive. Death was pronounced a short time later.  Per her treating physician who signed the death certificate, the cause of death is felt to be probable myocardial infarction due to electrolyte abnormalities due to complications of her diabetes mellitus."
	"1209422-1"	"1209422-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"Per the patient's husband, on 03/26/2021, the day after vaccination, the decedent complained of nausea with vomiting, and had difficulty driving. On 03/27/2021, her nausea continued and she complained of shortness of breath while walking. On 03/28/2021, she was short of breath before vomiting a small amount. She then became unresponsive. Death was pronounced a short time later.  Per her treating physician who signed the death certificate, the cause of death is felt to be probable myocardial infarction due to electrolyte abnormalities due to complications of her diabetes mellitus."
	"1209422-1"	"1209422-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Per the patient's husband, on 03/26/2021, the day after vaccination, the decedent complained of nausea with vomiting, and had difficulty driving. On 03/27/2021, her nausea continued and she complained of shortness of breath while walking. On 03/28/2021, she was short of breath before vomiting a small amount. She then became unresponsive. Death was pronounced a short time later.  Per her treating physician who signed the death certificate, the cause of death is felt to be probable myocardial infarction due to electrolyte abnormalities due to complications of her diabetes mellitus."
	"1209422-1"	"1209422-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Per the patient's husband, on 03/26/2021, the day after vaccination, the decedent complained of nausea with vomiting, and had difficulty driving. On 03/27/2021, her nausea continued and she complained of shortness of breath while walking. On 03/28/2021, she was short of breath before vomiting a small amount. She then became unresponsive. Death was pronounced a short time later.  Per her treating physician who signed the death certificate, the cause of death is felt to be probable myocardial infarction due to electrolyte abnormalities due to complications of her diabetes mellitus."
	"1209422-1"	"1209422-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"Per the patient's husband, on 03/26/2021, the day after vaccination, the decedent complained of nausea with vomiting, and had difficulty driving. On 03/27/2021, her nausea continued and she complained of shortness of breath while walking. On 03/28/2021, she was short of breath before vomiting a small amount. She then became unresponsive. Death was pronounced a short time later.  Per her treating physician who signed the death certificate, the cause of death is felt to be probable myocardial infarction due to electrolyte abnormalities due to complications of her diabetes mellitus."
	"1212220-1"	"1212220-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"Death SHORTNESS OF BREATH WEAKNESS - GENERALIZED"
	"1212220-1"	"1212220-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death SHORTNESS OF BREATH WEAKNESS - GENERALIZED"
	"1212220-1"	"1212220-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Death SHORTNESS OF BREATH WEAKNESS - GENERALIZED"
	"1212788-1"	"1212788-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient's wife notified our corporate office on 4/15/21 that her husband received a J&J COVID vaccine from our pharmacy on 3/23/2021 and that he passed away one week later, 3/30/2021, in their yard after having a heart attack. Phone number provided is the wife's."
	"1212788-1"	"1212788-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"Patient's wife notified our corporate office on 4/15/21 that her husband received a J&J COVID vaccine from our pharmacy on 3/23/2021 and that he passed away one week later, 3/30/2021, in their yard after having a heart attack. Phone number provided is the wife's."
	"1213304-1"	"1213304-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	""death Narrative:  Patient received Moderna Covid #1 on 3/11/21 in his home  by nurse. On 3/25/21, a note was entered to indicate that is wife had called EMS the day before as ""his heart stopped"" and he passed en route to the hospital. No further details available. No autopsy results available. 13 days between date of vaccination and date of death.""
	"1213304-1"	"1213304-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""death Narrative:  Patient received Moderna Covid #1 on 3/11/21 in his home  by nurse. On 3/25/21, a note was entered to indicate that is wife had called EMS the day before as ""his heart stopped"" and he passed en route to the hospital. No further details available. No autopsy results available. 13 days between date of vaccination and date of death.""
	"1213306-1"	"1213306-1"	"ANTICOAGULANT THERAPY"	"10053468"	"60-64 years"	"60-64"	"blood clotting in legs, lungs, resulting in hospitalization. Second clotting event resulting in stroke and hospitalization, ongoing treatment and evaluation"
	"1213306-1"	"1213306-1"	"BIOPSY"	"10004720"	"60-64 years"	"60-64"	"blood clotting in legs, lungs, resulting in hospitalization. Second clotting event resulting in stroke and hospitalization, ongoing treatment and evaluation"
	"1213306-1"	"1213306-1"	"BLOOD TEST"	"10061726"	"60-64 years"	"60-64"	"blood clotting in legs, lungs, resulting in hospitalization. Second clotting event resulting in stroke and hospitalization, ongoing treatment and evaluation"
	"1213306-1"	"1213306-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"60-64 years"	"60-64"	"blood clotting in legs, lungs, resulting in hospitalization. Second clotting event resulting in stroke and hospitalization, ongoing treatment and evaluation"
	"1213306-1"	"1213306-1"	"COLONOSCOPY"	"10010007"	"60-64 years"	"60-64"	"blood clotting in legs, lungs, resulting in hospitalization. Second clotting event resulting in stroke and hospitalization, ongoing treatment and evaluation"
	"1213306-1"	"1213306-1"	"COMPUTERISED TOMOGRAM"	"10010234"	"60-64 years"	"60-64"	"blood clotting in legs, lungs, resulting in hospitalization. Second clotting event resulting in stroke and hospitalization, ongoing treatment and evaluation"
	"1213306-1"	"1213306-1"	"ECHOCARDIOGRAM"	"10014113"	"60-64 years"	"60-64"	"blood clotting in legs, lungs, resulting in hospitalization. Second clotting event resulting in stroke and hospitalization, ongoing treatment and evaluation"
	"1213306-1"	"1213306-1"	"MAGNETIC RESONANCE IMAGING"	"10078223"	"60-64 years"	"60-64"	"blood clotting in legs, lungs, resulting in hospitalization. Second clotting event resulting in stroke and hospitalization, ongoing treatment and evaluation"
	"1213306-1"	"1213306-1"	"PULMONARY THROMBOSIS"	"10037437"	"60-64 years"	"60-64"	"blood clotting in legs, lungs, resulting in hospitalization. Second clotting event resulting in stroke and hospitalization, ongoing treatment and evaluation"
	"1213306-1"	"1213306-1"	"THROMBOSIS"	"10043607"	"60-64 years"	"60-64"	"blood clotting in legs, lungs, resulting in hospitalization. Second clotting event resulting in stroke and hospitalization, ongoing treatment and evaluation"
	"1213306-1"	"1213306-1"	"ULTRASOUND SCAN"	"10045434"	"60-64 years"	"60-64"	"blood clotting in legs, lungs, resulting in hospitalization. Second clotting event resulting in stroke and hospitalization, ongoing treatment and evaluation"
	"1213306-1"	"1213306-1"	"X-RAY"	"10048064"	"60-64 years"	"60-64"	"blood clotting in legs, lungs, resulting in hospitalization. Second clotting event resulting in stroke and hospitalization, ongoing treatment and evaluation"
	"1213993-1"	"1213993-1"	"ABDOMINAL PAIN"	"10000081"	"60-64 years"	"60-64"	"Abdominal pain, transferred to ER 2/24/21, admitted to hospital, Expired at hospital 3/21/21"
	"1213993-1"	"1213993-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Abdominal pain, transferred to ER 2/24/21, admitted to hospital, Expired at hospital 3/21/21"
	"1213993-1"	"1213993-1"	"URINARY SYSTEM X-RAY"	"10046558"	"60-64 years"	"60-64"	"Abdominal pain, transferred to ER 2/24/21, admitted to hospital, Expired at hospital 3/21/21"
	"1214516-1"	"1214516-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Client was monitored after being Vaccinated for 15 minutes and staff observed no symptoms. DHS CRT was made aware of the death two days prior to 2nd dose Vaccine Clinic."
	"1214705-1"	"1214705-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient passed away on April 4 2021"
	"1214800-1"	"1214800-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Patient per tracking received 2nd COVID vaccine on 4/5/2021 from Health Department.   Patient to Hospital Emergency department via EMS 4/6/2021 with cardiac arrest and death"
	"1214800-1"	"1214800-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient per tracking received 2nd COVID vaccine on 4/5/2021 from Health Department.   Patient to Hospital Emergency department via EMS 4/6/2021 with cardiac arrest and death"
	"1215095-1"	"1215095-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"ANAEMIA"	"10002034"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"ANTIBODY TEST POSITIVE"	"10061427"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"AUTOIMMUNE HAEMOLYTIC ANAEMIA"	"10073785"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"BACK PAIN"	"10003988"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"BILEVEL POSITIVE AIRWAY PRESSURE"	"10064530"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"BLOOD BILIRUBIN INCREASED"	"10005364"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"BLOOD CREATINE ABNORMAL"	"10005462"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"BLOOD LACTATE DEHYDROGENASE INCREASED"	"10005630"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"CHROMATURIA"	"10008796"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"COLD AGGLUTININS NEGATIVE"	"10009853"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"COMPUTERISED TOMOGRAM HEAD NORMAL"	"10072167"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"CONFUSIONAL STATE"	"10010305"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"DECREASED APPETITE"	"10061428"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"DISORIENTATION"	"10013395"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"DIZZINESS"	"10013573"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"ERYTHROID SERIES ABNORMAL"	"10049472"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"FEELING ABNORMAL"	"10016322"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"HAEMATOCHEZIA"	"10018836"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"HAEMOGLOBIN DECREASED"	"10018884"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"HAEMOLYSIS"	"10018910"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"HAPTOGLOBIN INCREASED"	"10019152"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"HYPERSENSITIVITY"	"10020751"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"HYPERTENSION"	"10020772"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"IMPAIRED WORK ABILITY"	"10052302"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"LEUKOERYTHROBLASTIC ANAEMIA"	"10053199"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"MOBILITY DECREASED"	"10048334"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"MUSCULAR WEAKNESS"	"10028372"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"MYALGIA"	"10028411"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"NORMOCHROMIC ANAEMIA"	"10029782"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"PAIN IN EXTREMITY"	"10033425"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"PLASMAPHERESIS"	"10035486"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"PLATELET COUNT DECREASED"	"10035528"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"RASH"	"10037844"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"RED BLOOD CELL COUNT INCREASED"	"10038155"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"RED BLOOD CELL SPHEROCYTES PRESENT"	"10059916"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215095-1"	"1215095-1"	"SINUS TACHYCARDIA"	"10040752"	"60-64 years"	"60-64"	""Received  her first COVID vaccine on Thursday, March 18.  On 3/23/21 she started to have new onset of generalized muscles aches and weakness.  She started feeling some pain in her back, which then spread to arms and legs. She is now beginning to feel weakness in her core and extremities. Having difficulty lifting arms above head. She is still able to walk without difficulty but legs do feel weak. Increase in SOB as well. Myalgias and chest pain resolved within a week, however she continued to feel weak, tired, and had DOE. She developed ""brain fog"" and talked to her boss about taking short-term disability as it had been hard to work.  No appetite. On 4/1/21, she presented to the ED with 2 weeks of worsening generalized weakness, SOB, lightheadedness, dizziness and found to have acute anemia. Was admitted for further workup.  Hgb at admission was 5.4.   This admission diagnosed her with a new warm autoantibody hemolytic anemia. This is new since the COVID vaccine was administered.  Upon admission there was no thrombocytopenia, so there was low suspicion for microangiopathic hemolytic anemia, TTP/HUS, or DIC. Peripheral blood smear at that time suggested a leukoerythroblastic blood picture (could be Bone Marrow recovery post chemo) but with marked normocytic, normochromic anemia, and with increased circulating erythroid precursors and increased red blood cell regeneration; spherocytes and fragments are present supporting hemolysis.  DAT positive (both IgG and C3) along with other hemolysis lab including elevated LDH, Bilirubin, haptoglobin 3, and PBS c/w hemolysis; no evidence of MAHA. So warm autoantibody hemolytic anemia is the most likely explanation. She had negative cold agglutinin antibodies <1:32 on 4/9. Started on methylprednisolone on 4/2/21, but Hgb continued to steadily decline despite treatment. Continued on methylprednisolone 87.5mg daily. Rituxan 375mg/m2 was started on 4/6/21 with plans for weekly infusions for a total of 4 weeks.  there was concern for a GI bleed on 4/10-4/11 due to bright red fluid appearing like blood in the toilet after a stool. This led to her receiving roughly 5 units of pRBCs. After these 5 units she started urinating red urine and we became highly concerned for hyperhemolysis. She did not have any further stools so we did not think a GI bleed was likely.    She was given 1 dose of Eculizumab (Soliris) (4/12). This treatment is for complement mediated intravascular hyperhemolysis. Unfortunately it did not appear to help her.   On 4/14, we were thinking TTP could be contributory with numerous schistocytes on peripheral smear. Her T bili was up to 7.8, and her hemoglobin plasma was trending up, in the 380 -- > 610 and in the 800s today. Cr was worsening. Platelet count was dropping.  With her worsening condition and concern for both hyperhemolysis and possible TTP, we decided to start her plasma exchange followed by her second dose of Rituximab.  Unfortunately she became disoriented/confused following line placement and while receiving plasmaphoresis. CT head returned without acute findings. She then had an allergic reaction with a rash during PLEX which was stopped (4L completed with a goal of 5L). Improved with benadryl.  She was then administered rituximab. Then she developed worsening sinus tachycardia and HTN.   Her respiratory status deteriorated and she eventually required high-flow oxygen to maintain saturations > 90%. CXR showed bilateral opacities, not drastically changed from previous films. Rituximab was stopped halfway through its infusion in case this was an adverse effect to the drug. She was given 20 mg IV Lasix per the nighttime sign-out. She was initially given ceftriaxone and azithromycin IV to cover CAP but later ABx were broadened to vanc and Zosyn with rising lactate of unknown source.   Ultimately she had acute respiratory failure with hypoxia and need BiPAP. She was eventually intubated and a code blue was called.  She unfortunately died shortly after intubation.""
	"1215435-1"	"1215435-1"	"BACK PAIN"	"10003988"	"60-64 years"	"60-64"	"Patient began experiencing back pain on March 14 and on or around March 18 he started coughing up blood clots according to a coworker.  Patient lived alone and was unable to be reached on Sunday March 21.  I went over to his house and found him deceased in his bed.  Patient had a trashcan beside his bed and it appeared to have some blood in it. Patient had thick mucus coming out of his mouth and blood coming out of his nose.  According to paramedics he had passed a few hours before finding him.  Unfortunately Patient has been cremated so there is no way to say that this was related to the Covid 19 shot from Johnson and Johnson, however there are new reports that blood clots have been a side effect. I would like to speak with someone from the Department of Health to discuss this further.  I feel this could be related to the vaccination and I would to know how long the Health Department knew about this possible side effect.  If patient would have known sooner that the blood clots were a side effect I feel he would have gone to the Emergency Room.  Patient had no health insurance and he was trying to prevent getting Covid.   This has caused our family so much heartache and we are all very apprehensive about getting the Covid Vaccine ourselves.  Please contact me as soon as possible, I am also patient's  executor so I am able to speak to you on behalf of patient and our family. Thank you."
	"1215435-1"	"1215435-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient began experiencing back pain on March 14 and on or around March 18 he started coughing up blood clots according to a coworker.  Patient lived alone and was unable to be reached on Sunday March 21.  I went over to his house and found him deceased in his bed.  Patient had a trashcan beside his bed and it appeared to have some blood in it. Patient had thick mucus coming out of his mouth and blood coming out of his nose.  According to paramedics he had passed a few hours before finding him.  Unfortunately Patient has been cremated so there is no way to say that this was related to the Covid 19 shot from Johnson and Johnson, however there are new reports that blood clots have been a side effect. I would like to speak with someone from the Department of Health to discuss this further.  I feel this could be related to the vaccination and I would to know how long the Health Department knew about this possible side effect.  If patient would have known sooner that the blood clots were a side effect I feel he would have gone to the Emergency Room.  Patient had no health insurance and he was trying to prevent getting Covid.   This has caused our family so much heartache and we are all very apprehensive about getting the Covid Vaccine ourselves.  Please contact me as soon as possible, I am also patient's  executor so I am able to speak to you on behalf of patient and our family. Thank you."
	"1215435-1"	"1215435-1"	"EPISTAXIS"	"10015090"	"60-64 years"	"60-64"	"Patient began experiencing back pain on March 14 and on or around March 18 he started coughing up blood clots according to a coworker.  Patient lived alone and was unable to be reached on Sunday March 21.  I went over to his house and found him deceased in his bed.  Patient had a trashcan beside his bed and it appeared to have some blood in it. Patient had thick mucus coming out of his mouth and blood coming out of his nose.  According to paramedics he had passed a few hours before finding him.  Unfortunately Patient has been cremated so there is no way to say that this was related to the Covid 19 shot from Johnson and Johnson, however there are new reports that blood clots have been a side effect. I would like to speak with someone from the Department of Health to discuss this further.  I feel this could be related to the vaccination and I would to know how long the Health Department knew about this possible side effect.  If patient would have known sooner that the blood clots were a side effect I feel he would have gone to the Emergency Room.  Patient had no health insurance and he was trying to prevent getting Covid.   This has caused our family so much heartache and we are all very apprehensive about getting the Covid Vaccine ourselves.  Please contact me as soon as possible, I am also patient's  executor so I am able to speak to you on behalf of patient and our family. Thank you."
	"1215435-1"	"1215435-1"	"HAEMOPTYSIS"	"10018964"	"60-64 years"	"60-64"	"Patient began experiencing back pain on March 14 and on or around March 18 he started coughing up blood clots according to a coworker.  Patient lived alone and was unable to be reached on Sunday March 21.  I went over to his house and found him deceased in his bed.  Patient had a trashcan beside his bed and it appeared to have some blood in it. Patient had thick mucus coming out of his mouth and blood coming out of his nose.  According to paramedics he had passed a few hours before finding him.  Unfortunately Patient has been cremated so there is no way to say that this was related to the Covid 19 shot from Johnson and Johnson, however there are new reports that blood clots have been a side effect. I would like to speak with someone from the Department of Health to discuss this further.  I feel this could be related to the vaccination and I would to know how long the Health Department knew about this possible side effect.  If patient would have known sooner that the blood clots were a side effect I feel he would have gone to the Emergency Room.  Patient had no health insurance and he was trying to prevent getting Covid.   This has caused our family so much heartache and we are all very apprehensive about getting the Covid Vaccine ourselves.  Please contact me as soon as possible, I am also patient's  executor so I am able to speak to you on behalf of patient and our family. Thank you."
	"1215435-1"	"1215435-1"	"INCREASED VISCOSITY OF UPPER RESPIRATORY SECRETION"	"10076745"	"60-64 years"	"60-64"	"Patient began experiencing back pain on March 14 and on or around March 18 he started coughing up blood clots according to a coworker.  Patient lived alone and was unable to be reached on Sunday March 21.  I went over to his house and found him deceased in his bed.  Patient had a trashcan beside his bed and it appeared to have some blood in it. Patient had thick mucus coming out of his mouth and blood coming out of his nose.  According to paramedics he had passed a few hours before finding him.  Unfortunately Patient has been cremated so there is no way to say that this was related to the Covid 19 shot from Johnson and Johnson, however there are new reports that blood clots have been a side effect. I would like to speak with someone from the Department of Health to discuss this further.  I feel this could be related to the vaccination and I would to know how long the Health Department knew about this possible side effect.  If patient would have known sooner that the blood clots were a side effect I feel he would have gone to the Emergency Room.  Patient had no health insurance and he was trying to prevent getting Covid.   This has caused our family so much heartache and we are all very apprehensive about getting the Covid Vaccine ourselves.  Please contact me as soon as possible, I am also patient's  executor so I am able to speak to you on behalf of patient and our family. Thank you."
	"1215435-1"	"1215435-1"	"SECRETION DISCHARGE"	"10053459"	"60-64 years"	"60-64"	"Patient began experiencing back pain on March 14 and on or around March 18 he started coughing up blood clots according to a coworker.  Patient lived alone and was unable to be reached on Sunday March 21.  I went over to his house and found him deceased in his bed.  Patient had a trashcan beside his bed and it appeared to have some blood in it. Patient had thick mucus coming out of his mouth and blood coming out of his nose.  According to paramedics he had passed a few hours before finding him.  Unfortunately Patient has been cremated so there is no way to say that this was related to the Covid 19 shot from Johnson and Johnson, however there are new reports that blood clots have been a side effect. I would like to speak with someone from the Department of Health to discuss this further.  I feel this could be related to the vaccination and I would to know how long the Health Department knew about this possible side effect.  If patient would have known sooner that the blood clots were a side effect I feel he would have gone to the Emergency Room.  Patient had no health insurance and he was trying to prevent getting Covid.   This has caused our family so much heartache and we are all very apprehensive about getting the Covid Vaccine ourselves.  Please contact me as soon as possible, I am also patient's  executor so I am able to speak to you on behalf of patient and our family. Thank you."
	"1215435-1"	"1215435-1"	"THROMBOSIS"	"10043607"	"60-64 years"	"60-64"	"Patient began experiencing back pain on March 14 and on or around March 18 he started coughing up blood clots according to a coworker.  Patient lived alone and was unable to be reached on Sunday March 21.  I went over to his house and found him deceased in his bed.  Patient had a trashcan beside his bed and it appeared to have some blood in it. Patient had thick mucus coming out of his mouth and blood coming out of his nose.  According to paramedics he had passed a few hours before finding him.  Unfortunately Patient has been cremated so there is no way to say that this was related to the Covid 19 shot from Johnson and Johnson, however there are new reports that blood clots have been a side effect. I would like to speak with someone from the Department of Health to discuss this further.  I feel this could be related to the vaccination and I would to know how long the Health Department knew about this possible side effect.  If patient would have known sooner that the blood clots were a side effect I feel he would have gone to the Emergency Room.  Patient had no health insurance and he was trying to prevent getting Covid.   This has caused our family so much heartache and we are all very apprehensive about getting the Covid Vaccine ourselves.  Please contact me as soon as possible, I am also patient's  executor so I am able to speak to you on behalf of patient and our family. Thank you."
	"1218602-1"	"1218602-1"	"ABDOMINAL X-RAY"	"10061612"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"CEREBRAL ATROPHY"	"10008096"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"COMPUTERISED TOMOGRAM ABDOMEN ABNORMAL"	"10057798"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"COMPUTERISED TOMOGRAM PELVIS ABNORMAL"	"10081333"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"ENCEPHALOMALACIA"	"10051818"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"GASTROINTESTINAL NECROSIS"	"10017982"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"HYPOTENSION"	"10021097"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"LUNG INFILTRATION"	"10025102"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"MAGNETIC RESONANCE IMAGING"	"10078223"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"MENTAL STATUS CHANGES"	"10048294"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"METABOLIC ACIDOSIS"	"10027417"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"PLATELET COUNT NORMAL"	"10035530"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"PNEUMATOSIS INTESTINALIS"	"10057030"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"PNEUMOBILIA"	"10066004"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"PORTAL VENOUS GAS"	"10064711"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"RENAL FAILURE"	"10038435"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218602-1"	"1218602-1"	"SHOCK"	"10040560"	"60-64 years"	"60-64"	"colonic necrosis  62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes.  Patient was noted to be in severe metabolic acidosis, renal failure and shock.  Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2.  She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension.   She started to spike fevers up to 40.  Abdominal CXR ordered prior to MRI,  showed possible pneumatosis.  A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April 8."
	"1218848-1"	"1218848-1"	"ANGIOEDEMA"	"10002424"	"60-64 years"	"60-64"	"Angioedema on 4/2/21 leading to death"
	"1218848-1"	"1218848-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Angioedema on 4/2/21 leading to death"
	"1219334-1"	"1219334-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death on 3/22. Unknown cause. Family found him unresponsive. Did not pursue autopsy."
	"1219334-1"	"1219334-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Death on 3/22. Unknown cause. Family found him unresponsive. Did not pursue autopsy."
	"1219402-1"	"1219402-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Homebound visit complete 4/14/21 around 1230-1300, monitored for 15 minutes, left attended with home health nurse. Patient was found dead per EMS and had passed sometime during the night."
	"1219667-1"	"1219667-1"	"COMPUTERISED TOMOGRAM"	"10010234"	"60-64 years"	"60-64"	"Patient had a Hemorrhagic stoke and passed away."
	"1219667-1"	"1219667-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient had a Hemorrhagic stoke and passed away."
	"1219667-1"	"1219667-1"	"HAEMORRHAGIC STROKE"	"10019016"	"60-64 years"	"60-64"	"Patient had a Hemorrhagic stoke and passed away."
	"1219816-1"	"1219816-1"	"ASPIRATION"	"10003504"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"BARIUM SWALLOW ABNORMAL"	"10004125"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"BLOOD CREATININE NORMAL"	"10005484"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"BLOOD UREA INCREASED"	"10005851"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"CARDIOMEGALY"	"10007632"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"DECUBITUS ULCER"	"10011985"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"DYSKINESIA"	"10013916"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"DYSPHAGIA"	"10013950"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"HYPERHIDROSIS"	"10020642"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"LUNG INFILTRATION"	"10025102"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"OSTEOARTHRITIS"	"10031161"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"PREALBUMIN"	"10036508"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"RIB DEFORMITY"	"10059011"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"SCOLIOSIS"	"10039722"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"SPINAL OSTEOARTHRITIS"	"10041591"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"WEIGHT DECREASED"	"10047895"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1219816-1"	"1219816-1"	"WHITE BLOOD CELL COUNT NORMAL"	"10047944"	"60-64 years"	"60-64"	"Resident passed on  3/23/2021. Resident continues to decline medically. 2/22  He was admitted to nursing home with worsening pressure injury."
	"1221329-1"	"1221329-1"	"ABDOMINAL DISCOMFORT"	"10000059"	"60-64 years"	"60-64"	"My Dad was healthy no symptoms on first shot . On Second shoot just slight pain in arm ,  he felt sick on Sunday the 4 of April  at around 7pm he had a upset stomach. He got worse at night. in the morning Monday the 5 April we decided it was time to take him to the hospital. Due to the covid 19 restriction we were not able  to go in with him He was stable until 1 pm when he suffered 4 heart attacks . He Died .  He was healthy he exercise and was active every day . We were told to report this because it was close to dates of vaccination."
	"1221329-1"	"1221329-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"My Dad was healthy no symptoms on first shot . On Second shoot just slight pain in arm ,  he felt sick on Sunday the 4 of April  at around 7pm he had a upset stomach. He got worse at night. in the morning Monday the 5 April we decided it was time to take him to the hospital. Due to the covid 19 restriction we were not able  to go in with him He was stable until 1 pm when he suffered 4 heart attacks . He Died .  He was healthy he exercise and was active every day . We were told to report this because it was close to dates of vaccination."
	"1221329-1"	"1221329-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"My Dad was healthy no symptoms on first shot . On Second shoot just slight pain in arm ,  he felt sick on Sunday the 4 of April  at around 7pm he had a upset stomach. He got worse at night. in the morning Monday the 5 April we decided it was time to take him to the hospital. Due to the covid 19 restriction we were not able  to go in with him He was stable until 1 pm when he suffered 4 heart attacks . He Died .  He was healthy he exercise and was active every day . We were told to report this because it was close to dates of vaccination."
	"1221329-1"	"1221329-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"My Dad was healthy no symptoms on first shot . On Second shoot just slight pain in arm ,  he felt sick on Sunday the 4 of April  at around 7pm he had a upset stomach. He got worse at night. in the morning Monday the 5 April we decided it was time to take him to the hospital. Due to the covid 19 restriction we were not able  to go in with him He was stable until 1 pm when he suffered 4 heart attacks . He Died .  He was healthy he exercise and was active every day . We were told to report this because it was close to dates of vaccination."
	"1221329-1"	"1221329-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"My Dad was healthy no symptoms on first shot . On Second shoot just slight pain in arm ,  he felt sick on Sunday the 4 of April  at around 7pm he had a upset stomach. He got worse at night. in the morning Monday the 5 April we decided it was time to take him to the hospital. Due to the covid 19 restriction we were not able  to go in with him He was stable until 1 pm when he suffered 4 heart attacks . He Died .  He was healthy he exercise and was active every day . We were told to report this because it was close to dates of vaccination."
	"1221329-1"	"1221329-1"	"PAIN IN EXTREMITY"	"10033425"	"60-64 years"	"60-64"	"My Dad was healthy no symptoms on first shot . On Second shoot just slight pain in arm ,  he felt sick on Sunday the 4 of April  at around 7pm he had a upset stomach. He got worse at night. in the morning Monday the 5 April we decided it was time to take him to the hospital. Due to the covid 19 restriction we were not able  to go in with him He was stable until 1 pm when he suffered 4 heart attacks . He Died .  He was healthy he exercise and was active every day . We were told to report this because it was close to dates of vaccination."
	"1221521-1"	"1221521-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"60-64 years"	"60-64"	"Patient reported after 1st vaccine experiencing some itching.  Patient also reported an increase in his BS after vaccine 1.  Provider prescribed Atarax to patient for this, patient had previously been prescribed this as he has had a similar reaction to other vaccines and medication changes.  Patient was seen by provider for high BS, patients insurance stopped paying for his insulin and they were transitioning him to Trulicity.  Patient came to vaccine clinic on 4/13/2021.   Patient was given 2nd dose of vaccine and monitored for appropriate period of time post vaccination.  Patients family reports that patient had been feeling SOB for the past several weeks and more fatigue than usual.  4/14/2021, patient triggered an alert thru the monitoring system, nurse reached out to patient to discuss and schedule appointment for further DM education and appt with provider.  Nurse had difficult time reaching patient, but patient did call back same day and scheduled appt on 4/23/21.  Family reports they went to bed on 4/14/2021, brother went upstairs for bed checked on patient and he was unresponsive.  911 called, paramedics and fire department responded, but CPR was unsuccessful.  Patient pronounced dea 4/15/2021 @ 12:26am."
	"1221521-1"	"1221521-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient reported after 1st vaccine experiencing some itching.  Patient also reported an increase in his BS after vaccine 1.  Provider prescribed Atarax to patient for this, patient had previously been prescribed this as he has had a similar reaction to other vaccines and medication changes.  Patient was seen by provider for high BS, patients insurance stopped paying for his insulin and they were transitioning him to Trulicity.  Patient came to vaccine clinic on 4/13/2021.   Patient was given 2nd dose of vaccine and monitored for appropriate period of time post vaccination.  Patients family reports that patient had been feeling SOB for the past several weeks and more fatigue than usual.  4/14/2021, patient triggered an alert thru the monitoring system, nurse reached out to patient to discuss and schedule appointment for further DM education and appt with provider.  Nurse had difficult time reaching patient, but patient did call back same day and scheduled appt on 4/23/21.  Family reports they went to bed on 4/14/2021, brother went upstairs for bed checked on patient and he was unresponsive.  911 called, paramedics and fire department responded, but CPR was unsuccessful.  Patient pronounced dea 4/15/2021 @ 12:26am."
	"1221521-1"	"1221521-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Patient reported after 1st vaccine experiencing some itching.  Patient also reported an increase in his BS after vaccine 1.  Provider prescribed Atarax to patient for this, patient had previously been prescribed this as he has had a similar reaction to other vaccines and medication changes.  Patient was seen by provider for high BS, patients insurance stopped paying for his insulin and they were transitioning him to Trulicity.  Patient came to vaccine clinic on 4/13/2021.   Patient was given 2nd dose of vaccine and monitored for appropriate period of time post vaccination.  Patients family reports that patient had been feeling SOB for the past several weeks and more fatigue than usual.  4/14/2021, patient triggered an alert thru the monitoring system, nurse reached out to patient to discuss and schedule appointment for further DM education and appt with provider.  Nurse had difficult time reaching patient, but patient did call back same day and scheduled appt on 4/23/21.  Family reports they went to bed on 4/14/2021, brother went upstairs for bed checked on patient and he was unresponsive.  911 called, paramedics and fire department responded, but CPR was unsuccessful.  Patient pronounced dea 4/15/2021 @ 12:26am."
	"1221521-1"	"1221521-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Patient reported after 1st vaccine experiencing some itching.  Patient also reported an increase in his BS after vaccine 1.  Provider prescribed Atarax to patient for this, patient had previously been prescribed this as he has had a similar reaction to other vaccines and medication changes.  Patient was seen by provider for high BS, patients insurance stopped paying for his insulin and they were transitioning him to Trulicity.  Patient came to vaccine clinic on 4/13/2021.   Patient was given 2nd dose of vaccine and monitored for appropriate period of time post vaccination.  Patients family reports that patient had been feeling SOB for the past several weeks and more fatigue than usual.  4/14/2021, patient triggered an alert thru the monitoring system, nurse reached out to patient to discuss and schedule appointment for further DM education and appt with provider.  Nurse had difficult time reaching patient, but patient did call back same day and scheduled appt on 4/23/21.  Family reports they went to bed on 4/14/2021, brother went upstairs for bed checked on patient and he was unresponsive.  911 called, paramedics and fire department responded, but CPR was unsuccessful.  Patient pronounced dea 4/15/2021 @ 12:26am."
	"1221521-1"	"1221521-1"	"PRURITUS"	"10037087"	"60-64 years"	"60-64"	"Patient reported after 1st vaccine experiencing some itching.  Patient also reported an increase in his BS after vaccine 1.  Provider prescribed Atarax to patient for this, patient had previously been prescribed this as he has had a similar reaction to other vaccines and medication changes.  Patient was seen by provider for high BS, patients insurance stopped paying for his insulin and they were transitioning him to Trulicity.  Patient came to vaccine clinic on 4/13/2021.   Patient was given 2nd dose of vaccine and monitored for appropriate period of time post vaccination.  Patients family reports that patient had been feeling SOB for the past several weeks and more fatigue than usual.  4/14/2021, patient triggered an alert thru the monitoring system, nurse reached out to patient to discuss and schedule appointment for further DM education and appt with provider.  Nurse had difficult time reaching patient, but patient did call back same day and scheduled appt on 4/23/21.  Family reports they went to bed on 4/14/2021, brother went upstairs for bed checked on patient and he was unresponsive.  911 called, paramedics and fire department responded, but CPR was unsuccessful.  Patient pronounced dea 4/15/2021 @ 12:26am."
	"1221521-1"	"1221521-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Patient reported after 1st vaccine experiencing some itching.  Patient also reported an increase in his BS after vaccine 1.  Provider prescribed Atarax to patient for this, patient had previously been prescribed this as he has had a similar reaction to other vaccines and medication changes.  Patient was seen by provider for high BS, patients insurance stopped paying for his insulin and they were transitioning him to Trulicity.  Patient came to vaccine clinic on 4/13/2021.   Patient was given 2nd dose of vaccine and monitored for appropriate period of time post vaccination.  Patients family reports that patient had been feeling SOB for the past several weeks and more fatigue than usual.  4/14/2021, patient triggered an alert thru the monitoring system, nurse reached out to patient to discuss and schedule appointment for further DM education and appt with provider.  Nurse had difficult time reaching patient, but patient did call back same day and scheduled appt on 4/23/21.  Family reports they went to bed on 4/14/2021, brother went upstairs for bed checked on patient and he was unresponsive.  911 called, paramedics and fire department responded, but CPR was unsuccessful.  Patient pronounced dea 4/15/2021 @ 12:26am."
	"1221521-1"	"1221521-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Patient reported after 1st vaccine experiencing some itching.  Patient also reported an increase in his BS after vaccine 1.  Provider prescribed Atarax to patient for this, patient had previously been prescribed this as he has had a similar reaction to other vaccines and medication changes.  Patient was seen by provider for high BS, patients insurance stopped paying for his insulin and they were transitioning him to Trulicity.  Patient came to vaccine clinic on 4/13/2021.   Patient was given 2nd dose of vaccine and monitored for appropriate period of time post vaccination.  Patients family reports that patient had been feeling SOB for the past several weeks and more fatigue than usual.  4/14/2021, patient triggered an alert thru the monitoring system, nurse reached out to patient to discuss and schedule appointment for further DM education and appt with provider.  Nurse had difficult time reaching patient, but patient did call back same day and scheduled appt on 4/23/21.  Family reports they went to bed on 4/14/2021, brother went upstairs for bed checked on patient and he was unresponsive.  911 called, paramedics and fire department responded, but CPR was unsuccessful.  Patient pronounced dea 4/15/2021 @ 12:26am."
	"1222021-1"	"1222021-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"Client became ill approximately one hour after COVID immunization. Symptoms include weakness, light headed, general malaise. Client refused wife's offer for medical assistance."
	"1222021-1"	"1222021-1"	"DIZZINESS"	"10013573"	"60-64 years"	"60-64"	"Client became ill approximately one hour after COVID immunization. Symptoms include weakness, light headed, general malaise. Client refused wife's offer for medical assistance."
	"1222021-1"	"1222021-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"Client became ill approximately one hour after COVID immunization. Symptoms include weakness, light headed, general malaise. Client refused wife's offer for medical assistance."
	"1222817-1"	"1222817-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient called me Wednesday April 14,2021 at 12:44 pm explaining that she was having a hard time breathing that day. Due to her chronic lung health, I didn?t think much of it. She passed away in the early hours of Thursday April 15,2021 in her sleep."
	"1222817-1"	"1222817-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Patient called me Wednesday April 14,2021 at 12:44 pm explaining that she was having a hard time breathing that day. Due to her chronic lung health, I didn?t think much of it. She passed away in the early hours of Thursday April 15,2021 in her sleep."
	"1223056-1"	"1223056-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"My wife started to fall and pass out had no strength to get up this happened two to three times cinch she got the shot the last time she past out in the shower and i rushed her to hospital were she pasted away from blood clots to the right side of the neck and stated bleed on the brain"
	"1223056-1"	"1223056-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"60-64 years"	"60-64"	"My wife started to fall and pass out had no strength to get up this happened two to three times cinch she got the shot the last time she past out in the shower and i rushed her to hospital were she pasted away from blood clots to the right side of the neck and stated bleed on the brain"
	"1223056-1"	"1223056-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"My wife started to fall and pass out had no strength to get up this happened two to three times cinch she got the shot the last time she past out in the shower and i rushed her to hospital were she pasted away from blood clots to the right side of the neck and stated bleed on the brain"
	"1223056-1"	"1223056-1"	"FALL"	"10016173"	"60-64 years"	"60-64"	"My wife started to fall and pass out had no strength to get up this happened two to three times cinch she got the shot the last time she past out in the shower and i rushed her to hospital were she pasted away from blood clots to the right side of the neck and stated bleed on the brain"
	"1223056-1"	"1223056-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"60-64 years"	"60-64"	"My wife started to fall and pass out had no strength to get up this happened two to three times cinch she got the shot the last time she past out in the shower and i rushed her to hospital were she pasted away from blood clots to the right side of the neck and stated bleed on the brain"
	"1223056-1"	"1223056-1"	"THROMBOSIS"	"10043607"	"60-64 years"	"60-64"	"My wife started to fall and pass out had no strength to get up this happened two to three times cinch she got the shot the last time she past out in the shower and i rushed her to hospital were she pasted away from blood clots to the right side of the neck and stated bleed on the brain"
	"1223630-1"	"1223630-1"	"ANXIETY"	"10002855"	"60-64 years"	"60-64"	"Nausea vomiting throughout the day and continuous the next night,  sense on impending doom"
	"1223630-1"	"1223630-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Nausea vomiting throughout the day and continuous the next night,  sense on impending doom"
	"1223630-1"	"1223630-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Nausea vomiting throughout the day and continuous the next night,  sense on impending doom"
	"1223630-1"	"1223630-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"Nausea vomiting throughout the day and continuous the next night,  sense on impending doom"
	"1223669-1"	"1223669-1"	"ARTERIOSCLEROSIS"	"10003210"	"60-64 years"	"60-64"	"60 year old male died unexpectedly at home, found 04/11/2021. Last known contact was by phone with his brother on 04/10/2021. Cause of death was determined to be MI due to ASCVD due to tobacco dependence, cigarettes. Autopsy was not requested. This medical examiner was later contacted by the daughter of the decedent to report that he had received the Johnson & Johnson COVID vaccine on 04/08/2021, 2-3 days prior to his death."
	"1223669-1"	"1223669-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"60 year old male died unexpectedly at home, found 04/11/2021. Last known contact was by phone with his brother on 04/10/2021. Cause of death was determined to be MI due to ASCVD due to tobacco dependence, cigarettes. Autopsy was not requested. This medical examiner was later contacted by the daughter of the decedent to report that he had received the Johnson & Johnson COVID vaccine on 04/08/2021, 2-3 days prior to his death."
	"1223669-1"	"1223669-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"60 year old male died unexpectedly at home, found 04/11/2021. Last known contact was by phone with his brother on 04/10/2021. Cause of death was determined to be MI due to ASCVD due to tobacco dependence, cigarettes. Autopsy was not requested. This medical examiner was later contacted by the daughter of the decedent to report that he had received the Johnson & Johnson COVID vaccine on 04/08/2021, 2-3 days prior to his death."
	"1225829-1"	"1225829-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"Extreme weakness & Fatique Dizziness Fainting Death 04/09/2021"
	"1225829-1"	"1225829-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Extreme weakness & Fatique Dizziness Fainting Death 04/09/2021"
	"1225829-1"	"1225829-1"	"DIZZINESS"	"10013573"	"60-64 years"	"60-64"	"Extreme weakness & Fatique Dizziness Fainting Death 04/09/2021"
	"1225829-1"	"1225829-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Extreme weakness & Fatique Dizziness Fainting Death 04/09/2021"
	"1225829-1"	"1225829-1"	"SYNCOPE"	"10042772"	"60-64 years"	"60-64"	"Extreme weakness & Fatique Dizziness Fainting Death 04/09/2021"
	"1228875-1"	"1228875-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"woke up with trouble breathin like couldn't get enough air into lungs,  happened when sleeping  for several nights"
	"1228875-1"	"1228875-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"woke up with trouble breathin like couldn't get enough air into lungs,  happened when sleeping  for several nights"
	"1229092-1"	"1229092-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"PATIENT GOT FIRST MODERNA DOSE 03/11/2021 AND SECOND DOSE 04/08/2021 AND PASSED AWAY ON 04/14/2021"
	"1229214-1"	"1229214-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"WE RECEIVED A CALL ON TUESDAY AFTERNOON THE 13TH OF APRIL FROM THE MEDICAL EXAMINER REQUIRING INFORMATION ON HOW TO CONTACTB THE PATIENT'S DOCTOR. WHEN ASKED AS TO WHAT HAPPENED WE WERE TOLD THAT THE PATIENT WAS FOUND DEAD IN HER APARTMENT ON TUESDA.Y.  WE DID INFORM THEM THAT THE PATIENT HAD  RECEIVED THE JANSSEN VACCINE AT THE PHARMACY ON FRIDAY THE 9TH. WE DONT KNOW  THE CAUSE OF ADVERSE EVENT."
	"1229390-1"	"1229390-1"	"BLOOD LACTIC ACID INCREASED"	"10005635"	"60-64 years"	"60-64"	"Pt found unresponsive in hospital room with large amount of vomit.  Patient pronounced dead shortly after with cause of death noted to be aspiration pneumonia with hypoxemia leading to cardiac arrest.  Pt received vaccine 1 month prior so I wanted to report this."
	"1229390-1"	"1229390-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Pt found unresponsive in hospital room with large amount of vomit.  Patient pronounced dead shortly after with cause of death noted to be aspiration pneumonia with hypoxemia leading to cardiac arrest.  Pt received vaccine 1 month prior so I wanted to report this."
	"1229390-1"	"1229390-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pt found unresponsive in hospital room with large amount of vomit.  Patient pronounced dead shortly after with cause of death noted to be aspiration pneumonia with hypoxemia leading to cardiac arrest.  Pt received vaccine 1 month prior so I wanted to report this."
	"1229390-1"	"1229390-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"Pt found unresponsive in hospital room with large amount of vomit.  Patient pronounced dead shortly after with cause of death noted to be aspiration pneumonia with hypoxemia leading to cardiac arrest.  Pt received vaccine 1 month prior so I wanted to report this."
	"1229390-1"	"1229390-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"Pt found unresponsive in hospital room with large amount of vomit.  Patient pronounced dead shortly after with cause of death noted to be aspiration pneumonia with hypoxemia leading to cardiac arrest.  Pt received vaccine 1 month prior so I wanted to report this."
	"1229390-1"	"1229390-1"	"PNEUMONIA ASPIRATION"	"10035669"	"60-64 years"	"60-64"	"Pt found unresponsive in hospital room with large amount of vomit.  Patient pronounced dead shortly after with cause of death noted to be aspiration pneumonia with hypoxemia leading to cardiac arrest.  Pt received vaccine 1 month prior so I wanted to report this."
	"1229390-1"	"1229390-1"	"SINUS TACHYCARDIA"	"10040752"	"60-64 years"	"60-64"	"Pt found unresponsive in hospital room with large amount of vomit.  Patient pronounced dead shortly after with cause of death noted to be aspiration pneumonia with hypoxemia leading to cardiac arrest.  Pt received vaccine 1 month prior so I wanted to report this."
	"1229390-1"	"1229390-1"	"SUPRAVENTRICULAR TACHYCARDIA"	"10042604"	"60-64 years"	"60-64"	"Pt found unresponsive in hospital room with large amount of vomit.  Patient pronounced dead shortly after with cause of death noted to be aspiration pneumonia with hypoxemia leading to cardiac arrest.  Pt received vaccine 1 month prior so I wanted to report this."
	"1229390-1"	"1229390-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Pt found unresponsive in hospital room with large amount of vomit.  Patient pronounced dead shortly after with cause of death noted to be aspiration pneumonia with hypoxemia leading to cardiac arrest.  Pt received vaccine 1 month prior so I wanted to report this."
	"1229390-1"	"1229390-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"Pt found unresponsive in hospital room with large amount of vomit.  Patient pronounced dead shortly after with cause of death noted to be aspiration pneumonia with hypoxemia leading to cardiac arrest.  Pt received vaccine 1 month prior so I wanted to report this."
	"1230230-1"	"1230230-1"	"BIOPSY SOFT TISSUE"	"10069752"	"60-64 years"	"60-64"	"Fatigue, dizziness, heart attack and death"
	"1230230-1"	"1230230-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Fatigue, dizziness, heart attack and death"
	"1230230-1"	"1230230-1"	"DIZZINESS"	"10013573"	"60-64 years"	"60-64"	"Fatigue, dizziness, heart attack and death"
	"1230230-1"	"1230230-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Fatigue, dizziness, heart attack and death"
	"1230230-1"	"1230230-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"Fatigue, dizziness, heart attack and death"
	"1230246-1"	"1230246-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"My husband developed severe COVID symptoms, despite testing negative for COVID via pcr tests on Sunday 3/21 /21 and Tuesday 3/23.  He was hospitalized on 3/28 due to low blood oxygen levels.  Was diagnosed with COVID and pneumonia.  Treated with remdesivir and a steroid, then monoclonal antibodies.  Despite making progress to the extent doctors were cautiously optimistic on 4/9/21 he would be discharged on 4/16/21, he instead was transferred to ICU on 4/10/21, placed on a ventilator on 4/11/21 and died on 4/15/21."
	"1230246-1"	"1230246-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"My husband developed severe COVID symptoms, despite testing negative for COVID via pcr tests on Sunday 3/21 /21 and Tuesday 3/23.  He was hospitalized on 3/28 due to low blood oxygen levels.  Was diagnosed with COVID and pneumonia.  Treated with remdesivir and a steroid, then monoclonal antibodies.  Despite making progress to the extent doctors were cautiously optimistic on 4/9/21 he would be discharged on 4/16/21, he instead was transferred to ICU on 4/10/21, placed on a ventilator on 4/11/21 and died on 4/15/21."
	"1230246-1"	"1230246-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"My husband developed severe COVID symptoms, despite testing negative for COVID via pcr tests on Sunday 3/21 /21 and Tuesday 3/23.  He was hospitalized on 3/28 due to low blood oxygen levels.  Was diagnosed with COVID and pneumonia.  Treated with remdesivir and a steroid, then monoclonal antibodies.  Despite making progress to the extent doctors were cautiously optimistic on 4/9/21 he would be discharged on 4/16/21, he instead was transferred to ICU on 4/10/21, placed on a ventilator on 4/11/21 and died on 4/15/21."
	"1230246-1"	"1230246-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"My husband developed severe COVID symptoms, despite testing negative for COVID via pcr tests on Sunday 3/21 /21 and Tuesday 3/23.  He was hospitalized on 3/28 due to low blood oxygen levels.  Was diagnosed with COVID and pneumonia.  Treated with remdesivir and a steroid, then monoclonal antibodies.  Despite making progress to the extent doctors were cautiously optimistic on 4/9/21 he would be discharged on 4/16/21, he instead was transferred to ICU on 4/10/21, placed on a ventilator on 4/11/21 and died on 4/15/21."
	"1230246-1"	"1230246-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"My husband developed severe COVID symptoms, despite testing negative for COVID via pcr tests on Sunday 3/21 /21 and Tuesday 3/23.  He was hospitalized on 3/28 due to low blood oxygen levels.  Was diagnosed with COVID and pneumonia.  Treated with remdesivir and a steroid, then monoclonal antibodies.  Despite making progress to the extent doctors were cautiously optimistic on 4/9/21 he would be discharged on 4/16/21, he instead was transferred to ICU on 4/10/21, placed on a ventilator on 4/11/21 and died on 4/15/21."
	"1230246-1"	"1230246-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"My husband developed severe COVID symptoms, despite testing negative for COVID via pcr tests on Sunday 3/21 /21 and Tuesday 3/23.  He was hospitalized on 3/28 due to low blood oxygen levels.  Was diagnosed with COVID and pneumonia.  Treated with remdesivir and a steroid, then monoclonal antibodies.  Despite making progress to the extent doctors were cautiously optimistic on 4/9/21 he would be discharged on 4/16/21, he instead was transferred to ICU on 4/10/21, placed on a ventilator on 4/11/21 and died on 4/15/21."
	"1230246-1"	"1230246-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	"My husband developed severe COVID symptoms, despite testing negative for COVID via pcr tests on Sunday 3/21 /21 and Tuesday 3/23.  He was hospitalized on 3/28 due to low blood oxygen levels.  Was diagnosed with COVID and pneumonia.  Treated with remdesivir and a steroid, then monoclonal antibodies.  Despite making progress to the extent doctors were cautiously optimistic on 4/9/21 he would be discharged on 4/16/21, he instead was transferred to ICU on 4/10/21, placed on a ventilator on 4/11/21 and died on 4/15/21."
	"1233795-1"	"1233795-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Information obtained from the Hospital. Began to not feel well the next day, SOB, diarrhea and fatigue. Was admitted to hospital on 4/9/21, diagnosed with COVID, placed on a vent and died on 4/19/21."
	"1233795-1"	"1233795-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Information obtained from the Hospital. Began to not feel well the next day, SOB, diarrhea and fatigue. Was admitted to hospital on 4/9/21, diagnosed with COVID, placed on a vent and died on 4/19/21."
	"1233795-1"	"1233795-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"Information obtained from the Hospital. Began to not feel well the next day, SOB, diarrhea and fatigue. Was admitted to hospital on 4/9/21, diagnosed with COVID, placed on a vent and died on 4/19/21."
	"1233795-1"	"1233795-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Information obtained from the Hospital. Began to not feel well the next day, SOB, diarrhea and fatigue. Was admitted to hospital on 4/9/21, diagnosed with COVID, placed on a vent and died on 4/19/21."
	"1233795-1"	"1233795-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Information obtained from the Hospital. Began to not feel well the next day, SOB, diarrhea and fatigue. Was admitted to hospital on 4/9/21, diagnosed with COVID, placed on a vent and died on 4/19/21."
	"1233795-1"	"1233795-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"Information obtained from the Hospital. Began to not feel well the next day, SOB, diarrhea and fatigue. Was admitted to hospital on 4/9/21, diagnosed with COVID, placed on a vent and died on 4/19/21."
	"1233795-1"	"1233795-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Information obtained from the Hospital. Began to not feel well the next day, SOB, diarrhea and fatigue. Was admitted to hospital on 4/9/21, diagnosed with COVID, placed on a vent and died on 4/19/21."
	"1235915-1"	"1235915-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"My father complained of soreness and body aches from the shot Sunday night to my mom and Monday morning to his boss at work. My sister found  him that afternoon in my parent's home unresponsive and call proceeded to call 911 and start CPR. But it was to late and he was already gone."
	"1235915-1"	"1235915-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"My father complained of soreness and body aches from the shot Sunday night to my mom and Monday morning to his boss at work. My sister found  him that afternoon in my parent's home unresponsive and call proceeded to call 911 and start CPR. But it was to late and he was already gone."
	"1235915-1"	"1235915-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"My father complained of soreness and body aches from the shot Sunday night to my mom and Monday morning to his boss at work. My sister found  him that afternoon in my parent's home unresponsive and call proceeded to call 911 and start CPR. But it was to late and he was already gone."
	"1235915-1"	"1235915-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"My father complained of soreness and body aches from the shot Sunday night to my mom and Monday morning to his boss at work. My sister found  him that afternoon in my parent's home unresponsive and call proceeded to call 911 and start CPR. But it was to late and he was already gone."
	"1237478-1"	"1237478-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"6-8 hours following the vaccine, the patient developed a severe head ache, SOB and fatigue. Patient took an unknown OTC medication, this did not help her symptoms. Her headache receded on 04/08, and her symptoms improved, but never fully resolved (per patient's son)."
	"1237478-1"	"1237478-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"6-8 hours following the vaccine, the patient developed a severe head ache, SOB and fatigue. Patient took an unknown OTC medication, this did not help her symptoms. Her headache receded on 04/08, and her symptoms improved, but never fully resolved (per patient's son)."
	"1237478-1"	"1237478-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"6-8 hours following the vaccine, the patient developed a severe head ache, SOB and fatigue. Patient took an unknown OTC medication, this did not help her symptoms. Her headache receded on 04/08, and her symptoms improved, but never fully resolved (per patient's son)."
	"1237478-1"	"1237478-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"6-8 hours following the vaccine, the patient developed a severe head ache, SOB and fatigue. Patient took an unknown OTC medication, this did not help her symptoms. Her headache receded on 04/08, and her symptoms improved, but never fully resolved (per patient's son)."
	"1238170-1"	"1238170-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Found dead at home 10 days post vaccine administration. Unclear correlation."
	"1238188-1"	"1238188-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"The decedent suffered fever and malaise after the second dose on 04/13/2021."
	"1238188-1"	"1238188-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"The decedent suffered fever and malaise after the second dose on 04/13/2021."
	"1238188-1"	"1238188-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"The decedent suffered fever and malaise after the second dose on 04/13/2021."
	"1238478-1"	"1238478-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"He was healthy before vaccine.  After vaccine a small amount of chills for a couple days.  He was sicker and was exposed to COVID 19, so went to hospital 4/14/2021 tested neg for influenza and + Coronavirus.  Died on 4/15/2021"
	"1238478-1"	"1238478-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"He was healthy before vaccine.  After vaccine a small amount of chills for a couple days.  He was sicker and was exposed to COVID 19, so went to hospital 4/14/2021 tested neg for influenza and + Coronavirus.  Died on 4/15/2021"
	"1238478-1"	"1238478-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"He was healthy before vaccine.  After vaccine a small amount of chills for a couple days.  He was sicker and was exposed to COVID 19, so went to hospital 4/14/2021 tested neg for influenza and + Coronavirus.  Died on 4/15/2021"
	"1238478-1"	"1238478-1"	"EXPOSURE TO SARS-COV-2"	"10084456"	"60-64 years"	"60-64"	"He was healthy before vaccine.  After vaccine a small amount of chills for a couple days.  He was sicker and was exposed to COVID 19, so went to hospital 4/14/2021 tested neg for influenza and + Coronavirus.  Died on 4/15/2021"
	"1238478-1"	"1238478-1"	"INFLUENZA VIRUS TEST NEGATIVE"	"10070718"	"60-64 years"	"60-64"	"He was healthy before vaccine.  After vaccine a small amount of chills for a couple days.  He was sicker and was exposed to COVID 19, so went to hospital 4/14/2021 tested neg for influenza and + Coronavirus.  Died on 4/15/2021"
	"1238478-1"	"1238478-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"He was healthy before vaccine.  After vaccine a small amount of chills for a couple days.  He was sicker and was exposed to COVID 19, so went to hospital 4/14/2021 tested neg for influenza and + Coronavirus.  Died on 4/15/2021"
	"1238478-1"	"1238478-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"He was healthy before vaccine.  After vaccine a small amount of chills for a couple days.  He was sicker and was exposed to COVID 19, so went to hospital 4/14/2021 tested neg for influenza and + Coronavirus.  Died on 4/15/2021"
	"1238733-1"	"1238733-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"Resident was found kneeling over walker with face down in the bathtub right before 1700.  Code called and initiated.  Resident pronounced dead at 1721 by EMS."
	"1238733-1"	"1238733-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Resident was found kneeling over walker with face down in the bathtub right before 1700.  Code called and initiated.  Resident pronounced dead at 1721 by EMS."
	"1238733-1"	"1238733-1"	"POSTURE ABNORMAL"	"10036436"	"60-64 years"	"60-64"	"Resident was found kneeling over walker with face down in the bathtub right before 1700.  Code called and initiated.  Resident pronounced dead at 1721 by EMS."
	"1242079-1"	"1242079-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"diarrhea. No fevers.  Occasional cough. No loss of taste or smell."
	"1242079-1"	"1242079-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"diarrhea. No fevers.  Occasional cough. No loss of taste or smell."
	"1242079-1"	"1242079-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"diarrhea. No fevers.  Occasional cough. No loss of taste or smell."
	"1242376-1"	"1242376-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Vaccine on 04/10/21.Shortness of breath, dizziness, nausea 04/13/2021. Death on at hospital on 04/14/2021 Autopsy found Bilateral pulmonary thromboemnbolus"
	"1242376-1"	"1242376-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Vaccine on 04/10/21.Shortness of breath, dizziness, nausea 04/13/2021. Death on at hospital on 04/14/2021 Autopsy found Bilateral pulmonary thromboemnbolus"
	"1242376-1"	"1242376-1"	"DIZZINESS"	"10013573"	"60-64 years"	"60-64"	"Vaccine on 04/10/21.Shortness of breath, dizziness, nausea 04/13/2021. Death on at hospital on 04/14/2021 Autopsy found Bilateral pulmonary thromboemnbolus"
	"1242376-1"	"1242376-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Vaccine on 04/10/21.Shortness of breath, dizziness, nausea 04/13/2021. Death on at hospital on 04/14/2021 Autopsy found Bilateral pulmonary thromboemnbolus"
	"1242376-1"	"1242376-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Vaccine on 04/10/21.Shortness of breath, dizziness, nausea 04/13/2021. Death on at hospital on 04/14/2021 Autopsy found Bilateral pulmonary thromboemnbolus"
	"1242376-1"	"1242376-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"Vaccine on 04/10/21.Shortness of breath, dizziness, nausea 04/13/2021. Death on at hospital on 04/14/2021 Autopsy found Bilateral pulmonary thromboemnbolus"
	"1243461-1"	"1243461-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"My father passed away on the 5th day and was in pretty good health."
	"1243715-1"	"1243715-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"60-64 years"	"60-64"	"Report received from co-worker of patient. Patient received J&J vaccine on 3/13/21. Patient was at work and collapsed 11 days after vaccination.  Was intubated at work site and taken to local hospital - the patient was then airlifted to a Medcial Center.  Diagnosed with a brain bleed and subsequently died on 4/6/21."
	"1243715-1"	"1243715-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Report received from co-worker of patient. Patient received J&J vaccine on 3/13/21. Patient was at work and collapsed 11 days after vaccination.  Was intubated at work site and taken to local hospital - the patient was then airlifted to a Medcial Center.  Diagnosed with a brain bleed and subsequently died on 4/6/21."
	"1243715-1"	"1243715-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Report received from co-worker of patient. Patient received J&J vaccine on 3/13/21. Patient was at work and collapsed 11 days after vaccination.  Was intubated at work site and taken to local hospital - the patient was then airlifted to a Medcial Center.  Diagnosed with a brain bleed and subsequently died on 4/6/21."
	"1243715-1"	"1243715-1"	"SYNCOPE"	"10042772"	"60-64 years"	"60-64"	"Report received from co-worker of patient. Patient received J&J vaccine on 3/13/21. Patient was at work and collapsed 11 days after vaccination.  Was intubated at work site and taken to local hospital - the patient was then airlifted to a Medcial Center.  Diagnosed with a brain bleed and subsequently died on 4/6/21."
	"1246863-1"	"1246863-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Shortness of breath, blood clot in lungs"
	"1246863-1"	"1246863-1"	"PULMONARY THROMBOSIS"	"10037437"	"60-64 years"	"60-64"	"Shortness of breath, blood clot in lungs"
	"1247290-1"	"1247290-1"	"AORTIC ANEURYSM RUPTURE"	"10002886"	"60-64 years"	"60-64"	"He found dead after 2 days he got the vaccine."
	"1247290-1"	"1247290-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"He found dead after 2 days he got the vaccine."
	"1247290-1"	"1247290-1"	"HYPERTENSION"	"10020772"	"60-64 years"	"60-64"	"He found dead after 2 days he got the vaccine."
	"1248554-1"	"1248554-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"PATIENT RECEIVED THE VACCINE ON 3/15, HE PASSED AWAY ON 3/29"
	"1248554-1"	"1248554-1"	"CARDIOVASCULAR DISORDER"	"10007649"	"60-64 years"	"60-64"	"PATIENT RECEIVED THE VACCINE ON 3/15, HE PASSED AWAY ON 3/29"
	"1248554-1"	"1248554-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"PATIENT RECEIVED THE VACCINE ON 3/15, HE PASSED AWAY ON 3/29"
	"1248554-1"	"1248554-1"	"HYPERTENSION"	"10020772"	"60-64 years"	"60-64"	"PATIENT RECEIVED THE VACCINE ON 3/15, HE PASSED AWAY ON 3/29"
	"1250966-1"	"1250966-1"	"BLOOD GLUCOSE NORMAL"	"10005558"	"60-64 years"	"60-64"	"Per family, patient received 2nd vaccination and began experiencing swelling and shortness of breath the following day.  This progressed over the course of 2 weeks until this today when he suffered a cardiopulmonary arrest and could not be resuscitated.  Death resulted on April 24th 2021."
	"1250966-1"	"1250966-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Per family, patient received 2nd vaccination and began experiencing swelling and shortness of breath the following day.  This progressed over the course of 2 weeks until this today when he suffered a cardiopulmonary arrest and could not be resuscitated.  Death resulted on April 24th 2021."
	"1250966-1"	"1250966-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"Per family, patient received 2nd vaccination and began experiencing swelling and shortness of breath the following day.  This progressed over the course of 2 weeks until this today when he suffered a cardiopulmonary arrest and could not be resuscitated.  Death resulted on April 24th 2021."
	"1250966-1"	"1250966-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Per family, patient received 2nd vaccination and began experiencing swelling and shortness of breath the following day.  This progressed over the course of 2 weeks until this today when he suffered a cardiopulmonary arrest and could not be resuscitated.  Death resulted on April 24th 2021."
	"1250966-1"	"1250966-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Per family, patient received 2nd vaccination and began experiencing swelling and shortness of breath the following day.  This progressed over the course of 2 weeks until this today when he suffered a cardiopulmonary arrest and could not be resuscitated.  Death resulted on April 24th 2021."
	"1250966-1"	"1250966-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Per family, patient received 2nd vaccination and began experiencing swelling and shortness of breath the following day.  This progressed over the course of 2 weeks until this today when he suffered a cardiopulmonary arrest and could not be resuscitated.  Death resulted on April 24th 2021."
	"1250966-1"	"1250966-1"	"SWELLING"	"10042674"	"60-64 years"	"60-64"	"Per family, patient received 2nd vaccination and began experiencing swelling and shortness of breath the following day.  This progressed over the course of 2 weeks until this today when he suffered a cardiopulmonary arrest and could not be resuscitated.  Death resulted on April 24th 2021."
	"1251507-1"	"1251507-1"	"APHASIA"	"10002948"	"60-64 years"	"60-64"	""Department of Health received a call from her sister, in response to a call/letter/text sent out to all recipients of the Janssen vaccine. She stated that her sister received the J and J vaccine on 3/12/21 (confirmed in State vaccine system) at the hospital where she receives her oncology care.  She reported the following:  ""She had a massive stroke on MARCH 27TH, 2021 leaving her paralyzed on the right side with the inability to speak, swallow, or see. She was initially diagnosed with Ovarian cancer approximately three and one half years ago. She was chosen for a study with Pharmaceuticals and her diagnosis was changed to a vary rare form of cancer called clear cell carcinoma which originates in the gynecological area. She did have a previous stroke approximately three years ago, (just after original diagnosis) but she was on a different course of treatment at that time...Oncologists have explained that this most recent stroke event would not be considered a side effect of her current treatment routine. She wanted to bring it to the attention of the health department in case it needs to be looked at more closely by the J&J research/scientific team. She passed away on 4/5/21. Her current treatment consisted of palliative chemo only. ""  Decedent was a resident but was vaccinated in another state. After the CVA she was brought to the hospital and subsequently transferred to the Medical Center where she died on 4/5/2021. Sister is willing to speak with any investigators if deemed necessary.""
	"1251507-1"	"1251507-1"	"BLINDNESS"	"10005169"	"60-64 years"	"60-64"	""Department of Health received a call from her sister, in response to a call/letter/text sent out to all recipients of the Janssen vaccine. She stated that her sister received the J and J vaccine on 3/12/21 (confirmed in State vaccine system) at the hospital where she receives her oncology care.  She reported the following:  ""She had a massive stroke on MARCH 27TH, 2021 leaving her paralyzed on the right side with the inability to speak, swallow, or see. She was initially diagnosed with Ovarian cancer approximately three and one half years ago. She was chosen for a study with Pharmaceuticals and her diagnosis was changed to a vary rare form of cancer called clear cell carcinoma which originates in the gynecological area. She did have a previous stroke approximately three years ago, (just after original diagnosis) but she was on a different course of treatment at that time...Oncologists have explained that this most recent stroke event would not be considered a side effect of her current treatment routine. She wanted to bring it to the attention of the health department in case it needs to be looked at more closely by the J&J research/scientific team. She passed away on 4/5/21. Her current treatment consisted of palliative chemo only. ""  Decedent was a resident but was vaccinated in another state. After the CVA she was brought to the hospital and subsequently transferred to the Medical Center where she died on 4/5/2021. Sister is willing to speak with any investigators if deemed necessary.""
	"1251507-1"	"1251507-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"60-64 years"	"60-64"	""Department of Health received a call from her sister, in response to a call/letter/text sent out to all recipients of the Janssen vaccine. She stated that her sister received the J and J vaccine on 3/12/21 (confirmed in State vaccine system) at the hospital where she receives her oncology care.  She reported the following:  ""She had a massive stroke on MARCH 27TH, 2021 leaving her paralyzed on the right side with the inability to speak, swallow, or see. She was initially diagnosed with Ovarian cancer approximately three and one half years ago. She was chosen for a study with Pharmaceuticals and her diagnosis was changed to a vary rare form of cancer called clear cell carcinoma which originates in the gynecological area. She did have a previous stroke approximately three years ago, (just after original diagnosis) but she was on a different course of treatment at that time...Oncologists have explained that this most recent stroke event would not be considered a side effect of her current treatment routine. She wanted to bring it to the attention of the health department in case it needs to be looked at more closely by the J&J research/scientific team. She passed away on 4/5/21. Her current treatment consisted of palliative chemo only. ""  Decedent was a resident but was vaccinated in another state. After the CVA she was brought to the hospital and subsequently transferred to the Medical Center where she died on 4/5/2021. Sister is willing to speak with any investigators if deemed necessary.""
	"1251507-1"	"1251507-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	""Department of Health received a call from her sister, in response to a call/letter/text sent out to all recipients of the Janssen vaccine. She stated that her sister received the J and J vaccine on 3/12/21 (confirmed in State vaccine system) at the hospital where she receives her oncology care.  She reported the following:  ""She had a massive stroke on MARCH 27TH, 2021 leaving her paralyzed on the right side with the inability to speak, swallow, or see. She was initially diagnosed with Ovarian cancer approximately three and one half years ago. She was chosen for a study with Pharmaceuticals and her diagnosis was changed to a vary rare form of cancer called clear cell carcinoma which originates in the gynecological area. She did have a previous stroke approximately three years ago, (just after original diagnosis) but she was on a different course of treatment at that time...Oncologists have explained that this most recent stroke event would not be considered a side effect of her current treatment routine. She wanted to bring it to the attention of the health department in case it needs to be looked at more closely by the J&J research/scientific team. She passed away on 4/5/21. Her current treatment consisted of palliative chemo only. ""  Decedent was a resident but was vaccinated in another state. After the CVA she was brought to the hospital and subsequently transferred to the Medical Center where she died on 4/5/2021. Sister is willing to speak with any investigators if deemed necessary.""
	"1251507-1"	"1251507-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""Department of Health received a call from her sister, in response to a call/letter/text sent out to all recipients of the Janssen vaccine. She stated that her sister received the J and J vaccine on 3/12/21 (confirmed in State vaccine system) at the hospital where she receives her oncology care.  She reported the following:  ""She had a massive stroke on MARCH 27TH, 2021 leaving her paralyzed on the right side with the inability to speak, swallow, or see. She was initially diagnosed with Ovarian cancer approximately three and one half years ago. She was chosen for a study with Pharmaceuticals and her diagnosis was changed to a vary rare form of cancer called clear cell carcinoma which originates in the gynecological area. She did have a previous stroke approximately three years ago, (just after original diagnosis) but she was on a different course of treatment at that time...Oncologists have explained that this most recent stroke event would not be considered a side effect of her current treatment routine. She wanted to bring it to the attention of the health department in case it needs to be looked at more closely by the J&J research/scientific team. She passed away on 4/5/21. Her current treatment consisted of palliative chemo only. ""  Decedent was a resident but was vaccinated in another state. After the CVA she was brought to the hospital and subsequently transferred to the Medical Center where she died on 4/5/2021. Sister is willing to speak with any investigators if deemed necessary.""
	"1251507-1"	"1251507-1"	"DYSPHAGIA"	"10013950"	"60-64 years"	"60-64"	""Department of Health received a call from her sister, in response to a call/letter/text sent out to all recipients of the Janssen vaccine. She stated that her sister received the J and J vaccine on 3/12/21 (confirmed in State vaccine system) at the hospital where she receives her oncology care.  She reported the following:  ""She had a massive stroke on MARCH 27TH, 2021 leaving her paralyzed on the right side with the inability to speak, swallow, or see. She was initially diagnosed with Ovarian cancer approximately three and one half years ago. She was chosen for a study with Pharmaceuticals and her diagnosis was changed to a vary rare form of cancer called clear cell carcinoma which originates in the gynecological area. She did have a previous stroke approximately three years ago, (just after original diagnosis) but she was on a different course of treatment at that time...Oncologists have explained that this most recent stroke event would not be considered a side effect of her current treatment routine. She wanted to bring it to the attention of the health department in case it needs to be looked at more closely by the J&J research/scientific team. She passed away on 4/5/21. Her current treatment consisted of palliative chemo only. ""  Decedent was a resident but was vaccinated in another state. After the CVA she was brought to the hospital and subsequently transferred to the Medical Center where she died on 4/5/2021. Sister is willing to speak with any investigators if deemed necessary.""
	"1251507-1"	"1251507-1"	"HEMIPLEGIA"	"10019468"	"60-64 years"	"60-64"	""Department of Health received a call from her sister, in response to a call/letter/text sent out to all recipients of the Janssen vaccine. She stated that her sister received the J and J vaccine on 3/12/21 (confirmed in State vaccine system) at the hospital where she receives her oncology care.  She reported the following:  ""She had a massive stroke on MARCH 27TH, 2021 leaving her paralyzed on the right side with the inability to speak, swallow, or see. She was initially diagnosed with Ovarian cancer approximately three and one half years ago. She was chosen for a study with Pharmaceuticals and her diagnosis was changed to a vary rare form of cancer called clear cell carcinoma which originates in the gynecological area. She did have a previous stroke approximately three years ago, (just after original diagnosis) but she was on a different course of treatment at that time...Oncologists have explained that this most recent stroke event would not be considered a side effect of her current treatment routine. She wanted to bring it to the attention of the health department in case it needs to be looked at more closely by the J&J research/scientific team. She passed away on 4/5/21. Her current treatment consisted of palliative chemo only. ""  Decedent was a resident but was vaccinated in another state. After the CVA she was brought to the hospital and subsequently transferred to the Medical Center where she died on 4/5/2021. Sister is willing to speak with any investigators if deemed necessary.""
	"1257772-1"	"1257772-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient started not feeling well and told friends  and family that he was not feeling well and that his doctor believed he was having a side effect to the 2nd dose of his COVID-19 Vaccine. He died 11 days after receiving his vaccine."
	"1257772-1"	"1257772-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"Patient started not feeling well and told friends  and family that he was not feeling well and that his doctor believed he was having a side effect to the 2nd dose of his COVID-19 Vaccine. He died 11 days after receiving his vaccine."
	"1257832-1"	"1257832-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Hospitalized +Covid post vaccination with decreased mental status"
	"1257832-1"	"1257832-1"	"MENTAL STATUS CHANGES"	"10048294"	"60-64 years"	"60-64"	"Hospitalized +Covid post vaccination with decreased mental status"
	"1257832-1"	"1257832-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Hospitalized +Covid post vaccination with decreased mental status"
	"1258453-1"	"1258453-1"	"ABDOMINAL PAIN"	"10000081"	"60-64 years"	"60-64"	"my auntie, who was trying to be supportive and to get vaccinated just passed away like this is not worse it.   My auntie, passed away the next two days after she got her Pfizer Covid vaccine.   My auntie, who is 65 years old, got her Pfizer vaccine the the morning of April 22 2021. She told us he was completely find on the day of the vaccine. But the next morning around 9 am, she told us she has  severe abdominal pain, has the need to have a bowel movement, but she was defecated. She also told us that she vomit couple times already,  then she has no more energy to talk. She got into the hospital and she was announced right after midnight at 12:04 April 25th.  The reported death reason is due to Bowel Ischemia with Perforation and it has nothing to do with Pfizer vaccine that she got. But I believe it is her post Pfizer covid vaccine reaction that result in Bowel Ischemia with Perforation.  My auntie lived with a very healthy life style. She walked every morning, and has a shorter walk in the evening. She has no blood pressure, no blood sugar, everything is fine with her medical check.  My auntie had a kidney transplant 20+ years ago and she is on the track for monthly doctor visit. When she asked her general doctor if she could get the vaccine, her general doctor asked her to consult her kidney doctor. She then went to ask her kidney doctor and her kidney doctor call her general doctor to discuss her health conditions. Both of her doctor decided that she could take the vaccine and one of the doctor registered her for the vaccine on April 15 2021. The she nurse told her to came in for vaccine on Apr 22, and she is now death after the Pfizer vaccine.    I only read about people with recent organ transplant is not recommended to take the Covid vaccine. But there is no information about people that ever had kidney transplant shouldn?t take the vaccine.   My auntie, who was trying to be supportive and to get vaccinated just passed away like this is not worse it without a clear explanation.   I would like you to contact health department to follow up on this case and find out the real root cause. If the vaccine is not recommended for people that ever got kidney transplant, CDC should publish the information so that there won?t be more victims.   Please take necessary action ASAP.     Thank you!"
	"1258453-1"	"1258453-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"my auntie, who was trying to be supportive and to get vaccinated just passed away like this is not worse it.   My auntie, passed away the next two days after she got her Pfizer Covid vaccine.   My auntie, who is 65 years old, got her Pfizer vaccine the the morning of April 22 2021. She told us he was completely find on the day of the vaccine. But the next morning around 9 am, she told us she has  severe abdominal pain, has the need to have a bowel movement, but she was defecated. She also told us that she vomit couple times already,  then she has no more energy to talk. She got into the hospital and she was announced right after midnight at 12:04 April 25th.  The reported death reason is due to Bowel Ischemia with Perforation and it has nothing to do with Pfizer vaccine that she got. But I believe it is her post Pfizer covid vaccine reaction that result in Bowel Ischemia with Perforation.  My auntie lived with a very healthy life style. She walked every morning, and has a shorter walk in the evening. She has no blood pressure, no blood sugar, everything is fine with her medical check.  My auntie had a kidney transplant 20+ years ago and she is on the track for monthly doctor visit. When she asked her general doctor if she could get the vaccine, her general doctor asked her to consult her kidney doctor. She then went to ask her kidney doctor and her kidney doctor call her general doctor to discuss her health conditions. Both of her doctor decided that she could take the vaccine and one of the doctor registered her for the vaccine on April 15 2021. The she nurse told her to came in for vaccine on Apr 22, and she is now death after the Pfizer vaccine.    I only read about people with recent organ transplant is not recommended to take the Covid vaccine. But there is no information about people that ever had kidney transplant shouldn?t take the vaccine.   My auntie, who was trying to be supportive and to get vaccinated just passed away like this is not worse it without a clear explanation.   I would like you to contact health department to follow up on this case and find out the real root cause. If the vaccine is not recommended for people that ever got kidney transplant, CDC should publish the information so that there won?t be more victims.   Please take necessary action ASAP.     Thank you!"
	"1258453-1"	"1258453-1"	"CONTRAINDICATION TO VACCINATION"	"10010835"	"60-64 years"	"60-64"	"my auntie, who was trying to be supportive and to get vaccinated just passed away like this is not worse it.   My auntie, passed away the next two days after she got her Pfizer Covid vaccine.   My auntie, who is 65 years old, got her Pfizer vaccine the the morning of April 22 2021. She told us he was completely find on the day of the vaccine. But the next morning around 9 am, she told us she has  severe abdominal pain, has the need to have a bowel movement, but she was defecated. She also told us that she vomit couple times already,  then she has no more energy to talk. She got into the hospital and she was announced right after midnight at 12:04 April 25th.  The reported death reason is due to Bowel Ischemia with Perforation and it has nothing to do with Pfizer vaccine that she got. But I believe it is her post Pfizer covid vaccine reaction that result in Bowel Ischemia with Perforation.  My auntie lived with a very healthy life style. She walked every morning, and has a shorter walk in the evening. She has no blood pressure, no blood sugar, everything is fine with her medical check.  My auntie had a kidney transplant 20+ years ago and she is on the track for monthly doctor visit. When she asked her general doctor if she could get the vaccine, her general doctor asked her to consult her kidney doctor. She then went to ask her kidney doctor and her kidney doctor call her general doctor to discuss her health conditions. Both of her doctor decided that she could take the vaccine and one of the doctor registered her for the vaccine on April 15 2021. The she nurse told her to came in for vaccine on Apr 22, and she is now death after the Pfizer vaccine.    I only read about people with recent organ transplant is not recommended to take the Covid vaccine. But there is no information about people that ever had kidney transplant shouldn?t take the vaccine.   My auntie, who was trying to be supportive and to get vaccinated just passed away like this is not worse it without a clear explanation.   I would like you to contact health department to follow up on this case and find out the real root cause. If the vaccine is not recommended for people that ever got kidney transplant, CDC should publish the information so that there won?t be more victims.   Please take necessary action ASAP.     Thank you!"
	"1258453-1"	"1258453-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"my auntie, who was trying to be supportive and to get vaccinated just passed away like this is not worse it.   My auntie, passed away the next two days after she got her Pfizer Covid vaccine.   My auntie, who is 65 years old, got her Pfizer vaccine the the morning of April 22 2021. She told us he was completely find on the day of the vaccine. But the next morning around 9 am, she told us she has  severe abdominal pain, has the need to have a bowel movement, but she was defecated. She also told us that she vomit couple times already,  then she has no more energy to talk. She got into the hospital and she was announced right after midnight at 12:04 April 25th.  The reported death reason is due to Bowel Ischemia with Perforation and it has nothing to do with Pfizer vaccine that she got. But I believe it is her post Pfizer covid vaccine reaction that result in Bowel Ischemia with Perforation.  My auntie lived with a very healthy life style. She walked every morning, and has a shorter walk in the evening. She has no blood pressure, no blood sugar, everything is fine with her medical check.  My auntie had a kidney transplant 20+ years ago and she is on the track for monthly doctor visit. When she asked her general doctor if she could get the vaccine, her general doctor asked her to consult her kidney doctor. She then went to ask her kidney doctor and her kidney doctor call her general doctor to discuss her health conditions. Both of her doctor decided that she could take the vaccine and one of the doctor registered her for the vaccine on April 15 2021. The she nurse told her to came in for vaccine on Apr 22, and she is now death after the Pfizer vaccine.    I only read about people with recent organ transplant is not recommended to take the Covid vaccine. But there is no information about people that ever had kidney transplant shouldn?t take the vaccine.   My auntie, who was trying to be supportive and to get vaccinated just passed away like this is not worse it without a clear explanation.   I would like you to contact health department to follow up on this case and find out the real root cause. If the vaccine is not recommended for people that ever got kidney transplant, CDC should publish the information so that there won?t be more victims.   Please take necessary action ASAP.     Thank you!"
	"1258453-1"	"1258453-1"	"DEFAECATION URGENCY"	"10012110"	"60-64 years"	"60-64"	"my auntie, who was trying to be supportive and to get vaccinated just passed away like this is not worse it.   My auntie, passed away the next two days after she got her Pfizer Covid vaccine.   My auntie, who is 65 years old, got her Pfizer vaccine the the morning of April 22 2021. She told us he was completely find on the day of the vaccine. But the next morning around 9 am, she told us she has  severe abdominal pain, has the need to have a bowel movement, but she was defecated. She also told us that she vomit couple times already,  then she has no more energy to talk. She got into the hospital and she was announced right after midnight at 12:04 April 25th.  The reported death reason is due to Bowel Ischemia with Perforation and it has nothing to do with Pfizer vaccine that she got. But I believe it is her post Pfizer covid vaccine reaction that result in Bowel Ischemia with Perforation.  My auntie lived with a very healthy life style. She walked every morning, and has a shorter walk in the evening. She has no blood pressure, no blood sugar, everything is fine with her medical check.  My auntie had a kidney transplant 20+ years ago and she is on the track for monthly doctor visit. When she asked her general doctor if she could get the vaccine, her general doctor asked her to consult her kidney doctor. She then went to ask her kidney doctor and her kidney doctor call her general doctor to discuss her health conditions. Both of her doctor decided that she could take the vaccine and one of the doctor registered her for the vaccine on April 15 2021. The she nurse told her to came in for vaccine on Apr 22, and she is now death after the Pfizer vaccine.    I only read about people with recent organ transplant is not recommended to take the Covid vaccine. But there is no information about people that ever had kidney transplant shouldn?t take the vaccine.   My auntie, who was trying to be supportive and to get vaccinated just passed away like this is not worse it without a clear explanation.   I would like you to contact health department to follow up on this case and find out the real root cause. If the vaccine is not recommended for people that ever got kidney transplant, CDC should publish the information so that there won?t be more victims.   Please take necessary action ASAP.     Thank you!"
	"1258453-1"	"1258453-1"	"INTESTINAL ISCHAEMIA"	"10022680"	"60-64 years"	"60-64"	"my auntie, who was trying to be supportive and to get vaccinated just passed away like this is not worse it.   My auntie, passed away the next two days after she got her Pfizer Covid vaccine.   My auntie, who is 65 years old, got her Pfizer vaccine the the morning of April 22 2021. She told us he was completely find on the day of the vaccine. But the next morning around 9 am, she told us she has  severe abdominal pain, has the need to have a bowel movement, but she was defecated. She also told us that she vomit couple times already,  then she has no more energy to talk. She got into the hospital and she was announced right after midnight at 12:04 April 25th.  The reported death reason is due to Bowel Ischemia with Perforation and it has nothing to do with Pfizer vaccine that she got. But I believe it is her post Pfizer covid vaccine reaction that result in Bowel Ischemia with Perforation.  My auntie lived with a very healthy life style. She walked every morning, and has a shorter walk in the evening. She has no blood pressure, no blood sugar, everything is fine with her medical check.  My auntie had a kidney transplant 20+ years ago and she is on the track for monthly doctor visit. When she asked her general doctor if she could get the vaccine, her general doctor asked her to consult her kidney doctor. She then went to ask her kidney doctor and her kidney doctor call her general doctor to discuss her health conditions. Both of her doctor decided that she could take the vaccine and one of the doctor registered her for the vaccine on April 15 2021. The she nurse told her to came in for vaccine on Apr 22, and she is now death after the Pfizer vaccine.    I only read about people with recent organ transplant is not recommended to take the Covid vaccine. But there is no information about people that ever had kidney transplant shouldn?t take the vaccine.   My auntie, who was trying to be supportive and to get vaccinated just passed away like this is not worse it without a clear explanation.   I would like you to contact health department to follow up on this case and find out the real root cause. If the vaccine is not recommended for people that ever got kidney transplant, CDC should publish the information so that there won?t be more victims.   Please take necessary action ASAP.     Thank you!"
	"1258453-1"	"1258453-1"	"INTESTINAL PERFORATION"	"10022694"	"60-64 years"	"60-64"	"my auntie, who was trying to be supportive and to get vaccinated just passed away like this is not worse it.   My auntie, passed away the next two days after she got her Pfizer Covid vaccine.   My auntie, who is 65 years old, got her Pfizer vaccine the the morning of April 22 2021. She told us he was completely find on the day of the vaccine. But the next morning around 9 am, she told us she has  severe abdominal pain, has the need to have a bowel movement, but she was defecated. She also told us that she vomit couple times already,  then she has no more energy to talk. She got into the hospital and she was announced right after midnight at 12:04 April 25th.  The reported death reason is due to Bowel Ischemia with Perforation and it has nothing to do with Pfizer vaccine that she got. But I believe it is her post Pfizer covid vaccine reaction that result in Bowel Ischemia with Perforation.  My auntie lived with a very healthy life style. She walked every morning, and has a shorter walk in the evening. She has no blood pressure, no blood sugar, everything is fine with her medical check.  My auntie had a kidney transplant 20+ years ago and she is on the track for monthly doctor visit. When she asked her general doctor if she could get the vaccine, her general doctor asked her to consult her kidney doctor. She then went to ask her kidney doctor and her kidney doctor call her general doctor to discuss her health conditions. Both of her doctor decided that she could take the vaccine and one of the doctor registered her for the vaccine on April 15 2021. The she nurse told her to came in for vaccine on Apr 22, and she is now death after the Pfizer vaccine.    I only read about people with recent organ transplant is not recommended to take the Covid vaccine. But there is no information about people that ever had kidney transplant shouldn?t take the vaccine.   My auntie, who was trying to be supportive and to get vaccinated just passed away like this is not worse it without a clear explanation.   I would like you to contact health department to follow up on this case and find out the real root cause. If the vaccine is not recommended for people that ever got kidney transplant, CDC should publish the information so that there won?t be more victims.   Please take necessary action ASAP.     Thank you!"
	"1258453-1"	"1258453-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"my auntie, who was trying to be supportive and to get vaccinated just passed away like this is not worse it.   My auntie, passed away the next two days after she got her Pfizer Covid vaccine.   My auntie, who is 65 years old, got her Pfizer vaccine the the morning of April 22 2021. She told us he was completely find on the day of the vaccine. But the next morning around 9 am, she told us she has  severe abdominal pain, has the need to have a bowel movement, but she was defecated. She also told us that she vomit couple times already,  then she has no more energy to talk. She got into the hospital and she was announced right after midnight at 12:04 April 25th.  The reported death reason is due to Bowel Ischemia with Perforation and it has nothing to do with Pfizer vaccine that she got. But I believe it is her post Pfizer covid vaccine reaction that result in Bowel Ischemia with Perforation.  My auntie lived with a very healthy life style. She walked every morning, and has a shorter walk in the evening. She has no blood pressure, no blood sugar, everything is fine with her medical check.  My auntie had a kidney transplant 20+ years ago and she is on the track for monthly doctor visit. When she asked her general doctor if she could get the vaccine, her general doctor asked her to consult her kidney doctor. She then went to ask her kidney doctor and her kidney doctor call her general doctor to discuss her health conditions. Both of her doctor decided that she could take the vaccine and one of the doctor registered her for the vaccine on April 15 2021. The she nurse told her to came in for vaccine on Apr 22, and she is now death after the Pfizer vaccine.    I only read about people with recent organ transplant is not recommended to take the Covid vaccine. But there is no information about people that ever had kidney transplant shouldn?t take the vaccine.   My auntie, who was trying to be supportive and to get vaccinated just passed away like this is not worse it without a clear explanation.   I would like you to contact health department to follow up on this case and find out the real root cause. If the vaccine is not recommended for people that ever got kidney transplant, CDC should publish the information so that there won?t be more victims.   Please take necessary action ASAP.     Thank you!"
	"1260537-1"	"1260537-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"60-64 years"	"60-64"	""Patient (per family member) received 1st dose of Pfizer COVID vaccine on 4/24/2021.  On 4/26/2021 at 6 AM patient presented to hospital with chest pain for 2 hours.  EKG showed inferior ST segment elevation myocardial infarction (a ""heart attack"") and the patient was brought emergently for cardiac catheterization.  Catheterization showed an occluded right coronary artery, and angioplasty/stenting was performed.  Following brief restoration of blood flow to the heart, the artery re-occluded and the patient arrested.  After 90 minutes of CPR, the patient expired.""
	"1260537-1"	"1260537-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	""Patient (per family member) received 1st dose of Pfizer COVID vaccine on 4/24/2021.  On 4/26/2021 at 6 AM patient presented to hospital with chest pain for 2 hours.  EKG showed inferior ST segment elevation myocardial infarction (a ""heart attack"") and the patient was brought emergently for cardiac catheterization.  Catheterization showed an occluded right coronary artery, and angioplasty/stenting was performed.  Following brief restoration of blood flow to the heart, the artery re-occluded and the patient arrested.  After 90 minutes of CPR, the patient expired.""
	"1260537-1"	"1260537-1"	"CATHETERISATION CARDIAC ABNORMAL"	"10007816"	"60-64 years"	"60-64"	""Patient (per family member) received 1st dose of Pfizer COVID vaccine on 4/24/2021.  On 4/26/2021 at 6 AM patient presented to hospital with chest pain for 2 hours.  EKG showed inferior ST segment elevation myocardial infarction (a ""heart attack"") and the patient was brought emergently for cardiac catheterization.  Catheterization showed an occluded right coronary artery, and angioplasty/stenting was performed.  Following brief restoration of blood flow to the heart, the artery re-occluded and the patient arrested.  After 90 minutes of CPR, the patient expired.""
	"1260537-1"	"1260537-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	""Patient (per family member) received 1st dose of Pfizer COVID vaccine on 4/24/2021.  On 4/26/2021 at 6 AM patient presented to hospital with chest pain for 2 hours.  EKG showed inferior ST segment elevation myocardial infarction (a ""heart attack"") and the patient was brought emergently for cardiac catheterization.  Catheterization showed an occluded right coronary artery, and angioplasty/stenting was performed.  Following brief restoration of blood flow to the heart, the artery re-occluded and the patient arrested.  After 90 minutes of CPR, the patient expired.""
	"1260537-1"	"1260537-1"	"CORONARY ANGIOPLASTY"	"10050329"	"60-64 years"	"60-64"	""Patient (per family member) received 1st dose of Pfizer COVID vaccine on 4/24/2021.  On 4/26/2021 at 6 AM patient presented to hospital with chest pain for 2 hours.  EKG showed inferior ST segment elevation myocardial infarction (a ""heart attack"") and the patient was brought emergently for cardiac catheterization.  Catheterization showed an occluded right coronary artery, and angioplasty/stenting was performed.  Following brief restoration of blood flow to the heart, the artery re-occluded and the patient arrested.  After 90 minutes of CPR, the patient expired.""
	"1260537-1"	"1260537-1"	"CORONARY ARTERIAL STENT INSERTION"	"10052086"	"60-64 years"	"60-64"	""Patient (per family member) received 1st dose of Pfizer COVID vaccine on 4/24/2021.  On 4/26/2021 at 6 AM patient presented to hospital with chest pain for 2 hours.  EKG showed inferior ST segment elevation myocardial infarction (a ""heart attack"") and the patient was brought emergently for cardiac catheterization.  Catheterization showed an occluded right coronary artery, and angioplasty/stenting was performed.  Following brief restoration of blood flow to the heart, the artery re-occluded and the patient arrested.  After 90 minutes of CPR, the patient expired.""
	"1260537-1"	"1260537-1"	"CORONARY ARTERY OCCLUSION"	"10011086"	"60-64 years"	"60-64"	""Patient (per family member) received 1st dose of Pfizer COVID vaccine on 4/24/2021.  On 4/26/2021 at 6 AM patient presented to hospital with chest pain for 2 hours.  EKG showed inferior ST segment elevation myocardial infarction (a ""heart attack"") and the patient was brought emergently for cardiac catheterization.  Catheterization showed an occluded right coronary artery, and angioplasty/stenting was performed.  Following brief restoration of blood flow to the heart, the artery re-occluded and the patient arrested.  After 90 minutes of CPR, the patient expired.""
	"1260537-1"	"1260537-1"	"CORONARY ARTERY REOCCLUSION"	"10053261"	"60-64 years"	"60-64"	""Patient (per family member) received 1st dose of Pfizer COVID vaccine on 4/24/2021.  On 4/26/2021 at 6 AM patient presented to hospital with chest pain for 2 hours.  EKG showed inferior ST segment elevation myocardial infarction (a ""heart attack"") and the patient was brought emergently for cardiac catheterization.  Catheterization showed an occluded right coronary artery, and angioplasty/stenting was performed.  Following brief restoration of blood flow to the heart, the artery re-occluded and the patient arrested.  After 90 minutes of CPR, the patient expired.""
	"1260537-1"	"1260537-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""Patient (per family member) received 1st dose of Pfizer COVID vaccine on 4/24/2021.  On 4/26/2021 at 6 AM patient presented to hospital with chest pain for 2 hours.  EKG showed inferior ST segment elevation myocardial infarction (a ""heart attack"") and the patient was brought emergently for cardiac catheterization.  Catheterization showed an occluded right coronary artery, and angioplasty/stenting was performed.  Following brief restoration of blood flow to the heart, the artery re-occluded and the patient arrested.  After 90 minutes of CPR, the patient expired.""
	"1260537-1"	"1260537-1"	"ELECTROCARDIOGRAM ST SEGMENT ELEVATION"	"10014392"	"60-64 years"	"60-64"	""Patient (per family member) received 1st dose of Pfizer COVID vaccine on 4/24/2021.  On 4/26/2021 at 6 AM patient presented to hospital with chest pain for 2 hours.  EKG showed inferior ST segment elevation myocardial infarction (a ""heart attack"") and the patient was brought emergently for cardiac catheterization.  Catheterization showed an occluded right coronary artery, and angioplasty/stenting was performed.  Following brief restoration of blood flow to the heart, the artery re-occluded and the patient arrested.  After 90 minutes of CPR, the patient expired.""
	"1260537-1"	"1260537-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	""Patient (per family member) received 1st dose of Pfizer COVID vaccine on 4/24/2021.  On 4/26/2021 at 6 AM patient presented to hospital with chest pain for 2 hours.  EKG showed inferior ST segment elevation myocardial infarction (a ""heart attack"") and the patient was brought emergently for cardiac catheterization.  Catheterization showed an occluded right coronary artery, and angioplasty/stenting was performed.  Following brief restoration of blood flow to the heart, the artery re-occluded and the patient arrested.  After 90 minutes of CPR, the patient expired.""
	"1262349-1"	"1262349-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"Pt came in with positive D-dimer, coded and passed"
	"1262349-1"	"1262349-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pt came in with positive D-dimer, coded and passed"
	"1262349-1"	"1262349-1"	"FIBRIN D DIMER INCREASED"	"10016581"	"60-64 years"	"60-64"	"Pt came in with positive D-dimer, coded and passed"
	"1263591-1"	"1263591-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Within 12 hours of vaccine patient complained of being short of breath and asked his wife to call 911, he then stopped breathing and she did CPR until rescue squad arrived. Pt was unable to be revived and died."
	"1263591-1"	"1263591-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Within 12 hours of vaccine patient complained of being short of breath and asked his wife to call 911, he then stopped breathing and she did CPR until rescue squad arrived. Pt was unable to be revived and died."
	"1263591-1"	"1263591-1"	"RESPIRATORY ARREST"	"10038669"	"60-64 years"	"60-64"	"Within 12 hours of vaccine patient complained of being short of breath and asked his wife to call 911, he then stopped breathing and she did CPR until rescue squad arrived. Pt was unable to be revived and died."
	"1263591-1"	"1263591-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Within 12 hours of vaccine patient complained of being short of breath and asked his wife to call 911, he then stopped breathing and she did CPR until rescue squad arrived. Pt was unable to be revived and died."
	"1263989-1"	"1263989-1"	"BLOOD CALCIUM DECREASED"	"10005395"	"60-64 years"	"60-64"	"Nausea, vomiting, burning in stomach, high blood sugars- symptoms started the day after the vaccine. Found obtunded 3 days after vaccine given. 911 called in route to the hospital had a cardiac arrest, resuscitated, arrested again and resuscitated. Upon admission to the hospital diagnosed with diabetic ketoacidosis and died the next day- 4 days after the vaccine was administered"
	"1263989-1"	"1263989-1"	"BLOOD CREATININE NORMAL"	"10005484"	"60-64 years"	"60-64"	"Nausea, vomiting, burning in stomach, high blood sugars- symptoms started the day after the vaccine. Found obtunded 3 days after vaccine given. 911 called in route to the hospital had a cardiac arrest, resuscitated, arrested again and resuscitated. Upon admission to the hospital diagnosed with diabetic ketoacidosis and died the next day- 4 days after the vaccine was administered"
	"1263989-1"	"1263989-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"60-64 years"	"60-64"	"Nausea, vomiting, burning in stomach, high blood sugars- symptoms started the day after the vaccine. Found obtunded 3 days after vaccine given. 911 called in route to the hospital had a cardiac arrest, resuscitated, arrested again and resuscitated. Upon admission to the hospital diagnosed with diabetic ketoacidosis and died the next day- 4 days after the vaccine was administered"
	"1263989-1"	"1263989-1"	"BLOOD THYROID STIMULATING HORMONE DECREASED"	"10005832"	"60-64 years"	"60-64"	"Nausea, vomiting, burning in stomach, high blood sugars- symptoms started the day after the vaccine. Found obtunded 3 days after vaccine given. 911 called in route to the hospital had a cardiac arrest, resuscitated, arrested again and resuscitated. Upon admission to the hospital diagnosed with diabetic ketoacidosis and died the next day- 4 days after the vaccine was administered"
	"1263989-1"	"1263989-1"	"BLOOD UREA NORMAL"	"10005857"	"60-64 years"	"60-64"	"Nausea, vomiting, burning in stomach, high blood sugars- symptoms started the day after the vaccine. Found obtunded 3 days after vaccine given. 911 called in route to the hospital had a cardiac arrest, resuscitated, arrested again and resuscitated. Upon admission to the hospital diagnosed with diabetic ketoacidosis and died the next day- 4 days after the vaccine was administered"
	"1263989-1"	"1263989-1"	"CARBON DIOXIDE DECREASED"	"10007223"	"60-64 years"	"60-64"	"Nausea, vomiting, burning in stomach, high blood sugars- symptoms started the day after the vaccine. Found obtunded 3 days after vaccine given. 911 called in route to the hospital had a cardiac arrest, resuscitated, arrested again and resuscitated. Upon admission to the hospital diagnosed with diabetic ketoacidosis and died the next day- 4 days after the vaccine was administered"
	"1263989-1"	"1263989-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Nausea, vomiting, burning in stomach, high blood sugars- symptoms started the day after the vaccine. Found obtunded 3 days after vaccine given. 911 called in route to the hospital had a cardiac arrest, resuscitated, arrested again and resuscitated. Upon admission to the hospital diagnosed with diabetic ketoacidosis and died the next day- 4 days after the vaccine was administered"
	"1263989-1"	"1263989-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Nausea, vomiting, burning in stomach, high blood sugars- symptoms started the day after the vaccine. Found obtunded 3 days after vaccine given. 911 called in route to the hospital had a cardiac arrest, resuscitated, arrested again and resuscitated. Upon admission to the hospital diagnosed with diabetic ketoacidosis and died the next day- 4 days after the vaccine was administered"
	"1263989-1"	"1263989-1"	"DEPRESSED LEVEL OF CONSCIOUSNESS"	"10012373"	"60-64 years"	"60-64"	"Nausea, vomiting, burning in stomach, high blood sugars- symptoms started the day after the vaccine. Found obtunded 3 days after vaccine given. 911 called in route to the hospital had a cardiac arrest, resuscitated, arrested again and resuscitated. Upon admission to the hospital diagnosed with diabetic ketoacidosis and died the next day- 4 days after the vaccine was administered"
	"1263989-1"	"1263989-1"	"DIABETIC KETOACIDOSIS"	"10012671"	"60-64 years"	"60-64"	"Nausea, vomiting, burning in stomach, high blood sugars- symptoms started the day after the vaccine. Found obtunded 3 days after vaccine given. 911 called in route to the hospital had a cardiac arrest, resuscitated, arrested again and resuscitated. Upon admission to the hospital diagnosed with diabetic ketoacidosis and died the next day- 4 days after the vaccine was administered"
	"1263989-1"	"1263989-1"	"DYSPEPSIA"	"10013946"	"60-64 years"	"60-64"	"Nausea, vomiting, burning in stomach, high blood sugars- symptoms started the day after the vaccine. Found obtunded 3 days after vaccine given. 911 called in route to the hospital had a cardiac arrest, resuscitated, arrested again and resuscitated. Upon admission to the hospital diagnosed with diabetic ketoacidosis and died the next day- 4 days after the vaccine was administered"
	"1263989-1"	"1263989-1"	"FULL BLOOD COUNT NORMAL"	"10017414"	"60-64 years"	"60-64"	"Nausea, vomiting, burning in stomach, high blood sugars- symptoms started the day after the vaccine. Found obtunded 3 days after vaccine given. 911 called in route to the hospital had a cardiac arrest, resuscitated, arrested again and resuscitated. Upon admission to the hospital diagnosed with diabetic ketoacidosis and died the next day- 4 days after the vaccine was administered"
	"1263989-1"	"1263989-1"	"GLYCOSYLATED HAEMOGLOBIN INCREASED"	"10018484"	"60-64 years"	"60-64"	"Nausea, vomiting, burning in stomach, high blood sugars- symptoms started the day after the vaccine. Found obtunded 3 days after vaccine given. 911 called in route to the hospital had a cardiac arrest, resuscitated, arrested again and resuscitated. Upon admission to the hospital diagnosed with diabetic ketoacidosis and died the next day- 4 days after the vaccine was administered"
	"1263989-1"	"1263989-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Nausea, vomiting, burning in stomach, high blood sugars- symptoms started the day after the vaccine. Found obtunded 3 days after vaccine given. 911 called in route to the hospital had a cardiac arrest, resuscitated, arrested again and resuscitated. Upon admission to the hospital diagnosed with diabetic ketoacidosis and died the next day- 4 days after the vaccine was administered"
	"1263989-1"	"1263989-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Nausea, vomiting, burning in stomach, high blood sugars- symptoms started the day after the vaccine. Found obtunded 3 days after vaccine given. 911 called in route to the hospital had a cardiac arrest, resuscitated, arrested again and resuscitated. Upon admission to the hospital diagnosed with diabetic ketoacidosis and died the next day- 4 days after the vaccine was administered"
	"1263989-1"	"1263989-1"	"THYROXINE FREE NORMAL"	"10055159"	"60-64 years"	"60-64"	"Nausea, vomiting, burning in stomach, high blood sugars- symptoms started the day after the vaccine. Found obtunded 3 days after vaccine given. 911 called in route to the hospital had a cardiac arrest, resuscitated, arrested again and resuscitated. Upon admission to the hospital diagnosed with diabetic ketoacidosis and died the next day- 4 days after the vaccine was administered"
	"1263989-1"	"1263989-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"Nausea, vomiting, burning in stomach, high blood sugars- symptoms started the day after the vaccine. Found obtunded 3 days after vaccine given. 911 called in route to the hospital had a cardiac arrest, resuscitated, arrested again and resuscitated. Upon admission to the hospital diagnosed with diabetic ketoacidosis and died the next day- 4 days after the vaccine was administered"
	"1265810-1"	"1265810-1"	"BLOOD TEST"	"10061726"	"60-64 years"	"60-64"	"sweating; felt cold/intense cold even in his bones; He was told by the professional health care that he had small clots in his blood; death cause: Medication; arm started to sore; Doctor identified he had DVT; her husband during that night was not able to sleep; He started having fever; This is a spontaneous report from a contactable consumer (patient's spouse).   A 61-year-old male patient received bnt162b2 (BNT162B2), via an unspecified route of administration on 21Mar2021 09:00 (Batch/Lot number was not reported) as single dose f(at the age of 61-year-old) or COVID-19 immunisation.  Medical history included dialysis, diabetes mellitus, known allergies: A7, Penicillin, Aspirin, Iodine, Povidone, Pepcid, dyes, iodine allergy. The patient's concomitant medications were not reported. The patient previously took Aspirin, povidone and pepcid ac and experienced drug hypersensitivity with all. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced death cause: medication on 18Apr2021, he was told by the professional health care that he had small clots in his blood in Mar2021, felt cold/intense cold even in his bones on 21Mar2021, sweating on 26Mar2021, her husband during that night was not able to sleep on 21Mar2021, he started having fever on 21Mar2021, arm started to sore and DVT on 29Mar2021.  The patient was hospitalized for he had small clots in his blood, felt cold/intense cold even in his bones, sweating for 27 days. The event DVT was medically significant. The course of events was as follows: After getting the vaccine in 21Mar2021 her husband during that night was not able to sleep. He started having fever and felt cold. Days later he continued with the symptoms. On 26Mar2021 after vaccination he had dialysis same day in the afternoon. When arriving home the person notifies symptoms of intense cold even in his bones and then he started to sweat excessively on 26Mar2021 (Friday).  The reporter decided to take her husband to the emergency room on 28Mar2021 (Sunday) where he had a general checkup. He was told by the professional health care that he had small clots in his blood. After some time he had health complications where they had suggested to amputate some of the limbs because of this, the reporter alleges those complications were due to the vaccine. On Monday 29Mar2021 same symptoms reappeared and he was admitted to Hospital. Had a blood test and notified to health professional that blood presents small clots. His arm started to sore severely after the sample. Doctor identified he had DVT. Doctor decided to proceed with various medications. Patient received treatment and he was injected: Percose, Morphine, Benadryl, Triphetarin for blood clot reduction. The patient underwent lab tests and procedures which included blood test: blood clot in Mar2021, Sars-cov-2 Nasal swab test: negative in Mar2021 post vaccination. The patient died on 18Apr2021. It was not reported if an autopsy was performed. The outcome of death cause: medication was fatal, of the other events was unknown.  Information about the lot/batch number has been requested.; Reported Cause(s) of Death: death cause: Medication"
	"1265810-1"	"1265810-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"sweating; felt cold/intense cold even in his bones; He was told by the professional health care that he had small clots in his blood; death cause: Medication; arm started to sore; Doctor identified he had DVT; her husband during that night was not able to sleep; He started having fever; This is a spontaneous report from a contactable consumer (patient's spouse).   A 61-year-old male patient received bnt162b2 (BNT162B2), via an unspecified route of administration on 21Mar2021 09:00 (Batch/Lot number was not reported) as single dose f(at the age of 61-year-old) or COVID-19 immunisation.  Medical history included dialysis, diabetes mellitus, known allergies: A7, Penicillin, Aspirin, Iodine, Povidone, Pepcid, dyes, iodine allergy. The patient's concomitant medications were not reported. The patient previously took Aspirin, povidone and pepcid ac and experienced drug hypersensitivity with all. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced death cause: medication on 18Apr2021, he was told by the professional health care that he had small clots in his blood in Mar2021, felt cold/intense cold even in his bones on 21Mar2021, sweating on 26Mar2021, her husband during that night was not able to sleep on 21Mar2021, he started having fever on 21Mar2021, arm started to sore and DVT on 29Mar2021.  The patient was hospitalized for he had small clots in his blood, felt cold/intense cold even in his bones, sweating for 27 days. The event DVT was medically significant. The course of events was as follows: After getting the vaccine in 21Mar2021 her husband during that night was not able to sleep. He started having fever and felt cold. Days later he continued with the symptoms. On 26Mar2021 after vaccination he had dialysis same day in the afternoon. When arriving home the person notifies symptoms of intense cold even in his bones and then he started to sweat excessively on 26Mar2021 (Friday).  The reporter decided to take her husband to the emergency room on 28Mar2021 (Sunday) where he had a general checkup. He was told by the professional health care that he had small clots in his blood. After some time he had health complications where they had suggested to amputate some of the limbs because of this, the reporter alleges those complications were due to the vaccine. On Monday 29Mar2021 same symptoms reappeared and he was admitted to Hospital. Had a blood test and notified to health professional that blood presents small clots. His arm started to sore severely after the sample. Doctor identified he had DVT. Doctor decided to proceed with various medications. Patient received treatment and he was injected: Percose, Morphine, Benadryl, Triphetarin for blood clot reduction. The patient underwent lab tests and procedures which included blood test: blood clot in Mar2021, Sars-cov-2 Nasal swab test: negative in Mar2021 post vaccination. The patient died on 18Apr2021. It was not reported if an autopsy was performed. The outcome of death cause: medication was fatal, of the other events was unknown.  Information about the lot/batch number has been requested.; Reported Cause(s) of Death: death cause: Medication"
	"1265810-1"	"1265810-1"	"DEEP VEIN THROMBOSIS"	"10051055"	"60-64 years"	"60-64"	"sweating; felt cold/intense cold even in his bones; He was told by the professional health care that he had small clots in his blood; death cause: Medication; arm started to sore; Doctor identified he had DVT; her husband during that night was not able to sleep; He started having fever; This is a spontaneous report from a contactable consumer (patient's spouse).   A 61-year-old male patient received bnt162b2 (BNT162B2), via an unspecified route of administration on 21Mar2021 09:00 (Batch/Lot number was not reported) as single dose f(at the age of 61-year-old) or COVID-19 immunisation.  Medical history included dialysis, diabetes mellitus, known allergies: A7, Penicillin, Aspirin, Iodine, Povidone, Pepcid, dyes, iodine allergy. The patient's concomitant medications were not reported. The patient previously took Aspirin, povidone and pepcid ac and experienced drug hypersensitivity with all. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced death cause: medication on 18Apr2021, he was told by the professional health care that he had small clots in his blood in Mar2021, felt cold/intense cold even in his bones on 21Mar2021, sweating on 26Mar2021, her husband during that night was not able to sleep on 21Mar2021, he started having fever on 21Mar2021, arm started to sore and DVT on 29Mar2021.  The patient was hospitalized for he had small clots in his blood, felt cold/intense cold even in his bones, sweating for 27 days. The event DVT was medically significant. The course of events was as follows: After getting the vaccine in 21Mar2021 her husband during that night was not able to sleep. He started having fever and felt cold. Days later he continued with the symptoms. On 26Mar2021 after vaccination he had dialysis same day in the afternoon. When arriving home the person notifies symptoms of intense cold even in his bones and then he started to sweat excessively on 26Mar2021 (Friday).  The reporter decided to take her husband to the emergency room on 28Mar2021 (Sunday) where he had a general checkup. He was told by the professional health care that he had small clots in his blood. After some time he had health complications where they had suggested to amputate some of the limbs because of this, the reporter alleges those complications were due to the vaccine. On Monday 29Mar2021 same symptoms reappeared and he was admitted to Hospital. Had a blood test and notified to health professional that blood presents small clots. His arm started to sore severely after the sample. Doctor identified he had DVT. Doctor decided to proceed with various medications. Patient received treatment and he was injected: Percose, Morphine, Benadryl, Triphetarin for blood clot reduction. The patient underwent lab tests and procedures which included blood test: blood clot in Mar2021, Sars-cov-2 Nasal swab test: negative in Mar2021 post vaccination. The patient died on 18Apr2021. It was not reported if an autopsy was performed. The outcome of death cause: medication was fatal, of the other events was unknown.  Information about the lot/batch number has been requested.; Reported Cause(s) of Death: death cause: Medication"
	"1265810-1"	"1265810-1"	"FEELING COLD"	"10016326"	"60-64 years"	"60-64"	"sweating; felt cold/intense cold even in his bones; He was told by the professional health care that he had small clots in his blood; death cause: Medication; arm started to sore; Doctor identified he had DVT; her husband during that night was not able to sleep; He started having fever; This is a spontaneous report from a contactable consumer (patient's spouse).   A 61-year-old male patient received bnt162b2 (BNT162B2), via an unspecified route of administration on 21Mar2021 09:00 (Batch/Lot number was not reported) as single dose f(at the age of 61-year-old) or COVID-19 immunisation.  Medical history included dialysis, diabetes mellitus, known allergies: A7, Penicillin, Aspirin, Iodine, Povidone, Pepcid, dyes, iodine allergy. The patient's concomitant medications were not reported. The patient previously took Aspirin, povidone and pepcid ac and experienced drug hypersensitivity with all. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced death cause: medication on 18Apr2021, he was told by the professional health care that he had small clots in his blood in Mar2021, felt cold/intense cold even in his bones on 21Mar2021, sweating on 26Mar2021, her husband during that night was not able to sleep on 21Mar2021, he started having fever on 21Mar2021, arm started to sore and DVT on 29Mar2021.  The patient was hospitalized for he had small clots in his blood, felt cold/intense cold even in his bones, sweating for 27 days. The event DVT was medically significant. The course of events was as follows: After getting the vaccine in 21Mar2021 her husband during that night was not able to sleep. He started having fever and felt cold. Days later he continued with the symptoms. On 26Mar2021 after vaccination he had dialysis same day in the afternoon. When arriving home the person notifies symptoms of intense cold even in his bones and then he started to sweat excessively on 26Mar2021 (Friday).  The reporter decided to take her husband to the emergency room on 28Mar2021 (Sunday) where he had a general checkup. He was told by the professional health care that he had small clots in his blood. After some time he had health complications where they had suggested to amputate some of the limbs because of this, the reporter alleges those complications were due to the vaccine. On Monday 29Mar2021 same symptoms reappeared and he was admitted to Hospital. Had a blood test and notified to health professional that blood presents small clots. His arm started to sore severely after the sample. Doctor identified he had DVT. Doctor decided to proceed with various medications. Patient received treatment and he was injected: Percose, Morphine, Benadryl, Triphetarin for blood clot reduction. The patient underwent lab tests and procedures which included blood test: blood clot in Mar2021, Sars-cov-2 Nasal swab test: negative in Mar2021 post vaccination. The patient died on 18Apr2021. It was not reported if an autopsy was performed. The outcome of death cause: medication was fatal, of the other events was unknown.  Information about the lot/batch number has been requested.; Reported Cause(s) of Death: death cause: Medication"
	"1265810-1"	"1265810-1"	"HYPERHIDROSIS"	"10020642"	"60-64 years"	"60-64"	"sweating; felt cold/intense cold even in his bones; He was told by the professional health care that he had small clots in his blood; death cause: Medication; arm started to sore; Doctor identified he had DVT; her husband during that night was not able to sleep; He started having fever; This is a spontaneous report from a contactable consumer (patient's spouse).   A 61-year-old male patient received bnt162b2 (BNT162B2), via an unspecified route of administration on 21Mar2021 09:00 (Batch/Lot number was not reported) as single dose f(at the age of 61-year-old) or COVID-19 immunisation.  Medical history included dialysis, diabetes mellitus, known allergies: A7, Penicillin, Aspirin, Iodine, Povidone, Pepcid, dyes, iodine allergy. The patient's concomitant medications were not reported. The patient previously took Aspirin, povidone and pepcid ac and experienced drug hypersensitivity with all. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced death cause: medication on 18Apr2021, he was told by the professional health care that he had small clots in his blood in Mar2021, felt cold/intense cold even in his bones on 21Mar2021, sweating on 26Mar2021, her husband during that night was not able to sleep on 21Mar2021, he started having fever on 21Mar2021, arm started to sore and DVT on 29Mar2021.  The patient was hospitalized for he had small clots in his blood, felt cold/intense cold even in his bones, sweating for 27 days. The event DVT was medically significant. The course of events was as follows: After getting the vaccine in 21Mar2021 her husband during that night was not able to sleep. He started having fever and felt cold. Days later he continued with the symptoms. On 26Mar2021 after vaccination he had dialysis same day in the afternoon. When arriving home the person notifies symptoms of intense cold even in his bones and then he started to sweat excessively on 26Mar2021 (Friday).  The reporter decided to take her husband to the emergency room on 28Mar2021 (Sunday) where he had a general checkup. He was told by the professional health care that he had small clots in his blood. After some time he had health complications where they had suggested to amputate some of the limbs because of this, the reporter alleges those complications were due to the vaccine. On Monday 29Mar2021 same symptoms reappeared and he was admitted to Hospital. Had a blood test and notified to health professional that blood presents small clots. His arm started to sore severely after the sample. Doctor identified he had DVT. Doctor decided to proceed with various medications. Patient received treatment and he was injected: Percose, Morphine, Benadryl, Triphetarin for blood clot reduction. The patient underwent lab tests and procedures which included blood test: blood clot in Mar2021, Sars-cov-2 Nasal swab test: negative in Mar2021 post vaccination. The patient died on 18Apr2021. It was not reported if an autopsy was performed. The outcome of death cause: medication was fatal, of the other events was unknown.  Information about the lot/batch number has been requested.; Reported Cause(s) of Death: death cause: Medication"
	"1265810-1"	"1265810-1"	"INSOMNIA"	"10022437"	"60-64 years"	"60-64"	"sweating; felt cold/intense cold even in his bones; He was told by the professional health care that he had small clots in his blood; death cause: Medication; arm started to sore; Doctor identified he had DVT; her husband during that night was not able to sleep; He started having fever; This is a spontaneous report from a contactable consumer (patient's spouse).   A 61-year-old male patient received bnt162b2 (BNT162B2), via an unspecified route of administration on 21Mar2021 09:00 (Batch/Lot number was not reported) as single dose f(at the age of 61-year-old) or COVID-19 immunisation.  Medical history included dialysis, diabetes mellitus, known allergies: A7, Penicillin, Aspirin, Iodine, Povidone, Pepcid, dyes, iodine allergy. The patient's concomitant medications were not reported. The patient previously took Aspirin, povidone and pepcid ac and experienced drug hypersensitivity with all. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced death cause: medication on 18Apr2021, he was told by the professional health care that he had small clots in his blood in Mar2021, felt cold/intense cold even in his bones on 21Mar2021, sweating on 26Mar2021, her husband during that night was not able to sleep on 21Mar2021, he started having fever on 21Mar2021, arm started to sore and DVT on 29Mar2021.  The patient was hospitalized for he had small clots in his blood, felt cold/intense cold even in his bones, sweating for 27 days. The event DVT was medically significant. The course of events was as follows: After getting the vaccine in 21Mar2021 her husband during that night was not able to sleep. He started having fever and felt cold. Days later he continued with the symptoms. On 26Mar2021 after vaccination he had dialysis same day in the afternoon. When arriving home the person notifies symptoms of intense cold even in his bones and then he started to sweat excessively on 26Mar2021 (Friday).  The reporter decided to take her husband to the emergency room on 28Mar2021 (Sunday) where he had a general checkup. He was told by the professional health care that he had small clots in his blood. After some time he had health complications where they had suggested to amputate some of the limbs because of this, the reporter alleges those complications were due to the vaccine. On Monday 29Mar2021 same symptoms reappeared and he was admitted to Hospital. Had a blood test and notified to health professional that blood presents small clots. His arm started to sore severely after the sample. Doctor identified he had DVT. Doctor decided to proceed with various medications. Patient received treatment and he was injected: Percose, Morphine, Benadryl, Triphetarin for blood clot reduction. The patient underwent lab tests and procedures which included blood test: blood clot in Mar2021, Sars-cov-2 Nasal swab test: negative in Mar2021 post vaccination. The patient died on 18Apr2021. It was not reported if an autopsy was performed. The outcome of death cause: medication was fatal, of the other events was unknown.  Information about the lot/batch number has been requested.; Reported Cause(s) of Death: death cause: Medication"
	"1265810-1"	"1265810-1"	"PAIN IN EXTREMITY"	"10033425"	"60-64 years"	"60-64"	"sweating; felt cold/intense cold even in his bones; He was told by the professional health care that he had small clots in his blood; death cause: Medication; arm started to sore; Doctor identified he had DVT; her husband during that night was not able to sleep; He started having fever; This is a spontaneous report from a contactable consumer (patient's spouse).   A 61-year-old male patient received bnt162b2 (BNT162B2), via an unspecified route of administration on 21Mar2021 09:00 (Batch/Lot number was not reported) as single dose f(at the age of 61-year-old) or COVID-19 immunisation.  Medical history included dialysis, diabetes mellitus, known allergies: A7, Penicillin, Aspirin, Iodine, Povidone, Pepcid, dyes, iodine allergy. The patient's concomitant medications were not reported. The patient previously took Aspirin, povidone and pepcid ac and experienced drug hypersensitivity with all. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced death cause: medication on 18Apr2021, he was told by the professional health care that he had small clots in his blood in Mar2021, felt cold/intense cold even in his bones on 21Mar2021, sweating on 26Mar2021, her husband during that night was not able to sleep on 21Mar2021, he started having fever on 21Mar2021, arm started to sore and DVT on 29Mar2021.  The patient was hospitalized for he had small clots in his blood, felt cold/intense cold even in his bones, sweating for 27 days. The event DVT was medically significant. The course of events was as follows: After getting the vaccine in 21Mar2021 her husband during that night was not able to sleep. He started having fever and felt cold. Days later he continued with the symptoms. On 26Mar2021 after vaccination he had dialysis same day in the afternoon. When arriving home the person notifies symptoms of intense cold even in his bones and then he started to sweat excessively on 26Mar2021 (Friday).  The reporter decided to take her husband to the emergency room on 28Mar2021 (Sunday) where he had a general checkup. He was told by the professional health care that he had small clots in his blood. After some time he had health complications where they had suggested to amputate some of the limbs because of this, the reporter alleges those complications were due to the vaccine. On Monday 29Mar2021 same symptoms reappeared and he was admitted to Hospital. Had a blood test and notified to health professional that blood presents small clots. His arm started to sore severely after the sample. Doctor identified he had DVT. Doctor decided to proceed with various medications. Patient received treatment and he was injected: Percose, Morphine, Benadryl, Triphetarin for blood clot reduction. The patient underwent lab tests and procedures which included blood test: blood clot in Mar2021, Sars-cov-2 Nasal swab test: negative in Mar2021 post vaccination. The patient died on 18Apr2021. It was not reported if an autopsy was performed. The outcome of death cause: medication was fatal, of the other events was unknown.  Information about the lot/batch number has been requested.; Reported Cause(s) of Death: death cause: Medication"
	"1265810-1"	"1265810-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"sweating; felt cold/intense cold even in his bones; He was told by the professional health care that he had small clots in his blood; death cause: Medication; arm started to sore; Doctor identified he had DVT; her husband during that night was not able to sleep; He started having fever; This is a spontaneous report from a contactable consumer (patient's spouse).   A 61-year-old male patient received bnt162b2 (BNT162B2), via an unspecified route of administration on 21Mar2021 09:00 (Batch/Lot number was not reported) as single dose f(at the age of 61-year-old) or COVID-19 immunisation.  Medical history included dialysis, diabetes mellitus, known allergies: A7, Penicillin, Aspirin, Iodine, Povidone, Pepcid, dyes, iodine allergy. The patient's concomitant medications were not reported. The patient previously took Aspirin, povidone and pepcid ac and experienced drug hypersensitivity with all. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced death cause: medication on 18Apr2021, he was told by the professional health care that he had small clots in his blood in Mar2021, felt cold/intense cold even in his bones on 21Mar2021, sweating on 26Mar2021, her husband during that night was not able to sleep on 21Mar2021, he started having fever on 21Mar2021, arm started to sore and DVT on 29Mar2021.  The patient was hospitalized for he had small clots in his blood, felt cold/intense cold even in his bones, sweating for 27 days. The event DVT was medically significant. The course of events was as follows: After getting the vaccine in 21Mar2021 her husband during that night was not able to sleep. He started having fever and felt cold. Days later he continued with the symptoms. On 26Mar2021 after vaccination he had dialysis same day in the afternoon. When arriving home the person notifies symptoms of intense cold even in his bones and then he started to sweat excessively on 26Mar2021 (Friday).  The reporter decided to take her husband to the emergency room on 28Mar2021 (Sunday) where he had a general checkup. He was told by the professional health care that he had small clots in his blood. After some time he had health complications where they had suggested to amputate some of the limbs because of this, the reporter alleges those complications were due to the vaccine. On Monday 29Mar2021 same symptoms reappeared and he was admitted to Hospital. Had a blood test and notified to health professional that blood presents small clots. His arm started to sore severely after the sample. Doctor identified he had DVT. Doctor decided to proceed with various medications. Patient received treatment and he was injected: Percose, Morphine, Benadryl, Triphetarin for blood clot reduction. The patient underwent lab tests and procedures which included blood test: blood clot in Mar2021, Sars-cov-2 Nasal swab test: negative in Mar2021 post vaccination. The patient died on 18Apr2021. It was not reported if an autopsy was performed. The outcome of death cause: medication was fatal, of the other events was unknown.  Information about the lot/batch number has been requested.; Reported Cause(s) of Death: death cause: Medication"
	"1265810-1"	"1265810-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	"sweating; felt cold/intense cold even in his bones; He was told by the professional health care that he had small clots in his blood; death cause: Medication; arm started to sore; Doctor identified he had DVT; her husband during that night was not able to sleep; He started having fever; This is a spontaneous report from a contactable consumer (patient's spouse).   A 61-year-old male patient received bnt162b2 (BNT162B2), via an unspecified route of administration on 21Mar2021 09:00 (Batch/Lot number was not reported) as single dose f(at the age of 61-year-old) or COVID-19 immunisation.  Medical history included dialysis, diabetes mellitus, known allergies: A7, Penicillin, Aspirin, Iodine, Povidone, Pepcid, dyes, iodine allergy. The patient's concomitant medications were not reported. The patient previously took Aspirin, povidone and pepcid ac and experienced drug hypersensitivity with all. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced death cause: medication on 18Apr2021, he was told by the professional health care that he had small clots in his blood in Mar2021, felt cold/intense cold even in his bones on 21Mar2021, sweating on 26Mar2021, her husband during that night was not able to sleep on 21Mar2021, he started having fever on 21Mar2021, arm started to sore and DVT on 29Mar2021.  The patient was hospitalized for he had small clots in his blood, felt cold/intense cold even in his bones, sweating for 27 days. The event DVT was medically significant. The course of events was as follows: After getting the vaccine in 21Mar2021 her husband during that night was not able to sleep. He started having fever and felt cold. Days later he continued with the symptoms. On 26Mar2021 after vaccination he had dialysis same day in the afternoon. When arriving home the person notifies symptoms of intense cold even in his bones and then he started to sweat excessively on 26Mar2021 (Friday).  The reporter decided to take her husband to the emergency room on 28Mar2021 (Sunday) where he had a general checkup. He was told by the professional health care that he had small clots in his blood. After some time he had health complications where they had suggested to amputate some of the limbs because of this, the reporter alleges those complications were due to the vaccine. On Monday 29Mar2021 same symptoms reappeared and he was admitted to Hospital. Had a blood test and notified to health professional that blood presents small clots. His arm started to sore severely after the sample. Doctor identified he had DVT. Doctor decided to proceed with various medications. Patient received treatment and he was injected: Percose, Morphine, Benadryl, Triphetarin for blood clot reduction. The patient underwent lab tests and procedures which included blood test: blood clot in Mar2021, Sars-cov-2 Nasal swab test: negative in Mar2021 post vaccination. The patient died on 18Apr2021. It was not reported if an autopsy was performed. The outcome of death cause: medication was fatal, of the other events was unknown.  Information about the lot/batch number has been requested.; Reported Cause(s) of Death: death cause: Medication"
	"1265810-1"	"1265810-1"	"THROMBOSIS"	"10043607"	"60-64 years"	"60-64"	"sweating; felt cold/intense cold even in his bones; He was told by the professional health care that he had small clots in his blood; death cause: Medication; arm started to sore; Doctor identified he had DVT; her husband during that night was not able to sleep; He started having fever; This is a spontaneous report from a contactable consumer (patient's spouse).   A 61-year-old male patient received bnt162b2 (BNT162B2), via an unspecified route of administration on 21Mar2021 09:00 (Batch/Lot number was not reported) as single dose f(at the age of 61-year-old) or COVID-19 immunisation.  Medical history included dialysis, diabetes mellitus, known allergies: A7, Penicillin, Aspirin, Iodine, Povidone, Pepcid, dyes, iodine allergy. The patient's concomitant medications were not reported. The patient previously took Aspirin, povidone and pepcid ac and experienced drug hypersensitivity with all. Prior to vaccination, the patient was not diagnosed with COVID-19. The patient experienced death cause: medication on 18Apr2021, he was told by the professional health care that he had small clots in his blood in Mar2021, felt cold/intense cold even in his bones on 21Mar2021, sweating on 26Mar2021, her husband during that night was not able to sleep on 21Mar2021, he started having fever on 21Mar2021, arm started to sore and DVT on 29Mar2021.  The patient was hospitalized for he had small clots in his blood, felt cold/intense cold even in his bones, sweating for 27 days. The event DVT was medically significant. The course of events was as follows: After getting the vaccine in 21Mar2021 her husband during that night was not able to sleep. He started having fever and felt cold. Days later he continued with the symptoms. On 26Mar2021 after vaccination he had dialysis same day in the afternoon. When arriving home the person notifies symptoms of intense cold even in his bones and then he started to sweat excessively on 26Mar2021 (Friday).  The reporter decided to take her husband to the emergency room on 28Mar2021 (Sunday) where he had a general checkup. He was told by the professional health care that he had small clots in his blood. After some time he had health complications where they had suggested to amputate some of the limbs because of this, the reporter alleges those complications were due to the vaccine. On Monday 29Mar2021 same symptoms reappeared and he was admitted to Hospital. Had a blood test and notified to health professional that blood presents small clots. His arm started to sore severely after the sample. Doctor identified he had DVT. Doctor decided to proceed with various medications. Patient received treatment and he was injected: Percose, Morphine, Benadryl, Triphetarin for blood clot reduction. The patient underwent lab tests and procedures which included blood test: blood clot in Mar2021, Sars-cov-2 Nasal swab test: negative in Mar2021 post vaccination. The patient died on 18Apr2021. It was not reported if an autopsy was performed. The outcome of death cause: medication was fatal, of the other events was unknown.  Information about the lot/batch number has been requested.; Reported Cause(s) of Death: death cause: Medication"
	"1266936-1"	"1266936-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"Employee developed a fever and chills on 01-Apr-21 which he managed with Tylenol. Symptoms resolved as per patient who contributed the symptoms as a result of the J&J vaccine. On 10-Apr-21 he developed a cough and requested a day to rest. On 11-Apr-21, he went to  Hospital to be  evaluated by the physician who ordered some labs which were normal. He was then advised to complete PCR swab and was notified on 12-Apri-21 that his test is positive. As per the protocol, all COVID-19 positive individuals must report to the Health Center within 24 hours of notification and complete 10 days home isolation. During isolation, on 17-Apr-21, patient developed hemoptysis and difficulty breathing a breathing and notified his supervisor who called 112 for an ambulance. He was transferred to  Hospital. Evaluated and started treatment for pneumonia and was transferred to Hospital on 18-Apr-21. His condition started declining on 21-Apr-21 as he became hypoxic and tachypneic and was subsequently sedated and intubated. As he became HD unstable, Levophed and Vasopressin were started and reached maxed doses. On 25-Apr-21 Dr. from the hospital called and stated that patient expired at 0830."
	"1266936-1"	"1266936-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Employee developed a fever and chills on 01-Apr-21 which he managed with Tylenol. Symptoms resolved as per patient who contributed the symptoms as a result of the J&J vaccine. On 10-Apr-21 he developed a cough and requested a day to rest. On 11-Apr-21, he went to  Hospital to be  evaluated by the physician who ordered some labs which were normal. He was then advised to complete PCR swab and was notified on 12-Apri-21 that his test is positive. As per the protocol, all COVID-19 positive individuals must report to the Health Center within 24 hours of notification and complete 10 days home isolation. During isolation, on 17-Apr-21, patient developed hemoptysis and difficulty breathing a breathing and notified his supervisor who called 112 for an ambulance. He was transferred to  Hospital. Evaluated and started treatment for pneumonia and was transferred to Hospital on 18-Apr-21. His condition started declining on 21-Apr-21 as he became hypoxic and tachypneic and was subsequently sedated and intubated. As he became HD unstable, Levophed and Vasopressin were started and reached maxed doses. On 25-Apr-21 Dr. from the hospital called and stated that patient expired at 0830."
	"1266936-1"	"1266936-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Employee developed a fever and chills on 01-Apr-21 which he managed with Tylenol. Symptoms resolved as per patient who contributed the symptoms as a result of the J&J vaccine. On 10-Apr-21 he developed a cough and requested a day to rest. On 11-Apr-21, he went to  Hospital to be  evaluated by the physician who ordered some labs which were normal. He was then advised to complete PCR swab and was notified on 12-Apri-21 that his test is positive. As per the protocol, all COVID-19 positive individuals must report to the Health Center within 24 hours of notification and complete 10 days home isolation. During isolation, on 17-Apr-21, patient developed hemoptysis and difficulty breathing a breathing and notified his supervisor who called 112 for an ambulance. He was transferred to  Hospital. Evaluated and started treatment for pneumonia and was transferred to Hospital on 18-Apr-21. His condition started declining on 21-Apr-21 as he became hypoxic and tachypneic and was subsequently sedated and intubated. As he became HD unstable, Levophed and Vasopressin were started and reached maxed doses. On 25-Apr-21 Dr. from the hospital called and stated that patient expired at 0830."
	"1266936-1"	"1266936-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Employee developed a fever and chills on 01-Apr-21 which he managed with Tylenol. Symptoms resolved as per patient who contributed the symptoms as a result of the J&J vaccine. On 10-Apr-21 he developed a cough and requested a day to rest. On 11-Apr-21, he went to  Hospital to be  evaluated by the physician who ordered some labs which were normal. He was then advised to complete PCR swab and was notified on 12-Apri-21 that his test is positive. As per the protocol, all COVID-19 positive individuals must report to the Health Center within 24 hours of notification and complete 10 days home isolation. During isolation, on 17-Apr-21, patient developed hemoptysis and difficulty breathing a breathing and notified his supervisor who called 112 for an ambulance. He was transferred to  Hospital. Evaluated and started treatment for pneumonia and was transferred to Hospital on 18-Apr-21. His condition started declining on 21-Apr-21 as he became hypoxic and tachypneic and was subsequently sedated and intubated. As he became HD unstable, Levophed and Vasopressin were started and reached maxed doses. On 25-Apr-21 Dr. from the hospital called and stated that patient expired at 0830."
	"1266936-1"	"1266936-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Employee developed a fever and chills on 01-Apr-21 which he managed with Tylenol. Symptoms resolved as per patient who contributed the symptoms as a result of the J&J vaccine. On 10-Apr-21 he developed a cough and requested a day to rest. On 11-Apr-21, he went to  Hospital to be  evaluated by the physician who ordered some labs which were normal. He was then advised to complete PCR swab and was notified on 12-Apri-21 that his test is positive. As per the protocol, all COVID-19 positive individuals must report to the Health Center within 24 hours of notification and complete 10 days home isolation. During isolation, on 17-Apr-21, patient developed hemoptysis and difficulty breathing a breathing and notified his supervisor who called 112 for an ambulance. He was transferred to  Hospital. Evaluated and started treatment for pneumonia and was transferred to Hospital on 18-Apr-21. His condition started declining on 21-Apr-21 as he became hypoxic and tachypneic and was subsequently sedated and intubated. As he became HD unstable, Levophed and Vasopressin were started and reached maxed doses. On 25-Apr-21 Dr. from the hospital called and stated that patient expired at 0830."
	"1266936-1"	"1266936-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Employee developed a fever and chills on 01-Apr-21 which he managed with Tylenol. Symptoms resolved as per patient who contributed the symptoms as a result of the J&J vaccine. On 10-Apr-21 he developed a cough and requested a day to rest. On 11-Apr-21, he went to  Hospital to be  evaluated by the physician who ordered some labs which were normal. He was then advised to complete PCR swab and was notified on 12-Apri-21 that his test is positive. As per the protocol, all COVID-19 positive individuals must report to the Health Center within 24 hours of notification and complete 10 days home isolation. During isolation, on 17-Apr-21, patient developed hemoptysis and difficulty breathing a breathing and notified his supervisor who called 112 for an ambulance. He was transferred to  Hospital. Evaluated and started treatment for pneumonia and was transferred to Hospital on 18-Apr-21. His condition started declining on 21-Apr-21 as he became hypoxic and tachypneic and was subsequently sedated and intubated. As he became HD unstable, Levophed and Vasopressin were started and reached maxed doses. On 25-Apr-21 Dr. from the hospital called and stated that patient expired at 0830."
	"1266936-1"	"1266936-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"60-64 years"	"60-64"	"Employee developed a fever and chills on 01-Apr-21 which he managed with Tylenol. Symptoms resolved as per patient who contributed the symptoms as a result of the J&J vaccine. On 10-Apr-21 he developed a cough and requested a day to rest. On 11-Apr-21, he went to  Hospital to be  evaluated by the physician who ordered some labs which were normal. He was then advised to complete PCR swab and was notified on 12-Apri-21 that his test is positive. As per the protocol, all COVID-19 positive individuals must report to the Health Center within 24 hours of notification and complete 10 days home isolation. During isolation, on 17-Apr-21, patient developed hemoptysis and difficulty breathing a breathing and notified his supervisor who called 112 for an ambulance. He was transferred to  Hospital. Evaluated and started treatment for pneumonia and was transferred to Hospital on 18-Apr-21. His condition started declining on 21-Apr-21 as he became hypoxic and tachypneic and was subsequently sedated and intubated. As he became HD unstable, Levophed and Vasopressin were started and reached maxed doses. On 25-Apr-21 Dr. from the hospital called and stated that patient expired at 0830."
	"1266936-1"	"1266936-1"	"HAEMODYNAMIC INSTABILITY"	"10052076"	"60-64 years"	"60-64"	"Employee developed a fever and chills on 01-Apr-21 which he managed with Tylenol. Symptoms resolved as per patient who contributed the symptoms as a result of the J&J vaccine. On 10-Apr-21 he developed a cough and requested a day to rest. On 11-Apr-21, he went to  Hospital to be  evaluated by the physician who ordered some labs which were normal. He was then advised to complete PCR swab and was notified on 12-Apri-21 that his test is positive. As per the protocol, all COVID-19 positive individuals must report to the Health Center within 24 hours of notification and complete 10 days home isolation. During isolation, on 17-Apr-21, patient developed hemoptysis and difficulty breathing a breathing and notified his supervisor who called 112 for an ambulance. He was transferred to  Hospital. Evaluated and started treatment for pneumonia and was transferred to Hospital on 18-Apr-21. His condition started declining on 21-Apr-21 as he became hypoxic and tachypneic and was subsequently sedated and intubated. As he became HD unstable, Levophed and Vasopressin were started and reached maxed doses. On 25-Apr-21 Dr. from the hospital called and stated that patient expired at 0830."
	"1266936-1"	"1266936-1"	"HAEMOPTYSIS"	"10018964"	"60-64 years"	"60-64"	"Employee developed a fever and chills on 01-Apr-21 which he managed with Tylenol. Symptoms resolved as per patient who contributed the symptoms as a result of the J&J vaccine. On 10-Apr-21 he developed a cough and requested a day to rest. On 11-Apr-21, he went to  Hospital to be  evaluated by the physician who ordered some labs which were normal. He was then advised to complete PCR swab and was notified on 12-Apri-21 that his test is positive. As per the protocol, all COVID-19 positive individuals must report to the Health Center within 24 hours of notification and complete 10 days home isolation. During isolation, on 17-Apr-21, patient developed hemoptysis and difficulty breathing a breathing and notified his supervisor who called 112 for an ambulance. He was transferred to  Hospital. Evaluated and started treatment for pneumonia and was transferred to Hospital on 18-Apr-21. His condition started declining on 21-Apr-21 as he became hypoxic and tachypneic and was subsequently sedated and intubated. As he became HD unstable, Levophed and Vasopressin were started and reached maxed doses. On 25-Apr-21 Dr. from the hospital called and stated that patient expired at 0830."
	"1266936-1"	"1266936-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"Employee developed a fever and chills on 01-Apr-21 which he managed with Tylenol. Symptoms resolved as per patient who contributed the symptoms as a result of the J&J vaccine. On 10-Apr-21 he developed a cough and requested a day to rest. On 11-Apr-21, he went to  Hospital to be  evaluated by the physician who ordered some labs which were normal. He was then advised to complete PCR swab and was notified on 12-Apri-21 that his test is positive. As per the protocol, all COVID-19 positive individuals must report to the Health Center within 24 hours of notification and complete 10 days home isolation. During isolation, on 17-Apr-21, patient developed hemoptysis and difficulty breathing a breathing and notified his supervisor who called 112 for an ambulance. He was transferred to  Hospital. Evaluated and started treatment for pneumonia and was transferred to Hospital on 18-Apr-21. His condition started declining on 21-Apr-21 as he became hypoxic and tachypneic and was subsequently sedated and intubated. As he became HD unstable, Levophed and Vasopressin were started and reached maxed doses. On 25-Apr-21 Dr. from the hospital called and stated that patient expired at 0830."
	"1266936-1"	"1266936-1"	"LABORATORY TEST NORMAL"	"10054052"	"60-64 years"	"60-64"	"Employee developed a fever and chills on 01-Apr-21 which he managed with Tylenol. Symptoms resolved as per patient who contributed the symptoms as a result of the J&J vaccine. On 10-Apr-21 he developed a cough and requested a day to rest. On 11-Apr-21, he went to  Hospital to be  evaluated by the physician who ordered some labs which were normal. He was then advised to complete PCR swab and was notified on 12-Apri-21 that his test is positive. As per the protocol, all COVID-19 positive individuals must report to the Health Center within 24 hours of notification and complete 10 days home isolation. During isolation, on 17-Apr-21, patient developed hemoptysis and difficulty breathing a breathing and notified his supervisor who called 112 for an ambulance. He was transferred to  Hospital. Evaluated and started treatment for pneumonia and was transferred to Hospital on 18-Apr-21. His condition started declining on 21-Apr-21 as he became hypoxic and tachypneic and was subsequently sedated and intubated. As he became HD unstable, Levophed and Vasopressin were started and reached maxed doses. On 25-Apr-21 Dr. from the hospital called and stated that patient expired at 0830."
	"1266936-1"	"1266936-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"Employee developed a fever and chills on 01-Apr-21 which he managed with Tylenol. Symptoms resolved as per patient who contributed the symptoms as a result of the J&J vaccine. On 10-Apr-21 he developed a cough and requested a day to rest. On 11-Apr-21, he went to  Hospital to be  evaluated by the physician who ordered some labs which were normal. He was then advised to complete PCR swab and was notified on 12-Apri-21 that his test is positive. As per the protocol, all COVID-19 positive individuals must report to the Health Center within 24 hours of notification and complete 10 days home isolation. During isolation, on 17-Apr-21, patient developed hemoptysis and difficulty breathing a breathing and notified his supervisor who called 112 for an ambulance. He was transferred to  Hospital. Evaluated and started treatment for pneumonia and was transferred to Hospital on 18-Apr-21. His condition started declining on 21-Apr-21 as he became hypoxic and tachypneic and was subsequently sedated and intubated. As he became HD unstable, Levophed and Vasopressin were started and reached maxed doses. On 25-Apr-21 Dr. from the hospital called and stated that patient expired at 0830."
	"1266936-1"	"1266936-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Employee developed a fever and chills on 01-Apr-21 which he managed with Tylenol. Symptoms resolved as per patient who contributed the symptoms as a result of the J&J vaccine. On 10-Apr-21 he developed a cough and requested a day to rest. On 11-Apr-21, he went to  Hospital to be  evaluated by the physician who ordered some labs which were normal. He was then advised to complete PCR swab and was notified on 12-Apri-21 that his test is positive. As per the protocol, all COVID-19 positive individuals must report to the Health Center within 24 hours of notification and complete 10 days home isolation. During isolation, on 17-Apr-21, patient developed hemoptysis and difficulty breathing a breathing and notified his supervisor who called 112 for an ambulance. He was transferred to  Hospital. Evaluated and started treatment for pneumonia and was transferred to Hospital on 18-Apr-21. His condition started declining on 21-Apr-21 as he became hypoxic and tachypneic and was subsequently sedated and intubated. As he became HD unstable, Levophed and Vasopressin were started and reached maxed doses. On 25-Apr-21 Dr. from the hospital called and stated that patient expired at 0830."
	"1266936-1"	"1266936-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Employee developed a fever and chills on 01-Apr-21 which he managed with Tylenol. Symptoms resolved as per patient who contributed the symptoms as a result of the J&J vaccine. On 10-Apr-21 he developed a cough and requested a day to rest. On 11-Apr-21, he went to  Hospital to be  evaluated by the physician who ordered some labs which were normal. He was then advised to complete PCR swab and was notified on 12-Apri-21 that his test is positive. As per the protocol, all COVID-19 positive individuals must report to the Health Center within 24 hours of notification and complete 10 days home isolation. During isolation, on 17-Apr-21, patient developed hemoptysis and difficulty breathing a breathing and notified his supervisor who called 112 for an ambulance. He was transferred to  Hospital. Evaluated and started treatment for pneumonia and was transferred to Hospital on 18-Apr-21. His condition started declining on 21-Apr-21 as he became hypoxic and tachypneic and was subsequently sedated and intubated. As he became HD unstable, Levophed and Vasopressin were started and reached maxed doses. On 25-Apr-21 Dr. from the hospital called and stated that patient expired at 0830."
	"1266936-1"	"1266936-1"	"SEDATIVE THERAPY"	"10059283"	"60-64 years"	"60-64"	"Employee developed a fever and chills on 01-Apr-21 which he managed with Tylenol. Symptoms resolved as per patient who contributed the symptoms as a result of the J&J vaccine. On 10-Apr-21 he developed a cough and requested a day to rest. On 11-Apr-21, he went to  Hospital to be  evaluated by the physician who ordered some labs which were normal. He was then advised to complete PCR swab and was notified on 12-Apri-21 that his test is positive. As per the protocol, all COVID-19 positive individuals must report to the Health Center within 24 hours of notification and complete 10 days home isolation. During isolation, on 17-Apr-21, patient developed hemoptysis and difficulty breathing a breathing and notified his supervisor who called 112 for an ambulance. He was transferred to  Hospital. Evaluated and started treatment for pneumonia and was transferred to Hospital on 18-Apr-21. His condition started declining on 21-Apr-21 as he became hypoxic and tachypneic and was subsequently sedated and intubated. As he became HD unstable, Levophed and Vasopressin were started and reached maxed doses. On 25-Apr-21 Dr. from the hospital called and stated that patient expired at 0830."
	"1266936-1"	"1266936-1"	"TACHYPNOEA"	"10043089"	"60-64 years"	"60-64"	"Employee developed a fever and chills on 01-Apr-21 which he managed with Tylenol. Symptoms resolved as per patient who contributed the symptoms as a result of the J&J vaccine. On 10-Apr-21 he developed a cough and requested a day to rest. On 11-Apr-21, he went to  Hospital to be  evaluated by the physician who ordered some labs which were normal. He was then advised to complete PCR swab and was notified on 12-Apri-21 that his test is positive. As per the protocol, all COVID-19 positive individuals must report to the Health Center within 24 hours of notification and complete 10 days home isolation. During isolation, on 17-Apr-21, patient developed hemoptysis and difficulty breathing a breathing and notified his supervisor who called 112 for an ambulance. He was transferred to  Hospital. Evaluated and started treatment for pneumonia and was transferred to Hospital on 18-Apr-21. His condition started declining on 21-Apr-21 as he became hypoxic and tachypneic and was subsequently sedated and intubated. As he became HD unstable, Levophed and Vasopressin were started and reached maxed doses. On 25-Apr-21 Dr. from the hospital called and stated that patient expired at 0830."
	"1267665-1"	"1267665-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"4/8/21 pt had brain fog like he was in a haze and felt strange being very relaxed like he had taken a tranquillizer  he felt better next day.  pt seemed to be fine at this point. 4/22/21 pt seemed to be fine and went to the store where he went shopping.  He put shopping bags in car.  He was found in his car after and hour and 20 minutes by a couple of bystanders unresponsive.  911 was called and he transported to ER.  He was intubated but patient died. Unknown is any test were performed."
	"1267665-1"	"1267665-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"4/8/21 pt had brain fog like he was in a haze and felt strange being very relaxed like he had taken a tranquillizer  he felt better next day.  pt seemed to be fine at this point. 4/22/21 pt seemed to be fine and went to the store where he went shopping.  He put shopping bags in car.  He was found in his car after and hour and 20 minutes by a couple of bystanders unresponsive.  911 was called and he transported to ER.  He was intubated but patient died. Unknown is any test were performed."
	"1267665-1"	"1267665-1"	"FEELING ABNORMAL"	"10016322"	"60-64 years"	"60-64"	"4/8/21 pt had brain fog like he was in a haze and felt strange being very relaxed like he had taken a tranquillizer  he felt better next day.  pt seemed to be fine at this point. 4/22/21 pt seemed to be fine and went to the store where he went shopping.  He put shopping bags in car.  He was found in his car after and hour and 20 minutes by a couple of bystanders unresponsive.  911 was called and he transported to ER.  He was intubated but patient died. Unknown is any test were performed."
	"1267665-1"	"1267665-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"4/8/21 pt had brain fog like he was in a haze and felt strange being very relaxed like he had taken a tranquillizer  he felt better next day.  pt seemed to be fine at this point. 4/22/21 pt seemed to be fine and went to the store where he went shopping.  He put shopping bags in car.  He was found in his car after and hour and 20 minutes by a couple of bystanders unresponsive.  911 was called and he transported to ER.  He was intubated but patient died. Unknown is any test were performed."
	"1267795-1"	"1267795-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"After receiving the initial dose, the decedent had complaints of extreme weakness and lethargy."
	"1267795-1"	"1267795-1"	"LETHARGY"	"10024264"	"60-64 years"	"60-64"	"After receiving the initial dose, the decedent had complaints of extreme weakness and lethargy."
	"1267822-1"	"1267822-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Admitted to hospital on 9/30/2020 and discharged on 10/28/2020."
	"1267822-1"	"1267822-1"	"UNEVALUABLE EVENT"	"10062355"	"60-64 years"	"60-64"	"Admitted to hospital on 9/30/2020 and discharged on 10/28/2020."
	"1268212-1"	"1268212-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient died on 4/23/21"
	"1269224-1"	"1269224-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"My partner felt pain overnight. Then, felt flu like symptoms- plus chills- the next day and night. The following morning at 7:00 am, Patient said that she felt real sick. She also, complained of having a real bad Headache, Not long after that, she felt like throwing up. She tried to throw up. Except, nothing came out and she felt very nauseous because of the vaccine. When she came call to bed, I offered to make her some breakfast to help her feel better.  Unfortunately, she felt, too, I'll to try and eat an food because of the way she felt. So, I laid next to her with the hope that all would be well. Because, the pharmacist who administered the second dose.  Assured my partner, that it was normal to feel flu like symptoms the next day. So, we never doubted what the pharmacist advised. All of sudden, she suffered a cardiac arrest in my presence and died in front of me."
	"1269224-1"	"1269224-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"My partner felt pain overnight. Then, felt flu like symptoms- plus chills- the next day and night. The following morning at 7:00 am, Patient said that she felt real sick. She also, complained of having a real bad Headache, Not long after that, she felt like throwing up. She tried to throw up. Except, nothing came out and she felt very nauseous because of the vaccine. When she came call to bed, I offered to make her some breakfast to help her feel better.  Unfortunately, she felt, too, I'll to try and eat an food because of the way she felt. So, I laid next to her with the hope that all would be well. Because, the pharmacist who administered the second dose.  Assured my partner, that it was normal to feel flu like symptoms the next day. So, we never doubted what the pharmacist advised. All of sudden, she suffered a cardiac arrest in my presence and died in front of me."
	"1269224-1"	"1269224-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"My partner felt pain overnight. Then, felt flu like symptoms- plus chills- the next day and night. The following morning at 7:00 am, Patient said that she felt real sick. She also, complained of having a real bad Headache, Not long after that, she felt like throwing up. She tried to throw up. Except, nothing came out and she felt very nauseous because of the vaccine. When she came call to bed, I offered to make her some breakfast to help her feel better.  Unfortunately, she felt, too, I'll to try and eat an food because of the way she felt. So, I laid next to her with the hope that all would be well. Because, the pharmacist who administered the second dose.  Assured my partner, that it was normal to feel flu like symptoms the next day. So, we never doubted what the pharmacist advised. All of sudden, she suffered a cardiac arrest in my presence and died in front of me."
	"1269224-1"	"1269224-1"	"FEEDING DISORDER"	"10061148"	"60-64 years"	"60-64"	"My partner felt pain overnight. Then, felt flu like symptoms- plus chills- the next day and night. The following morning at 7:00 am, Patient said that she felt real sick. She also, complained of having a real bad Headache, Not long after that, she felt like throwing up. She tried to throw up. Except, nothing came out and she felt very nauseous because of the vaccine. When she came call to bed, I offered to make her some breakfast to help her feel better.  Unfortunately, she felt, too, I'll to try and eat an food because of the way she felt. So, I laid next to her with the hope that all would be well. Because, the pharmacist who administered the second dose.  Assured my partner, that it was normal to feel flu like symptoms the next day. So, we never doubted what the pharmacist advised. All of sudden, she suffered a cardiac arrest in my presence and died in front of me."
	"1269224-1"	"1269224-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"My partner felt pain overnight. Then, felt flu like symptoms- plus chills- the next day and night. The following morning at 7:00 am, Patient said that she felt real sick. She also, complained of having a real bad Headache, Not long after that, she felt like throwing up. She tried to throw up. Except, nothing came out and she felt very nauseous because of the vaccine. When she came call to bed, I offered to make her some breakfast to help her feel better.  Unfortunately, she felt, too, I'll to try and eat an food because of the way she felt. So, I laid next to her with the hope that all would be well. Because, the pharmacist who administered the second dose.  Assured my partner, that it was normal to feel flu like symptoms the next day. So, we never doubted what the pharmacist advised. All of sudden, she suffered a cardiac arrest in my presence and died in front of me."
	"1269224-1"	"1269224-1"	"INFLUENZA LIKE ILLNESS"	"10022004"	"60-64 years"	"60-64"	"My partner felt pain overnight. Then, felt flu like symptoms- plus chills- the next day and night. The following morning at 7:00 am, Patient said that she felt real sick. She also, complained of having a real bad Headache, Not long after that, she felt like throwing up. She tried to throw up. Except, nothing came out and she felt very nauseous because of the vaccine. When she came call to bed, I offered to make her some breakfast to help her feel better.  Unfortunately, she felt, too, I'll to try and eat an food because of the way she felt. So, I laid next to her with the hope that all would be well. Because, the pharmacist who administered the second dose.  Assured my partner, that it was normal to feel flu like symptoms the next day. So, we never doubted what the pharmacist advised. All of sudden, she suffered a cardiac arrest in my presence and died in front of me."
	"1269224-1"	"1269224-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"My partner felt pain overnight. Then, felt flu like symptoms- plus chills- the next day and night. The following morning at 7:00 am, Patient said that she felt real sick. She also, complained of having a real bad Headache, Not long after that, she felt like throwing up. She tried to throw up. Except, nothing came out and she felt very nauseous because of the vaccine. When she came call to bed, I offered to make her some breakfast to help her feel better.  Unfortunately, she felt, too, I'll to try and eat an food because of the way she felt. So, I laid next to her with the hope that all would be well. Because, the pharmacist who administered the second dose.  Assured my partner, that it was normal to feel flu like symptoms the next day. So, we never doubted what the pharmacist advised. All of sudden, she suffered a cardiac arrest in my presence and died in front of me."
	"1269224-1"	"1269224-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"My partner felt pain overnight. Then, felt flu like symptoms- plus chills- the next day and night. The following morning at 7:00 am, Patient said that she felt real sick. She also, complained of having a real bad Headache, Not long after that, she felt like throwing up. She tried to throw up. Except, nothing came out and she felt very nauseous because of the vaccine. When she came call to bed, I offered to make her some breakfast to help her feel better.  Unfortunately, she felt, too, I'll to try and eat an food because of the way she felt. So, I laid next to her with the hope that all would be well. Because, the pharmacist who administered the second dose.  Assured my partner, that it was normal to feel flu like symptoms the next day. So, we never doubted what the pharmacist advised. All of sudden, she suffered a cardiac arrest in my presence and died in front of me."
	"1269224-1"	"1269224-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"My partner felt pain overnight. Then, felt flu like symptoms- plus chills- the next day and night. The following morning at 7:00 am, Patient said that she felt real sick. She also, complained of having a real bad Headache, Not long after that, she felt like throwing up. She tried to throw up. Except, nothing came out and she felt very nauseous because of the vaccine. When she came call to bed, I offered to make her some breakfast to help her feel better.  Unfortunately, she felt, too, I'll to try and eat an food because of the way she felt. So, I laid next to her with the hope that all would be well. Because, the pharmacist who administered the second dose.  Assured my partner, that it was normal to feel flu like symptoms the next day. So, we never doubted what the pharmacist advised. All of sudden, she suffered a cardiac arrest in my presence and died in front of me."
	"1269415-1"	"1269415-1"	"ABDOMINAL PAIN UPPER"	"10000087"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"ABNORMAL BEHAVIOUR"	"10061422"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"ACIDOSIS"	"10000486"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"BLOOD POTASSIUM DECREASED"	"10005724"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"BLOOD PRESSURE ABNORMAL"	"10005728"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"COMPUTERISED TOMOGRAM ABDOMEN NORMAL"	"10057800"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"COMPUTERISED TOMOGRAM NORMAL"	"10010236"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"CONFUSIONAL STATE"	"10010305"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"CYTOKINE STORM"	"10050685"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"DEHYDRATION"	"10012174"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"DELIRIUM"	"10012218"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"DIABETIC KETOACIDOSIS"	"10012671"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"DIALYSIS"	"10061105"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"ELECTROENCEPHALOGRAM NORMAL"	"10014409"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"HYPERSOMNIA"	"10020765"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"LUMBAR PUNCTURE NORMAL"	"10025002"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"MAGNETIC RESONANCE IMAGING NORMAL"	"10078225"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"MEMORY IMPAIRMENT"	"10027175"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"PANIC REACTION"	"10033670"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"PATIENT RESTRAINT"	"10053316"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"PERIPHERAL ARTERY OCCLUSION"	"10057525"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"PERIPHERAL SWELLING"	"10048959"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"POOR PERIPHERAL CIRCULATION"	"10036155"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"RESTLESSNESS"	"10038743"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"SEDATIVE THERAPY"	"10059283"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"STOMACH SCAN NORMAL"	"10062146"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1269415-1"	"1269415-1"	"WHITE BLOOD CELL COUNT INCREASED"	"10047943"	"60-64 years"	"60-64"	"? Tuesday, April 6th ? Patient receives the 2nd Pfizer vaccine shot ? Thursday, April 8th ? Patient is sick with vomiting and diarrhea ? Friday, April 9th ? Patient is delirious and still sick with vomiting and diarrhea. She is also has pain in her stomach.  An ambulance is called to take her to the hospital.  The hospital determines her white blood count is elevated, indicating an infection.  Blood sugar is very high ? approximately 400.  Covid test is negative.  She is restless upon arrival.  She tries to climb out of bed continuously. She is restrained. o Saturday, April 10th ? Patient is running a fever and is in pain.  She is also confused and doesn?t recognize her oldest sister.  Meds are administered to handle both items. (Toradol?).  Blood sugar around 200.  She continuously counts and calls for Mother and Father.   Patient continues to be restless o Sunday, April 11th  - at request of family, a CT scan is done of her stomach and abdomen.  Nothing is found.  Potassium was at 3.2 (normal is 3.5) so she received an IV drip to help with potassium levels.  Sugar ? 206.  Later drops to 176.  Patient calms down some. She is still confused and doesn?t recognize her oldest sister. ? Monday April 12th ? the hospital attempts to do an MRI, but patient panics.    This is a closed MRI and her 1st husband died in one.   The MRI isn?t done. ? Tuesday, April 13th ? she is asked by the doctor to state her name and wiggle her toes.  She complies. Doctor orders speech therapy.  She is sedated for an MRI and a CT scan. Both are successfully completed.  She sleeps for the rest of the day.  Blood sugar ? 274 @ 5:09pm. ? Wednesday, April 14th ? Patient was asleep all day.  Most of the day she isn?t responsive when nurses come in and do things like take blood.  She normally responds even if she is asleep.   Around 5pm she starts to respond and make noises; she briefly opens her eyes then falls asleep.  She continues to run a temperature. ? Thursday, April 15th ? Patient is asleep most of the day.  She is responsive when nurses do things like take blood.  A spinal tap is performed.  There was mention of dementia.  Hospital is sharing little information, varying from she is retreating into herself vs. something worth isolating is going on.  Temp was 102.3 at 7:37, but later dropped to 99.3 without meds.  Dr.  (neurologist) provides an update to the family.  Tests so far are negative.  EEG showed sleeping brain (she was asleep during test).  MRI showed nothing.  Spinal tap negative so far.  No infection or anything has shown up.  Orders another EEG and MRI ? Friday, April 16th ? Patient tried to open her eyes.  ? Saturday, April 17th ? a met code was called on her and she was moved to ICU.  A circulation issue was found in right leg.   Occlusion was really bad.  Initially the doctor was concerned about blood clots.  None were found, just swelling.   Pressure was relieved.  Blood pressure issues.    She was put on 2 blood pressure meds, at least.  She was dehydrated and acidic.  Diabetic ketoacidosis was mentioned.  A cytokine storm was expected. ? Sunday, April 18th ? blood pressure not stable.  She was put on dialysis.  Peripheral circulation was worse. ? Monday, April 19th ? she coded around 5am.  Doctors were trying to save her.  She passed away about 30 minutes later ."
	"1270605-1"	"1270605-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"His brother reporting that he got the vaccine, the following day he was coughing.  The coughing caused him not to be able to sleep and was weak due to that.  He could feel his throat closing and he was having a hard time breathing and he called his brother who told him to call 9-1-1.  He was taken to Medical Center 4/17/2021, diagnosed with possibly COVID.   He was admitted to the COVID ward and he died on 4/26/2021.   The doctor that pronounced him was .   Cause of death diagnosis.  Hypoxic respiratory arrest, COVID 19"
	"1270605-1"	"1270605-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"His brother reporting that he got the vaccine, the following day he was coughing.  The coughing caused him not to be able to sleep and was weak due to that.  He could feel his throat closing and he was having a hard time breathing and he called his brother who told him to call 9-1-1.  He was taken to Medical Center 4/17/2021, diagnosed with possibly COVID.   He was admitted to the COVID ward and he died on 4/26/2021.   The doctor that pronounced him was .   Cause of death diagnosis.  Hypoxic respiratory arrest, COVID 19"
	"1270605-1"	"1270605-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"His brother reporting that he got the vaccine, the following day he was coughing.  The coughing caused him not to be able to sleep and was weak due to that.  He could feel his throat closing and he was having a hard time breathing and he called his brother who told him to call 9-1-1.  He was taken to Medical Center 4/17/2021, diagnosed with possibly COVID.   He was admitted to the COVID ward and he died on 4/26/2021.   The doctor that pronounced him was .   Cause of death diagnosis.  Hypoxic respiratory arrest, COVID 19"
	"1270605-1"	"1270605-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"His brother reporting that he got the vaccine, the following day he was coughing.  The coughing caused him not to be able to sleep and was weak due to that.  He could feel his throat closing and he was having a hard time breathing and he called his brother who told him to call 9-1-1.  He was taken to Medical Center 4/17/2021, diagnosed with possibly COVID.   He was admitted to the COVID ward and he died on 4/26/2021.   The doctor that pronounced him was .   Cause of death diagnosis.  Hypoxic respiratory arrest, COVID 19"
	"1270605-1"	"1270605-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"His brother reporting that he got the vaccine, the following day he was coughing.  The coughing caused him not to be able to sleep and was weak due to that.  He could feel his throat closing and he was having a hard time breathing and he called his brother who told him to call 9-1-1.  He was taken to Medical Center 4/17/2021, diagnosed with possibly COVID.   He was admitted to the COVID ward and he died on 4/26/2021.   The doctor that pronounced him was .   Cause of death diagnosis.  Hypoxic respiratory arrest, COVID 19"
	"1270605-1"	"1270605-1"	"INSOMNIA"	"10022437"	"60-64 years"	"60-64"	"His brother reporting that he got the vaccine, the following day he was coughing.  The coughing caused him not to be able to sleep and was weak due to that.  He could feel his throat closing and he was having a hard time breathing and he called his brother who told him to call 9-1-1.  He was taken to Medical Center 4/17/2021, diagnosed with possibly COVID.   He was admitted to the COVID ward and he died on 4/26/2021.   The doctor that pronounced him was .   Cause of death diagnosis.  Hypoxic respiratory arrest, COVID 19"
	"1270605-1"	"1270605-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	"His brother reporting that he got the vaccine, the following day he was coughing.  The coughing caused him not to be able to sleep and was weak due to that.  He could feel his throat closing and he was having a hard time breathing and he called his brother who told him to call 9-1-1.  He was taken to Medical Center 4/17/2021, diagnosed with possibly COVID.   He was admitted to the COVID ward and he died on 4/26/2021.   The doctor that pronounced him was .   Cause of death diagnosis.  Hypoxic respiratory arrest, COVID 19"
	"1270605-1"	"1270605-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"His brother reporting that he got the vaccine, the following day he was coughing.  The coughing caused him not to be able to sleep and was weak due to that.  He could feel his throat closing and he was having a hard time breathing and he called his brother who told him to call 9-1-1.  He was taken to Medical Center 4/17/2021, diagnosed with possibly COVID.   He was admitted to the COVID ward and he died on 4/26/2021.   The doctor that pronounced him was .   Cause of death diagnosis.  Hypoxic respiratory arrest, COVID 19"
	"1270605-1"	"1270605-1"	"THROAT TIGHTNESS"	"10043528"	"60-64 years"	"60-64"	"His brother reporting that he got the vaccine, the following day he was coughing.  The coughing caused him not to be able to sleep and was weak due to that.  He could feel his throat closing and he was having a hard time breathing and he called his brother who told him to call 9-1-1.  He was taken to Medical Center 4/17/2021, diagnosed with possibly COVID.   He was admitted to the COVID ward and he died on 4/26/2021.   The doctor that pronounced him was .   Cause of death diagnosis.  Hypoxic respiratory arrest, COVID 19"
	"1271382-1"	"1271382-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient was admitted to facility 2/25 and passed away 3/4."
	"1273483-1"	"1273483-1"	"APNOEA"	"10002974"	"60-64 years"	"60-64"	"Medical team dispatched to the residence of the the name person on April 10, 2021 at 2327. Pt assessed by medic on scene and determine patient with obvious death. Pt found halfway on the couch and to be pulseless, apneic, and with rigor mortis. Unknown down time and when further assessed, patient death determine by EMS.   pt had fixed and dilated pupils, non-responsive to painful stimuli, absent breath sounds, no heart sounds auscultated. Pt was also placed on the monitor and found to be in asystole in 2 contiguous leads. CPR with held and no resuscitative measures performed."
	"1273483-1"	"1273483-1"	"BREATH SOUNDS ABSENT"	"10062285"	"60-64 years"	"60-64"	"Medical team dispatched to the residence of the the name person on April 10, 2021 at 2327. Pt assessed by medic on scene and determine patient with obvious death. Pt found halfway on the couch and to be pulseless, apneic, and with rigor mortis. Unknown down time and when further assessed, patient death determine by EMS.   pt had fixed and dilated pupils, non-responsive to painful stimuli, absent breath sounds, no heart sounds auscultated. Pt was also placed on the monitor and found to be in asystole in 2 contiguous leads. CPR with held and no resuscitative measures performed."
	"1273483-1"	"1273483-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Medical team dispatched to the residence of the the name person on April 10, 2021 at 2327. Pt assessed by medic on scene and determine patient with obvious death. Pt found halfway on the couch and to be pulseless, apneic, and with rigor mortis. Unknown down time and when further assessed, patient death determine by EMS.   pt had fixed and dilated pupils, non-responsive to painful stimuli, absent breath sounds, no heart sounds auscultated. Pt was also placed on the monitor and found to be in asystole in 2 contiguous leads. CPR with held and no resuscitative measures performed."
	"1273483-1"	"1273483-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Medical team dispatched to the residence of the the name person on April 10, 2021 at 2327. Pt assessed by medic on scene and determine patient with obvious death. Pt found halfway on the couch and to be pulseless, apneic, and with rigor mortis. Unknown down time and when further assessed, patient death determine by EMS.   pt had fixed and dilated pupils, non-responsive to painful stimuli, absent breath sounds, no heart sounds auscultated. Pt was also placed on the monitor and found to be in asystole in 2 contiguous leads. CPR with held and no resuscitative measures performed."
	"1273483-1"	"1273483-1"	"ELECTROCARDIOGRAM ABNORMAL"	"10014363"	"60-64 years"	"60-64"	"Medical team dispatched to the residence of the the name person on April 10, 2021 at 2327. Pt assessed by medic on scene and determine patient with obvious death. Pt found halfway on the couch and to be pulseless, apneic, and with rigor mortis. Unknown down time and when further assessed, patient death determine by EMS.   pt had fixed and dilated pupils, non-responsive to painful stimuli, absent breath sounds, no heart sounds auscultated. Pt was also placed on the monitor and found to be in asystole in 2 contiguous leads. CPR with held and no resuscitative measures performed."
	"1273483-1"	"1273483-1"	"HEART SOUNDS ABNORMAL"	"10019311"	"60-64 years"	"60-64"	"Medical team dispatched to the residence of the the name person on April 10, 2021 at 2327. Pt assessed by medic on scene and determine patient with obvious death. Pt found halfway on the couch and to be pulseless, apneic, and with rigor mortis. Unknown down time and when further assessed, patient death determine by EMS.   pt had fixed and dilated pupils, non-responsive to painful stimuli, absent breath sounds, no heart sounds auscultated. Pt was also placed on the monitor and found to be in asystole in 2 contiguous leads. CPR with held and no resuscitative measures performed."
	"1273483-1"	"1273483-1"	"MUSCLE RIGIDITY"	"10028330"	"60-64 years"	"60-64"	"Medical team dispatched to the residence of the the name person on April 10, 2021 at 2327. Pt assessed by medic on scene and determine patient with obvious death. Pt found halfway on the couch and to be pulseless, apneic, and with rigor mortis. Unknown down time and when further assessed, patient death determine by EMS.   pt had fixed and dilated pupils, non-responsive to painful stimuli, absent breath sounds, no heart sounds auscultated. Pt was also placed on the monitor and found to be in asystole in 2 contiguous leads. CPR with held and no resuscitative measures performed."
	"1273483-1"	"1273483-1"	"PULSE ABSENT"	"10037469"	"60-64 years"	"60-64"	"Medical team dispatched to the residence of the the name person on April 10, 2021 at 2327. Pt assessed by medic on scene and determine patient with obvious death. Pt found halfway on the couch and to be pulseless, apneic, and with rigor mortis. Unknown down time and when further assessed, patient death determine by EMS.   pt had fixed and dilated pupils, non-responsive to painful stimuli, absent breath sounds, no heart sounds auscultated. Pt was also placed on the monitor and found to be in asystole in 2 contiguous leads. CPR with held and no resuscitative measures performed."
	"1273483-1"	"1273483-1"	"PUPIL FIXED"	"10037515"	"60-64 years"	"60-64"	"Medical team dispatched to the residence of the the name person on April 10, 2021 at 2327. Pt assessed by medic on scene and determine patient with obvious death. Pt found halfway on the couch and to be pulseless, apneic, and with rigor mortis. Unknown down time and when further assessed, patient death determine by EMS.   pt had fixed and dilated pupils, non-responsive to painful stimuli, absent breath sounds, no heart sounds auscultated. Pt was also placed on the monitor and found to be in asystole in 2 contiguous leads. CPR with held and no resuscitative measures performed."
	"1273483-1"	"1273483-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Medical team dispatched to the residence of the the name person on April 10, 2021 at 2327. Pt assessed by medic on scene and determine patient with obvious death. Pt found halfway on the couch and to be pulseless, apneic, and with rigor mortis. Unknown down time and when further assessed, patient death determine by EMS.   pt had fixed and dilated pupils, non-responsive to painful stimuli, absent breath sounds, no heart sounds auscultated. Pt was also placed on the monitor and found to be in asystole in 2 contiguous leads. CPR with held and no resuscitative measures performed."
	"1273671-1"	"1273671-1"	"ANEURYSM"	"10002329"	"60-64 years"	"60-64"	"Husband stated that she died of an aneurysm on March 28, 2021. He will provide details later."
	"1273671-1"	"1273671-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Husband stated that she died of an aneurysm on March 28, 2021. He will provide details later."
	"1275910-1"	"1275910-1"	"AGEUSIA"	"10001480"	"60-64 years"	"60-64"	"Patient presented to ED on 3/28/21 with the following information:  patient reports home daughter was diagnosed with COVID-19 infection a few days ago.  For about a week now the patient herself has had severe fatigue, loss of taste, loss of appetite, nausea, vomiting and diarrhea.  She denies fevers.  She has however had a persistent cough and over the last few days has been short of breath.  Tested positive for COVID-19 on 3/27/2021 at outside facility.  Last night patient had multiple episodes of diarrhea making her fatigue significantly worse today.  Has been drinking a lot of free water.  Additionally noted increased cough and shortness of breath. Patient was admitted to the hospital with COVID-19 pneumonia on 3/28/21 and expired on 4/13/21."
	"1275910-1"	"1275910-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Patient presented to ED on 3/28/21 with the following information:  patient reports home daughter was diagnosed with COVID-19 infection a few days ago.  For about a week now the patient herself has had severe fatigue, loss of taste, loss of appetite, nausea, vomiting and diarrhea.  She denies fevers.  She has however had a persistent cough and over the last few days has been short of breath.  Tested positive for COVID-19 on 3/27/2021 at outside facility.  Last night patient had multiple episodes of diarrhea making her fatigue significantly worse today.  Has been drinking a lot of free water.  Additionally noted increased cough and shortness of breath. Patient was admitted to the hospital with COVID-19 pneumonia on 3/28/21 and expired on 4/13/21."
	"1275910-1"	"1275910-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient presented to ED on 3/28/21 with the following information:  patient reports home daughter was diagnosed with COVID-19 infection a few days ago.  For about a week now the patient herself has had severe fatigue, loss of taste, loss of appetite, nausea, vomiting and diarrhea.  She denies fevers.  She has however had a persistent cough and over the last few days has been short of breath.  Tested positive for COVID-19 on 3/27/2021 at outside facility.  Last night patient had multiple episodes of diarrhea making her fatigue significantly worse today.  Has been drinking a lot of free water.  Additionally noted increased cough and shortness of breath. Patient was admitted to the hospital with COVID-19 pneumonia on 3/28/21 and expired on 4/13/21."
	"1275910-1"	"1275910-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Patient presented to ED on 3/28/21 with the following information:  patient reports home daughter was diagnosed with COVID-19 infection a few days ago.  For about a week now the patient herself has had severe fatigue, loss of taste, loss of appetite, nausea, vomiting and diarrhea.  She denies fevers.  She has however had a persistent cough and over the last few days has been short of breath.  Tested positive for COVID-19 on 3/27/2021 at outside facility.  Last night patient had multiple episodes of diarrhea making her fatigue significantly worse today.  Has been drinking a lot of free water.  Additionally noted increased cough and shortness of breath. Patient was admitted to the hospital with COVID-19 pneumonia on 3/28/21 and expired on 4/13/21."
	"1275910-1"	"1275910-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient presented to ED on 3/28/21 with the following information:  patient reports home daughter was diagnosed with COVID-19 infection a few days ago.  For about a week now the patient herself has had severe fatigue, loss of taste, loss of appetite, nausea, vomiting and diarrhea.  She denies fevers.  She has however had a persistent cough and over the last few days has been short of breath.  Tested positive for COVID-19 on 3/27/2021 at outside facility.  Last night patient had multiple episodes of diarrhea making her fatigue significantly worse today.  Has been drinking a lot of free water.  Additionally noted increased cough and shortness of breath. Patient was admitted to the hospital with COVID-19 pneumonia on 3/28/21 and expired on 4/13/21."
	"1275910-1"	"1275910-1"	"DECREASED APPETITE"	"10061428"	"60-64 years"	"60-64"	"Patient presented to ED on 3/28/21 with the following information:  patient reports home daughter was diagnosed with COVID-19 infection a few days ago.  For about a week now the patient herself has had severe fatigue, loss of taste, loss of appetite, nausea, vomiting and diarrhea.  She denies fevers.  She has however had a persistent cough and over the last few days has been short of breath.  Tested positive for COVID-19 on 3/27/2021 at outside facility.  Last night patient had multiple episodes of diarrhea making her fatigue significantly worse today.  Has been drinking a lot of free water.  Additionally noted increased cough and shortness of breath. Patient was admitted to the hospital with COVID-19 pneumonia on 3/28/21 and expired on 4/13/21."
	"1275910-1"	"1275910-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"Patient presented to ED on 3/28/21 with the following information:  patient reports home daughter was diagnosed with COVID-19 infection a few days ago.  For about a week now the patient herself has had severe fatigue, loss of taste, loss of appetite, nausea, vomiting and diarrhea.  She denies fevers.  She has however had a persistent cough and over the last few days has been short of breath.  Tested positive for COVID-19 on 3/27/2021 at outside facility.  Last night patient had multiple episodes of diarrhea making her fatigue significantly worse today.  Has been drinking a lot of free water.  Additionally noted increased cough and shortness of breath. Patient was admitted to the hospital with COVID-19 pneumonia on 3/28/21 and expired on 4/13/21."
	"1275910-1"	"1275910-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Patient presented to ED on 3/28/21 with the following information:  patient reports home daughter was diagnosed with COVID-19 infection a few days ago.  For about a week now the patient herself has had severe fatigue, loss of taste, loss of appetite, nausea, vomiting and diarrhea.  She denies fevers.  She has however had a persistent cough and over the last few days has been short of breath.  Tested positive for COVID-19 on 3/27/2021 at outside facility.  Last night patient had multiple episodes of diarrhea making her fatigue significantly worse today.  Has been drinking a lot of free water.  Additionally noted increased cough and shortness of breath. Patient was admitted to the hospital with COVID-19 pneumonia on 3/28/21 and expired on 4/13/21."
	"1275910-1"	"1275910-1"	"EXPOSURE TO SARS-COV-2"	"10084456"	"60-64 years"	"60-64"	"Patient presented to ED on 3/28/21 with the following information:  patient reports home daughter was diagnosed with COVID-19 infection a few days ago.  For about a week now the patient herself has had severe fatigue, loss of taste, loss of appetite, nausea, vomiting and diarrhea.  She denies fevers.  She has however had a persistent cough and over the last few days has been short of breath.  Tested positive for COVID-19 on 3/27/2021 at outside facility.  Last night patient had multiple episodes of diarrhea making her fatigue significantly worse today.  Has been drinking a lot of free water.  Additionally noted increased cough and shortness of breath. Patient was admitted to the hospital with COVID-19 pneumonia on 3/28/21 and expired on 4/13/21."
	"1275910-1"	"1275910-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Patient presented to ED on 3/28/21 with the following information:  patient reports home daughter was diagnosed with COVID-19 infection a few days ago.  For about a week now the patient herself has had severe fatigue, loss of taste, loss of appetite, nausea, vomiting and diarrhea.  She denies fevers.  She has however had a persistent cough and over the last few days has been short of breath.  Tested positive for COVID-19 on 3/27/2021 at outside facility.  Last night patient had multiple episodes of diarrhea making her fatigue significantly worse today.  Has been drinking a lot of free water.  Additionally noted increased cough and shortness of breath. Patient was admitted to the hospital with COVID-19 pneumonia on 3/28/21 and expired on 4/13/21."
	"1275910-1"	"1275910-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Patient presented to ED on 3/28/21 with the following information:  patient reports home daughter was diagnosed with COVID-19 infection a few days ago.  For about a week now the patient herself has had severe fatigue, loss of taste, loss of appetite, nausea, vomiting and diarrhea.  She denies fevers.  She has however had a persistent cough and over the last few days has been short of breath.  Tested positive for COVID-19 on 3/27/2021 at outside facility.  Last night patient had multiple episodes of diarrhea making her fatigue significantly worse today.  Has been drinking a lot of free water.  Additionally noted increased cough and shortness of breath. Patient was admitted to the hospital with COVID-19 pneumonia on 3/28/21 and expired on 4/13/21."
	"1275910-1"	"1275910-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Patient presented to ED on 3/28/21 with the following information:  patient reports home daughter was diagnosed with COVID-19 infection a few days ago.  For about a week now the patient herself has had severe fatigue, loss of taste, loss of appetite, nausea, vomiting and diarrhea.  She denies fevers.  She has however had a persistent cough and over the last few days has been short of breath.  Tested positive for COVID-19 on 3/27/2021 at outside facility.  Last night patient had multiple episodes of diarrhea making her fatigue significantly worse today.  Has been drinking a lot of free water.  Additionally noted increased cough and shortness of breath. Patient was admitted to the hospital with COVID-19 pneumonia on 3/28/21 and expired on 4/13/21."
	"1275910-1"	"1275910-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"Patient presented to ED on 3/28/21 with the following information:  patient reports home daughter was diagnosed with COVID-19 infection a few days ago.  For about a week now the patient herself has had severe fatigue, loss of taste, loss of appetite, nausea, vomiting and diarrhea.  She denies fevers.  She has however had a persistent cough and over the last few days has been short of breath.  Tested positive for COVID-19 on 3/27/2021 at outside facility.  Last night patient had multiple episodes of diarrhea making her fatigue significantly worse today.  Has been drinking a lot of free water.  Additionally noted increased cough and shortness of breath. Patient was admitted to the hospital with COVID-19 pneumonia on 3/28/21 and expired on 4/13/21."
	"1279431-1"	"1279431-1"	"CARDIAC DISORDER"	"10061024"	"60-64 years"	"60-64"	"Unspecified Cardiac Event; This is a spontaneous report from a contactable consumer (Patient's Daughter). A 60-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number: EK4176), via an unspecified route of administration on 15Jan2021 at single dose for COVID-19 immunization. The patient also received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number: EK4176), via an unspecified route of administration on 05Feb2021 at single dose for COVID-19 immunization. Medical history included chronic obstructive pulmonary disease from an unknown date to 21Feb2021, brain aneurysm, smoker. Family medical history included States her Grandfather had skin cancer, but it was benign, moles and then freeze them off. No cardiac events. Grandma passed away infection from knee surgery. The patient received a Prior Vaccinations within 4 weeks has received both doses of the Pfizer Covid Vaccine. Concomitant medication was not reported. On 21Feb2021, patient experienced unspecified cardiac event. Caller stated that she was calling in regards to her mother regarding the Covid19 vaccine. States she was instructed by the pathologist to call Pfizer directly, rather than just report on VAERS. States this was not the same pathologist as the one that did the autopsy. Caller states does have a copy of the autopsy. States she called several pathologist to get the autopsy done. Dr. called her back after it had been done, and the caller discussed with him, the patient passed away after some cardiac event. States it is not clear what cardiac event. States she passed away 16 days after receiving her second dose of the vaccine. States the patient's physician would be happy to talk to Pfizer about it. Reporter states her mom was an LPN there and they all know her. States anyone there is fully aware of who she is. States some people in the office are taking it hard, and they may get sentimental. States it helps if people get things business and not talk about feelings. Reporter states it was 8:50am when the EMTs arrived and she had already passed. Caller states was who did the autopsy. She has been speaking with a lady, but she goes by (university name). States (Hospital Name) is a hospital, it used to be (University name). Hospital. Reporter states (phone number) is a direct line to (university name). Reporter states when the autopsy results came back she had the original and they are sending another because of the cause of death. Reporter states the autopsy showed no Pulmonary Obstruction, which made them question, well did she have COPD? States it was interesting because her mom was a smoker but her lungs were pink, and there was no fluid or obstruction in her lungs. States her mom taught her a little bit growing up. Reporter states she was going to be a nurse too but she lost her grant because she got married, now she doesn't qualify. Caller stats an autopsy was done; however they did not do a toxicology report. Caller states that patient was an organ donor. States she received a letter from them stating the patient will be helping a lot of people with skin grafts. Reporter adds, the patient was negative for Covid, she had to be tested for the autopsy. States she died from some type of cardiac event. States the patient did have COPD but on the autopsy, her lungs were clear and there were no pulmonary obstructions. States the liver showed possible hypertension, but the patient did not have hypertension. Reporter states there are some interesting things with her autopsy report and the patient's PCP could go over it medically if necessary. Reporter states this morning she saw several articles that state heart inflammation has been linked to the vaccine. Caller asks if she still needs to report it through VAERS? States she should have done it in the beginning but her mom was a big supporter of the vaccine. Reporter states her mom was on Facebook, and someone stated they weren't sure about getting the vaccine and her mom had commented, well she just got her second one, let's see what happens and then she died 16 days later. States that is why she was hesitated to report it. States the Pathologist encouraged her to call in and report it. Caller states she does not know if her mom had any other adverse events. States she will not say a word about things unless it gets really bad. Reporter states the only person that would know is Dr. meant a lot to her mom and she would be willing to tell her doctor, but not her daughter because she wouldn't want her to worry. Caller states the patient never used her inhaler, it is still full. States she took her mom's purse because her mom lived out of her purse, everything she needed was in there. Reporter states the patient had Tylenol, Sudafed, Advil, and Prednisone in her purse. Reporter states she knows she wasn't taking Prednisone. States the pill box is locked and it looks like it hasn't been open in a while. Reporter states she does not know if she was taking any medication, Dr. may have more information. Reporter states no, she didn't go to the doctor or the ER. States the patient's dog woke up her stepdad and she had already passed away. States they have her dog and he is going through a lot, when she first passed the dog had aggressive tendencies, and when she would lay with him, he would nudge her to get up. He doesn't like it when people go to sleep and that makes it harder. States the dog ended up getting an eye infection, because his tear ducts were clogged, states he did that a couple weeks, and now he is getting better, not as fearful or aggressive. Reporter states when her mom had the brain aneurysm, it takes a little bit longer for anesthesia to wear off. States it was an extremely strong anesthesia that she had never had before. States she wouldn't let anyone take care of her except for her. States when she was under anesthesia, she would call her mom. States they would know when she said mom, she was talking about her daughter. States her mom said she looks like her grandma when she was younger. Consumer adds the patient's husband's contact information, in case it is needed. On 21Feb2021, the patient died due to cardiac event secondary to COPD. Autopsy was perfomed. Autopsy details was available. The outcome of the event was fatal.; Reported Cause(s) of Death: Cardiac Event Secondary to COPD"
	"1279431-1"	"1279431-1"	"SARS-COV-2 TEST"	"10084354"	"60-64 years"	"60-64"	"Unspecified Cardiac Event; This is a spontaneous report from a contactable consumer (Patient's Daughter). A 60-year-old female patient received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number: EK4176), via an unspecified route of administration on 15Jan2021 at single dose for COVID-19 immunization. The patient also received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, Solution for injection, Lot number: EK4176), via an unspecified route of administration on 05Feb2021 at single dose for COVID-19 immunization. Medical history included chronic obstructive pulmonary disease from an unknown date to 21Feb2021, brain aneurysm, smoker. Family medical history included States her Grandfather had skin cancer, but it was benign, moles and then freeze them off. No cardiac events. Grandma passed away infection from knee surgery. The patient received a Prior Vaccinations within 4 weeks has received both doses of the Pfizer Covid Vaccine. Concomitant medication was not reported. On 21Feb2021, patient experienced unspecified cardiac event. Caller stated that she was calling in regards to her mother regarding the Covid19 vaccine. States she was instructed by the pathologist to call Pfizer directly, rather than just report on VAERS. States this was not the same pathologist as the one that did the autopsy. Caller states does have a copy of the autopsy. States she called several pathologist to get the autopsy done. Dr. called her back after it had been done, and the caller discussed with him, the patient passed away after some cardiac event. States it is not clear what cardiac event. States she passed away 16 days after receiving her second dose of the vaccine. States the patient's physician would be happy to talk to Pfizer about it. Reporter states her mom was an LPN there and they all know her. States anyone there is fully aware of who she is. States some people in the office are taking it hard, and they may get sentimental. States it helps if people get things business and not talk about feelings. Reporter states it was 8:50am when the EMTs arrived and she had already passed. Caller states was who did the autopsy. She has been speaking with a lady, but she goes by (university name). States (Hospital Name) is a hospital, it used to be (University name). Hospital. Reporter states (phone number) is a direct line to (university name). Reporter states when the autopsy results came back she had the original and they are sending another because of the cause of death. Reporter states the autopsy showed no Pulmonary Obstruction, which made them question, well did she have COPD? States it was interesting because her mom was a smoker but her lungs were pink, and there was no fluid or obstruction in her lungs. States her mom taught her a little bit growing up. Reporter states she was going to be a nurse too but she lost her grant because she got married, now she doesn't qualify. Caller stats an autopsy was done; however they did not do a toxicology report. Caller states that patient was an organ donor. States she received a letter from them stating the patient will be helping a lot of people with skin grafts. Reporter adds, the patient was negative for Covid, she had to be tested for the autopsy. States she died from some type of cardiac event. States the patient did have COPD but on the autopsy, her lungs were clear and there were no pulmonary obstructions. States the liver showed possible hypertension, but the patient did not have hypertension. Reporter states there are some interesting things with her autopsy report and the patient's PCP could go over it medically if necessary. Reporter states this morning she saw several articles that state heart inflammation has been linked to the vaccine. Caller asks if she still needs to report it through VAERS? States she should have done it in the beginning but her mom was a big supporter of the vaccine. Reporter states her mom was on Facebook, and someone stated they weren't sure about getting the vaccine and her mom had commented, well she just got her second one, let's see what happens and then she died 16 days later. States that is why she was hesitated to report it. States the Pathologist encouraged her to call in and report it. Caller states she does not know if her mom had any other adverse events. States she will not say a word about things unless it gets really bad. Reporter states the only person that would know is Dr. meant a lot to her mom and she would be willing to tell her doctor, but not her daughter because she wouldn't want her to worry. Caller states the patient never used her inhaler, it is still full. States she took her mom's purse because her mom lived out of her purse, everything she needed was in there. Reporter states the patient had Tylenol, Sudafed, Advil, and Prednisone in her purse. Reporter states she knows she wasn't taking Prednisone. States the pill box is locked and it looks like it hasn't been open in a while. Reporter states she does not know if she was taking any medication, Dr. may have more information. Reporter states no, she didn't go to the doctor or the ER. States the patient's dog woke up her stepdad and she had already passed away. States they have her dog and he is going through a lot, when she first passed the dog had aggressive tendencies, and when she would lay with him, he would nudge her to get up. He doesn't like it when people go to sleep and that makes it harder. States the dog ended up getting an eye infection, because his tear ducts were clogged, states he did that a couple weeks, and now he is getting better, not as fearful or aggressive. Reporter states when her mom had the brain aneurysm, it takes a little bit longer for anesthesia to wear off. States it was an extremely strong anesthesia that she had never had before. States she wouldn't let anyone take care of her except for her. States when she was under anesthesia, she would call her mom. States they would know when she said mom, she was talking about her daughter. States her mom said she looks like her grandma when she was younger. Consumer adds the patient's husband's contact information, in case it is needed. On 21Feb2021, the patient died due to cardiac event secondary to COPD. Autopsy was perfomed. Autopsy details was available. The outcome of the event was fatal.; Reported Cause(s) of Death: Cardiac Event Secondary to COPD"
	"1281552-1"	"1281552-1"	"ARTERIOGRAM CORONARY NORMAL"	"10003202"	"60-64 years"	"60-64"	"I cannot confirm the type of vaccine the pt received as it didn't occur in our health system.  Pt experienced out of hospital cardiac arrest a few days after vaccination.  Pt resuscitated; however never regained consciousness.  Coronary angiogram revealed normal coronary arteries."
	"1281552-1"	"1281552-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"I cannot confirm the type of vaccine the pt received as it didn't occur in our health system.  Pt experienced out of hospital cardiac arrest a few days after vaccination.  Pt resuscitated; however never regained consciousness.  Coronary angiogram revealed normal coronary arteries."
	"1281552-1"	"1281552-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"I cannot confirm the type of vaccine the pt received as it didn't occur in our health system.  Pt experienced out of hospital cardiac arrest a few days after vaccination.  Pt resuscitated; however never regained consciousness.  Coronary angiogram revealed normal coronary arteries."
	"1281552-1"	"1281552-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"I cannot confirm the type of vaccine the pt received as it didn't occur in our health system.  Pt experienced out of hospital cardiac arrest a few days after vaccination.  Pt resuscitated; however never regained consciousness.  Coronary angiogram revealed normal coronary arteries."
	"1281552-1"	"1281552-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"60-64 years"	"60-64"	"I cannot confirm the type of vaccine the pt received as it didn't occur in our health system.  Pt experienced out of hospital cardiac arrest a few days after vaccination.  Pt resuscitated; however never regained consciousness.  Coronary angiogram revealed normal coronary arteries."
	"1281552-1"	"1281552-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"I cannot confirm the type of vaccine the pt received as it didn't occur in our health system.  Pt experienced out of hospital cardiac arrest a few days after vaccination.  Pt resuscitated; however never regained consciousness.  Coronary angiogram revealed normal coronary arteries."
	"1282520-1"	"1282520-1"	"ACUTE HEPATIC FAILURE"	"10000804"	"60-64 years"	"60-64"	"62F with stage 2 mycoises fungoides, peripheral neuropathy, HTN, HLD, admitted from hepatology clinic on 3/25/21 for worsening liver injury and URI symptoms, found to be COVID positive. Liver biopsy with evidence of severe hepatitis with bridging necrosis. Course complicated by increase encephalopathy 3/31/21 concerning for acute liver failure, requiring stay in COVID ICU, transferred to hepatology service on 4/2/21. DDx remains viral hepatitis, autoimmune hepatitis, and drug-induced liver injury now on steroid therapy as of 3/31/21 and NAC. Pt. had worsening ALF and encephalopathy, transitioned to comfort care.  Pt died early morning of 4/4/21"
	"1282520-1"	"1282520-1"	"AUTOIMMUNE HEPATITIS"	"10003827"	"60-64 years"	"60-64"	"62F with stage 2 mycoises fungoides, peripheral neuropathy, HTN, HLD, admitted from hepatology clinic on 3/25/21 for worsening liver injury and URI symptoms, found to be COVID positive. Liver biopsy with evidence of severe hepatitis with bridging necrosis. Course complicated by increase encephalopathy 3/31/21 concerning for acute liver failure, requiring stay in COVID ICU, transferred to hepatology service on 4/2/21. DDx remains viral hepatitis, autoimmune hepatitis, and drug-induced liver injury now on steroid therapy as of 3/31/21 and NAC. Pt. had worsening ALF and encephalopathy, transitioned to comfort care.  Pt died early morning of 4/4/21"
	"1282520-1"	"1282520-1"	"BIOPSY LIVER ABNORMAL"	"10004792"	"60-64 years"	"60-64"	"62F with stage 2 mycoises fungoides, peripheral neuropathy, HTN, HLD, admitted from hepatology clinic on 3/25/21 for worsening liver injury and URI symptoms, found to be COVID positive. Liver biopsy with evidence of severe hepatitis with bridging necrosis. Course complicated by increase encephalopathy 3/31/21 concerning for acute liver failure, requiring stay in COVID ICU, transferred to hepatology service on 4/2/21. DDx remains viral hepatitis, autoimmune hepatitis, and drug-induced liver injury now on steroid therapy as of 3/31/21 and NAC. Pt. had worsening ALF and encephalopathy, transitioned to comfort care.  Pt died early morning of 4/4/21"
	"1282520-1"	"1282520-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"62F with stage 2 mycoises fungoides, peripheral neuropathy, HTN, HLD, admitted from hepatology clinic on 3/25/21 for worsening liver injury and URI symptoms, found to be COVID positive. Liver biopsy with evidence of severe hepatitis with bridging necrosis. Course complicated by increase encephalopathy 3/31/21 concerning for acute liver failure, requiring stay in COVID ICU, transferred to hepatology service on 4/2/21. DDx remains viral hepatitis, autoimmune hepatitis, and drug-induced liver injury now on steroid therapy as of 3/31/21 and NAC. Pt. had worsening ALF and encephalopathy, transitioned to comfort care.  Pt died early morning of 4/4/21"
	"1282520-1"	"1282520-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"62F with stage 2 mycoises fungoides, peripheral neuropathy, HTN, HLD, admitted from hepatology clinic on 3/25/21 for worsening liver injury and URI symptoms, found to be COVID positive. Liver biopsy with evidence of severe hepatitis with bridging necrosis. Course complicated by increase encephalopathy 3/31/21 concerning for acute liver failure, requiring stay in COVID ICU, transferred to hepatology service on 4/2/21. DDx remains viral hepatitis, autoimmune hepatitis, and drug-induced liver injury now on steroid therapy as of 3/31/21 and NAC. Pt. had worsening ALF and encephalopathy, transitioned to comfort care.  Pt died early morning of 4/4/21"
	"1282520-1"	"1282520-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"62F with stage 2 mycoises fungoides, peripheral neuropathy, HTN, HLD, admitted from hepatology clinic on 3/25/21 for worsening liver injury and URI symptoms, found to be COVID positive. Liver biopsy with evidence of severe hepatitis with bridging necrosis. Course complicated by increase encephalopathy 3/31/21 concerning for acute liver failure, requiring stay in COVID ICU, transferred to hepatology service on 4/2/21. DDx remains viral hepatitis, autoimmune hepatitis, and drug-induced liver injury now on steroid therapy as of 3/31/21 and NAC. Pt. had worsening ALF and encephalopathy, transitioned to comfort care.  Pt died early morning of 4/4/21"
	"1282520-1"	"1282520-1"	"DRUG-INDUCED LIVER INJURY"	"10072268"	"60-64 years"	"60-64"	"62F with stage 2 mycoises fungoides, peripheral neuropathy, HTN, HLD, admitted from hepatology clinic on 3/25/21 for worsening liver injury and URI symptoms, found to be COVID positive. Liver biopsy with evidence of severe hepatitis with bridging necrosis. Course complicated by increase encephalopathy 3/31/21 concerning for acute liver failure, requiring stay in COVID ICU, transferred to hepatology service on 4/2/21. DDx remains viral hepatitis, autoimmune hepatitis, and drug-induced liver injury now on steroid therapy as of 3/31/21 and NAC. Pt. had worsening ALF and encephalopathy, transitioned to comfort care.  Pt died early morning of 4/4/21"
	"1282520-1"	"1282520-1"	"ENCEPHALOPATHY"	"10014625"	"60-64 years"	"60-64"	"62F with stage 2 mycoises fungoides, peripheral neuropathy, HTN, HLD, admitted from hepatology clinic on 3/25/21 for worsening liver injury and URI symptoms, found to be COVID positive. Liver biopsy with evidence of severe hepatitis with bridging necrosis. Course complicated by increase encephalopathy 3/31/21 concerning for acute liver failure, requiring stay in COVID ICU, transferred to hepatology service on 4/2/21. DDx remains viral hepatitis, autoimmune hepatitis, and drug-induced liver injury now on steroid therapy as of 3/31/21 and NAC. Pt. had worsening ALF and encephalopathy, transitioned to comfort care.  Pt died early morning of 4/4/21"
	"1282520-1"	"1282520-1"	"HEPATIC NECROSIS"	"10019692"	"60-64 years"	"60-64"	"62F with stage 2 mycoises fungoides, peripheral neuropathy, HTN, HLD, admitted from hepatology clinic on 3/25/21 for worsening liver injury and URI symptoms, found to be COVID positive. Liver biopsy with evidence of severe hepatitis with bridging necrosis. Course complicated by increase encephalopathy 3/31/21 concerning for acute liver failure, requiring stay in COVID ICU, transferred to hepatology service on 4/2/21. DDx remains viral hepatitis, autoimmune hepatitis, and drug-induced liver injury now on steroid therapy as of 3/31/21 and NAC. Pt. had worsening ALF and encephalopathy, transitioned to comfort care.  Pt died early morning of 4/4/21"
	"1282520-1"	"1282520-1"	"HEPATITIS VIRAL"	"10019799"	"60-64 years"	"60-64"	"62F with stage 2 mycoises fungoides, peripheral neuropathy, HTN, HLD, admitted from hepatology clinic on 3/25/21 for worsening liver injury and URI symptoms, found to be COVID positive. Liver biopsy with evidence of severe hepatitis with bridging necrosis. Course complicated by increase encephalopathy 3/31/21 concerning for acute liver failure, requiring stay in COVID ICU, transferred to hepatology service on 4/2/21. DDx remains viral hepatitis, autoimmune hepatitis, and drug-induced liver injury now on steroid therapy as of 3/31/21 and NAC. Pt. had worsening ALF and encephalopathy, transitioned to comfort care.  Pt died early morning of 4/4/21"
	"1282520-1"	"1282520-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"62F with stage 2 mycoises fungoides, peripheral neuropathy, HTN, HLD, admitted from hepatology clinic on 3/25/21 for worsening liver injury and URI symptoms, found to be COVID positive. Liver biopsy with evidence of severe hepatitis with bridging necrosis. Course complicated by increase encephalopathy 3/31/21 concerning for acute liver failure, requiring stay in COVID ICU, transferred to hepatology service on 4/2/21. DDx remains viral hepatitis, autoimmune hepatitis, and drug-induced liver injury now on steroid therapy as of 3/31/21 and NAC. Pt. had worsening ALF and encephalopathy, transitioned to comfort care.  Pt died early morning of 4/4/21"
	"1282520-1"	"1282520-1"	"LIVER INJURY"	"10067125"	"60-64 years"	"60-64"	"62F with stage 2 mycoises fungoides, peripheral neuropathy, HTN, HLD, admitted from hepatology clinic on 3/25/21 for worsening liver injury and URI symptoms, found to be COVID positive. Liver biopsy with evidence of severe hepatitis with bridging necrosis. Course complicated by increase encephalopathy 3/31/21 concerning for acute liver failure, requiring stay in COVID ICU, transferred to hepatology service on 4/2/21. DDx remains viral hepatitis, autoimmune hepatitis, and drug-induced liver injury now on steroid therapy as of 3/31/21 and NAC. Pt. had worsening ALF and encephalopathy, transitioned to comfort care.  Pt died early morning of 4/4/21"
	"1282520-1"	"1282520-1"	"RESPIRATORY SYMPTOM"	"10075535"	"60-64 years"	"60-64"	"62F with stage 2 mycoises fungoides, peripheral neuropathy, HTN, HLD, admitted from hepatology clinic on 3/25/21 for worsening liver injury and URI symptoms, found to be COVID positive. Liver biopsy with evidence of severe hepatitis with bridging necrosis. Course complicated by increase encephalopathy 3/31/21 concerning for acute liver failure, requiring stay in COVID ICU, transferred to hepatology service on 4/2/21. DDx remains viral hepatitis, autoimmune hepatitis, and drug-induced liver injury now on steroid therapy as of 3/31/21 and NAC. Pt. had worsening ALF and encephalopathy, transitioned to comfort care.  Pt died early morning of 4/4/21"
	"1282946-1"	"1282946-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"The patient passed away."
	"1283733-1"	"1283733-1"	"BACK PAIN"	"10003988"	"60-64 years"	"60-64"	"on April 2nd patient woke up at around 4:30 am and complained of pain in his back. I rubbed his back and he wondered if it was just something he ate.  He then tried to calm down and got back into bed . He was holding my hand when suddenly his hand felt cold. I turned on the light to find his eyes rolled back and he was gasping his last breath . This was about 5:20 AM . Patient was a healthy active man."
	"1283733-1"	"1283733-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"on April 2nd patient woke up at around 4:30 am and complained of pain in his back. I rubbed his back and he wondered if it was just something he ate.  He then tried to calm down and got back into bed . He was holding my hand when suddenly his hand felt cold. I turned on the light to find his eyes rolled back and he was gasping his last breath . This was about 5:20 AM . Patient was a healthy active man."
	"1283733-1"	"1283733-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"on April 2nd patient woke up at around 4:30 am and complained of pain in his back. I rubbed his back and he wondered if it was just something he ate.  He then tried to calm down and got back into bed . He was holding my hand when suddenly his hand felt cold. I turned on the light to find his eyes rolled back and he was gasping his last breath . This was about 5:20 AM . Patient was a healthy active man."
	"1283733-1"	"1283733-1"	"EYE MOVEMENT DISORDER"	"10061129"	"60-64 years"	"60-64"	"on April 2nd patient woke up at around 4:30 am and complained of pain in his back. I rubbed his back and he wondered if it was just something he ate.  He then tried to calm down and got back into bed . He was holding my hand when suddenly his hand felt cold. I turned on the light to find his eyes rolled back and he was gasping his last breath . This was about 5:20 AM . Patient was a healthy active man."
	"1283733-1"	"1283733-1"	"PERIPHERAL COLDNESS"	"10034568"	"60-64 years"	"60-64"	"on April 2nd patient woke up at around 4:30 am and complained of pain in his back. I rubbed his back and he wondered if it was just something he ate.  He then tried to calm down and got back into bed . He was holding my hand when suddenly his hand felt cold. I turned on the light to find his eyes rolled back and he was gasping his last breath . This was about 5:20 AM . Patient was a healthy active man."
	"1285387-1"	"1285387-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"From what I understand the night of the dose she had chills and a headache. She had several bad headaches since that vaccine up until her death on April 21st.  She was given the J&J vaccine on April 8th at the CVS.  Died on April 21. at home. I just saw an article today, May 4th that about 1-2 hours from her death, another female in her 30's got the J&J vaccine on the SAME DATE April 8 and she died on APRIL 19th. Pretty close in deaths and same vaccine. IS IT CONNECTED?"
	"1285387-1"	"1285387-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"From what I understand the night of the dose she had chills and a headache. She had several bad headaches since that vaccine up until her death on April 21st.  She was given the J&J vaccine on April 8th at the CVS.  Died on April 21. at home. I just saw an article today, May 4th that about 1-2 hours from her death, another female in her 30's got the J&J vaccine on the SAME DATE April 8 and she died on APRIL 19th. Pretty close in deaths and same vaccine. IS IT CONNECTED?"
	"1285387-1"	"1285387-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"From what I understand the night of the dose she had chills and a headache. She had several bad headaches since that vaccine up until her death on April 21st.  She was given the J&J vaccine on April 8th at the CVS.  Died on April 21. at home. I just saw an article today, May 4th that about 1-2 hours from her death, another female in her 30's got the J&J vaccine on the SAME DATE April 8 and she died on APRIL 19th. Pretty close in deaths and same vaccine. IS IT CONNECTED?"
	"1285387-1"	"1285387-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"From what I understand the night of the dose she had chills and a headache. She had several bad headaches since that vaccine up until her death on April 21st.  She was given the J&J vaccine on April 8th at the CVS.  Died on April 21. at home. I just saw an article today, May 4th that about 1-2 hours from her death, another female in her 30's got the J&J vaccine on the SAME DATE April 8 and she died on APRIL 19th. Pretty close in deaths and same vaccine. IS IT CONNECTED?"
	"1285510-1"	"1285510-1"	"ANTICOAGULANT THERAPY"	"10053468"	"60-64 years"	"60-64"	"60 yo male with BMI 30 and vodka x 2-3 bottles per day. In hospital 4/9-14 for obstructive uropathy of undetermined origin. In hospital on 4/12 and got J & J there. 4/13 with no prior history developed a DVT. D/C'd on 4/14 on Eliquis. Found unresponsive 4/19. At autopsy, found pulmonary thromboemboli"
	"1285510-1"	"1285510-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"60 yo male with BMI 30 and vodka x 2-3 bottles per day. In hospital 4/9-14 for obstructive uropathy of undetermined origin. In hospital on 4/12 and got J & J there. 4/13 with no prior history developed a DVT. D/C'd on 4/14 on Eliquis. Found unresponsive 4/19. At autopsy, found pulmonary thromboemboli"
	"1285510-1"	"1285510-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"60 yo male with BMI 30 and vodka x 2-3 bottles per day. In hospital 4/9-14 for obstructive uropathy of undetermined origin. In hospital on 4/12 and got J & J there. 4/13 with no prior history developed a DVT. D/C'd on 4/14 on Eliquis. Found unresponsive 4/19. At autopsy, found pulmonary thromboemboli"
	"1285510-1"	"1285510-1"	"DEEP VEIN THROMBOSIS"	"10051055"	"60-64 years"	"60-64"	"60 yo male with BMI 30 and vodka x 2-3 bottles per day. In hospital 4/9-14 for obstructive uropathy of undetermined origin. In hospital on 4/12 and got J & J there. 4/13 with no prior history developed a DVT. D/C'd on 4/14 on Eliquis. Found unresponsive 4/19. At autopsy, found pulmonary thromboemboli"
	"1285510-1"	"1285510-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"60 yo male with BMI 30 and vodka x 2-3 bottles per day. In hospital 4/9-14 for obstructive uropathy of undetermined origin. In hospital on 4/12 and got J & J there. 4/13 with no prior history developed a DVT. D/C'd on 4/14 on Eliquis. Found unresponsive 4/19. At autopsy, found pulmonary thromboemboli"
	"1285510-1"	"1285510-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"60 yo male with BMI 30 and vodka x 2-3 bottles per day. In hospital 4/9-14 for obstructive uropathy of undetermined origin. In hospital on 4/12 and got J & J there. 4/13 with no prior history developed a DVT. D/C'd on 4/14 on Eliquis. Found unresponsive 4/19. At autopsy, found pulmonary thromboemboli"
	"1289022-1"	"1289022-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient passed away on 4/29/2021. A member of our staff noticed his name on the obituary section of our local news. We do not know of any other details."
	"1289390-1"	"1289390-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient hospitalized and died of pneumonia caused by COVID-19 after being fully vaccinated."
	"1289390-1"	"1289390-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Patient hospitalized and died of pneumonia caused by COVID-19 after being fully vaccinated."
	"1289390-1"	"1289390-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient hospitalized and died of pneumonia caused by COVID-19 after being fully vaccinated."
	"1289390-1"	"1289390-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Patient hospitalized and died of pneumonia caused by COVID-19 after being fully vaccinated."
	"1289390-1"	"1289390-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"60-64 years"	"60-64"	"Patient hospitalized and died of pneumonia caused by COVID-19 after being fully vaccinated."
	"1289460-1"	"1289460-1"	"ILLNESS"	"10080284"	"60-64 years"	"60-64"	"Only information known is what is in the obituary, Obituary states died suddenly on 5/1/21 after an illness."
	"1289460-1"	"1289460-1"	"SUDDEN DEATH"	"10042434"	"60-64 years"	"60-64"	"Only information known is what is in the obituary, Obituary states died suddenly on 5/1/21 after an illness."
	"1289866-1"	"1289866-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"On 4-15-21, patient started having breathing problems and shortness of breath.   He had a cough that he had productive phlegm.  He continued to get worse.  On 4-18-21, he fell getting out of the shower and slumped onto the floor, stating that he couldn't breathe.  His wife and neighbor took him to the local ER.  His condition improved with oxygen.  He was admitted on 4-18-21 and then was transported by Air Evac to ICU.  He was placed on the ventilator prior to leaving on 4-21-21 and transferred to hospital.  His condition continued to deteriorate and he passed away on 4-25-21."
	"1289866-1"	"1289866-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"On 4-15-21, patient started having breathing problems and shortness of breath.   He had a cough that he had productive phlegm.  He continued to get worse.  On 4-18-21, he fell getting out of the shower and slumped onto the floor, stating that he couldn't breathe.  His wife and neighbor took him to the local ER.  His condition improved with oxygen.  He was admitted on 4-18-21 and then was transported by Air Evac to ICU.  He was placed on the ventilator prior to leaving on 4-21-21 and transferred to hospital.  His condition continued to deteriorate and he passed away on 4-25-21."
	"1289866-1"	"1289866-1"	"FALL"	"10016173"	"60-64 years"	"60-64"	"On 4-15-21, patient started having breathing problems and shortness of breath.   He had a cough that he had productive phlegm.  He continued to get worse.  On 4-18-21, he fell getting out of the shower and slumped onto the floor, stating that he couldn't breathe.  His wife and neighbor took him to the local ER.  His condition improved with oxygen.  He was admitted on 4-18-21 and then was transported by Air Evac to ICU.  He was placed on the ventilator prior to leaving on 4-21-21 and transferred to hospital.  His condition continued to deteriorate and he passed away on 4-25-21."
	"1289866-1"	"1289866-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"60-64 years"	"60-64"	"On 4-15-21, patient started having breathing problems and shortness of breath.   He had a cough that he had productive phlegm.  He continued to get worse.  On 4-18-21, he fell getting out of the shower and slumped onto the floor, stating that he couldn't breathe.  His wife and neighbor took him to the local ER.  His condition improved with oxygen.  He was admitted on 4-18-21 and then was transported by Air Evac to ICU.  He was placed on the ventilator prior to leaving on 4-21-21 and transferred to hospital.  His condition continued to deteriorate and he passed away on 4-25-21."
	"1289866-1"	"1289866-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"On 4-15-21, patient started having breathing problems and shortness of breath.   He had a cough that he had productive phlegm.  He continued to get worse.  On 4-18-21, he fell getting out of the shower and slumped onto the floor, stating that he couldn't breathe.  His wife and neighbor took him to the local ER.  His condition improved with oxygen.  He was admitted on 4-18-21 and then was transported by Air Evac to ICU.  He was placed on the ventilator prior to leaving on 4-21-21 and transferred to hospital.  His condition continued to deteriorate and he passed away on 4-25-21."
	"1289866-1"	"1289866-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"On 4-15-21, patient started having breathing problems and shortness of breath.   He had a cough that he had productive phlegm.  He continued to get worse.  On 4-18-21, he fell getting out of the shower and slumped onto the floor, stating that he couldn't breathe.  His wife and neighbor took him to the local ER.  His condition improved with oxygen.  He was admitted on 4-18-21 and then was transported by Air Evac to ICU.  He was placed on the ventilator prior to leaving on 4-21-21 and transferred to hospital.  His condition continued to deteriorate and he passed away on 4-25-21."
	"1289866-1"	"1289866-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"On 4-15-21, patient started having breathing problems and shortness of breath.   He had a cough that he had productive phlegm.  He continued to get worse.  On 4-18-21, he fell getting out of the shower and slumped onto the floor, stating that he couldn't breathe.  His wife and neighbor took him to the local ER.  His condition improved with oxygen.  He was admitted on 4-18-21 and then was transported by Air Evac to ICU.  He was placed on the ventilator prior to leaving on 4-21-21 and transferred to hospital.  His condition continued to deteriorate and he passed away on 4-25-21."
	"1289866-1"	"1289866-1"	"PRODUCTIVE COUGH"	"10036790"	"60-64 years"	"60-64"	"On 4-15-21, patient started having breathing problems and shortness of breath.   He had a cough that he had productive phlegm.  He continued to get worse.  On 4-18-21, he fell getting out of the shower and slumped onto the floor, stating that he couldn't breathe.  His wife and neighbor took him to the local ER.  His condition improved with oxygen.  He was admitted on 4-18-21 and then was transported by Air Evac to ICU.  He was placed on the ventilator prior to leaving on 4-21-21 and transferred to hospital.  His condition continued to deteriorate and he passed away on 4-25-21."
	"1289866-1"	"1289866-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"On 4-15-21, patient started having breathing problems and shortness of breath.   He had a cough that he had productive phlegm.  He continued to get worse.  On 4-18-21, he fell getting out of the shower and slumped onto the floor, stating that he couldn't breathe.  His wife and neighbor took him to the local ER.  His condition improved with oxygen.  He was admitted on 4-18-21 and then was transported by Air Evac to ICU.  He was placed on the ventilator prior to leaving on 4-21-21 and transferred to hospital.  His condition continued to deteriorate and he passed away on 4-25-21."
	"1290186-1"	"1290186-1"	"AGONAL RESPIRATION"	"10085467"	"60-64 years"	"60-64"	"Vaccine was administered at 12:10pm The patient was observed for 15 minutes and sent over to her oncologist for an appointment. A CT scan was ordered- CT done (no contrast)  in the same building with daughter transporting. Daughter states mother became unresponsive after CT scan. She alerted the doctor and staff who responded. They moved her to an exam room. Noted agonal breaths on vital signs. CPR started. CPR stopped shortly after per the families request. Death pronounced at 2:34pm."
	"1290186-1"	"1290186-1"	"COMPUTERISED TOMOGRAM"	"10010234"	"60-64 years"	"60-64"	"Vaccine was administered at 12:10pm The patient was observed for 15 minutes and sent over to her oncologist for an appointment. A CT scan was ordered- CT done (no contrast)  in the same building with daughter transporting. Daughter states mother became unresponsive after CT scan. She alerted the doctor and staff who responded. They moved her to an exam room. Noted agonal breaths on vital signs. CPR started. CPR stopped shortly after per the families request. Death pronounced at 2:34pm."
	"1290186-1"	"1290186-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Vaccine was administered at 12:10pm The patient was observed for 15 minutes and sent over to her oncologist for an appointment. A CT scan was ordered- CT done (no contrast)  in the same building with daughter transporting. Daughter states mother became unresponsive after CT scan. She alerted the doctor and staff who responded. They moved her to an exam room. Noted agonal breaths on vital signs. CPR started. CPR stopped shortly after per the families request. Death pronounced at 2:34pm."
	"1290186-1"	"1290186-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Vaccine was administered at 12:10pm The patient was observed for 15 minutes and sent over to her oncologist for an appointment. A CT scan was ordered- CT done (no contrast)  in the same building with daughter transporting. Daughter states mother became unresponsive after CT scan. She alerted the doctor and staff who responded. They moved her to an exam room. Noted agonal breaths on vital signs. CPR started. CPR stopped shortly after per the families request. Death pronounced at 2:34pm."
	"1290186-1"	"1290186-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Vaccine was administered at 12:10pm The patient was observed for 15 minutes and sent over to her oncologist for an appointment. A CT scan was ordered- CT done (no contrast)  in the same building with daughter transporting. Daughter states mother became unresponsive after CT scan. She alerted the doctor and staff who responded. They moved her to an exam room. Noted agonal breaths on vital signs. CPR started. CPR stopped shortly after per the families request. Death pronounced at 2:34pm."
	"1290448-1"	"1290448-1"	"CATHETER SITE ERYTHEMA"	"10052264"	"60-64 years"	"60-64"	"5/4 : Resident with PICC line following course of IV ABX for osteomylitis. Resident was administered Jassen vaccine at 1100am. Resident had PICC line and PIV removed at aprox 1700. He was followed up by nursing staff at 2000 at which time he complained of swelling, redness, and heat to the PICC site.  On-call provider was notified and ordered transportation to Emergency Department for evaluation.  Facility was notified of passing at 0200 on 5/5"
	"1290448-1"	"1290448-1"	"CATHETER SITE SWELLING"	"10067996"	"60-64 years"	"60-64"	"5/4 : Resident with PICC line following course of IV ABX for osteomylitis. Resident was administered Jassen vaccine at 1100am. Resident had PICC line and PIV removed at aprox 1700. He was followed up by nursing staff at 2000 at which time he complained of swelling, redness, and heat to the PICC site.  On-call provider was notified and ordered transportation to Emergency Department for evaluation.  Facility was notified of passing at 0200 on 5/5"
	"1290448-1"	"1290448-1"	"CATHETER SITE WARMTH"	"10074015"	"60-64 years"	"60-64"	"5/4 : Resident with PICC line following course of IV ABX for osteomylitis. Resident was administered Jassen vaccine at 1100am. Resident had PICC line and PIV removed at aprox 1700. He was followed up by nursing staff at 2000 at which time he complained of swelling, redness, and heat to the PICC site.  On-call provider was notified and ordered transportation to Emergency Department for evaluation.  Facility was notified of passing at 0200 on 5/5"
	"1290448-1"	"1290448-1"	"CENTRAL VENOUS CATHETER REMOVAL"	"10067098"	"60-64 years"	"60-64"	"5/4 : Resident with PICC line following course of IV ABX for osteomylitis. Resident was administered Jassen vaccine at 1100am. Resident had PICC line and PIV removed at aprox 1700. He was followed up by nursing staff at 2000 at which time he complained of swelling, redness, and heat to the PICC site.  On-call provider was notified and ordered transportation to Emergency Department for evaluation.  Facility was notified of passing at 0200 on 5/5"
	"1290448-1"	"1290448-1"	"CENTRAL VENOUS CATHETERISATION"	"10053377"	"60-64 years"	"60-64"	"5/4 : Resident with PICC line following course of IV ABX for osteomylitis. Resident was administered Jassen vaccine at 1100am. Resident had PICC line and PIV removed at aprox 1700. He was followed up by nursing staff at 2000 at which time he complained of swelling, redness, and heat to the PICC site.  On-call provider was notified and ordered transportation to Emergency Department for evaluation.  Facility was notified of passing at 0200 on 5/5"
	"1290448-1"	"1290448-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"5/4 : Resident with PICC line following course of IV ABX for osteomylitis. Resident was administered Jassen vaccine at 1100am. Resident had PICC line and PIV removed at aprox 1700. He was followed up by nursing staff at 2000 at which time he complained of swelling, redness, and heat to the PICC site.  On-call provider was notified and ordered transportation to Emergency Department for evaluation.  Facility was notified of passing at 0200 on 5/5"
	"1292206-1"	"1292206-1"	"PULMONARY THROMBOSIS"	"10037437"	"60-64 years"	"60-64"	"Extreme blood clots in lungs and legs"
	"1292206-1"	"1292206-1"	"THROMBOSIS"	"10043607"	"60-64 years"	"60-64"	"Extreme blood clots in lungs and legs"
	"1293272-1"	"1293272-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"This 61 year old white female received the covid-19 vaccine on 4/21/21 and died on 5/5/21."
	"1293462-1"	"1293462-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"60-64 years"	"60-64"	"This 64 year old    male received the Covid shot on  3/29/21 and went to the ED on 3/29/21 and was admitted for left-sided nontraumatic intracerebral hemorrhage and died on  5/4/21.  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."
	"1293462-1"	"1293462-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"This 64 year old    male received the Covid shot on  3/29/21 and went to the ED on 3/29/21 and was admitted for left-sided nontraumatic intracerebral hemorrhage and died on  5/4/21.  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."
	"1293530-1"	"1293530-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death"
	"1296384-1"	"1296384-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Client admitted to the hospital on 4/26/2021 with Covid symptoms, body aches, SOB and chest pain. Diagnosed with Covid -19 pneumonia. Antigen test positive for Covid-19 on 4/26/2021.  Subsequent admission on 5/4/2021 with cardiac arrest secondary to hypovolemic shock from UGI bleed, likely variceal. Client died 5/5/2021."
	"1296384-1"	"1296384-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"Client admitted to the hospital on 4/26/2021 with Covid symptoms, body aches, SOB and chest pain. Diagnosed with Covid -19 pneumonia. Antigen test positive for Covid-19 on 4/26/2021.  Subsequent admission on 5/4/2021 with cardiac arrest secondary to hypovolemic shock from UGI bleed, likely variceal. Client died 5/5/2021."
	"1296384-1"	"1296384-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Client admitted to the hospital on 4/26/2021 with Covid symptoms, body aches, SOB and chest pain. Diagnosed with Covid -19 pneumonia. Antigen test positive for Covid-19 on 4/26/2021.  Subsequent admission on 5/4/2021 with cardiac arrest secondary to hypovolemic shock from UGI bleed, likely variceal. Client died 5/5/2021."
	"1296384-1"	"1296384-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Client admitted to the hospital on 4/26/2021 with Covid symptoms, body aches, SOB and chest pain. Diagnosed with Covid -19 pneumonia. Antigen test positive for Covid-19 on 4/26/2021.  Subsequent admission on 5/4/2021 with cardiac arrest secondary to hypovolemic shock from UGI bleed, likely variceal. Client died 5/5/2021."
	"1296384-1"	"1296384-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Client admitted to the hospital on 4/26/2021 with Covid symptoms, body aches, SOB and chest pain. Diagnosed with Covid -19 pneumonia. Antigen test positive for Covid-19 on 4/26/2021.  Subsequent admission on 5/4/2021 with cardiac arrest secondary to hypovolemic shock from UGI bleed, likely variceal. Client died 5/5/2021."
	"1296384-1"	"1296384-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Client admitted to the hospital on 4/26/2021 with Covid symptoms, body aches, SOB and chest pain. Diagnosed with Covid -19 pneumonia. Antigen test positive for Covid-19 on 4/26/2021.  Subsequent admission on 5/4/2021 with cardiac arrest secondary to hypovolemic shock from UGI bleed, likely variceal. Client died 5/5/2021."
	"1296384-1"	"1296384-1"	"HYPOVOLAEMIC SHOCK"	"10021138"	"60-64 years"	"60-64"	"Client admitted to the hospital on 4/26/2021 with Covid symptoms, body aches, SOB and chest pain. Diagnosed with Covid -19 pneumonia. Antigen test positive for Covid-19 on 4/26/2021.  Subsequent admission on 5/4/2021 with cardiac arrest secondary to hypovolemic shock from UGI bleed, likely variceal. Client died 5/5/2021."
	"1296384-1"	"1296384-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"Client admitted to the hospital on 4/26/2021 with Covid symptoms, body aches, SOB and chest pain. Diagnosed with Covid -19 pneumonia. Antigen test positive for Covid-19 on 4/26/2021.  Subsequent admission on 5/4/2021 with cardiac arrest secondary to hypovolemic shock from UGI bleed, likely variceal. Client died 5/5/2021."
	"1296384-1"	"1296384-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Client admitted to the hospital on 4/26/2021 with Covid symptoms, body aches, SOB and chest pain. Diagnosed with Covid -19 pneumonia. Antigen test positive for Covid-19 on 4/26/2021.  Subsequent admission on 5/4/2021 with cardiac arrest secondary to hypovolemic shock from UGI bleed, likely variceal. Client died 5/5/2021."
	"1296384-1"	"1296384-1"	"UPPER GASTROINTESTINAL HAEMORRHAGE"	"10046274"	"60-64 years"	"60-64"	"Client admitted to the hospital on 4/26/2021 with Covid symptoms, body aches, SOB and chest pain. Diagnosed with Covid -19 pneumonia. Antigen test positive for Covid-19 on 4/26/2021.  Subsequent admission on 5/4/2021 with cardiac arrest secondary to hypovolemic shock from UGI bleed, likely variceal. Client died 5/5/2021."
	"1296477-1"	"1296477-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Case had COVID-19 in November 2020 as part of an outbreak in the SNF she lives in. She recovered then received her first COVID-19 vaccination on 1/4/21. She received her 2nd dose of Moderna on 2/1/21. On 4/11/21 she became ill and was transferred to the hospital where she tested PCR positive for COVID-19. She continued to decline and was intubated. She died on 4/28/21 while still in the hospital. The diagnosis on her death summary from the hospital is COVID-19 pneumonia."
	"1296477-1"	"1296477-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Case had COVID-19 in November 2020 as part of an outbreak in the SNF she lives in. She recovered then received her first COVID-19 vaccination on 1/4/21. She received her 2nd dose of Moderna on 2/1/21. On 4/11/21 she became ill and was transferred to the hospital where she tested PCR positive for COVID-19. She continued to decline and was intubated. She died on 4/28/21 while still in the hospital. The diagnosis on her death summary from the hospital is COVID-19 pneumonia."
	"1296477-1"	"1296477-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Case had COVID-19 in November 2020 as part of an outbreak in the SNF she lives in. She recovered then received her first COVID-19 vaccination on 1/4/21. She received her 2nd dose of Moderna on 2/1/21. On 4/11/21 she became ill and was transferred to the hospital where she tested PCR positive for COVID-19. She continued to decline and was intubated. She died on 4/28/21 while still in the hospital. The diagnosis on her death summary from the hospital is COVID-19 pneumonia."
	"1296477-1"	"1296477-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Case had COVID-19 in November 2020 as part of an outbreak in the SNF she lives in. She recovered then received her first COVID-19 vaccination on 1/4/21. She received her 2nd dose of Moderna on 2/1/21. On 4/11/21 she became ill and was transferred to the hospital where she tested PCR positive for COVID-19. She continued to decline and was intubated. She died on 4/28/21 while still in the hospital. The diagnosis on her death summary from the hospital is COVID-19 pneumonia."
	"1296477-1"	"1296477-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"60-64 years"	"60-64"	"Case had COVID-19 in November 2020 as part of an outbreak in the SNF she lives in. She recovered then received her first COVID-19 vaccination on 1/4/21. She received her 2nd dose of Moderna on 2/1/21. On 4/11/21 she became ill and was transferred to the hospital where she tested PCR positive for COVID-19. She continued to decline and was intubated. She died on 4/28/21 while still in the hospital. The diagnosis on her death summary from the hospital is COVID-19 pneumonia."
	"1296477-1"	"1296477-1"	"ILLNESS"	"10080284"	"60-64 years"	"60-64"	"Case had COVID-19 in November 2020 as part of an outbreak in the SNF she lives in. She recovered then received her first COVID-19 vaccination on 1/4/21. She received her 2nd dose of Moderna on 2/1/21. On 4/11/21 she became ill and was transferred to the hospital where she tested PCR positive for COVID-19. She continued to decline and was intubated. She died on 4/28/21 while still in the hospital. The diagnosis on her death summary from the hospital is COVID-19 pneumonia."
	"1296477-1"	"1296477-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Case had COVID-19 in November 2020 as part of an outbreak in the SNF she lives in. She recovered then received her first COVID-19 vaccination on 1/4/21. She received her 2nd dose of Moderna on 2/1/21. On 4/11/21 she became ill and was transferred to the hospital where she tested PCR positive for COVID-19. She continued to decline and was intubated. She died on 4/28/21 while still in the hospital. The diagnosis on her death summary from the hospital is COVID-19 pneumonia."
	"1296678-1"	"1296678-1"	"BALANCE DISORDER"	"10049848"	"60-64 years"	"60-64"	"April 8, 2021- Vaccinated with the Johnson and Johnson vaccine.  April 10, 2021 ? Fever, strong headache, unable to hold on, diarrheas, respiratory difficulty.  April 14, 2021-  She lost her balance and fall, hitting her face.  Had a CT scan and no mass nor bleeding was found, only sinus. Discharged home. SARS-CoV-2 test ? Negative results  April 18, 2021- Found dead in her sofa.  No thromboembolism nor bleeding"
	"1296678-1"	"1296678-1"	"COMPUTERISED TOMOGRAM HEAD NORMAL"	"10072167"	"60-64 years"	"60-64"	"April 8, 2021- Vaccinated with the Johnson and Johnson vaccine.  April 10, 2021 ? Fever, strong headache, unable to hold on, diarrheas, respiratory difficulty.  April 14, 2021-  She lost her balance and fall, hitting her face.  Had a CT scan and no mass nor bleeding was found, only sinus. Discharged home. SARS-CoV-2 test ? Negative results  April 18, 2021- Found dead in her sofa.  No thromboembolism nor bleeding"
	"1296678-1"	"1296678-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"April 8, 2021- Vaccinated with the Johnson and Johnson vaccine.  April 10, 2021 ? Fever, strong headache, unable to hold on, diarrheas, respiratory difficulty.  April 14, 2021-  She lost her balance and fall, hitting her face.  Had a CT scan and no mass nor bleeding was found, only sinus. Discharged home. SARS-CoV-2 test ? Negative results  April 18, 2021- Found dead in her sofa.  No thromboembolism nor bleeding"
	"1296678-1"	"1296678-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"April 8, 2021- Vaccinated with the Johnson and Johnson vaccine.  April 10, 2021 ? Fever, strong headache, unable to hold on, diarrheas, respiratory difficulty.  April 14, 2021-  She lost her balance and fall, hitting her face.  Had a CT scan and no mass nor bleeding was found, only sinus. Discharged home. SARS-CoV-2 test ? Negative results  April 18, 2021- Found dead in her sofa.  No thromboembolism nor bleeding"
	"1296678-1"	"1296678-1"	"FACE INJURY"	"10050392"	"60-64 years"	"60-64"	"April 8, 2021- Vaccinated with the Johnson and Johnson vaccine.  April 10, 2021 ? Fever, strong headache, unable to hold on, diarrheas, respiratory difficulty.  April 14, 2021-  She lost her balance and fall, hitting her face.  Had a CT scan and no mass nor bleeding was found, only sinus. Discharged home. SARS-CoV-2 test ? Negative results  April 18, 2021- Found dead in her sofa.  No thromboembolism nor bleeding"
	"1296678-1"	"1296678-1"	"FALL"	"10016173"	"60-64 years"	"60-64"	"April 8, 2021- Vaccinated with the Johnson and Johnson vaccine.  April 10, 2021 ? Fever, strong headache, unable to hold on, diarrheas, respiratory difficulty.  April 14, 2021-  She lost her balance and fall, hitting her face.  Had a CT scan and no mass nor bleeding was found, only sinus. Discharged home. SARS-CoV-2 test ? Negative results  April 18, 2021- Found dead in her sofa.  No thromboembolism nor bleeding"
	"1296678-1"	"1296678-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"April 8, 2021- Vaccinated with the Johnson and Johnson vaccine.  April 10, 2021 ? Fever, strong headache, unable to hold on, diarrheas, respiratory difficulty.  April 14, 2021-  She lost her balance and fall, hitting her face.  Had a CT scan and no mass nor bleeding was found, only sinus. Discharged home. SARS-CoV-2 test ? Negative results  April 18, 2021- Found dead in her sofa.  No thromboembolism nor bleeding"
	"1296678-1"	"1296678-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"April 8, 2021- Vaccinated with the Johnson and Johnson vaccine.  April 10, 2021 ? Fever, strong headache, unable to hold on, diarrheas, respiratory difficulty.  April 14, 2021-  She lost her balance and fall, hitting her face.  Had a CT scan and no mass nor bleeding was found, only sinus. Discharged home. SARS-CoV-2 test ? Negative results  April 18, 2021- Found dead in her sofa.  No thromboembolism nor bleeding"
	"1296678-1"	"1296678-1"	"RESPIRATORY DISORDER"	"10038683"	"60-64 years"	"60-64"	"April 8, 2021- Vaccinated with the Johnson and Johnson vaccine.  April 10, 2021 ? Fever, strong headache, unable to hold on, diarrheas, respiratory difficulty.  April 14, 2021-  She lost her balance and fall, hitting her face.  Had a CT scan and no mass nor bleeding was found, only sinus. Discharged home. SARS-CoV-2 test ? Negative results  April 18, 2021- Found dead in her sofa.  No thromboembolism nor bleeding"
	"1296678-1"	"1296678-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	"April 8, 2021- Vaccinated with the Johnson and Johnson vaccine.  April 10, 2021 ? Fever, strong headache, unable to hold on, diarrheas, respiratory difficulty.  April 14, 2021-  She lost her balance and fall, hitting her face.  Had a CT scan and no mass nor bleeding was found, only sinus. Discharged home. SARS-CoV-2 test ? Negative results  April 18, 2021- Found dead in her sofa.  No thromboembolism nor bleeding"
	"1296678-1"	"1296678-1"	"SINUS DISORDER"	"10062244"	"60-64 years"	"60-64"	"April 8, 2021- Vaccinated with the Johnson and Johnson vaccine.  April 10, 2021 ? Fever, strong headache, unable to hold on, diarrheas, respiratory difficulty.  April 14, 2021-  She lost her balance and fall, hitting her face.  Had a CT scan and no mass nor bleeding was found, only sinus. Discharged home. SARS-CoV-2 test ? Negative results  April 18, 2021- Found dead in her sofa.  No thromboembolism nor bleeding"
	"1301096-1"	"1301096-1"	"ANTICOAGULANT THERAPY"	"10053468"	"60-64 years"	"60-64"	"32 hours after the vaccine, he suffered a massive heart attack due to a blood clot and a massive clot in the right arm. He went to the hospital and under went surgery at 12 am on Saturday. The coronary surgeon mentioned that this was not from heart disease as all vessels were clear. Rather, this was due to an embolism due to an unknown origin. A further work up concluded that he also had blood clots throughout his body (both lungs, one kidney, heart, liver, legs, arms, and possibly brain). By 12 p.m. we were asked back to the hospital as he was worsening. Treatment options included a heparin drip, which caused a brain hemorrhage. He was just at the doctors two times this week, on Tuesday and Wednesday and was fine no issues found. They went through with the 2nd dose and came to our home on Thursday."
	"1301096-1"	"1301096-1"	"BLOOD LACTIC ACID"	"10005632"	"60-64 years"	"60-64"	"32 hours after the vaccine, he suffered a massive heart attack due to a blood clot and a massive clot in the right arm. He went to the hospital and under went surgery at 12 am on Saturday. The coronary surgeon mentioned that this was not from heart disease as all vessels were clear. Rather, this was due to an embolism due to an unknown origin. A further work up concluded that he also had blood clots throughout his body (both lungs, one kidney, heart, liver, legs, arms, and possibly brain). By 12 p.m. we were asked back to the hospital as he was worsening. Treatment options included a heparin drip, which caused a brain hemorrhage. He was just at the doctors two times this week, on Tuesday and Wednesday and was fine no issues found. They went through with the 2nd dose and came to our home on Thursday."
	"1301096-1"	"1301096-1"	"CARDIAC OPERATION"	"10061026"	"60-64 years"	"60-64"	"32 hours after the vaccine, he suffered a massive heart attack due to a blood clot and a massive clot in the right arm. He went to the hospital and under went surgery at 12 am on Saturday. The coronary surgeon mentioned that this was not from heart disease as all vessels were clear. Rather, this was due to an embolism due to an unknown origin. A further work up concluded that he also had blood clots throughout his body (both lungs, one kidney, heart, liver, legs, arms, and possibly brain). By 12 p.m. we were asked back to the hospital as he was worsening. Treatment options included a heparin drip, which caused a brain hemorrhage. He was just at the doctors two times this week, on Tuesday and Wednesday and was fine no issues found. They went through with the 2nd dose and came to our home on Thursday."
	"1301096-1"	"1301096-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"60-64 years"	"60-64"	"32 hours after the vaccine, he suffered a massive heart attack due to a blood clot and a massive clot in the right arm. He went to the hospital and under went surgery at 12 am on Saturday. The coronary surgeon mentioned that this was not from heart disease as all vessels were clear. Rather, this was due to an embolism due to an unknown origin. A further work up concluded that he also had blood clots throughout his body (both lungs, one kidney, heart, liver, legs, arms, and possibly brain). By 12 p.m. we were asked back to the hospital as he was worsening. Treatment options included a heparin drip, which caused a brain hemorrhage. He was just at the doctors two times this week, on Tuesday and Wednesday and was fine no issues found. They went through with the 2nd dose and came to our home on Thursday."
	"1301096-1"	"1301096-1"	"COMPUTERISED TOMOGRAM ABNORMAL"	"10010235"	"60-64 years"	"60-64"	"32 hours after the vaccine, he suffered a massive heart attack due to a blood clot and a massive clot in the right arm. He went to the hospital and under went surgery at 12 am on Saturday. The coronary surgeon mentioned that this was not from heart disease as all vessels were clear. Rather, this was due to an embolism due to an unknown origin. A further work up concluded that he also had blood clots throughout his body (both lungs, one kidney, heart, liver, legs, arms, and possibly brain). By 12 p.m. we were asked back to the hospital as he was worsening. Treatment options included a heparin drip, which caused a brain hemorrhage. He was just at the doctors two times this week, on Tuesday and Wednesday and was fine no issues found. They went through with the 2nd dose and came to our home on Thursday."
	"1301096-1"	"1301096-1"	"CORONARY ARTERY EMBOLISM"	"10011084"	"60-64 years"	"60-64"	"32 hours after the vaccine, he suffered a massive heart attack due to a blood clot and a massive clot in the right arm. He went to the hospital and under went surgery at 12 am on Saturday. The coronary surgeon mentioned that this was not from heart disease as all vessels were clear. Rather, this was due to an embolism due to an unknown origin. A further work up concluded that he also had blood clots throughout his body (both lungs, one kidney, heart, liver, legs, arms, and possibly brain). By 12 p.m. we were asked back to the hospital as he was worsening. Treatment options included a heparin drip, which caused a brain hemorrhage. He was just at the doctors two times this week, on Tuesday and Wednesday and was fine no issues found. They went through with the 2nd dose and came to our home on Thursday."
	"1301096-1"	"1301096-1"	"HEPATIC VASCULAR THROMBOSIS"	"10074494"	"60-64 years"	"60-64"	"32 hours after the vaccine, he suffered a massive heart attack due to a blood clot and a massive clot in the right arm. He went to the hospital and under went surgery at 12 am on Saturday. The coronary surgeon mentioned that this was not from heart disease as all vessels were clear. Rather, this was due to an embolism due to an unknown origin. A further work up concluded that he also had blood clots throughout his body (both lungs, one kidney, heart, liver, legs, arms, and possibly brain). By 12 p.m. we were asked back to the hospital as he was worsening. Treatment options included a heparin drip, which caused a brain hemorrhage. He was just at the doctors two times this week, on Tuesday and Wednesday and was fine no issues found. They went through with the 2nd dose and came to our home on Thursday."
	"1301096-1"	"1301096-1"	"INTRACARDIAC THROMBUS"	"10048620"	"60-64 years"	"60-64"	"32 hours after the vaccine, he suffered a massive heart attack due to a blood clot and a massive clot in the right arm. He went to the hospital and under went surgery at 12 am on Saturday. The coronary surgeon mentioned that this was not from heart disease as all vessels were clear. Rather, this was due to an embolism due to an unknown origin. A further work up concluded that he also had blood clots throughout his body (both lungs, one kidney, heart, liver, legs, arms, and possibly brain). By 12 p.m. we were asked back to the hospital as he was worsening. Treatment options included a heparin drip, which caused a brain hemorrhage. He was just at the doctors two times this week, on Tuesday and Wednesday and was fine no issues found. They went through with the 2nd dose and came to our home on Thursday."
	"1301096-1"	"1301096-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"32 hours after the vaccine, he suffered a massive heart attack due to a blood clot and a massive clot in the right arm. He went to the hospital and under went surgery at 12 am on Saturday. The coronary surgeon mentioned that this was not from heart disease as all vessels were clear. Rather, this was due to an embolism due to an unknown origin. A further work up concluded that he also had blood clots throughout his body (both lungs, one kidney, heart, liver, legs, arms, and possibly brain). By 12 p.m. we were asked back to the hospital as he was worsening. Treatment options included a heparin drip, which caused a brain hemorrhage. He was just at the doctors two times this week, on Tuesday and Wednesday and was fine no issues found. They went through with the 2nd dose and came to our home on Thursday."
	"1301096-1"	"1301096-1"	"PULMONARY THROMBOSIS"	"10037437"	"60-64 years"	"60-64"	"32 hours after the vaccine, he suffered a massive heart attack due to a blood clot and a massive clot in the right arm. He went to the hospital and under went surgery at 12 am on Saturday. The coronary surgeon mentioned that this was not from heart disease as all vessels were clear. Rather, this was due to an embolism due to an unknown origin. A further work up concluded that he also had blood clots throughout his body (both lungs, one kidney, heart, liver, legs, arms, and possibly brain). By 12 p.m. we were asked back to the hospital as he was worsening. Treatment options included a heparin drip, which caused a brain hemorrhage. He was just at the doctors two times this week, on Tuesday and Wednesday and was fine no issues found. They went through with the 2nd dose and came to our home on Thursday."
	"1301096-1"	"1301096-1"	"RENAL VASCULAR THROMBOSIS"	"10072226"	"60-64 years"	"60-64"	"32 hours after the vaccine, he suffered a massive heart attack due to a blood clot and a massive clot in the right arm. He went to the hospital and under went surgery at 12 am on Saturday. The coronary surgeon mentioned that this was not from heart disease as all vessels were clear. Rather, this was due to an embolism due to an unknown origin. A further work up concluded that he also had blood clots throughout his body (both lungs, one kidney, heart, liver, legs, arms, and possibly brain). By 12 p.m. we were asked back to the hospital as he was worsening. Treatment options included a heparin drip, which caused a brain hemorrhage. He was just at the doctors two times this week, on Tuesday and Wednesday and was fine no issues found. They went through with the 2nd dose and came to our home on Thursday."
	"1301096-1"	"1301096-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	"32 hours after the vaccine, he suffered a massive heart attack due to a blood clot and a massive clot in the right arm. He went to the hospital and under went surgery at 12 am on Saturday. The coronary surgeon mentioned that this was not from heart disease as all vessels were clear. Rather, this was due to an embolism due to an unknown origin. A further work up concluded that he also had blood clots throughout his body (both lungs, one kidney, heart, liver, legs, arms, and possibly brain). By 12 p.m. we were asked back to the hospital as he was worsening. Treatment options included a heparin drip, which caused a brain hemorrhage. He was just at the doctors two times this week, on Tuesday and Wednesday and was fine no issues found. They went through with the 2nd dose and came to our home on Thursday."
	"1301096-1"	"1301096-1"	"THROMBOSIS"	"10043607"	"60-64 years"	"60-64"	"32 hours after the vaccine, he suffered a massive heart attack due to a blood clot and a massive clot in the right arm. He went to the hospital and under went surgery at 12 am on Saturday. The coronary surgeon mentioned that this was not from heart disease as all vessels were clear. Rather, this was due to an embolism due to an unknown origin. A further work up concluded that he also had blood clots throughout his body (both lungs, one kidney, heart, liver, legs, arms, and possibly brain). By 12 p.m. we were asked back to the hospital as he was worsening. Treatment options included a heparin drip, which caused a brain hemorrhage. He was just at the doctors two times this week, on Tuesday and Wednesday and was fine no issues found. They went through with the 2nd dose and came to our home on Thursday."
	"1301797-1"	"1301797-1"	"ABDOMINAL PAIN UPPER"	"10000087"	"60-64 years"	"60-64"	"Renal failure; Liver failure; Unresponsive; Died; Stomach pain; Nausea; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of UNRESPONSIVE TO STIMULI (Unresponsive), DEATH (Died), RENAL FAILURE (Renal failure) and HEPATIC FAILURE (Liver failure) in a 62-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.     Concurrent medical conditions included Primary biliary cirrhosis.    On 07-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Apr-2021, the patient experienced ABDOMINAL PAIN UPPER (Stomach pain) and NAUSEA (Nausea). On 08-Apr-2021, the patient experienced UNRESPONSIVE TO STIMULI (Unresponsive) (seriousness criterion hospitalization). On 23-Apr-2021, the patient experienced DEATH (Died) (seriousness criterion death), RENAL FAILURE (Renal failure) (seriousness criterion hospitalization) and HEPATIC FAILURE (Liver failure) (seriousness criterion hospitalization). On 23-Apr-2021, RENAL FAILURE (Renal failure) and HEPATIC FAILURE (Liver failure) had resolved and NAUSEA (Nausea) outcome was unknown. The patient died on 23-Apr-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, UNRESPONSIVE TO STIMULI (Unresponsive) and ABDOMINAL PAIN UPPER (Stomach pain) outcome was unknown.            The concomitant medication included liver medications, as reported by the reporter. On 07Apr2021 around 1230pm, the patient experienced stomach pain and nausea which the family attributed to her liver medications. The patient went to sleep later that evening. The next day, 08Apr2021, the patient was found to be sleeping around 8am but was unresponsive around 1:30pm. She was taken by ambulance to the local hospital. The patient was eventually placed on life support and passed on 23Apr2021.  No other treatment medication were reported.  Company comment: Very limited information regarding this events has been provided at this time.  However, based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.  Further information has been requested.; Sender's Comments: Very limited information regarding this events has been provided at this time.  However, based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.  Further information has been requested.; Reported Cause(s) of Death: unkown cause of death"
	"1301797-1"	"1301797-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Renal failure; Liver failure; Unresponsive; Died; Stomach pain; Nausea; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of UNRESPONSIVE TO STIMULI (Unresponsive), DEATH (Died), RENAL FAILURE (Renal failure) and HEPATIC FAILURE (Liver failure) in a 62-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.     Concurrent medical conditions included Primary biliary cirrhosis.    On 07-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Apr-2021, the patient experienced ABDOMINAL PAIN UPPER (Stomach pain) and NAUSEA (Nausea). On 08-Apr-2021, the patient experienced UNRESPONSIVE TO STIMULI (Unresponsive) (seriousness criterion hospitalization). On 23-Apr-2021, the patient experienced DEATH (Died) (seriousness criterion death), RENAL FAILURE (Renal failure) (seriousness criterion hospitalization) and HEPATIC FAILURE (Liver failure) (seriousness criterion hospitalization). On 23-Apr-2021, RENAL FAILURE (Renal failure) and HEPATIC FAILURE (Liver failure) had resolved and NAUSEA (Nausea) outcome was unknown. The patient died on 23-Apr-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, UNRESPONSIVE TO STIMULI (Unresponsive) and ABDOMINAL PAIN UPPER (Stomach pain) outcome was unknown.            The concomitant medication included liver medications, as reported by the reporter. On 07Apr2021 around 1230pm, the patient experienced stomach pain and nausea which the family attributed to her liver medications. The patient went to sleep later that evening. The next day, 08Apr2021, the patient was found to be sleeping around 8am but was unresponsive around 1:30pm. She was taken by ambulance to the local hospital. The patient was eventually placed on life support and passed on 23Apr2021.  No other treatment medication were reported.  Company comment: Very limited information regarding this events has been provided at this time.  However, based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.  Further information has been requested.; Sender's Comments: Very limited information regarding this events has been provided at this time.  However, based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.  Further information has been requested.; Reported Cause(s) of Death: unkown cause of death"
	"1301797-1"	"1301797-1"	"HEPATIC FAILURE"	"10019663"	"60-64 years"	"60-64"	"Renal failure; Liver failure; Unresponsive; Died; Stomach pain; Nausea; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of UNRESPONSIVE TO STIMULI (Unresponsive), DEATH (Died), RENAL FAILURE (Renal failure) and HEPATIC FAILURE (Liver failure) in a 62-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.     Concurrent medical conditions included Primary biliary cirrhosis.    On 07-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Apr-2021, the patient experienced ABDOMINAL PAIN UPPER (Stomach pain) and NAUSEA (Nausea). On 08-Apr-2021, the patient experienced UNRESPONSIVE TO STIMULI (Unresponsive) (seriousness criterion hospitalization). On 23-Apr-2021, the patient experienced DEATH (Died) (seriousness criterion death), RENAL FAILURE (Renal failure) (seriousness criterion hospitalization) and HEPATIC FAILURE (Liver failure) (seriousness criterion hospitalization). On 23-Apr-2021, RENAL FAILURE (Renal failure) and HEPATIC FAILURE (Liver failure) had resolved and NAUSEA (Nausea) outcome was unknown. The patient died on 23-Apr-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, UNRESPONSIVE TO STIMULI (Unresponsive) and ABDOMINAL PAIN UPPER (Stomach pain) outcome was unknown.            The concomitant medication included liver medications, as reported by the reporter. On 07Apr2021 around 1230pm, the patient experienced stomach pain and nausea which the family attributed to her liver medications. The patient went to sleep later that evening. The next day, 08Apr2021, the patient was found to be sleeping around 8am but was unresponsive around 1:30pm. She was taken by ambulance to the local hospital. The patient was eventually placed on life support and passed on 23Apr2021.  No other treatment medication were reported.  Company comment: Very limited information regarding this events has been provided at this time.  However, based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.  Further information has been requested.; Sender's Comments: Very limited information regarding this events has been provided at this time.  However, based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.  Further information has been requested.; Reported Cause(s) of Death: unkown cause of death"
	"1301797-1"	"1301797-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Renal failure; Liver failure; Unresponsive; Died; Stomach pain; Nausea; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of UNRESPONSIVE TO STIMULI (Unresponsive), DEATH (Died), RENAL FAILURE (Renal failure) and HEPATIC FAILURE (Liver failure) in a 62-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.     Concurrent medical conditions included Primary biliary cirrhosis.    On 07-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Apr-2021, the patient experienced ABDOMINAL PAIN UPPER (Stomach pain) and NAUSEA (Nausea). On 08-Apr-2021, the patient experienced UNRESPONSIVE TO STIMULI (Unresponsive) (seriousness criterion hospitalization). On 23-Apr-2021, the patient experienced DEATH (Died) (seriousness criterion death), RENAL FAILURE (Renal failure) (seriousness criterion hospitalization) and HEPATIC FAILURE (Liver failure) (seriousness criterion hospitalization). On 23-Apr-2021, RENAL FAILURE (Renal failure) and HEPATIC FAILURE (Liver failure) had resolved and NAUSEA (Nausea) outcome was unknown. The patient died on 23-Apr-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, UNRESPONSIVE TO STIMULI (Unresponsive) and ABDOMINAL PAIN UPPER (Stomach pain) outcome was unknown.            The concomitant medication included liver medications, as reported by the reporter. On 07Apr2021 around 1230pm, the patient experienced stomach pain and nausea which the family attributed to her liver medications. The patient went to sleep later that evening. The next day, 08Apr2021, the patient was found to be sleeping around 8am but was unresponsive around 1:30pm. She was taken by ambulance to the local hospital. The patient was eventually placed on life support and passed on 23Apr2021.  No other treatment medication were reported.  Company comment: Very limited information regarding this events has been provided at this time.  However, based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.  Further information has been requested.; Sender's Comments: Very limited information regarding this events has been provided at this time.  However, based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.  Further information has been requested.; Reported Cause(s) of Death: unkown cause of death"
	"1301797-1"	"1301797-1"	"RENAL FAILURE"	"10038435"	"60-64 years"	"60-64"	"Renal failure; Liver failure; Unresponsive; Died; Stomach pain; Nausea; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of UNRESPONSIVE TO STIMULI (Unresponsive), DEATH (Died), RENAL FAILURE (Renal failure) and HEPATIC FAILURE (Liver failure) in a 62-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.     Concurrent medical conditions included Primary biliary cirrhosis.    On 07-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Apr-2021, the patient experienced ABDOMINAL PAIN UPPER (Stomach pain) and NAUSEA (Nausea). On 08-Apr-2021, the patient experienced UNRESPONSIVE TO STIMULI (Unresponsive) (seriousness criterion hospitalization). On 23-Apr-2021, the patient experienced DEATH (Died) (seriousness criterion death), RENAL FAILURE (Renal failure) (seriousness criterion hospitalization) and HEPATIC FAILURE (Liver failure) (seriousness criterion hospitalization). On 23-Apr-2021, RENAL FAILURE (Renal failure) and HEPATIC FAILURE (Liver failure) had resolved and NAUSEA (Nausea) outcome was unknown. The patient died on 23-Apr-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, UNRESPONSIVE TO STIMULI (Unresponsive) and ABDOMINAL PAIN UPPER (Stomach pain) outcome was unknown.            The concomitant medication included liver medications, as reported by the reporter. On 07Apr2021 around 1230pm, the patient experienced stomach pain and nausea which the family attributed to her liver medications. The patient went to sleep later that evening. The next day, 08Apr2021, the patient was found to be sleeping around 8am but was unresponsive around 1:30pm. She was taken by ambulance to the local hospital. The patient was eventually placed on life support and passed on 23Apr2021.  No other treatment medication were reported.  Company comment: Very limited information regarding this events has been provided at this time.  However, based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.  Further information has been requested.; Sender's Comments: Very limited information regarding this events has been provided at this time.  However, based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.  Further information has been requested.; Reported Cause(s) of Death: unkown cause of death"
	"1301797-1"	"1301797-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Renal failure; Liver failure; Unresponsive; Died; Stomach pain; Nausea; This spontaneous case was reported by a consumer (subsequently medically confirmed) and describes the occurrence of UNRESPONSIVE TO STIMULI (Unresponsive), DEATH (Died), RENAL FAILURE (Renal failure) and HEPATIC FAILURE (Liver failure) in a 62-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.     Concurrent medical conditions included Primary biliary cirrhosis.    On 07-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 07-Apr-2021, the patient experienced ABDOMINAL PAIN UPPER (Stomach pain) and NAUSEA (Nausea). On 08-Apr-2021, the patient experienced UNRESPONSIVE TO STIMULI (Unresponsive) (seriousness criterion hospitalization). On 23-Apr-2021, the patient experienced DEATH (Died) (seriousness criterion death), RENAL FAILURE (Renal failure) (seriousness criterion hospitalization) and HEPATIC FAILURE (Liver failure) (seriousness criterion hospitalization). On 23-Apr-2021, RENAL FAILURE (Renal failure) and HEPATIC FAILURE (Liver failure) had resolved and NAUSEA (Nausea) outcome was unknown. The patient died on 23-Apr-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, UNRESPONSIVE TO STIMULI (Unresponsive) and ABDOMINAL PAIN UPPER (Stomach pain) outcome was unknown.            The concomitant medication included liver medications, as reported by the reporter. On 07Apr2021 around 1230pm, the patient experienced stomach pain and nausea which the family attributed to her liver medications. The patient went to sleep later that evening. The next day, 08Apr2021, the patient was found to be sleeping around 8am but was unresponsive around 1:30pm. She was taken by ambulance to the local hospital. The patient was eventually placed on life support and passed on 23Apr2021.  No other treatment medication were reported.  Company comment: Very limited information regarding this events has been provided at this time.  However, based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.  Further information has been requested.; Sender's Comments: Very limited information regarding this events has been provided at this time.  However, based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.  Further information has been requested.; Reported Cause(s) of Death: unkown cause of death"
	"1302239-1"	"1302239-1"	"ATRIAL FIBRILLATION"	"10003658"	"60-64 years"	"60-64"	"Patient developed paroxysmal atrial fibrillation. Upon date of death- pt husband reported SOB, incontinence, gasping for air, slumped forward and died upon 911 arrival."
	"1302239-1"	"1302239-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient developed paroxysmal atrial fibrillation. Upon date of death- pt husband reported SOB, incontinence, gasping for air, slumped forward and died upon 911 arrival."
	"1302239-1"	"1302239-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Patient developed paroxysmal atrial fibrillation. Upon date of death- pt husband reported SOB, incontinence, gasping for air, slumped forward and died upon 911 arrival."
	"1302239-1"	"1302239-1"	"INCONTINENCE"	"10021639"	"60-64 years"	"60-64"	"Patient developed paroxysmal atrial fibrillation. Upon date of death- pt husband reported SOB, incontinence, gasping for air, slumped forward and died upon 911 arrival."
	"1302239-1"	"1302239-1"	"POSTURE ABNORMAL"	"10036436"	"60-64 years"	"60-64"	"Patient developed paroxysmal atrial fibrillation. Upon date of death- pt husband reported SOB, incontinence, gasping for air, slumped forward and died upon 911 arrival."
	"1302490-1"	"1302490-1"	"BACK PAIN"	"10003988"	"60-64 years"	"60-64"	""On 4/26/21 The patient presents to our clinic with concerns for back pain, fever, shortness of breath, fatigue and coughing. We performed a covid19 antigen test which resulted positive. Based on this and his history and examination we recommended he go straight to the hospital for further evaluation and treatment. He was admitted to  medical center where a PCR was performed and confirmed positive. He was discharged on 4/29. Per his wife, they felt he was discharged too soon and he went to another hospital. He passed away 5/10/2021.  This report is being made in regards to the claim by the CDC that ""no one that has been infected with covid19 4 weeks after having the janssen vaccine has been hospitalized."" This patient was not only hospitalized but passed away.""
	"1302490-1"	"1302490-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	""On 4/26/21 The patient presents to our clinic with concerns for back pain, fever, shortness of breath, fatigue and coughing. We performed a covid19 antigen test which resulted positive. Based on this and his history and examination we recommended he go straight to the hospital for further evaluation and treatment. He was admitted to  medical center where a PCR was performed and confirmed positive. He was discharged on 4/29. Per his wife, they felt he was discharged too soon and he went to another hospital. He passed away 5/10/2021.  This report is being made in regards to the claim by the CDC that ""no one that has been infected with covid19 4 weeks after having the janssen vaccine has been hospitalized."" This patient was not only hospitalized but passed away.""
	"1302490-1"	"1302490-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	""On 4/26/21 The patient presents to our clinic with concerns for back pain, fever, shortness of breath, fatigue and coughing. We performed a covid19 antigen test which resulted positive. Based on this and his history and examination we recommended he go straight to the hospital for further evaluation and treatment. He was admitted to  medical center where a PCR was performed and confirmed positive. He was discharged on 4/29. Per his wife, they felt he was discharged too soon and he went to another hospital. He passed away 5/10/2021.  This report is being made in regards to the claim by the CDC that ""no one that has been infected with covid19 4 weeks after having the janssen vaccine has been hospitalized."" This patient was not only hospitalized but passed away.""
	"1302490-1"	"1302490-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""On 4/26/21 The patient presents to our clinic with concerns for back pain, fever, shortness of breath, fatigue and coughing. We performed a covid19 antigen test which resulted positive. Based on this and his history and examination we recommended he go straight to the hospital for further evaluation and treatment. He was admitted to  medical center where a PCR was performed and confirmed positive. He was discharged on 4/29. Per his wife, they felt he was discharged too soon and he went to another hospital. He passed away 5/10/2021.  This report is being made in regards to the claim by the CDC that ""no one that has been infected with covid19 4 weeks after having the janssen vaccine has been hospitalized."" This patient was not only hospitalized but passed away.""
	"1302490-1"	"1302490-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	""On 4/26/21 The patient presents to our clinic with concerns for back pain, fever, shortness of breath, fatigue and coughing. We performed a covid19 antigen test which resulted positive. Based on this and his history and examination we recommended he go straight to the hospital for further evaluation and treatment. He was admitted to  medical center where a PCR was performed and confirmed positive. He was discharged on 4/29. Per his wife, they felt he was discharged too soon and he went to another hospital. He passed away 5/10/2021.  This report is being made in regards to the claim by the CDC that ""no one that has been infected with covid19 4 weeks after having the janssen vaccine has been hospitalized."" This patient was not only hospitalized but passed away.""
	"1302490-1"	"1302490-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	""On 4/26/21 The patient presents to our clinic with concerns for back pain, fever, shortness of breath, fatigue and coughing. We performed a covid19 antigen test which resulted positive. Based on this and his history and examination we recommended he go straight to the hospital for further evaluation and treatment. He was admitted to  medical center where a PCR was performed and confirmed positive. He was discharged on 4/29. Per his wife, they felt he was discharged too soon and he went to another hospital. He passed away 5/10/2021.  This report is being made in regards to the claim by the CDC that ""no one that has been infected with covid19 4 weeks after having the janssen vaccine has been hospitalized."" This patient was not only hospitalized but passed away.""
	"1302490-1"	"1302490-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	""On 4/26/21 The patient presents to our clinic with concerns for back pain, fever, shortness of breath, fatigue and coughing. We performed a covid19 antigen test which resulted positive. Based on this and his history and examination we recommended he go straight to the hospital for further evaluation and treatment. He was admitted to  medical center where a PCR was performed and confirmed positive. He was discharged on 4/29. Per his wife, they felt he was discharged too soon and he went to another hospital. He passed away 5/10/2021.  This report is being made in regards to the claim by the CDC that ""no one that has been infected with covid19 4 weeks after having the janssen vaccine has been hospitalized."" This patient was not only hospitalized but passed away.""
	"1302490-1"	"1302490-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	""On 4/26/21 The patient presents to our clinic with concerns for back pain, fever, shortness of breath, fatigue and coughing. We performed a covid19 antigen test which resulted positive. Based on this and his history and examination we recommended he go straight to the hospital for further evaluation and treatment. He was admitted to  medical center where a PCR was performed and confirmed positive. He was discharged on 4/29. Per his wife, they felt he was discharged too soon and he went to another hospital. He passed away 5/10/2021.  This report is being made in regards to the claim by the CDC that ""no one that has been infected with covid19 4 weeks after having the janssen vaccine has been hospitalized."" This patient was not only hospitalized but passed away.""
	"1302958-1"	"1302958-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Hospitalization and Death"
	"1303074-1"	"1303074-1"	"ANTICOAGULANT THERAPY"	"10053468"	"60-64 years"	"60-64"	"1st dose in series on 03-18-2021; 2nd dose in series on 04-08-2021  2 days after 2nd dose, he developed severe pain in both legs.  He was taken to the hospital where clots were diagnosed in both legs and groin area.  A previously undiagnosed lung nodule was found and he was given a cancer diagnosis.  He was discharged home on apixaban (Eliquis) and comfort measures 2 days after admission.  Over the following weeks, he had a permanent lung drain placed.  He died on May 5th or 6th at home.  No autopsy performed."
	"1303074-1"	"1303074-1"	"CHEST TUBE INSERTION"	"10050522"	"60-64 years"	"60-64"	"1st dose in series on 03-18-2021; 2nd dose in series on 04-08-2021  2 days after 2nd dose, he developed severe pain in both legs.  He was taken to the hospital where clots were diagnosed in both legs and groin area.  A previously undiagnosed lung nodule was found and he was given a cancer diagnosis.  He was discharged home on apixaban (Eliquis) and comfort measures 2 days after admission.  Over the following weeks, he had a permanent lung drain placed.  He died on May 5th or 6th at home.  No autopsy performed."
	"1303074-1"	"1303074-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"1st dose in series on 03-18-2021; 2nd dose in series on 04-08-2021  2 days after 2nd dose, he developed severe pain in both legs.  He was taken to the hospital where clots were diagnosed in both legs and groin area.  A previously undiagnosed lung nodule was found and he was given a cancer diagnosis.  He was discharged home on apixaban (Eliquis) and comfort measures 2 days after admission.  Over the following weeks, he had a permanent lung drain placed.  He died on May 5th or 6th at home.  No autopsy performed."
	"1303074-1"	"1303074-1"	"DEEP VEIN THROMBOSIS"	"10051055"	"60-64 years"	"60-64"	"1st dose in series on 03-18-2021; 2nd dose in series on 04-08-2021  2 days after 2nd dose, he developed severe pain in both legs.  He was taken to the hospital where clots were diagnosed in both legs and groin area.  A previously undiagnosed lung nodule was found and he was given a cancer diagnosis.  He was discharged home on apixaban (Eliquis) and comfort measures 2 days after admission.  Over the following weeks, he had a permanent lung drain placed.  He died on May 5th or 6th at home.  No autopsy performed."
	"1303074-1"	"1303074-1"	"LUNG NEOPLASM MALIGNANT"	"10058467"	"60-64 years"	"60-64"	"1st dose in series on 03-18-2021; 2nd dose in series on 04-08-2021  2 days after 2nd dose, he developed severe pain in both legs.  He was taken to the hospital where clots were diagnosed in both legs and groin area.  A previously undiagnosed lung nodule was found and he was given a cancer diagnosis.  He was discharged home on apixaban (Eliquis) and comfort measures 2 days after admission.  Over the following weeks, he had a permanent lung drain placed.  He died on May 5th or 6th at home.  No autopsy performed."
	"1303074-1"	"1303074-1"	"PAIN IN EXTREMITY"	"10033425"	"60-64 years"	"60-64"	"1st dose in series on 03-18-2021; 2nd dose in series on 04-08-2021  2 days after 2nd dose, he developed severe pain in both legs.  He was taken to the hospital where clots were diagnosed in both legs and groin area.  A previously undiagnosed lung nodule was found and he was given a cancer diagnosis.  He was discharged home on apixaban (Eliquis) and comfort measures 2 days after admission.  Over the following weeks, he had a permanent lung drain placed.  He died on May 5th or 6th at home.  No autopsy performed."
	"1303074-1"	"1303074-1"	"PULMONARY MASS"	"10056342"	"60-64 years"	"60-64"	"1st dose in series on 03-18-2021; 2nd dose in series on 04-08-2021  2 days after 2nd dose, he developed severe pain in both legs.  He was taken to the hospital where clots were diagnosed in both legs and groin area.  A previously undiagnosed lung nodule was found and he was given a cancer diagnosis.  He was discharged home on apixaban (Eliquis) and comfort measures 2 days after admission.  Over the following weeks, he had a permanent lung drain placed.  He died on May 5th or 6th at home.  No autopsy performed."
	"1303074-1"	"1303074-1"	"THROMBOSIS"	"10043607"	"60-64 years"	"60-64"	"1st dose in series on 03-18-2021; 2nd dose in series on 04-08-2021  2 days after 2nd dose, he developed severe pain in both legs.  He was taken to the hospital where clots were diagnosed in both legs and groin area.  A previously undiagnosed lung nodule was found and he was given a cancer diagnosis.  He was discharged home on apixaban (Eliquis) and comfort measures 2 days after admission.  Over the following weeks, he had a permanent lung drain placed.  He died on May 5th or 6th at home.  No autopsy performed."
	"1303175-1"	"1303175-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"This 60 year old  black male received the Covid shot on  4/15/21  and went to the ED on  4/23/21  with the following diagnoses listed below and died on 4/27/21. K92.2 - Gastrointestinal hemorrhage, unspecified"
	"1303175-1"	"1303175-1"	"GASTROINTESTINAL HAEMORRHAGE"	"10017955"	"60-64 years"	"60-64"	"This 60 year old  black male received the Covid shot on  4/15/21  and went to the ED on  4/23/21  with the following diagnoses listed below and died on 4/27/21. K92.2 - Gastrointestinal hemorrhage, unspecified"
	"1303208-1"	"1303208-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"60-64 years"	"60-64"	"Recieved obituray on patient. Called pt. ER contact and she stated that she was unaware how patient died. Pt. died at home but states that pt. had been having flu-like symptoms in bed with chills after vaccination. Pt. ER contact is unaware of pt. medical history or current medications. Pt. ER contact that pt. PCP was not us but another medical facility. Called funeral home and spoke to employee and she stated that the coroner cause of death listed was acute MI. Employee stated that she does not have a certified copy of death certificate at this time."
	"1303208-1"	"1303208-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"Recieved obituray on patient. Called pt. ER contact and she stated that she was unaware how patient died. Pt. died at home but states that pt. had been having flu-like symptoms in bed with chills after vaccination. Pt. ER contact is unaware of pt. medical history or current medications. Pt. ER contact that pt. PCP was not us but another medical facility. Called funeral home and spoke to employee and she stated that the coroner cause of death listed was acute MI. Employee stated that she does not have a certified copy of death certificate at this time."
	"1303208-1"	"1303208-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Recieved obituray on patient. Called pt. ER contact and she stated that she was unaware how patient died. Pt. died at home but states that pt. had been having flu-like symptoms in bed with chills after vaccination. Pt. ER contact is unaware of pt. medical history or current medications. Pt. ER contact that pt. PCP was not us but another medical facility. Called funeral home and spoke to employee and she stated that the coroner cause of death listed was acute MI. Employee stated that she does not have a certified copy of death certificate at this time."
	"1303208-1"	"1303208-1"	"INFLUENZA LIKE ILLNESS"	"10022004"	"60-64 years"	"60-64"	"Recieved obituray on patient. Called pt. ER contact and she stated that she was unaware how patient died. Pt. died at home but states that pt. had been having flu-like symptoms in bed with chills after vaccination. Pt. ER contact is unaware of pt. medical history or current medications. Pt. ER contact that pt. PCP was not us but another medical facility. Called funeral home and spoke to employee and she stated that the coroner cause of death listed was acute MI. Employee stated that she does not have a certified copy of death certificate at this time."
	"1307636-1"	"1307636-1"	"DIABETIC KETOACIDOSIS"	"10012671"	"60-64 years"	"60-64"	"diabetic ketoacidosis on 5/8/21"
	"1310729-1"	"1310729-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient stopped breathing five days after the vaccine (5/29/21) He was taken to Hospital by paramedics and was put on ventilator in Intensive Care. They took him off the ventilator and he died 6 days after (5/5/21)."
	"1310729-1"	"1310729-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Patient stopped breathing five days after the vaccine (5/29/21) He was taken to Hospital by paramedics and was put on ventilator in Intensive Care. They took him off the ventilator and he died 6 days after (5/5/21)."
	"1310729-1"	"1310729-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Patient stopped breathing five days after the vaccine (5/29/21) He was taken to Hospital by paramedics and was put on ventilator in Intensive Care. They took him off the ventilator and he died 6 days after (5/5/21)."
	"1310729-1"	"1310729-1"	"RESPIRATORY ARREST"	"10038669"	"60-64 years"	"60-64"	"Patient stopped breathing five days after the vaccine (5/29/21) He was taken to Hospital by paramedics and was put on ventilator in Intensive Care. They took him off the ventilator and he died 6 days after (5/5/21)."
	"1314864-1"	"1314864-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"She was found dead in her home one week after the injection. She died the day of the injection according to the coroners office.  There was blood on the bed and down her chest."
	"1314864-1"	"1314864-1"	"HAEMORRHAGE"	"10055798"	"60-64 years"	"60-64"	"She was found dead in her home one week after the injection. She died the day of the injection according to the coroners office.  There was blood on the bed and down her chest."
	"1314985-1"	"1314985-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"The 2nd dose of Moderna was administered on 05/12/2021  at 9:40 am, patient waited for 15 minutes he was feeling well and left the pharmacy at 09:50 am. The patient-caregiver contacted us at 12pm on 05/13/2021 stating that the patient passed away today. She stated he was feeling fine yesterday and had his breathing treatment at night and in the morning he didn't wake up."
	"1317355-1"	"1317355-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"deatb"
	"1321898-1"	"1321898-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"patient died aprox 1 week after the 2nd dose . presumed cause of death stated by son was GI bleed. Not confirmed to be caused by the vaccine.  Autopsy not performed according to the son."
	"1321898-1"	"1321898-1"	"GASTROINTESTINAL HAEMORRHAGE"	"10017955"	"60-64 years"	"60-64"	"patient died aprox 1 week after the 2nd dose . presumed cause of death stated by son was GI bleed. Not confirmed to be caused by the vaccine.  Autopsy not performed according to the son."
	"1322292-1"	"1322292-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"Complained of chest pain at 3:50 pm may 15th. He went and layed down across his bed was coherent and talking, suddenly passed out. 911 was called and chest compressions were started.  Ambulance arrived his condition was 60/40 bp and heart rate of 40. Taken to hospital where he never recovered and passed away."
	"1322292-1"	"1322292-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Complained of chest pain at 3:50 pm may 15th. He went and layed down across his bed was coherent and talking, suddenly passed out. 911 was called and chest compressions were started.  Ambulance arrived his condition was 60/40 bp and heart rate of 40. Taken to hospital where he never recovered and passed away."
	"1322292-1"	"1322292-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"60-64 years"	"60-64"	"Complained of chest pain at 3:50 pm may 15th. He went and layed down across his bed was coherent and talking, suddenly passed out. 911 was called and chest compressions were started.  Ambulance arrived his condition was 60/40 bp and heart rate of 40. Taken to hospital where he never recovered and passed away."
	"1322292-1"	"1322292-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Complained of chest pain at 3:50 pm may 15th. He went and layed down across his bed was coherent and talking, suddenly passed out. 911 was called and chest compressions were started.  Ambulance arrived his condition was 60/40 bp and heart rate of 40. Taken to hospital where he never recovered and passed away."
	"1323593-1"	"1323593-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Family reported patient passed away in the evening."
	"1324012-1"	"1324012-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Acute trouble breathing followed by fainting/loss of consciousness. Chest compressions were started as paramedics were on the way. Paramedics worked on my dad for over 30 minutes but were unable to revive him.  They stated he went into cardiac arrest."
	"1324012-1"	"1324012-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Acute trouble breathing followed by fainting/loss of consciousness. Chest compressions were started as paramedics were on the way. Paramedics worked on my dad for over 30 minutes but were unable to revive him.  They stated he went into cardiac arrest."
	"1324012-1"	"1324012-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Acute trouble breathing followed by fainting/loss of consciousness. Chest compressions were started as paramedics were on the way. Paramedics worked on my dad for over 30 minutes but were unable to revive him.  They stated he went into cardiac arrest."
	"1324012-1"	"1324012-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"60-64 years"	"60-64"	"Acute trouble breathing followed by fainting/loss of consciousness. Chest compressions were started as paramedics were on the way. Paramedics worked on my dad for over 30 minutes but were unable to revive him.  They stated he went into cardiac arrest."
	"1324012-1"	"1324012-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Acute trouble breathing followed by fainting/loss of consciousness. Chest compressions were started as paramedics were on the way. Paramedics worked on my dad for over 30 minutes but were unable to revive him.  They stated he went into cardiac arrest."
	"1324012-1"	"1324012-1"	"SYNCOPE"	"10042772"	"60-64 years"	"60-64"	"Acute trouble breathing followed by fainting/loss of consciousness. Chest compressions were started as paramedics were on the way. Paramedics worked on my dad for over 30 minutes but were unable to revive him.  They stated he went into cardiac arrest."
	"1325015-1"	"1325015-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Severe headache nauseous"
	"1325015-1"	"1325015-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"Severe headache nauseous"
	"1325015-1"	"1325015-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Severe headache nauseous"
	"1325911-1"	"1325911-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"stated that her mother in law died; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (stated that her mother in law died) in a 61-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination.     No Medical History information was reported.   On 06-May-2021, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. Death occurred on 07-May-2021 The patient died on 07-May-2021. The cause of death was not reported. It is unknown if an autopsy was performed. Not Provided          Concomitant medications and treatment information was not provided.  A 61-year-old female patient who received mRNA-1273 died 2 days after the first dose of vaccine. No medical condition or conmeds were provided.  The cause of death was not reported. Very limited information has been reported at this time. Further information is being followed up.; Sender's Comments: A 61-year-old female patient who received mRNA-1273 died 2 days after the first dose of vaccine. No medical condition or conmeds were provided.  The cause of death was not reported. Very limited information has been reported at this time. Further information is being followed up.; Reported Cause(s) of Death: Unknown cause of death"
	"1327468-1"	"1327468-1"	"ANAL INCONTINENCE"	"10077605"	"60-64 years"	"60-64"	"She did not have control of her bowels when sneezed or coughing.  She complained of trouble breathing and in a lot of pain. She passed away on April 3 with pneumonia"
	"1327468-1"	"1327468-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"She did not have control of her bowels when sneezed or coughing.  She complained of trouble breathing and in a lot of pain. She passed away on April 3 with pneumonia"
	"1327468-1"	"1327468-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"She did not have control of her bowels when sneezed or coughing.  She complained of trouble breathing and in a lot of pain. She passed away on April 3 with pneumonia"
	"1327468-1"	"1327468-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"She did not have control of her bowels when sneezed or coughing.  She complained of trouble breathing and in a lot of pain. She passed away on April 3 with pneumonia"
	"1327468-1"	"1327468-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"She did not have control of her bowels when sneezed or coughing.  She complained of trouble breathing and in a lot of pain. She passed away on April 3 with pneumonia"
	"1327551-1"	"1327551-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Second vaccine 5/14/21 and death on 5/16/21"
	"1331122-1"	"1331122-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient was vaccinated on 3/31/21.  Noted to be positive for Covid on 4/19/21 and passed away on 5/8/21. Per the lab report, this is the information for the ordering provider:     He had an emergency contact but no number. Phone number for patient is no longer operational."
	"1331122-1"	"1331122-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient was vaccinated on 3/31/21.  Noted to be positive for Covid on 4/19/21 and passed away on 5/8/21. Per the lab report, this is the information for the ordering provider:     He had an emergency contact but no number. Phone number for patient is no longer operational."
	"1331122-1"	"1331122-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Patient was vaccinated on 3/31/21.  Noted to be positive for Covid on 4/19/21 and passed away on 5/8/21. Per the lab report, this is the information for the ordering provider:     He had an emergency contact but no number. Phone number for patient is no longer operational."
	"1333518-1"	"1333518-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"60-64 years"	"60-64"	"He had a stroke and bleeding on the brain"
	"1333518-1"	"1333518-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"60-64 years"	"60-64"	"He had a stroke and bleeding on the brain"
	"1333991-1"	"1333991-1"	"AORTIC THROMBOSIS"	"10002910"	"60-64 years"	"60-64"	"Blot clot followed by fatal aortic thrombosis"
	"1333991-1"	"1333991-1"	"CARDIAC PHARMACOLOGIC STRESS TEST"	"10054017"	"60-64 years"	"60-64"	"Blot clot followed by fatal aortic thrombosis"
	"1333991-1"	"1333991-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Blot clot followed by fatal aortic thrombosis"
	"1333991-1"	"1333991-1"	"THROMBOSIS"	"10043607"	"60-64 years"	"60-64"	"Blot clot followed by fatal aortic thrombosis"
	"1334068-1"	"1334068-1"	"BLOOD GASES"	"10005537"	"60-64 years"	"60-64"	"Patient was  provided with the COVID-19 vaccine outside of the hospital and begain having shortness of breath approximately 15-20 minutes after receiving the vaccination. In route home, the patient could not catch his breath. The patient was found slumped over at home. EMS arrived and the patient received ACLS and ROSC was achieved. Days later, the patient arrested again and passed away on  5/13/21."
	"1334068-1"	"1334068-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"Patient was  provided with the COVID-19 vaccine outside of the hospital and begain having shortness of breath approximately 15-20 minutes after receiving the vaccination. In route home, the patient could not catch his breath. The patient was found slumped over at home. EMS arrived and the patient received ACLS and ROSC was achieved. Days later, the patient arrested again and passed away on  5/13/21."
	"1334068-1"	"1334068-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient was  provided with the COVID-19 vaccine outside of the hospital and begain having shortness of breath approximately 15-20 minutes after receiving the vaccination. In route home, the patient could not catch his breath. The patient was found slumped over at home. EMS arrived and the patient received ACLS and ROSC was achieved. Days later, the patient arrested again and passed away on  5/13/21."
	"1334068-1"	"1334068-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Patient was  provided with the COVID-19 vaccine outside of the hospital and begain having shortness of breath approximately 15-20 minutes after receiving the vaccination. In route home, the patient could not catch his breath. The patient was found slumped over at home. EMS arrived and the patient received ACLS and ROSC was achieved. Days later, the patient arrested again and passed away on  5/13/21."
	"1334068-1"	"1334068-1"	"ELECTROCARDIOGRAM"	"10014362"	"60-64 years"	"60-64"	"Patient was  provided with the COVID-19 vaccine outside of the hospital and begain having shortness of breath approximately 15-20 minutes after receiving the vaccination. In route home, the patient could not catch his breath. The patient was found slumped over at home. EMS arrived and the patient received ACLS and ROSC was achieved. Days later, the patient arrested again and passed away on  5/13/21."
	"1334068-1"	"1334068-1"	"POSTURE ABNORMAL"	"10036436"	"60-64 years"	"60-64"	"Patient was  provided with the COVID-19 vaccine outside of the hospital and begain having shortness of breath approximately 15-20 minutes after receiving the vaccination. In route home, the patient could not catch his breath. The patient was found slumped over at home. EMS arrived and the patient received ACLS and ROSC was achieved. Days later, the patient arrested again and passed away on  5/13/21."
	"1334068-1"	"1334068-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Patient was  provided with the COVID-19 vaccine outside of the hospital and begain having shortness of breath approximately 15-20 minutes after receiving the vaccination. In route home, the patient could not catch his breath. The patient was found slumped over at home. EMS arrived and the patient received ACLS and ROSC was achieved. Days later, the patient arrested again and passed away on  5/13/21."
	"1337097-1"	"1337097-1"	"CARDIAC ASSISTANCE DEVICE USER"	"10053686"	"60-64 years"	"60-64"	"pt received Johnson and Johnson vaccine on 5/21/2021,  PT had been complaining of shortness of breath since getting the vaccine yesterday and today, pt collapsed at home, wife started CPR, EMS continued compessions and ACLS protocol when they arrived to ED he was in Vfib,  After multiple shocks, Epinephrine, bicarb, lidocaine and multiple other life saving medications were administered to no avail, pt expired on 5/21/2021 at 1729"
	"1337097-1"	"1337097-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"pt received Johnson and Johnson vaccine on 5/21/2021,  PT had been complaining of shortness of breath since getting the vaccine yesterday and today, pt collapsed at home, wife started CPR, EMS continued compessions and ACLS protocol when they arrived to ED he was in Vfib,  After multiple shocks, Epinephrine, bicarb, lidocaine and multiple other life saving medications were administered to no avail, pt expired on 5/21/2021 at 1729"
	"1337097-1"	"1337097-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"pt received Johnson and Johnson vaccine on 5/21/2021,  PT had been complaining of shortness of breath since getting the vaccine yesterday and today, pt collapsed at home, wife started CPR, EMS continued compessions and ACLS protocol when they arrived to ED he was in Vfib,  After multiple shocks, Epinephrine, bicarb, lidocaine and multiple other life saving medications were administered to no avail, pt expired on 5/21/2021 at 1729"
	"1337097-1"	"1337097-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"pt received Johnson and Johnson vaccine on 5/21/2021,  PT had been complaining of shortness of breath since getting the vaccine yesterday and today, pt collapsed at home, wife started CPR, EMS continued compessions and ACLS protocol when they arrived to ED he was in Vfib,  After multiple shocks, Epinephrine, bicarb, lidocaine and multiple other life saving medications were administered to no avail, pt expired on 5/21/2021 at 1729"
	"1337097-1"	"1337097-1"	"SYNCOPE"	"10042772"	"60-64 years"	"60-64"	"pt received Johnson and Johnson vaccine on 5/21/2021,  PT had been complaining of shortness of breath since getting the vaccine yesterday and today, pt collapsed at home, wife started CPR, EMS continued compessions and ACLS protocol when they arrived to ED he was in Vfib,  After multiple shocks, Epinephrine, bicarb, lidocaine and multiple other life saving medications were administered to no avail, pt expired on 5/21/2021 at 1729"
	"1337097-1"	"1337097-1"	"VENTRICULAR FIBRILLATION"	"10047290"	"60-64 years"	"60-64"	"pt received Johnson and Johnson vaccine on 5/21/2021,  PT had been complaining of shortness of breath since getting the vaccine yesterday and today, pt collapsed at home, wife started CPR, EMS continued compessions and ACLS protocol when they arrived to ED he was in Vfib,  After multiple shocks, Epinephrine, bicarb, lidocaine and multiple other life saving medications were administered to no avail, pt expired on 5/21/2021 at 1729"
	"1337701-1"	"1337701-1"	"BILEVEL POSITIVE AIRWAY PRESSURE"	"10064530"	"60-64 years"	"60-64"	"64 y.o. female who presented with SOB. She has a history of CAD, diabetes, CHF, CKD and DVT presents to the ED in respiratory distress.  Patient was brought in by EMS from nursing home.  Patient had reported onset of shortness of breath and respiratory distress over the last 6-7 hours.  Patient has O2 sat of 90% on 6 L.  Patient only uses 2 L nasal cannula oxygen all day long.  Patient is coherent and initially was placed on BIPAP but then stated she wanted to go back, now after ER doc spoke to her she is ok with being admitted but does not want BIPAP or to be placed in the ICU. She is DNR/DNI. She is working hard to breathe currently. Patient is unsure if she is making urine at this time. Workup in the ER revealed AKI on CKD and covid + pneumonia.   Patient elected hospice and expired 5/20/2021.  It was reported that patient had received vaccines at Walmart."
	"1337701-1"	"1337701-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"64 y.o. female who presented with SOB. She has a history of CAD, diabetes, CHF, CKD and DVT presents to the ED in respiratory distress.  Patient was brought in by EMS from nursing home.  Patient had reported onset of shortness of breath and respiratory distress over the last 6-7 hours.  Patient has O2 sat of 90% on 6 L.  Patient only uses 2 L nasal cannula oxygen all day long.  Patient is coherent and initially was placed on BIPAP but then stated she wanted to go back, now after ER doc spoke to her she is ok with being admitted but does not want BIPAP or to be placed in the ICU. She is DNR/DNI. She is working hard to breathe currently. Patient is unsure if she is making urine at this time. Workup in the ER revealed AKI on CKD and covid + pneumonia.   Patient elected hospice and expired 5/20/2021.  It was reported that patient had received vaccines at Walmart."
	"1337701-1"	"1337701-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"64 y.o. female who presented with SOB. She has a history of CAD, diabetes, CHF, CKD and DVT presents to the ED in respiratory distress.  Patient was brought in by EMS from nursing home.  Patient had reported onset of shortness of breath and respiratory distress over the last 6-7 hours.  Patient has O2 sat of 90% on 6 L.  Patient only uses 2 L nasal cannula oxygen all day long.  Patient is coherent and initially was placed on BIPAP but then stated she wanted to go back, now after ER doc spoke to her she is ok with being admitted but does not want BIPAP or to be placed in the ICU. She is DNR/DNI. She is working hard to breathe currently. Patient is unsure if she is making urine at this time. Workup in the ER revealed AKI on CKD and covid + pneumonia.   Patient elected hospice and expired 5/20/2021.  It was reported that patient had received vaccines at Walmart."
	"1337701-1"	"1337701-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"64 y.o. female who presented with SOB. She has a history of CAD, diabetes, CHF, CKD and DVT presents to the ED in respiratory distress.  Patient was brought in by EMS from nursing home.  Patient had reported onset of shortness of breath and respiratory distress over the last 6-7 hours.  Patient has O2 sat of 90% on 6 L.  Patient only uses 2 L nasal cannula oxygen all day long.  Patient is coherent and initially was placed on BIPAP but then stated she wanted to go back, now after ER doc spoke to her she is ok with being admitted but does not want BIPAP or to be placed in the ICU. She is DNR/DNI. She is working hard to breathe currently. Patient is unsure if she is making urine at this time. Workup in the ER revealed AKI on CKD and covid + pneumonia.   Patient elected hospice and expired 5/20/2021.  It was reported that patient had received vaccines at Walmart."
	"1337701-1"	"1337701-1"	"HOSPICE CARE"	"10067973"	"60-64 years"	"60-64"	"64 y.o. female who presented with SOB. She has a history of CAD, diabetes, CHF, CKD and DVT presents to the ED in respiratory distress.  Patient was brought in by EMS from nursing home.  Patient had reported onset of shortness of breath and respiratory distress over the last 6-7 hours.  Patient has O2 sat of 90% on 6 L.  Patient only uses 2 L nasal cannula oxygen all day long.  Patient is coherent and initially was placed on BIPAP but then stated she wanted to go back, now after ER doc spoke to her she is ok with being admitted but does not want BIPAP or to be placed in the ICU. She is DNR/DNI. She is working hard to breathe currently. Patient is unsure if she is making urine at this time. Workup in the ER revealed AKI on CKD and covid + pneumonia.   Patient elected hospice and expired 5/20/2021.  It was reported that patient had received vaccines at Walmart."
	"1337701-1"	"1337701-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"64 y.o. female who presented with SOB. She has a history of CAD, diabetes, CHF, CKD and DVT presents to the ED in respiratory distress.  Patient was brought in by EMS from nursing home.  Patient had reported onset of shortness of breath and respiratory distress over the last 6-7 hours.  Patient has O2 sat of 90% on 6 L.  Patient only uses 2 L nasal cannula oxygen all day long.  Patient is coherent and initially was placed on BIPAP but then stated she wanted to go back, now after ER doc spoke to her she is ok with being admitted but does not want BIPAP or to be placed in the ICU. She is DNR/DNI. She is working hard to breathe currently. Patient is unsure if she is making urine at this time. Workup in the ER revealed AKI on CKD and covid + pneumonia.   Patient elected hospice and expired 5/20/2021.  It was reported that patient had received vaccines at Walmart."
	"1337701-1"	"1337701-1"	"RESPIRATORY DISTRESS"	"10038687"	"60-64 years"	"60-64"	"64 y.o. female who presented with SOB. She has a history of CAD, diabetes, CHF, CKD and DVT presents to the ED in respiratory distress.  Patient was brought in by EMS from nursing home.  Patient had reported onset of shortness of breath and respiratory distress over the last 6-7 hours.  Patient has O2 sat of 90% on 6 L.  Patient only uses 2 L nasal cannula oxygen all day long.  Patient is coherent and initially was placed on BIPAP but then stated she wanted to go back, now after ER doc spoke to her she is ok with being admitted but does not want BIPAP or to be placed in the ICU. She is DNR/DNI. She is working hard to breathe currently. Patient is unsure if she is making urine at this time. Workup in the ER revealed AKI on CKD and covid + pneumonia.   Patient elected hospice and expired 5/20/2021.  It was reported that patient had received vaccines at Walmart."
	"1337701-1"	"1337701-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"64 y.o. female who presented with SOB. She has a history of CAD, diabetes, CHF, CKD and DVT presents to the ED in respiratory distress.  Patient was brought in by EMS from nursing home.  Patient had reported onset of shortness of breath and respiratory distress over the last 6-7 hours.  Patient has O2 sat of 90% on 6 L.  Patient only uses 2 L nasal cannula oxygen all day long.  Patient is coherent and initially was placed on BIPAP but then stated she wanted to go back, now after ER doc spoke to her she is ok with being admitted but does not want BIPAP or to be placed in the ICU. She is DNR/DNI. She is working hard to breathe currently. Patient is unsure if she is making urine at this time. Workup in the ER revealed AKI on CKD and covid + pneumonia.   Patient elected hospice and expired 5/20/2021.  It was reported that patient had received vaccines at Walmart."
	"1340672-1"	"1340672-1"	"ANGIOGRAM CEREBRAL ABNORMAL"	"10052906"	"60-64 years"	"60-64"	"Patient went to ER 4/4/21 with severe headache, inability to stay awake. CT scan of the head revealed multiple areas of SAH (unexplained no head injury) and a very large ruptured MCA aneurysm. Patient was COMPLETELY asymptomatic prior to vaccination. The aneurysm was repaired with success but the cerebral hemorrhages kept appearing - unexplained. Cerebral edema became so severe (midline shift up to 9-10mm) neurosurgery ended up performing a burr hole craniotomy to relieve pressure as well as placement of a ventriculostomy. This patient later ended up with severe vasospasms which results in an ischemic stroke of the L frontal lobe. Patient later died in a rehabilitation facility, all of this secondary to the Janssen vaccine. This vaccine should not be administered until further studied. This was a healthy 63 year old woman. Vitals always WNL labs WNL very active, BMI WNL. Absolutely NO comorbidities. A lifelong nurse who raised 2 nurses of her own.  These events took place for over a month. The trauma not only the patient has experienced but her family is unforgivable."
	"1340672-1"	"1340672-1"	"BRAIN OEDEMA"	"10048962"	"60-64 years"	"60-64"	"Patient went to ER 4/4/21 with severe headache, inability to stay awake. CT scan of the head revealed multiple areas of SAH (unexplained no head injury) and a very large ruptured MCA aneurysm. Patient was COMPLETELY asymptomatic prior to vaccination. The aneurysm was repaired with success but the cerebral hemorrhages kept appearing - unexplained. Cerebral edema became so severe (midline shift up to 9-10mm) neurosurgery ended up performing a burr hole craniotomy to relieve pressure as well as placement of a ventriculostomy. This patient later ended up with severe vasospasms which results in an ischemic stroke of the L frontal lobe. Patient later died in a rehabilitation facility, all of this secondary to the Janssen vaccine. This vaccine should not be administered until further studied. This was a healthy 63 year old woman. Vitals always WNL labs WNL very active, BMI WNL. Absolutely NO comorbidities. A lifelong nurse who raised 2 nurses of her own.  These events took place for over a month. The trauma not only the patient has experienced but her family is unforgivable."
	"1340672-1"	"1340672-1"	"CEREBRAL ENDOVASCULAR ANEURYSM REPAIR"	"10077079"	"60-64 years"	"60-64"	"Patient went to ER 4/4/21 with severe headache, inability to stay awake. CT scan of the head revealed multiple areas of SAH (unexplained no head injury) and a very large ruptured MCA aneurysm. Patient was COMPLETELY asymptomatic prior to vaccination. The aneurysm was repaired with success but the cerebral hemorrhages kept appearing - unexplained. Cerebral edema became so severe (midline shift up to 9-10mm) neurosurgery ended up performing a burr hole craniotomy to relieve pressure as well as placement of a ventriculostomy. This patient later ended up with severe vasospasms which results in an ischemic stroke of the L frontal lobe. Patient later died in a rehabilitation facility, all of this secondary to the Janssen vaccine. This vaccine should not be administered until further studied. This was a healthy 63 year old woman. Vitals always WNL labs WNL very active, BMI WNL. Absolutely NO comorbidities. A lifelong nurse who raised 2 nurses of her own.  These events took place for over a month. The trauma not only the patient has experienced but her family is unforgivable."
	"1340672-1"	"1340672-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"60-64 years"	"60-64"	"Patient went to ER 4/4/21 with severe headache, inability to stay awake. CT scan of the head revealed multiple areas of SAH (unexplained no head injury) and a very large ruptured MCA aneurysm. Patient was COMPLETELY asymptomatic prior to vaccination. The aneurysm was repaired with success but the cerebral hemorrhages kept appearing - unexplained. Cerebral edema became so severe (midline shift up to 9-10mm) neurosurgery ended up performing a burr hole craniotomy to relieve pressure as well as placement of a ventriculostomy. This patient later ended up with severe vasospasms which results in an ischemic stroke of the L frontal lobe. Patient later died in a rehabilitation facility, all of this secondary to the Janssen vaccine. This vaccine should not be administered until further studied. This was a healthy 63 year old woman. Vitals always WNL labs WNL very active, BMI WNL. Absolutely NO comorbidities. A lifelong nurse who raised 2 nurses of her own.  These events took place for over a month. The trauma not only the patient has experienced but her family is unforgivable."
	"1340672-1"	"1340672-1"	"CEREBRAL MASS EFFECT"	"10067086"	"60-64 years"	"60-64"	"Patient went to ER 4/4/21 with severe headache, inability to stay awake. CT scan of the head revealed multiple areas of SAH (unexplained no head injury) and a very large ruptured MCA aneurysm. Patient was COMPLETELY asymptomatic prior to vaccination. The aneurysm was repaired with success but the cerebral hemorrhages kept appearing - unexplained. Cerebral edema became so severe (midline shift up to 9-10mm) neurosurgery ended up performing a burr hole craniotomy to relieve pressure as well as placement of a ventriculostomy. This patient later ended up with severe vasospasms which results in an ischemic stroke of the L frontal lobe. Patient later died in a rehabilitation facility, all of this secondary to the Janssen vaccine. This vaccine should not be administered until further studied. This was a healthy 63 year old woman. Vitals always WNL labs WNL very active, BMI WNL. Absolutely NO comorbidities. A lifelong nurse who raised 2 nurses of her own.  These events took place for over a month. The trauma not only the patient has experienced but her family is unforgivable."
	"1340672-1"	"1340672-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"60-64 years"	"60-64"	"Patient went to ER 4/4/21 with severe headache, inability to stay awake. CT scan of the head revealed multiple areas of SAH (unexplained no head injury) and a very large ruptured MCA aneurysm. Patient was COMPLETELY asymptomatic prior to vaccination. The aneurysm was repaired with success but the cerebral hemorrhages kept appearing - unexplained. Cerebral edema became so severe (midline shift up to 9-10mm) neurosurgery ended up performing a burr hole craniotomy to relieve pressure as well as placement of a ventriculostomy. This patient later ended up with severe vasospasms which results in an ischemic stroke of the L frontal lobe. Patient later died in a rehabilitation facility, all of this secondary to the Janssen vaccine. This vaccine should not be administered until further studied. This was a healthy 63 year old woman. Vitals always WNL labs WNL very active, BMI WNL. Absolutely NO comorbidities. A lifelong nurse who raised 2 nurses of her own.  These events took place for over a month. The trauma not only the patient has experienced but her family is unforgivable."
	"1340672-1"	"1340672-1"	"CRANIOTOMY"	"10011322"	"60-64 years"	"60-64"	"Patient went to ER 4/4/21 with severe headache, inability to stay awake. CT scan of the head revealed multiple areas of SAH (unexplained no head injury) and a very large ruptured MCA aneurysm. Patient was COMPLETELY asymptomatic prior to vaccination. The aneurysm was repaired with success but the cerebral hemorrhages kept appearing - unexplained. Cerebral edema became so severe (midline shift up to 9-10mm) neurosurgery ended up performing a burr hole craniotomy to relieve pressure as well as placement of a ventriculostomy. This patient later ended up with severe vasospasms which results in an ischemic stroke of the L frontal lobe. Patient later died in a rehabilitation facility, all of this secondary to the Janssen vaccine. This vaccine should not be administered until further studied. This was a healthy 63 year old woman. Vitals always WNL labs WNL very active, BMI WNL. Absolutely NO comorbidities. A lifelong nurse who raised 2 nurses of her own.  These events took place for over a month. The trauma not only the patient has experienced but her family is unforgivable."
	"1340672-1"	"1340672-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient went to ER 4/4/21 with severe headache, inability to stay awake. CT scan of the head revealed multiple areas of SAH (unexplained no head injury) and a very large ruptured MCA aneurysm. Patient was COMPLETELY asymptomatic prior to vaccination. The aneurysm was repaired with success but the cerebral hemorrhages kept appearing - unexplained. Cerebral edema became so severe (midline shift up to 9-10mm) neurosurgery ended up performing a burr hole craniotomy to relieve pressure as well as placement of a ventriculostomy. This patient later ended up with severe vasospasms which results in an ischemic stroke of the L frontal lobe. Patient later died in a rehabilitation facility, all of this secondary to the Janssen vaccine. This vaccine should not be administered until further studied. This was a healthy 63 year old woman. Vitals always WNL labs WNL very active, BMI WNL. Absolutely NO comorbidities. A lifelong nurse who raised 2 nurses of her own.  These events took place for over a month. The trauma not only the patient has experienced but her family is unforgivable."
	"1340672-1"	"1340672-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"Patient went to ER 4/4/21 with severe headache, inability to stay awake. CT scan of the head revealed multiple areas of SAH (unexplained no head injury) and a very large ruptured MCA aneurysm. Patient was COMPLETELY asymptomatic prior to vaccination. The aneurysm was repaired with success but the cerebral hemorrhages kept appearing - unexplained. Cerebral edema became so severe (midline shift up to 9-10mm) neurosurgery ended up performing a burr hole craniotomy to relieve pressure as well as placement of a ventriculostomy. This patient later ended up with severe vasospasms which results in an ischemic stroke of the L frontal lobe. Patient later died in a rehabilitation facility, all of this secondary to the Janssen vaccine. This vaccine should not be administered until further studied. This was a healthy 63 year old woman. Vitals always WNL labs WNL very active, BMI WNL. Absolutely NO comorbidities. A lifelong nurse who raised 2 nurses of her own.  These events took place for over a month. The trauma not only the patient has experienced but her family is unforgivable."
	"1340672-1"	"1340672-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Patient went to ER 4/4/21 with severe headache, inability to stay awake. CT scan of the head revealed multiple areas of SAH (unexplained no head injury) and a very large ruptured MCA aneurysm. Patient was COMPLETELY asymptomatic prior to vaccination. The aneurysm was repaired with success but the cerebral hemorrhages kept appearing - unexplained. Cerebral edema became so severe (midline shift up to 9-10mm) neurosurgery ended up performing a burr hole craniotomy to relieve pressure as well as placement of a ventriculostomy. This patient later ended up with severe vasospasms which results in an ischemic stroke of the L frontal lobe. Patient later died in a rehabilitation facility, all of this secondary to the Janssen vaccine. This vaccine should not be administered until further studied. This was a healthy 63 year old woman. Vitals always WNL labs WNL very active, BMI WNL. Absolutely NO comorbidities. A lifelong nurse who raised 2 nurses of her own.  These events took place for over a month. The trauma not only the patient has experienced but her family is unforgivable."
	"1340672-1"	"1340672-1"	"INTRACRANIAL ANEURYSM"	"10022758"	"60-64 years"	"60-64"	"Patient went to ER 4/4/21 with severe headache, inability to stay awake. CT scan of the head revealed multiple areas of SAH (unexplained no head injury) and a very large ruptured MCA aneurysm. Patient was COMPLETELY asymptomatic prior to vaccination. The aneurysm was repaired with success but the cerebral hemorrhages kept appearing - unexplained. Cerebral edema became so severe (midline shift up to 9-10mm) neurosurgery ended up performing a burr hole craniotomy to relieve pressure as well as placement of a ventriculostomy. This patient later ended up with severe vasospasms which results in an ischemic stroke of the L frontal lobe. Patient later died in a rehabilitation facility, all of this secondary to the Janssen vaccine. This vaccine should not be administered until further studied. This was a healthy 63 year old woman. Vitals always WNL labs WNL very active, BMI WNL. Absolutely NO comorbidities. A lifelong nurse who raised 2 nurses of her own.  These events took place for over a month. The trauma not only the patient has experienced but her family is unforgivable."
	"1340672-1"	"1340672-1"	"ISCHAEMIC STROKE"	"10061256"	"60-64 years"	"60-64"	"Patient went to ER 4/4/21 with severe headache, inability to stay awake. CT scan of the head revealed multiple areas of SAH (unexplained no head injury) and a very large ruptured MCA aneurysm. Patient was COMPLETELY asymptomatic prior to vaccination. The aneurysm was repaired with success but the cerebral hemorrhages kept appearing - unexplained. Cerebral edema became so severe (midline shift up to 9-10mm) neurosurgery ended up performing a burr hole craniotomy to relieve pressure as well as placement of a ventriculostomy. This patient later ended up with severe vasospasms which results in an ischemic stroke of the L frontal lobe. Patient later died in a rehabilitation facility, all of this secondary to the Janssen vaccine. This vaccine should not be administered until further studied. This was a healthy 63 year old woman. Vitals always WNL labs WNL very active, BMI WNL. Absolutely NO comorbidities. A lifelong nurse who raised 2 nurses of her own.  These events took place for over a month. The trauma not only the patient has experienced but her family is unforgivable."
	"1340672-1"	"1340672-1"	"LABORATORY TEST"	"10059938"	"60-64 years"	"60-64"	"Patient went to ER 4/4/21 with severe headache, inability to stay awake. CT scan of the head revealed multiple areas of SAH (unexplained no head injury) and a very large ruptured MCA aneurysm. Patient was COMPLETELY asymptomatic prior to vaccination. The aneurysm was repaired with success but the cerebral hemorrhages kept appearing - unexplained. Cerebral edema became so severe (midline shift up to 9-10mm) neurosurgery ended up performing a burr hole craniotomy to relieve pressure as well as placement of a ventriculostomy. This patient later ended up with severe vasospasms which results in an ischemic stroke of the L frontal lobe. Patient later died in a rehabilitation facility, all of this secondary to the Janssen vaccine. This vaccine should not be administered until further studied. This was a healthy 63 year old woman. Vitals always WNL labs WNL very active, BMI WNL. Absolutely NO comorbidities. A lifelong nurse who raised 2 nurses of her own.  These events took place for over a month. The trauma not only the patient has experienced but her family is unforgivable."
	"1340672-1"	"1340672-1"	"RUPTURED CEREBRAL ANEURYSM"	"10039330"	"60-64 years"	"60-64"	"Patient went to ER 4/4/21 with severe headache, inability to stay awake. CT scan of the head revealed multiple areas of SAH (unexplained no head injury) and a very large ruptured MCA aneurysm. Patient was COMPLETELY asymptomatic prior to vaccination. The aneurysm was repaired with success but the cerebral hemorrhages kept appearing - unexplained. Cerebral edema became so severe (midline shift up to 9-10mm) neurosurgery ended up performing a burr hole craniotomy to relieve pressure as well as placement of a ventriculostomy. This patient later ended up with severe vasospasms which results in an ischemic stroke of the L frontal lobe. Patient later died in a rehabilitation facility, all of this secondary to the Janssen vaccine. This vaccine should not be administered until further studied. This was a healthy 63 year old woman. Vitals always WNL labs WNL very active, BMI WNL. Absolutely NO comorbidities. A lifelong nurse who raised 2 nurses of her own.  These events took place for over a month. The trauma not only the patient has experienced but her family is unforgivable."
	"1340672-1"	"1340672-1"	"SOMNOLENCE"	"10041349"	"60-64 years"	"60-64"	"Patient went to ER 4/4/21 with severe headache, inability to stay awake. CT scan of the head revealed multiple areas of SAH (unexplained no head injury) and a very large ruptured MCA aneurysm. Patient was COMPLETELY asymptomatic prior to vaccination. The aneurysm was repaired with success but the cerebral hemorrhages kept appearing - unexplained. Cerebral edema became so severe (midline shift up to 9-10mm) neurosurgery ended up performing a burr hole craniotomy to relieve pressure as well as placement of a ventriculostomy. This patient later ended up with severe vasospasms which results in an ischemic stroke of the L frontal lobe. Patient later died in a rehabilitation facility, all of this secondary to the Janssen vaccine. This vaccine should not be administered until further studied. This was a healthy 63 year old woman. Vitals always WNL labs WNL very active, BMI WNL. Absolutely NO comorbidities. A lifelong nurse who raised 2 nurses of her own.  These events took place for over a month. The trauma not only the patient has experienced but her family is unforgivable."
	"1340672-1"	"1340672-1"	"SUBARACHNOID HAEMORRHAGE"	"10042316"	"60-64 years"	"60-64"	"Patient went to ER 4/4/21 with severe headache, inability to stay awake. CT scan of the head revealed multiple areas of SAH (unexplained no head injury) and a very large ruptured MCA aneurysm. Patient was COMPLETELY asymptomatic prior to vaccination. The aneurysm was repaired with success but the cerebral hemorrhages kept appearing - unexplained. Cerebral edema became so severe (midline shift up to 9-10mm) neurosurgery ended up performing a burr hole craniotomy to relieve pressure as well as placement of a ventriculostomy. This patient later ended up with severe vasospasms which results in an ischemic stroke of the L frontal lobe. Patient later died in a rehabilitation facility, all of this secondary to the Janssen vaccine. This vaccine should not be administered until further studied. This was a healthy 63 year old woman. Vitals always WNL labs WNL very active, BMI WNL. Absolutely NO comorbidities. A lifelong nurse who raised 2 nurses of her own.  These events took place for over a month. The trauma not only the patient has experienced but her family is unforgivable."
	"1340672-1"	"1340672-1"	"VASOSPASM"	"10047163"	"60-64 years"	"60-64"	"Patient went to ER 4/4/21 with severe headache, inability to stay awake. CT scan of the head revealed multiple areas of SAH (unexplained no head injury) and a very large ruptured MCA aneurysm. Patient was COMPLETELY asymptomatic prior to vaccination. The aneurysm was repaired with success but the cerebral hemorrhages kept appearing - unexplained. Cerebral edema became so severe (midline shift up to 9-10mm) neurosurgery ended up performing a burr hole craniotomy to relieve pressure as well as placement of a ventriculostomy. This patient later ended up with severe vasospasms which results in an ischemic stroke of the L frontal lobe. Patient later died in a rehabilitation facility, all of this secondary to the Janssen vaccine. This vaccine should not be administered until further studied. This was a healthy 63 year old woman. Vitals always WNL labs WNL very active, BMI WNL. Absolutely NO comorbidities. A lifelong nurse who raised 2 nurses of her own.  These events took place for over a month. The trauma not only the patient has experienced but her family is unforgivable."
	"1340672-1"	"1340672-1"	"VENTRICULAR CISTERNOSTOMY"	"10047286"	"60-64 years"	"60-64"	"Patient went to ER 4/4/21 with severe headache, inability to stay awake. CT scan of the head revealed multiple areas of SAH (unexplained no head injury) and a very large ruptured MCA aneurysm. Patient was COMPLETELY asymptomatic prior to vaccination. The aneurysm was repaired with success but the cerebral hemorrhages kept appearing - unexplained. Cerebral edema became so severe (midline shift up to 9-10mm) neurosurgery ended up performing a burr hole craniotomy to relieve pressure as well as placement of a ventriculostomy. This patient later ended up with severe vasospasms which results in an ischemic stroke of the L frontal lobe. Patient later died in a rehabilitation facility, all of this secondary to the Janssen vaccine. This vaccine should not be administered until further studied. This was a healthy 63 year old woman. Vitals always WNL labs WNL very active, BMI WNL. Absolutely NO comorbidities. A lifelong nurse who raised 2 nurses of her own.  These events took place for over a month. The trauma not only the patient has experienced but her family is unforgivable."
	"1340773-1"	"1340773-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pulmonary Embolism, Died on way to hospital, medical examiner report pending"
	"1340773-1"	"1340773-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"Pulmonary Embolism, Died on way to hospital, medical examiner report pending"
	"1340821-1"	"1340821-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Please check with her doctors. I know she mentioned Myocarditis.  She was vaccinated I am correct, on March 8 and April 6, 2021"
	"1340821-1"	"1340821-1"	"MYOCARDITIS"	"10028606"	"60-64 years"	"60-64"	"Please check with her doctors. I know she mentioned Myocarditis.  She was vaccinated I am correct, on March 8 and April 6, 2021"
	"1343241-1"	"1343241-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"Outcome :  patient died  Cause :  cardio respiratory arrest  Had previously tested for any heart problem but his heart was in excellent conditions"
	"1343241-1"	"1343241-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Outcome :  patient died  Cause :  cardio respiratory arrest  Had previously tested for any heart problem but his heart was in excellent conditions"
	"1343926-1"	"1343926-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"60-64 years"	"60-64"	"Patient presented to the ED on 5/7/21 with CVA. He was hospitalized on 5/8/21 for 12 days, and died on 5/20/21."
	"1343926-1"	"1343926-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient presented to the ED on 5/7/21 with CVA. He was hospitalized on 5/8/21 for 12 days, and died on 5/20/21."
	"1347815-1"	"1347815-1"	"ANEURYSM"	"10002329"	"60-64 years"	"60-64"	"passed away suddenly a day after getting his first Moderna covid vaccine. He got the vaccine said he felt fine other that having a sore arm he has in good spirits and joking around according to his  coworkers. He died suddenly a day later circumstances are unknown ,He had passed before he was discovered.  No autopsy was done. Aneurysm is suspected."
	"1347815-1"	"1347815-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"passed away suddenly a day after getting his first Moderna covid vaccine. He got the vaccine said he felt fine other that having a sore arm he has in good spirits and joking around according to his  coworkers. He died suddenly a day later circumstances are unknown ,He had passed before he was discovered.  No autopsy was done. Aneurysm is suspected."
	"1347815-1"	"1347815-1"	"PAIN IN EXTREMITY"	"10033425"	"60-64 years"	"60-64"	"passed away suddenly a day after getting his first Moderna covid vaccine. He got the vaccine said he felt fine other that having a sore arm he has in good spirits and joking around according to his  coworkers. He died suddenly a day later circumstances are unknown ,He had passed before he was discovered.  No autopsy was done. Aneurysm is suspected."
	"1347815-1"	"1347815-1"	"SUDDEN DEATH"	"10042434"	"60-64 years"	"60-64"	"passed away suddenly a day after getting his first Moderna covid vaccine. He got the vaccine said he felt fine other that having a sore arm he has in good spirits and joking around according to his  coworkers. He died suddenly a day later circumstances are unknown ,He had passed before he was discovered.  No autopsy was done. Aneurysm is suspected."
	"1348290-1"	"1348290-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"The patient received the vaccine, but uses the other pharmacy in town for his medications. The pharmacist called me to relay the info he got from the patient's family. He said that the patient had a headache and body aches on Saturday 05/22/2021 and went to bed but did not wake up the next morning."
	"1348290-1"	"1348290-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"The patient received the vaccine, but uses the other pharmacy in town for his medications. The pharmacist called me to relay the info he got from the patient's family. He said that the patient had a headache and body aches on Saturday 05/22/2021 and went to bed but did not wake up the next morning."
	"1348290-1"	"1348290-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"The patient received the vaccine, but uses the other pharmacy in town for his medications. The pharmacist called me to relay the info he got from the patient's family. He said that the patient had a headache and body aches on Saturday 05/22/2021 and went to bed but did not wake up the next morning."
	"1350521-1"	"1350521-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient was hospitalized 5/7/2021 after testing positive for COVID-19 on 4/30/2021. Patient was fully vaccinated. He died 5/18/2021."
	"1350521-1"	"1350521-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient was hospitalized 5/7/2021 after testing positive for COVID-19 on 4/30/2021. Patient was fully vaccinated. He died 5/18/2021."
	"1350521-1"	"1350521-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Patient was hospitalized 5/7/2021 after testing positive for COVID-19 on 4/30/2021. Patient was fully vaccinated. He died 5/18/2021."
	"1350521-1"	"1350521-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"60-64 years"	"60-64"	"Patient was hospitalized 5/7/2021 after testing positive for COVID-19 on 4/30/2021. Patient was fully vaccinated. He died 5/18/2021."
	"1351564-1"	"1351564-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pulmonary embolism that resulted in death"
	"1351564-1"	"1351564-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"Pulmonary embolism that resulted in death"
	"1351581-1"	"1351581-1"	"BURNING SENSATION"	"10006784"	"60-64 years"	"60-64"	"Complaint of cramping in legs on April 26. 2021. Resolved for a short period of time. Earlier in May 2021 Complaint of Left Flank pain with Radiating  pain to Left Thigh.  Appointment with Orthopod cancelled due to inability to drive with pain. On May 15, 2021 complaint of continued Left Flank Pain Radiating to to Left thigh with burning and discoloration. Unresponsive on May 16, 2021. Pronounced Dead at 1:52pm by County Coroner. Cause of death noted as CV. Nature of death :Natural  This is being reported in case another patient complains of these same symptoms. There may or may not be a Correlation with this Death and The Jassen Covid-19 Vaccine"
	"1351581-1"	"1351581-1"	"CARDIOVASCULAR DISORDER"	"10007649"	"60-64 years"	"60-64"	"Complaint of cramping in legs on April 26. 2021. Resolved for a short period of time. Earlier in May 2021 Complaint of Left Flank pain with Radiating  pain to Left Thigh.  Appointment with Orthopod cancelled due to inability to drive with pain. On May 15, 2021 complaint of continued Left Flank Pain Radiating to to Left thigh with burning and discoloration. Unresponsive on May 16, 2021. Pronounced Dead at 1:52pm by County Coroner. Cause of death noted as CV. Nature of death :Natural  This is being reported in case another patient complains of these same symptoms. There may or may not be a Correlation with this Death and The Jassen Covid-19 Vaccine"
	"1351581-1"	"1351581-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Complaint of cramping in legs on April 26. 2021. Resolved for a short period of time. Earlier in May 2021 Complaint of Left Flank pain with Radiating  pain to Left Thigh.  Appointment with Orthopod cancelled due to inability to drive with pain. On May 15, 2021 complaint of continued Left Flank Pain Radiating to to Left thigh with burning and discoloration. Unresponsive on May 16, 2021. Pronounced Dead at 1:52pm by County Coroner. Cause of death noted as CV. Nature of death :Natural  This is being reported in case another patient complains of these same symptoms. There may or may not be a Correlation with this Death and The Jassen Covid-19 Vaccine"
	"1351581-1"	"1351581-1"	"FLANK PAIN"	"10016750"	"60-64 years"	"60-64"	"Complaint of cramping in legs on April 26. 2021. Resolved for a short period of time. Earlier in May 2021 Complaint of Left Flank pain with Radiating  pain to Left Thigh.  Appointment with Orthopod cancelled due to inability to drive with pain. On May 15, 2021 complaint of continued Left Flank Pain Radiating to to Left thigh with burning and discoloration. Unresponsive on May 16, 2021. Pronounced Dead at 1:52pm by County Coroner. Cause of death noted as CV. Nature of death :Natural  This is being reported in case another patient complains of these same symptoms. There may or may not be a Correlation with this Death and The Jassen Covid-19 Vaccine"
	"1351581-1"	"1351581-1"	"IMPAIRED DRIVING ABILITY"	"10049564"	"60-64 years"	"60-64"	"Complaint of cramping in legs on April 26. 2021. Resolved for a short period of time. Earlier in May 2021 Complaint of Left Flank pain with Radiating  pain to Left Thigh.  Appointment with Orthopod cancelled due to inability to drive with pain. On May 15, 2021 complaint of continued Left Flank Pain Radiating to to Left thigh with burning and discoloration. Unresponsive on May 16, 2021. Pronounced Dead at 1:52pm by County Coroner. Cause of death noted as CV. Nature of death :Natural  This is being reported in case another patient complains of these same symptoms. There may or may not be a Correlation with this Death and The Jassen Covid-19 Vaccine"
	"1351581-1"	"1351581-1"	"MUSCLE SPASMS"	"10028334"	"60-64 years"	"60-64"	"Complaint of cramping in legs on April 26. 2021. Resolved for a short period of time. Earlier in May 2021 Complaint of Left Flank pain with Radiating  pain to Left Thigh.  Appointment with Orthopod cancelled due to inability to drive with pain. On May 15, 2021 complaint of continued Left Flank Pain Radiating to to Left thigh with burning and discoloration. Unresponsive on May 16, 2021. Pronounced Dead at 1:52pm by County Coroner. Cause of death noted as CV. Nature of death :Natural  This is being reported in case another patient complains of these same symptoms. There may or may not be a Correlation with this Death and The Jassen Covid-19 Vaccine"
	"1351581-1"	"1351581-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"Complaint of cramping in legs on April 26. 2021. Resolved for a short period of time. Earlier in May 2021 Complaint of Left Flank pain with Radiating  pain to Left Thigh.  Appointment with Orthopod cancelled due to inability to drive with pain. On May 15, 2021 complaint of continued Left Flank Pain Radiating to to Left thigh with burning and discoloration. Unresponsive on May 16, 2021. Pronounced Dead at 1:52pm by County Coroner. Cause of death noted as CV. Nature of death :Natural  This is being reported in case another patient complains of these same symptoms. There may or may not be a Correlation with this Death and The Jassen Covid-19 Vaccine"
	"1351581-1"	"1351581-1"	"PAIN IN EXTREMITY"	"10033425"	"60-64 years"	"60-64"	"Complaint of cramping in legs on April 26. 2021. Resolved for a short period of time. Earlier in May 2021 Complaint of Left Flank pain with Radiating  pain to Left Thigh.  Appointment with Orthopod cancelled due to inability to drive with pain. On May 15, 2021 complaint of continued Left Flank Pain Radiating to to Left thigh with burning and discoloration. Unresponsive on May 16, 2021. Pronounced Dead at 1:52pm by County Coroner. Cause of death noted as CV. Nature of death :Natural  This is being reported in case another patient complains of these same symptoms. There may or may not be a Correlation with this Death and The Jassen Covid-19 Vaccine"
	"1351581-1"	"1351581-1"	"SKIN DISCOLOURATION"	"10040829"	"60-64 years"	"60-64"	"Complaint of cramping in legs on April 26. 2021. Resolved for a short period of time. Earlier in May 2021 Complaint of Left Flank pain with Radiating  pain to Left Thigh.  Appointment with Orthopod cancelled due to inability to drive with pain. On May 15, 2021 complaint of continued Left Flank Pain Radiating to to Left thigh with burning and discoloration. Unresponsive on May 16, 2021. Pronounced Dead at 1:52pm by County Coroner. Cause of death noted as CV. Nature of death :Natural  This is being reported in case another patient complains of these same symptoms. There may or may not be a Correlation with this Death and The Jassen Covid-19 Vaccine"
	"1351581-1"	"1351581-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Complaint of cramping in legs on April 26. 2021. Resolved for a short period of time. Earlier in May 2021 Complaint of Left Flank pain with Radiating  pain to Left Thigh.  Appointment with Orthopod cancelled due to inability to drive with pain. On May 15, 2021 complaint of continued Left Flank Pain Radiating to to Left thigh with burning and discoloration. Unresponsive on May 16, 2021. Pronounced Dead at 1:52pm by County Coroner. Cause of death noted as CV. Nature of death :Natural  This is being reported in case another patient complains of these same symptoms. There may or may not be a Correlation with this Death and The Jassen Covid-19 Vaccine"
	"1354601-1"	"1354601-1"	"BLOOD CREATINE INCREASED"	"10005464"	"60-64 years"	"60-64"	"cardiomegaly,  with significant bilateral lung abnormality. in addition, pulmonary edema with extensive bilateral multifocal pneumonia"
	"1354601-1"	"1354601-1"	"CARDIOMEGALY"	"10007632"	"60-64 years"	"60-64"	"cardiomegaly,  with significant bilateral lung abnormality. in addition, pulmonary edema with extensive bilateral multifocal pneumonia"
	"1354601-1"	"1354601-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"cardiomegaly,  with significant bilateral lung abnormality. in addition, pulmonary edema with extensive bilateral multifocal pneumonia"
	"1354601-1"	"1354601-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"cardiomegaly,  with significant bilateral lung abnormality. in addition, pulmonary edema with extensive bilateral multifocal pneumonia"
	"1354601-1"	"1354601-1"	"HAEMATOCRIT"	"10018837"	"60-64 years"	"60-64"	"cardiomegaly,  with significant bilateral lung abnormality. in addition, pulmonary edema with extensive bilateral multifocal pneumonia"
	"1354601-1"	"1354601-1"	"HAEMOGLOBIN DECREASED"	"10018884"	"60-64 years"	"60-64"	"cardiomegaly,  with significant bilateral lung abnormality. in addition, pulmonary edema with extensive bilateral multifocal pneumonia"
	"1354601-1"	"1354601-1"	"LIVER FUNCTION TEST INCREASED"	"10077692"	"60-64 years"	"60-64"	"cardiomegaly,  with significant bilateral lung abnormality. in addition, pulmonary edema with extensive bilateral multifocal pneumonia"
	"1354601-1"	"1354601-1"	"LUNG DISORDER"	"10025082"	"60-64 years"	"60-64"	"cardiomegaly,  with significant bilateral lung abnormality. in addition, pulmonary edema with extensive bilateral multifocal pneumonia"
	"1354601-1"	"1354601-1"	"MEAN CELL HAEMOGLOBIN"	"10026989"	"60-64 years"	"60-64"	"cardiomegaly,  with significant bilateral lung abnormality. in addition, pulmonary edema with extensive bilateral multifocal pneumonia"
	"1354601-1"	"1354601-1"	"MEAN CELL HAEMOGLOBIN CONCENTRATION"	"10026990"	"60-64 years"	"60-64"	"cardiomegaly,  with significant bilateral lung abnormality. in addition, pulmonary edema with extensive bilateral multifocal pneumonia"
	"1354601-1"	"1354601-1"	"MEAN CELL VOLUME"	"10026999"	"60-64 years"	"60-64"	"cardiomegaly,  with significant bilateral lung abnormality. in addition, pulmonary edema with extensive bilateral multifocal pneumonia"
	"1354601-1"	"1354601-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"cardiomegaly,  with significant bilateral lung abnormality. in addition, pulmonary edema with extensive bilateral multifocal pneumonia"
	"1354601-1"	"1354601-1"	"PULMONARY OEDEMA"	"10037423"	"60-64 years"	"60-64"	"cardiomegaly,  with significant bilateral lung abnormality. in addition, pulmonary edema with extensive bilateral multifocal pneumonia"
	"1354872-1"	"1354872-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient was hospitalized multiple times and died within 60 days of receiving a COVID vaccine series"
	"1358091-1"	"1358091-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"My husband died on May 1st after receiving the vaccine on April 27th."
	"1358542-1"	"1358542-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"The spouse reported onset of symptoms on 5/20/21 including lethargy.  He reported that on 5/27/21, her speech became slurred and she died.  Per spouse, an autopsy is pending."
	"1358542-1"	"1358542-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"The spouse reported onset of symptoms on 5/20/21 including lethargy.  He reported that on 5/27/21, her speech became slurred and she died.  Per spouse, an autopsy is pending."
	"1358542-1"	"1358542-1"	"DYSARTHRIA"	"10013887"	"60-64 years"	"60-64"	"The spouse reported onset of symptoms on 5/20/21 including lethargy.  He reported that on 5/27/21, her speech became slurred and she died.  Per spouse, an autopsy is pending."
	"1358542-1"	"1358542-1"	"LETHARGY"	"10024264"	"60-64 years"	"60-64"	"The spouse reported onset of symptoms on 5/20/21 including lethargy.  He reported that on 5/27/21, her speech became slurred and she died.  Per spouse, an autopsy is pending."
	"1361500-1"	"1361500-1"	"ABDOMINAL PAIN"	"10000081"	"60-64 years"	"60-64"	"Patient received vaccine on Thursday evening.  He began to feel very tired Monday and Tuesday.  Wednesday he woke up in alot of abdominal pain.  We went to healthcare facility at 4:30pm.  He was diagnosed with Acute Pancreatitis.  He was sent home at 10:30pm    We went back to ED at 1:30 am Thursday.  He was admitted during the day.  In the early morning of Friday May 28th his blood pressure tanked and he became unresponsive.  His heart stopped and they did compressions for 8-9 minutes.  He was put into ICU.  By 3am we were told he may not survive.  By 5 am we were told his organs were shutting down.  He passed around 7:45am.  In researching the vaccine we discovered the SARS virus used in vaccine can attack the pancreas.  We believe he died as a result of the reaction to the vaccine and his body and organs could not fight."
	"1361500-1"	"1361500-1"	"BLOOD PRESSURE DECREASED"	"10005734"	"60-64 years"	"60-64"	"Patient received vaccine on Thursday evening.  He began to feel very tired Monday and Tuesday.  Wednesday he woke up in alot of abdominal pain.  We went to healthcare facility at 4:30pm.  He was diagnosed with Acute Pancreatitis.  He was sent home at 10:30pm    We went back to ED at 1:30 am Thursday.  He was admitted during the day.  In the early morning of Friday May 28th his blood pressure tanked and he became unresponsive.  His heart stopped and they did compressions for 8-9 minutes.  He was put into ICU.  By 3am we were told he may not survive.  By 5 am we were told his organs were shutting down.  He passed around 7:45am.  In researching the vaccine we discovered the SARS virus used in vaccine can attack the pancreas.  We believe he died as a result of the reaction to the vaccine and his body and organs could not fight."
	"1361500-1"	"1361500-1"	"BLOOD TEST"	"10061726"	"60-64 years"	"60-64"	"Patient received vaccine on Thursday evening.  He began to feel very tired Monday and Tuesday.  Wednesday he woke up in alot of abdominal pain.  We went to healthcare facility at 4:30pm.  He was diagnosed with Acute Pancreatitis.  He was sent home at 10:30pm    We went back to ED at 1:30 am Thursday.  He was admitted during the day.  In the early morning of Friday May 28th his blood pressure tanked and he became unresponsive.  His heart stopped and they did compressions for 8-9 minutes.  He was put into ICU.  By 3am we were told he may not survive.  By 5 am we were told his organs were shutting down.  He passed around 7:45am.  In researching the vaccine we discovered the SARS virus used in vaccine can attack the pancreas.  We believe he died as a result of the reaction to the vaccine and his body and organs could not fight."
	"1361500-1"	"1361500-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Patient received vaccine on Thursday evening.  He began to feel very tired Monday and Tuesday.  Wednesday he woke up in alot of abdominal pain.  We went to healthcare facility at 4:30pm.  He was diagnosed with Acute Pancreatitis.  He was sent home at 10:30pm    We went back to ED at 1:30 am Thursday.  He was admitted during the day.  In the early morning of Friday May 28th his blood pressure tanked and he became unresponsive.  His heart stopped and they did compressions for 8-9 minutes.  He was put into ICU.  By 3am we were told he may not survive.  By 5 am we were told his organs were shutting down.  He passed around 7:45am.  In researching the vaccine we discovered the SARS virus used in vaccine can attack the pancreas.  We believe he died as a result of the reaction to the vaccine and his body and organs could not fight."
	"1361500-1"	"1361500-1"	"COMPUTERISED TOMOGRAM"	"10010234"	"60-64 years"	"60-64"	"Patient received vaccine on Thursday evening.  He began to feel very tired Monday and Tuesday.  Wednesday he woke up in alot of abdominal pain.  We went to healthcare facility at 4:30pm.  He was diagnosed with Acute Pancreatitis.  He was sent home at 10:30pm    We went back to ED at 1:30 am Thursday.  He was admitted during the day.  In the early morning of Friday May 28th his blood pressure tanked and he became unresponsive.  His heart stopped and they did compressions for 8-9 minutes.  He was put into ICU.  By 3am we were told he may not survive.  By 5 am we were told his organs were shutting down.  He passed around 7:45am.  In researching the vaccine we discovered the SARS virus used in vaccine can attack the pancreas.  We believe he died as a result of the reaction to the vaccine and his body and organs could not fight."
	"1361500-1"	"1361500-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient received vaccine on Thursday evening.  He began to feel very tired Monday and Tuesday.  Wednesday he woke up in alot of abdominal pain.  We went to healthcare facility at 4:30pm.  He was diagnosed with Acute Pancreatitis.  He was sent home at 10:30pm    We went back to ED at 1:30 am Thursday.  He was admitted during the day.  In the early morning of Friday May 28th his blood pressure tanked and he became unresponsive.  His heart stopped and they did compressions for 8-9 minutes.  He was put into ICU.  By 3am we were told he may not survive.  By 5 am we were told his organs were shutting down.  He passed around 7:45am.  In researching the vaccine we discovered the SARS virus used in vaccine can attack the pancreas.  We believe he died as a result of the reaction to the vaccine and his body and organs could not fight."
	"1361500-1"	"1361500-1"	"ELECTROCARDIOGRAM"	"10014362"	"60-64 years"	"60-64"	"Patient received vaccine on Thursday evening.  He began to feel very tired Monday and Tuesday.  Wednesday he woke up in alot of abdominal pain.  We went to healthcare facility at 4:30pm.  He was diagnosed with Acute Pancreatitis.  He was sent home at 10:30pm    We went back to ED at 1:30 am Thursday.  He was admitted during the day.  In the early morning of Friday May 28th his blood pressure tanked and he became unresponsive.  His heart stopped and they did compressions for 8-9 minutes.  He was put into ICU.  By 3am we were told he may not survive.  By 5 am we were told his organs were shutting down.  He passed around 7:45am.  In researching the vaccine we discovered the SARS virus used in vaccine can attack the pancreas.  We believe he died as a result of the reaction to the vaccine and his body and organs could not fight."
	"1361500-1"	"1361500-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Patient received vaccine on Thursday evening.  He began to feel very tired Monday and Tuesday.  Wednesday he woke up in alot of abdominal pain.  We went to healthcare facility at 4:30pm.  He was diagnosed with Acute Pancreatitis.  He was sent home at 10:30pm    We went back to ED at 1:30 am Thursday.  He was admitted during the day.  In the early morning of Friday May 28th his blood pressure tanked and he became unresponsive.  His heart stopped and they did compressions for 8-9 minutes.  He was put into ICU.  By 3am we were told he may not survive.  By 5 am we were told his organs were shutting down.  He passed around 7:45am.  In researching the vaccine we discovered the SARS virus used in vaccine can attack the pancreas.  We believe he died as a result of the reaction to the vaccine and his body and organs could not fight."
	"1361500-1"	"1361500-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Patient received vaccine on Thursday evening.  He began to feel very tired Monday and Tuesday.  Wednesday he woke up in alot of abdominal pain.  We went to healthcare facility at 4:30pm.  He was diagnosed with Acute Pancreatitis.  He was sent home at 10:30pm    We went back to ED at 1:30 am Thursday.  He was admitted during the day.  In the early morning of Friday May 28th his blood pressure tanked and he became unresponsive.  His heart stopped and they did compressions for 8-9 minutes.  He was put into ICU.  By 3am we were told he may not survive.  By 5 am we were told his organs were shutting down.  He passed around 7:45am.  In researching the vaccine we discovered the SARS virus used in vaccine can attack the pancreas.  We believe he died as a result of the reaction to the vaccine and his body and organs could not fight."
	"1361500-1"	"1361500-1"	"ORGAN FAILURE"	"10053159"	"60-64 years"	"60-64"	"Patient received vaccine on Thursday evening.  He began to feel very tired Monday and Tuesday.  Wednesday he woke up in alot of abdominal pain.  We went to healthcare facility at 4:30pm.  He was diagnosed with Acute Pancreatitis.  He was sent home at 10:30pm    We went back to ED at 1:30 am Thursday.  He was admitted during the day.  In the early morning of Friday May 28th his blood pressure tanked and he became unresponsive.  His heart stopped and they did compressions for 8-9 minutes.  He was put into ICU.  By 3am we were told he may not survive.  By 5 am we were told his organs were shutting down.  He passed around 7:45am.  In researching the vaccine we discovered the SARS virus used in vaccine can attack the pancreas.  We believe he died as a result of the reaction to the vaccine and his body and organs could not fight."
	"1361500-1"	"1361500-1"	"PANCREATITIS ACUTE"	"10033647"	"60-64 years"	"60-64"	"Patient received vaccine on Thursday evening.  He began to feel very tired Monday and Tuesday.  Wednesday he woke up in alot of abdominal pain.  We went to healthcare facility at 4:30pm.  He was diagnosed with Acute Pancreatitis.  He was sent home at 10:30pm    We went back to ED at 1:30 am Thursday.  He was admitted during the day.  In the early morning of Friday May 28th his blood pressure tanked and he became unresponsive.  His heart stopped and they did compressions for 8-9 minutes.  He was put into ICU.  By 3am we were told he may not survive.  By 5 am we were told his organs were shutting down.  He passed around 7:45am.  In researching the vaccine we discovered the SARS virus used in vaccine can attack the pancreas.  We believe he died as a result of the reaction to the vaccine and his body and organs could not fight."
	"1361500-1"	"1361500-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Patient received vaccine on Thursday evening.  He began to feel very tired Monday and Tuesday.  Wednesday he woke up in alot of abdominal pain.  We went to healthcare facility at 4:30pm.  He was diagnosed with Acute Pancreatitis.  He was sent home at 10:30pm    We went back to ED at 1:30 am Thursday.  He was admitted during the day.  In the early morning of Friday May 28th his blood pressure tanked and he became unresponsive.  His heart stopped and they did compressions for 8-9 minutes.  He was put into ICU.  By 3am we were told he may not survive.  By 5 am we were told his organs were shutting down.  He passed around 7:45am.  In researching the vaccine we discovered the SARS virus used in vaccine can attack the pancreas.  We believe he died as a result of the reaction to the vaccine and his body and organs could not fight."
	"1361500-1"	"1361500-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Patient received vaccine on Thursday evening.  He began to feel very tired Monday and Tuesday.  Wednesday he woke up in alot of abdominal pain.  We went to healthcare facility at 4:30pm.  He was diagnosed with Acute Pancreatitis.  He was sent home at 10:30pm    We went back to ED at 1:30 am Thursday.  He was admitted during the day.  In the early morning of Friday May 28th his blood pressure tanked and he became unresponsive.  His heart stopped and they did compressions for 8-9 minutes.  He was put into ICU.  By 3am we were told he may not survive.  By 5 am we were told his organs were shutting down.  He passed around 7:45am.  In researching the vaccine we discovered the SARS virus used in vaccine can attack the pancreas.  We believe he died as a result of the reaction to the vaccine and his body and organs could not fight."
	"1361857-1"	"1361857-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"DEATH, lethargic, migraines, tired"
	"1361857-1"	"1361857-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"DEATH, lethargic, migraines, tired"
	"1361857-1"	"1361857-1"	"LETHARGY"	"10024264"	"60-64 years"	"60-64"	"DEATH, lethargic, migraines, tired"
	"1361857-1"	"1361857-1"	"MIGRAINE"	"10027599"	"60-64 years"	"60-64"	"DEATH, lethargic, migraines, tired"
	"1362130-1"	"1362130-1"	"ANGIOGRAM PULMONARY"	"10002440"	"60-64 years"	"60-64"	"Acute onset stroke symptoms the afternoon of 4/13/21 after returning home from room.  EMS transported pt to local hospital. Dx with aortic arch/proximal subclavian artery thrombus, migration into axillary artery.   Treated at local hospital with TNK for aortic arch clot & ischemic stroke.  Transferred to tertiary medical center.  Pt had massive stroke (left & right side) with brain stem herniation. Pt CMO after 16hrs and expired on 4/14, <32 hrs after symptom onset."
	"1362130-1"	"1362130-1"	"AORTIC THROMBOSIS"	"10002910"	"60-64 years"	"60-64"	"Acute onset stroke symptoms the afternoon of 4/13/21 after returning home from room.  EMS transported pt to local hospital. Dx with aortic arch/proximal subclavian artery thrombus, migration into axillary artery.   Treated at local hospital with TNK for aortic arch clot & ischemic stroke.  Transferred to tertiary medical center.  Pt had massive stroke (left & right side) with brain stem herniation. Pt CMO after 16hrs and expired on 4/14, <32 hrs after symptom onset."
	"1362130-1"	"1362130-1"	"BRAIN HERNIATION"	"10006126"	"60-64 years"	"60-64"	"Acute onset stroke symptoms the afternoon of 4/13/21 after returning home from room.  EMS transported pt to local hospital. Dx with aortic arch/proximal subclavian artery thrombus, migration into axillary artery.   Treated at local hospital with TNK for aortic arch clot & ischemic stroke.  Transferred to tertiary medical center.  Pt had massive stroke (left & right side) with brain stem herniation. Pt CMO after 16hrs and expired on 4/14, <32 hrs after symptom onset."
	"1362130-1"	"1362130-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"60-64 years"	"60-64"	"Acute onset stroke symptoms the afternoon of 4/13/21 after returning home from room.  EMS transported pt to local hospital. Dx with aortic arch/proximal subclavian artery thrombus, migration into axillary artery.   Treated at local hospital with TNK for aortic arch clot & ischemic stroke.  Transferred to tertiary medical center.  Pt had massive stroke (left & right side) with brain stem herniation. Pt CMO after 16hrs and expired on 4/14, <32 hrs after symptom onset."
	"1362130-1"	"1362130-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"60-64 years"	"60-64"	"Acute onset stroke symptoms the afternoon of 4/13/21 after returning home from room.  EMS transported pt to local hospital. Dx with aortic arch/proximal subclavian artery thrombus, migration into axillary artery.   Treated at local hospital with TNK for aortic arch clot & ischemic stroke.  Transferred to tertiary medical center.  Pt had massive stroke (left & right side) with brain stem herniation. Pt CMO after 16hrs and expired on 4/14, <32 hrs after symptom onset."
	"1362130-1"	"1362130-1"	"COMPUTERISED TOMOGRAM THORAX ABNORMAL"	"10057799"	"60-64 years"	"60-64"	"Acute onset stroke symptoms the afternoon of 4/13/21 after returning home from room.  EMS transported pt to local hospital. Dx with aortic arch/proximal subclavian artery thrombus, migration into axillary artery.   Treated at local hospital with TNK for aortic arch clot & ischemic stroke.  Transferred to tertiary medical center.  Pt had massive stroke (left & right side) with brain stem herniation. Pt CMO after 16hrs and expired on 4/14, <32 hrs after symptom onset."
	"1362130-1"	"1362130-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Acute onset stroke symptoms the afternoon of 4/13/21 after returning home from room.  EMS transported pt to local hospital. Dx with aortic arch/proximal subclavian artery thrombus, migration into axillary artery.   Treated at local hospital with TNK for aortic arch clot & ischemic stroke.  Transferred to tertiary medical center.  Pt had massive stroke (left & right side) with brain stem herniation. Pt CMO after 16hrs and expired on 4/14, <32 hrs after symptom onset."
	"1362130-1"	"1362130-1"	"ISCHAEMIC STROKE"	"10061256"	"60-64 years"	"60-64"	"Acute onset stroke symptoms the afternoon of 4/13/21 after returning home from room.  EMS transported pt to local hospital. Dx with aortic arch/proximal subclavian artery thrombus, migration into axillary artery.   Treated at local hospital with TNK for aortic arch clot & ischemic stroke.  Transferred to tertiary medical center.  Pt had massive stroke (left & right side) with brain stem herniation. Pt CMO after 16hrs and expired on 4/14, <32 hrs after symptom onset."
	"1362130-1"	"1362130-1"	"LABORATORY TEST"	"10059938"	"60-64 years"	"60-64"	"Acute onset stroke symptoms the afternoon of 4/13/21 after returning home from room.  EMS transported pt to local hospital. Dx with aortic arch/proximal subclavian artery thrombus, migration into axillary artery.   Treated at local hospital with TNK for aortic arch clot & ischemic stroke.  Transferred to tertiary medical center.  Pt had massive stroke (left & right side) with brain stem herniation. Pt CMO after 16hrs and expired on 4/14, <32 hrs after symptom onset."
	"1362130-1"	"1362130-1"	"MAGNETIC RESONANCE IMAGING"	"10078223"	"60-64 years"	"60-64"	"Acute onset stroke symptoms the afternoon of 4/13/21 after returning home from room.  EMS transported pt to local hospital. Dx with aortic arch/proximal subclavian artery thrombus, migration into axillary artery.   Treated at local hospital with TNK for aortic arch clot & ischemic stroke.  Transferred to tertiary medical center.  Pt had massive stroke (left & right side) with brain stem herniation. Pt CMO after 16hrs and expired on 4/14, <32 hrs after symptom onset."
	"1362130-1"	"1362130-1"	"NEUROLOGICAL SYMPTOM"	"10060860"	"60-64 years"	"60-64"	"Acute onset stroke symptoms the afternoon of 4/13/21 after returning home from room.  EMS transported pt to local hospital. Dx with aortic arch/proximal subclavian artery thrombus, migration into axillary artery.   Treated at local hospital with TNK for aortic arch clot & ischemic stroke.  Transferred to tertiary medical center.  Pt had massive stroke (left & right side) with brain stem herniation. Pt CMO after 16hrs and expired on 4/14, <32 hrs after symptom onset."
	"1362130-1"	"1362130-1"	"PERIPHERAL ARTERY THROMBOSIS"	"10072564"	"60-64 years"	"60-64"	"Acute onset stroke symptoms the afternoon of 4/13/21 after returning home from room.  EMS transported pt to local hospital. Dx with aortic arch/proximal subclavian artery thrombus, migration into axillary artery.   Treated at local hospital with TNK for aortic arch clot & ischemic stroke.  Transferred to tertiary medical center.  Pt had massive stroke (left & right side) with brain stem herniation. Pt CMO after 16hrs and expired on 4/14, <32 hrs after symptom onset."
	"1364018-1"	"1364018-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	""Cardiac Arrest  (38 days after second vaccine); This spontaneous case was reported by a consumer and describes the occurrence of CARDIAC ARREST (Cardiac Arrest  (38 days after second vaccine)) in a 61-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination.     No Medical History information was reported.   On 03-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 31-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to 1 dosage form. On 08-May-2021,  after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced CARDIAC ARREST (Cardiac Arrest  (38 days after second vaccine)) (seriousness criteria death, medically significant and life threatening). The patient died on 08-May-2021. The reported cause of death was cardiac arrest  (38 days after second vaccine). It is unknown if an autopsy was performed.            It was reported  that Lot number 023M20A was the only lot on the vaccination card. Caller was not sure if this lot is from first or second vaccine.""  Treatment information was not reported but it was reported ""Paramedics were there at home and they could not resuscitate him.""  Concomitant medication was not reported.  Company Comment: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the event, a causal relationship cannot be excluded.; Reported Cause(s) of Death: Cardiac Arrest  (38 days after second vaccine)""
	"1364761-1"	"1364761-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"Please note the patient did not receive the vaccination at state Medicine  so the lot # and site of administration information is NOT available.  Unclear if vaccine contributed to patient condition or outcome, but reporting due to timing of events. Patient received her 2nd Pfizer COVID vaccine around 2 pm on 5/19. She felt fatigued and had some localized arm pain in the arm she received her shot. She returned home and took a long nap from 3:30 pm to 11 pm at her daughter's house. She was playing with her grand-daughter and lifting her up when all of a sudden the daughter and her daughter's husband noticed the patient made a grunting/choking noise. She all of a sudden became unresponsive, had fixed pupils and a blank stare and found to be in PEA arrest with acute respiratory failure. Patient was initially admitted 5/20 to  Medical Center and then transferred to state Medicine on 5/21.  Patient passed on 5/31/21."
	"1364761-1"	"1364761-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Please note the patient did not receive the vaccination at state Medicine  so the lot # and site of administration information is NOT available.  Unclear if vaccine contributed to patient condition or outcome, but reporting due to timing of events. Patient received her 2nd Pfizer COVID vaccine around 2 pm on 5/19. She felt fatigued and had some localized arm pain in the arm she received her shot. She returned home and took a long nap from 3:30 pm to 11 pm at her daughter's house. She was playing with her grand-daughter and lifting her up when all of a sudden the daughter and her daughter's husband noticed the patient made a grunting/choking noise. She all of a sudden became unresponsive, had fixed pupils and a blank stare and found to be in PEA arrest with acute respiratory failure. Patient was initially admitted 5/20 to  Medical Center and then transferred to state Medicine on 5/21.  Patient passed on 5/31/21."
	"1364761-1"	"1364761-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Please note the patient did not receive the vaccination at state Medicine  so the lot # and site of administration information is NOT available.  Unclear if vaccine contributed to patient condition or outcome, but reporting due to timing of events. Patient received her 2nd Pfizer COVID vaccine around 2 pm on 5/19. She felt fatigued and had some localized arm pain in the arm she received her shot. She returned home and took a long nap from 3:30 pm to 11 pm at her daughter's house. She was playing with her grand-daughter and lifting her up when all of a sudden the daughter and her daughter's husband noticed the patient made a grunting/choking noise. She all of a sudden became unresponsive, had fixed pupils and a blank stare and found to be in PEA arrest with acute respiratory failure. Patient was initially admitted 5/20 to  Medical Center and then transferred to state Medicine on 5/21.  Patient passed on 5/31/21."
	"1364761-1"	"1364761-1"	"GRUNTING"	"10018762"	"60-64 years"	"60-64"	"Please note the patient did not receive the vaccination at state Medicine  so the lot # and site of administration information is NOT available.  Unclear if vaccine contributed to patient condition or outcome, but reporting due to timing of events. Patient received her 2nd Pfizer COVID vaccine around 2 pm on 5/19. She felt fatigued and had some localized arm pain in the arm she received her shot. She returned home and took a long nap from 3:30 pm to 11 pm at her daughter's house. She was playing with her grand-daughter and lifting her up when all of a sudden the daughter and her daughter's husband noticed the patient made a grunting/choking noise. She all of a sudden became unresponsive, had fixed pupils and a blank stare and found to be in PEA arrest with acute respiratory failure. Patient was initially admitted 5/20 to  Medical Center and then transferred to state Medicine on 5/21.  Patient passed on 5/31/21."
	"1364761-1"	"1364761-1"	"INJECTION SITE PAIN"	"10022086"	"60-64 years"	"60-64"	"Please note the patient did not receive the vaccination at state Medicine  so the lot # and site of administration information is NOT available.  Unclear if vaccine contributed to patient condition or outcome, but reporting due to timing of events. Patient received her 2nd Pfizer COVID vaccine around 2 pm on 5/19. She felt fatigued and had some localized arm pain in the arm she received her shot. She returned home and took a long nap from 3:30 pm to 11 pm at her daughter's house. She was playing with her grand-daughter and lifting her up when all of a sudden the daughter and her daughter's husband noticed the patient made a grunting/choking noise. She all of a sudden became unresponsive, had fixed pupils and a blank stare and found to be in PEA arrest with acute respiratory failure. Patient was initially admitted 5/20 to  Medical Center and then transferred to state Medicine on 5/21.  Patient passed on 5/31/21."
	"1364761-1"	"1364761-1"	"PULSELESS ELECTRICAL ACTIVITY"	"10058151"	"60-64 years"	"60-64"	"Please note the patient did not receive the vaccination at state Medicine  so the lot # and site of administration information is NOT available.  Unclear if vaccine contributed to patient condition or outcome, but reporting due to timing of events. Patient received her 2nd Pfizer COVID vaccine around 2 pm on 5/19. She felt fatigued and had some localized arm pain in the arm she received her shot. She returned home and took a long nap from 3:30 pm to 11 pm at her daughter's house. She was playing with her grand-daughter and lifting her up when all of a sudden the daughter and her daughter's husband noticed the patient made a grunting/choking noise. She all of a sudden became unresponsive, had fixed pupils and a blank stare and found to be in PEA arrest with acute respiratory failure. Patient was initially admitted 5/20 to  Medical Center and then transferred to state Medicine on 5/21.  Patient passed on 5/31/21."
	"1364761-1"	"1364761-1"	"PUPIL FIXED"	"10037515"	"60-64 years"	"60-64"	"Please note the patient did not receive the vaccination at state Medicine  so the lot # and site of administration information is NOT available.  Unclear if vaccine contributed to patient condition or outcome, but reporting due to timing of events. Patient received her 2nd Pfizer COVID vaccine around 2 pm on 5/19. She felt fatigued and had some localized arm pain in the arm she received her shot. She returned home and took a long nap from 3:30 pm to 11 pm at her daughter's house. She was playing with her grand-daughter and lifting her up when all of a sudden the daughter and her daughter's husband noticed the patient made a grunting/choking noise. She all of a sudden became unresponsive, had fixed pupils and a blank stare and found to be in PEA arrest with acute respiratory failure. Patient was initially admitted 5/20 to  Medical Center and then transferred to state Medicine on 5/21.  Patient passed on 5/31/21."
	"1364761-1"	"1364761-1"	"REDUCED FACIAL EXPRESSION"	"10078576"	"60-64 years"	"60-64"	"Please note the patient did not receive the vaccination at state Medicine  so the lot # and site of administration information is NOT available.  Unclear if vaccine contributed to patient condition or outcome, but reporting due to timing of events. Patient received her 2nd Pfizer COVID vaccine around 2 pm on 5/19. She felt fatigued and had some localized arm pain in the arm she received her shot. She returned home and took a long nap from 3:30 pm to 11 pm at her daughter's house. She was playing with her grand-daughter and lifting her up when all of a sudden the daughter and her daughter's husband noticed the patient made a grunting/choking noise. She all of a sudden became unresponsive, had fixed pupils and a blank stare and found to be in PEA arrest with acute respiratory failure. Patient was initially admitted 5/20 to  Medical Center and then transferred to state Medicine on 5/21.  Patient passed on 5/31/21."
	"1364761-1"	"1364761-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Please note the patient did not receive the vaccination at state Medicine  so the lot # and site of administration information is NOT available.  Unclear if vaccine contributed to patient condition or outcome, but reporting due to timing of events. Patient received her 2nd Pfizer COVID vaccine around 2 pm on 5/19. She felt fatigued and had some localized arm pain in the arm she received her shot. She returned home and took a long nap from 3:30 pm to 11 pm at her daughter's house. She was playing with her grand-daughter and lifting her up when all of a sudden the daughter and her daughter's husband noticed the patient made a grunting/choking noise. She all of a sudden became unresponsive, had fixed pupils and a blank stare and found to be in PEA arrest with acute respiratory failure. Patient was initially admitted 5/20 to  Medical Center and then transferred to state Medicine on 5/21.  Patient passed on 5/31/21."
	"1365034-1"	"1365034-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"unknown"
	"1368008-1"	"1368008-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"BLOOD ELECTROLYTES NORMAL"	"10061015"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"BLOOD LACTIC ACID"	"10005632"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"CHEST TUBE INSERTION"	"10050522"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"FALL"	"10016173"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"FULL BLOOD COUNT NORMAL"	"10017414"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"GLYCOSYLATED HAEMOGLOBIN INCREASED"	"10018484"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"INFLUENZA A VIRUS TEST NEGATIVE"	"10070417"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"INFLUENZA B VIRUS TEST"	"10071544"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"LUNG INFILTRATION"	"10025102"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"LUNG OPACITY"	"10081792"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"PNEUMOTHORAX"	"10035759"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"PROCALCITONIN INCREASED"	"10067081"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"PULMONARY AIR LEAKAGE"	"10067826"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"PULMONARY OEDEMA"	"10037423"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"SEPSIS"	"10040047"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368008-1"	"1368008-1"	"TACHYPNOEA"	"10043089"	"60-64 years"	"60-64"	"4/28/21 Pt presented to the ED with complaints of a cough that started 2 weeks ago and was getting worse and weakness with several falls. She also admitted to intermittent diarrhea. She was found to be febrile with a temp to 101.1, tachypneic w/RR of 20. Sats were in the low 90's. NP was was positive for SARS-CoV-2. CXR showed bilateral opacities and she was admitted for PNA and sepsi. She was given Rocephin and Z-max in ED and both were discontinued upon admission. She was started on Decadron in ED  4/30 she had increasing hypoxemia and was placed on a non rebreather. She was transferred to critical care and given tocilizumab. Her respiratory status continued to worsen and she was intubated. She subsequently developed a pneumothorax that persisted despite 2 chest tubes. She developed a large air leak and she was not a surgical candidate. Family ultimately decided to w/draw care on 5/15/21"
	"1368325-1"	"1368325-1"	"BLOOD TEST"	"10061726"	"60-64 years"	"60-64"	"Reaction began within a few hours of vaccination.  Patient had fever, chills and diarrhea within a few hours of receiving the vaccine.  By 4:30am on 3/31 she could not walk and her legs went numb.  An ambulance was called and the EMTs had to carry her out of the house.  She was taken to Hospital where they started treating her for an infection but her fever went up over 103F so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms.  Doctors diagnosed sepsis.  They continued to do blood test and cultures but could not determine the cause. They did MRIs as follow-ups because she was not responding. The fever never went down.  She was awake for a few days (ventilator still in) and then started getting worse again.  This is about 1.5 weeks post vaccination.  They did an MRI and found a bleed on her brain and the infection had spread to her heart valves.  Symptoms began within hours of vaccination.  She was take to the hospital the morning after the vaccine and never came home.  Patient died after 2 weeks in the ICU."
	"1368325-1"	"1368325-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"60-64 years"	"60-64"	"Reaction began within a few hours of vaccination.  Patient had fever, chills and diarrhea within a few hours of receiving the vaccine.  By 4:30am on 3/31 she could not walk and her legs went numb.  An ambulance was called and the EMTs had to carry her out of the house.  She was taken to Hospital where they started treating her for an infection but her fever went up over 103F so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms.  Doctors diagnosed sepsis.  They continued to do blood test and cultures but could not determine the cause. They did MRIs as follow-ups because she was not responding. The fever never went down.  She was awake for a few days (ventilator still in) and then started getting worse again.  This is about 1.5 weeks post vaccination.  They did an MRI and found a bleed on her brain and the infection had spread to her heart valves.  Symptoms began within hours of vaccination.  She was take to the hospital the morning after the vaccine and never came home.  Patient died after 2 weeks in the ICU."
	"1368325-1"	"1368325-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"Reaction began within a few hours of vaccination.  Patient had fever, chills and diarrhea within a few hours of receiving the vaccine.  By 4:30am on 3/31 she could not walk and her legs went numb.  An ambulance was called and the EMTs had to carry her out of the house.  She was taken to Hospital where they started treating her for an infection but her fever went up over 103F so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms.  Doctors diagnosed sepsis.  They continued to do blood test and cultures but could not determine the cause. They did MRIs as follow-ups because she was not responding. The fever never went down.  She was awake for a few days (ventilator still in) and then started getting worse again.  This is about 1.5 weeks post vaccination.  They did an MRI and found a bleed on her brain and the infection had spread to her heart valves.  Symptoms began within hours of vaccination.  She was take to the hospital the morning after the vaccine and never came home.  Patient died after 2 weeks in the ICU."
	"1368325-1"	"1368325-1"	"CULTURE"	"10061447"	"60-64 years"	"60-64"	"Reaction began within a few hours of vaccination.  Patient had fever, chills and diarrhea within a few hours of receiving the vaccine.  By 4:30am on 3/31 she could not walk and her legs went numb.  An ambulance was called and the EMTs had to carry her out of the house.  She was taken to Hospital where they started treating her for an infection but her fever went up over 103F so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms.  Doctors diagnosed sepsis.  They continued to do blood test and cultures but could not determine the cause. They did MRIs as follow-ups because she was not responding. The fever never went down.  She was awake for a few days (ventilator still in) and then started getting worse again.  This is about 1.5 weeks post vaccination.  They did an MRI and found a bleed on her brain and the infection had spread to her heart valves.  Symptoms began within hours of vaccination.  She was take to the hospital the morning after the vaccine and never came home.  Patient died after 2 weeks in the ICU."
	"1368325-1"	"1368325-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Reaction began within a few hours of vaccination.  Patient had fever, chills and diarrhea within a few hours of receiving the vaccine.  By 4:30am on 3/31 she could not walk and her legs went numb.  An ambulance was called and the EMTs had to carry her out of the house.  She was taken to Hospital where they started treating her for an infection but her fever went up over 103F so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms.  Doctors diagnosed sepsis.  They continued to do blood test and cultures but could not determine the cause. They did MRIs as follow-ups because she was not responding. The fever never went down.  She was awake for a few days (ventilator still in) and then started getting worse again.  This is about 1.5 weeks post vaccination.  They did an MRI and found a bleed on her brain and the infection had spread to her heart valves.  Symptoms began within hours of vaccination.  She was take to the hospital the morning after the vaccine and never came home.  Patient died after 2 weeks in the ICU."
	"1368325-1"	"1368325-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"Reaction began within a few hours of vaccination.  Patient had fever, chills and diarrhea within a few hours of receiving the vaccine.  By 4:30am on 3/31 she could not walk and her legs went numb.  An ambulance was called and the EMTs had to carry her out of the house.  She was taken to Hospital where they started treating her for an infection but her fever went up over 103F so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms.  Doctors diagnosed sepsis.  They continued to do blood test and cultures but could not determine the cause. They did MRIs as follow-ups because she was not responding. The fever never went down.  She was awake for a few days (ventilator still in) and then started getting worse again.  This is about 1.5 weeks post vaccination.  They did an MRI and found a bleed on her brain and the infection had spread to her heart valves.  Symptoms began within hours of vaccination.  She was take to the hospital the morning after the vaccine and never came home.  Patient died after 2 weeks in the ICU."
	"1368325-1"	"1368325-1"	"ENDOCARDITIS"	"10014665"	"60-64 years"	"60-64"	"Reaction began within a few hours of vaccination.  Patient had fever, chills and diarrhea within a few hours of receiving the vaccine.  By 4:30am on 3/31 she could not walk and her legs went numb.  An ambulance was called and the EMTs had to carry her out of the house.  She was taken to Hospital where they started treating her for an infection but her fever went up over 103F so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms.  Doctors diagnosed sepsis.  They continued to do blood test and cultures but could not determine the cause. They did MRIs as follow-ups because she was not responding. The fever never went down.  She was awake for a few days (ventilator still in) and then started getting worse again.  This is about 1.5 weeks post vaccination.  They did an MRI and found a bleed on her brain and the infection had spread to her heart valves.  Symptoms began within hours of vaccination.  She was take to the hospital the morning after the vaccine and never came home.  Patient died after 2 weeks in the ICU."
	"1368325-1"	"1368325-1"	"GAIT INABILITY"	"10017581"	"60-64 years"	"60-64"	"Reaction began within a few hours of vaccination.  Patient had fever, chills and diarrhea within a few hours of receiving the vaccine.  By 4:30am on 3/31 she could not walk and her legs went numb.  An ambulance was called and the EMTs had to carry her out of the house.  She was taken to Hospital where they started treating her for an infection but her fever went up over 103F so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms.  Doctors diagnosed sepsis.  They continued to do blood test and cultures but could not determine the cause. They did MRIs as follow-ups because she was not responding. The fever never went down.  She was awake for a few days (ventilator still in) and then started getting worse again.  This is about 1.5 weeks post vaccination.  They did an MRI and found a bleed on her brain and the infection had spread to her heart valves.  Symptoms began within hours of vaccination.  She was take to the hospital the morning after the vaccine and never came home.  Patient died after 2 weeks in the ICU."
	"1368325-1"	"1368325-1"	"HYPOAESTHESIA"	"10020937"	"60-64 years"	"60-64"	"Reaction began within a few hours of vaccination.  Patient had fever, chills and diarrhea within a few hours of receiving the vaccine.  By 4:30am on 3/31 she could not walk and her legs went numb.  An ambulance was called and the EMTs had to carry her out of the house.  She was taken to Hospital where they started treating her for an infection but her fever went up over 103F so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms.  Doctors diagnosed sepsis.  They continued to do blood test and cultures but could not determine the cause. They did MRIs as follow-ups because she was not responding. The fever never went down.  She was awake for a few days (ventilator still in) and then started getting worse again.  This is about 1.5 weeks post vaccination.  They did an MRI and found a bleed on her brain and the infection had spread to her heart valves.  Symptoms began within hours of vaccination.  She was take to the hospital the morning after the vaccine and never came home.  Patient died after 2 weeks in the ICU."
	"1368325-1"	"1368325-1"	"INFECTION"	"10021789"	"60-64 years"	"60-64"	"Reaction began within a few hours of vaccination.  Patient had fever, chills and diarrhea within a few hours of receiving the vaccine.  By 4:30am on 3/31 she could not walk and her legs went numb.  An ambulance was called and the EMTs had to carry her out of the house.  She was taken to Hospital where they started treating her for an infection but her fever went up over 103F so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms.  Doctors diagnosed sepsis.  They continued to do blood test and cultures but could not determine the cause. They did MRIs as follow-ups because she was not responding. The fever never went down.  She was awake for a few days (ventilator still in) and then started getting worse again.  This is about 1.5 weeks post vaccination.  They did an MRI and found a bleed on her brain and the infection had spread to her heart valves.  Symptoms began within hours of vaccination.  She was take to the hospital the morning after the vaccine and never came home.  Patient died after 2 weeks in the ICU."
	"1368325-1"	"1368325-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Reaction began within a few hours of vaccination.  Patient had fever, chills and diarrhea within a few hours of receiving the vaccine.  By 4:30am on 3/31 she could not walk and her legs went numb.  An ambulance was called and the EMTs had to carry her out of the house.  She was taken to Hospital where they started treating her for an infection but her fever went up over 103F so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms.  Doctors diagnosed sepsis.  They continued to do blood test and cultures but could not determine the cause. They did MRIs as follow-ups because she was not responding. The fever never went down.  She was awake for a few days (ventilator still in) and then started getting worse again.  This is about 1.5 weeks post vaccination.  They did an MRI and found a bleed on her brain and the infection had spread to her heart valves.  Symptoms began within hours of vaccination.  She was take to the hospital the morning after the vaccine and never came home.  Patient died after 2 weeks in the ICU."
	"1368325-1"	"1368325-1"	"MAGNETIC RESONANCE IMAGING HEAD ABNORMAL"	"10085256"	"60-64 years"	"60-64"	"Reaction began within a few hours of vaccination.  Patient had fever, chills and diarrhea within a few hours of receiving the vaccine.  By 4:30am on 3/31 she could not walk and her legs went numb.  An ambulance was called and the EMTs had to carry her out of the house.  She was taken to Hospital where they started treating her for an infection but her fever went up over 103F so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms.  Doctors diagnosed sepsis.  They continued to do blood test and cultures but could not determine the cause. They did MRIs as follow-ups because she was not responding. The fever never went down.  She was awake for a few days (ventilator still in) and then started getting worse again.  This is about 1.5 weeks post vaccination.  They did an MRI and found a bleed on her brain and the infection had spread to her heart valves.  Symptoms began within hours of vaccination.  She was take to the hospital the morning after the vaccine and never came home.  Patient died after 2 weeks in the ICU."
	"1368325-1"	"1368325-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Reaction began within a few hours of vaccination.  Patient had fever, chills and diarrhea within a few hours of receiving the vaccine.  By 4:30am on 3/31 she could not walk and her legs went numb.  An ambulance was called and the EMTs had to carry her out of the house.  She was taken to Hospital where they started treating her for an infection but her fever went up over 103F so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms.  Doctors diagnosed sepsis.  They continued to do blood test and cultures but could not determine the cause. They did MRIs as follow-ups because she was not responding. The fever never went down.  She was awake for a few days (ventilator still in) and then started getting worse again.  This is about 1.5 weeks post vaccination.  They did an MRI and found a bleed on her brain and the infection had spread to her heart valves.  Symptoms began within hours of vaccination.  She was take to the hospital the morning after the vaccine and never came home.  Patient died after 2 weeks in the ICU."
	"1368325-1"	"1368325-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Reaction began within a few hours of vaccination.  Patient had fever, chills and diarrhea within a few hours of receiving the vaccine.  By 4:30am on 3/31 she could not walk and her legs went numb.  An ambulance was called and the EMTs had to carry her out of the house.  She was taken to Hospital where they started treating her for an infection but her fever went up over 103F so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms.  Doctors diagnosed sepsis.  They continued to do blood test and cultures but could not determine the cause. They did MRIs as follow-ups because she was not responding. The fever never went down.  She was awake for a few days (ventilator still in) and then started getting worse again.  This is about 1.5 weeks post vaccination.  They did an MRI and found a bleed on her brain and the infection had spread to her heart valves.  Symptoms began within hours of vaccination.  She was take to the hospital the morning after the vaccine and never came home.  Patient died after 2 weeks in the ICU."
	"1368325-1"	"1368325-1"	"SEPSIS"	"10040047"	"60-64 years"	"60-64"	"Reaction began within a few hours of vaccination.  Patient had fever, chills and diarrhea within a few hours of receiving the vaccine.  By 4:30am on 3/31 she could not walk and her legs went numb.  An ambulance was called and the EMTs had to carry her out of the house.  She was taken to Hospital where they started treating her for an infection but her fever went up over 103F so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms.  Doctors diagnosed sepsis.  They continued to do blood test and cultures but could not determine the cause. They did MRIs as follow-ups because she was not responding. The fever never went down.  She was awake for a few days (ventilator still in) and then started getting worse again.  This is about 1.5 weeks post vaccination.  They did an MRI and found a bleed on her brain and the infection had spread to her heart valves.  Symptoms began within hours of vaccination.  She was take to the hospital the morning after the vaccine and never came home.  Patient died after 2 weeks in the ICU."
	"1368325-1"	"1368325-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Reaction began within a few hours of vaccination.  Patient had fever, chills and diarrhea within a few hours of receiving the vaccine.  By 4:30am on 3/31 she could not walk and her legs went numb.  An ambulance was called and the EMTs had to carry her out of the house.  She was taken to Hospital where they started treating her for an infection but her fever went up over 103F so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms.  Doctors diagnosed sepsis.  They continued to do blood test and cultures but could not determine the cause. They did MRIs as follow-ups because she was not responding. The fever never went down.  She was awake for a few days (ventilator still in) and then started getting worse again.  This is about 1.5 weeks post vaccination.  They did an MRI and found a bleed on her brain and the infection had spread to her heart valves.  Symptoms began within hours of vaccination.  She was take to the hospital the morning after the vaccine and never came home.  Patient died after 2 weeks in the ICU."
	"1368553-1"	"1368553-1"	"AGONAL RESPIRATION"	"10085467"	"60-64 years"	"60-64"	"5/16- symptoms started- cough, fever body aches. admitted 5/19 with SOB in addition. COVID pnuemonitis, 5/23-sudden decrease in saturation - placed on BiPAP and transferred to the ICU. further decline and arrested on 5/27. PEA and agonal breathing.  intubated and ACLS meds given. Coded a second time and family elected to halt heroic measures."
	"1368553-1"	"1368553-1"	"BILEVEL POSITIVE AIRWAY PRESSURE"	"10064530"	"60-64 years"	"60-64"	"5/16- symptoms started- cough, fever body aches. admitted 5/19 with SOB in addition. COVID pnuemonitis, 5/23-sudden decrease in saturation - placed on BiPAP and transferred to the ICU. further decline and arrested on 5/27. PEA and agonal breathing.  intubated and ACLS meds given. Coded a second time and family elected to halt heroic measures."
	"1368553-1"	"1368553-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"5/16- symptoms started- cough, fever body aches. admitted 5/19 with SOB in addition. COVID pnuemonitis, 5/23-sudden decrease in saturation - placed on BiPAP and transferred to the ICU. further decline and arrested on 5/27. PEA and agonal breathing.  intubated and ACLS meds given. Coded a second time and family elected to halt heroic measures."
	"1368553-1"	"1368553-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"5/16- symptoms started- cough, fever body aches. admitted 5/19 with SOB in addition. COVID pnuemonitis, 5/23-sudden decrease in saturation - placed on BiPAP and transferred to the ICU. further decline and arrested on 5/27. PEA and agonal breathing.  intubated and ACLS meds given. Coded a second time and family elected to halt heroic measures."
	"1368553-1"	"1368553-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"5/16- symptoms started- cough, fever body aches. admitted 5/19 with SOB in addition. COVID pnuemonitis, 5/23-sudden decrease in saturation - placed on BiPAP and transferred to the ICU. further decline and arrested on 5/27. PEA and agonal breathing.  intubated and ACLS meds given. Coded a second time and family elected to halt heroic measures."
	"1368553-1"	"1368553-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"5/16- symptoms started- cough, fever body aches. admitted 5/19 with SOB in addition. COVID pnuemonitis, 5/23-sudden decrease in saturation - placed on BiPAP and transferred to the ICU. further decline and arrested on 5/27. PEA and agonal breathing.  intubated and ACLS meds given. Coded a second time and family elected to halt heroic measures."
	"1368553-1"	"1368553-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"5/16- symptoms started- cough, fever body aches. admitted 5/19 with SOB in addition. COVID pnuemonitis, 5/23-sudden decrease in saturation - placed on BiPAP and transferred to the ICU. further decline and arrested on 5/27. PEA and agonal breathing.  intubated and ACLS meds given. Coded a second time and family elected to halt heroic measures."
	"1368553-1"	"1368553-1"	"FIBRIN D DIMER INCREASED"	"10016581"	"60-64 years"	"60-64"	"5/16- symptoms started- cough, fever body aches. admitted 5/19 with SOB in addition. COVID pnuemonitis, 5/23-sudden decrease in saturation - placed on BiPAP and transferred to the ICU. further decline and arrested on 5/27. PEA and agonal breathing.  intubated and ACLS meds given. Coded a second time and family elected to halt heroic measures."
	"1368553-1"	"1368553-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"60-64 years"	"60-64"	"5/16- symptoms started- cough, fever body aches. admitted 5/19 with SOB in addition. COVID pnuemonitis, 5/23-sudden decrease in saturation - placed on BiPAP and transferred to the ICU. further decline and arrested on 5/27. PEA and agonal breathing.  intubated and ACLS meds given. Coded a second time and family elected to halt heroic measures."
	"1368553-1"	"1368553-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"5/16- symptoms started- cough, fever body aches. admitted 5/19 with SOB in addition. COVID pnuemonitis, 5/23-sudden decrease in saturation - placed on BiPAP and transferred to the ICU. further decline and arrested on 5/27. PEA and agonal breathing.  intubated and ACLS meds given. Coded a second time and family elected to halt heroic measures."
	"1368553-1"	"1368553-1"	"LIFE SUPPORT"	"10024447"	"60-64 years"	"60-64"	"5/16- symptoms started- cough, fever body aches. admitted 5/19 with SOB in addition. COVID pnuemonitis, 5/23-sudden decrease in saturation - placed on BiPAP and transferred to the ICU. further decline and arrested on 5/27. PEA and agonal breathing.  intubated and ACLS meds given. Coded a second time and family elected to halt heroic measures."
	"1368553-1"	"1368553-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"5/16- symptoms started- cough, fever body aches. admitted 5/19 with SOB in addition. COVID pnuemonitis, 5/23-sudden decrease in saturation - placed on BiPAP and transferred to the ICU. further decline and arrested on 5/27. PEA and agonal breathing.  intubated and ACLS meds given. Coded a second time and family elected to halt heroic measures."
	"1368553-1"	"1368553-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"5/16- symptoms started- cough, fever body aches. admitted 5/19 with SOB in addition. COVID pnuemonitis, 5/23-sudden decrease in saturation - placed on BiPAP and transferred to the ICU. further decline and arrested on 5/27. PEA and agonal breathing.  intubated and ACLS meds given. Coded a second time and family elected to halt heroic measures."
	"1368553-1"	"1368553-1"	"PROCALCITONIN INCREASED"	"10067081"	"60-64 years"	"60-64"	"5/16- symptoms started- cough, fever body aches. admitted 5/19 with SOB in addition. COVID pnuemonitis, 5/23-sudden decrease in saturation - placed on BiPAP and transferred to the ICU. further decline and arrested on 5/27. PEA and agonal breathing.  intubated and ACLS meds given. Coded a second time and family elected to halt heroic measures."
	"1368553-1"	"1368553-1"	"PULSELESS ELECTRICAL ACTIVITY"	"10058151"	"60-64 years"	"60-64"	"5/16- symptoms started- cough, fever body aches. admitted 5/19 with SOB in addition. COVID pnuemonitis, 5/23-sudden decrease in saturation - placed on BiPAP and transferred to the ICU. further decline and arrested on 5/27. PEA and agonal breathing.  intubated and ACLS meds given. Coded a second time and family elected to halt heroic measures."
	"1368553-1"	"1368553-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"5/16- symptoms started- cough, fever body aches. admitted 5/19 with SOB in addition. COVID pnuemonitis, 5/23-sudden decrease in saturation - placed on BiPAP and transferred to the ICU. further decline and arrested on 5/27. PEA and agonal breathing.  intubated and ACLS meds given. Coded a second time and family elected to halt heroic measures."
	"1368553-1"	"1368553-1"	"SERUM FERRITIN INCREASED"	"10040250"	"60-64 years"	"60-64"	"5/16- symptoms started- cough, fever body aches. admitted 5/19 with SOB in addition. COVID pnuemonitis, 5/23-sudden decrease in saturation - placed on BiPAP and transferred to the ICU. further decline and arrested on 5/27. PEA and agonal breathing.  intubated and ACLS meds given. Coded a second time and family elected to halt heroic measures."
	"1373090-1"	"1373090-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""Patient had received his first Moderna Covid vaccine on 4/8/21 (time unknown). He left the pharmacy after wait period of 15 minutes. Wife said that he complained of sore throat later in the day. Wife said ""he started having fever almost like COVID symptoms"". Wife said he went to the doctors office and received prescription for ibuprofen. on 4/10/21 at 10am. Wife said he didn't get any better so he was hospitalized at the Hospital 8 days later and he passed away.""
	"1373090-1"	"1373090-1"	"OROPHARYNGEAL PAIN"	"10068319"	"60-64 years"	"60-64"	""Patient had received his first Moderna Covid vaccine on 4/8/21 (time unknown). He left the pharmacy after wait period of 15 minutes. Wife said that he complained of sore throat later in the day. Wife said ""he started having fever almost like COVID symptoms"". Wife said he went to the doctors office and received prescription for ibuprofen. on 4/10/21 at 10am. Wife said he didn't get any better so he was hospitalized at the Hospital 8 days later and he passed away.""
	"1373090-1"	"1373090-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	""Patient had received his first Moderna Covid vaccine on 4/8/21 (time unknown). He left the pharmacy after wait period of 15 minutes. Wife said that he complained of sore throat later in the day. Wife said ""he started having fever almost like COVID symptoms"". Wife said he went to the doctors office and received prescription for ibuprofen. on 4/10/21 at 10am. Wife said he didn't get any better so he was hospitalized at the Hospital 8 days later and he passed away.""
	"1373776-1"	"1373776-1"	"BLOOD TEST"	"10061726"	"60-64 years"	"60-64"	"bleed on her brain; the infection had spread to her heart valves; she could not walk; legs went numb; sepsis; fever / fever went up over 103 F; chills; diarrhea; This is a spontaneous report received from a contactable consumer. A 61 years old female received the second single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot EP7533) on 30Mar2021 (at 61 years of age), in right arm, for COVID-19 immunisation. The patient received the first dose of BNT162B2 vaccine on 09Mar2021 (lot EN6202), at 61 years of age, in right arm. No other vaccines were given within 4 weeks prior to the COVID vaccine. Medical history included connective tissue disorder - scleroderma. The patient was not pregnant at the time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medication included methotrexate. On 30Mar2021, within a few hours of receiving the second vaccination, she had fever, chills and diarrhea. By 4:30 AM on 31Mar2021 she could not walk and her legs went numb. An ambulance was called and the EMTs had to carry her out of the house. She was taken to hospital where they started treating with antibiotics her for an infection but her fever went up over 103 F, so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms. Doctors diagnosed sepsis. They continued to do blood test and cultures but could not determine the cause. They did Magnetic Resonance Imaging (MRIs) as follow-ups because she was not responding. The fever never went down. She was awake for a few days (ventilator still in) and then started getting worse again. They did an MRI and found a bleed on her brain and the infection had spread to her heart valves. She died on 14Apr2021 after 15 days of hospital care and Intensive Care Unit (ICU) care. The events were reported with a fatal outcome. It was unknown if autopsy was performed. Since the vaccination, the patient had not been tested for COVID-19.; Reported Cause(s) of Death: chills; diarrhea; she could not walk; legs went numb; sepsis; bleed on her brain; the infection had spread to her heart valves; fever / fever went up over 103 F"
	"1373776-1"	"1373776-1"	"BODY TEMPERATURE"	"10005906"	"60-64 years"	"60-64"	"bleed on her brain; the infection had spread to her heart valves; she could not walk; legs went numb; sepsis; fever / fever went up over 103 F; chills; diarrhea; This is a spontaneous report received from a contactable consumer. A 61 years old female received the second single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot EP7533) on 30Mar2021 (at 61 years of age), in right arm, for COVID-19 immunisation. The patient received the first dose of BNT162B2 vaccine on 09Mar2021 (lot EN6202), at 61 years of age, in right arm. No other vaccines were given within 4 weeks prior to the COVID vaccine. Medical history included connective tissue disorder - scleroderma. The patient was not pregnant at the time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medication included methotrexate. On 30Mar2021, within a few hours of receiving the second vaccination, she had fever, chills and diarrhea. By 4:30 AM on 31Mar2021 she could not walk and her legs went numb. An ambulance was called and the EMTs had to carry her out of the house. She was taken to hospital where they started treating with antibiotics her for an infection but her fever went up over 103 F, so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms. Doctors diagnosed sepsis. They continued to do blood test and cultures but could not determine the cause. They did Magnetic Resonance Imaging (MRIs) as follow-ups because she was not responding. The fever never went down. She was awake for a few days (ventilator still in) and then started getting worse again. They did an MRI and found a bleed on her brain and the infection had spread to her heart valves. She died on 14Apr2021 after 15 days of hospital care and Intensive Care Unit (ICU) care. The events were reported with a fatal outcome. It was unknown if autopsy was performed. Since the vaccination, the patient had not been tested for COVID-19.; Reported Cause(s) of Death: chills; diarrhea; she could not walk; legs went numb; sepsis; bleed on her brain; the infection had spread to her heart valves; fever / fever went up over 103 F"
	"1373776-1"	"1373776-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"60-64 years"	"60-64"	"bleed on her brain; the infection had spread to her heart valves; she could not walk; legs went numb; sepsis; fever / fever went up over 103 F; chills; diarrhea; This is a spontaneous report received from a contactable consumer. A 61 years old female received the second single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot EP7533) on 30Mar2021 (at 61 years of age), in right arm, for COVID-19 immunisation. The patient received the first dose of BNT162B2 vaccine on 09Mar2021 (lot EN6202), at 61 years of age, in right arm. No other vaccines were given within 4 weeks prior to the COVID vaccine. Medical history included connective tissue disorder - scleroderma. The patient was not pregnant at the time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medication included methotrexate. On 30Mar2021, within a few hours of receiving the second vaccination, she had fever, chills and diarrhea. By 4:30 AM on 31Mar2021 she could not walk and her legs went numb. An ambulance was called and the EMTs had to carry her out of the house. She was taken to hospital where they started treating with antibiotics her for an infection but her fever went up over 103 F, so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms. Doctors diagnosed sepsis. They continued to do blood test and cultures but could not determine the cause. They did Magnetic Resonance Imaging (MRIs) as follow-ups because she was not responding. The fever never went down. She was awake for a few days (ventilator still in) and then started getting worse again. They did an MRI and found a bleed on her brain and the infection had spread to her heart valves. She died on 14Apr2021 after 15 days of hospital care and Intensive Care Unit (ICU) care. The events were reported with a fatal outcome. It was unknown if autopsy was performed. Since the vaccination, the patient had not been tested for COVID-19.; Reported Cause(s) of Death: chills; diarrhea; she could not walk; legs went numb; sepsis; bleed on her brain; the infection had spread to her heart valves; fever / fever went up over 103 F"
	"1373776-1"	"1373776-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"bleed on her brain; the infection had spread to her heart valves; she could not walk; legs went numb; sepsis; fever / fever went up over 103 F; chills; diarrhea; This is a spontaneous report received from a contactable consumer. A 61 years old female received the second single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot EP7533) on 30Mar2021 (at 61 years of age), in right arm, for COVID-19 immunisation. The patient received the first dose of BNT162B2 vaccine on 09Mar2021 (lot EN6202), at 61 years of age, in right arm. No other vaccines were given within 4 weeks prior to the COVID vaccine. Medical history included connective tissue disorder - scleroderma. The patient was not pregnant at the time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medication included methotrexate. On 30Mar2021, within a few hours of receiving the second vaccination, she had fever, chills and diarrhea. By 4:30 AM on 31Mar2021 she could not walk and her legs went numb. An ambulance was called and the EMTs had to carry her out of the house. She was taken to hospital where they started treating with antibiotics her for an infection but her fever went up over 103 F, so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms. Doctors diagnosed sepsis. They continued to do blood test and cultures but could not determine the cause. They did Magnetic Resonance Imaging (MRIs) as follow-ups because she was not responding. The fever never went down. She was awake for a few days (ventilator still in) and then started getting worse again. They did an MRI and found a bleed on her brain and the infection had spread to her heart valves. She died on 14Apr2021 after 15 days of hospital care and Intensive Care Unit (ICU) care. The events were reported with a fatal outcome. It was unknown if autopsy was performed. Since the vaccination, the patient had not been tested for COVID-19.; Reported Cause(s) of Death: chills; diarrhea; she could not walk; legs went numb; sepsis; bleed on her brain; the infection had spread to her heart valves; fever / fever went up over 103 F"
	"1373776-1"	"1373776-1"	"CULTURE"	"10061447"	"60-64 years"	"60-64"	"bleed on her brain; the infection had spread to her heart valves; she could not walk; legs went numb; sepsis; fever / fever went up over 103 F; chills; diarrhea; This is a spontaneous report received from a contactable consumer. A 61 years old female received the second single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot EP7533) on 30Mar2021 (at 61 years of age), in right arm, for COVID-19 immunisation. The patient received the first dose of BNT162B2 vaccine on 09Mar2021 (lot EN6202), at 61 years of age, in right arm. No other vaccines were given within 4 weeks prior to the COVID vaccine. Medical history included connective tissue disorder - scleroderma. The patient was not pregnant at the time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medication included methotrexate. On 30Mar2021, within a few hours of receiving the second vaccination, she had fever, chills and diarrhea. By 4:30 AM on 31Mar2021 she could not walk and her legs went numb. An ambulance was called and the EMTs had to carry her out of the house. She was taken to hospital where they started treating with antibiotics her for an infection but her fever went up over 103 F, so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms. Doctors diagnosed sepsis. They continued to do blood test and cultures but could not determine the cause. They did Magnetic Resonance Imaging (MRIs) as follow-ups because she was not responding. The fever never went down. She was awake for a few days (ventilator still in) and then started getting worse again. They did an MRI and found a bleed on her brain and the infection had spread to her heart valves. She died on 14Apr2021 after 15 days of hospital care and Intensive Care Unit (ICU) care. The events were reported with a fatal outcome. It was unknown if autopsy was performed. Since the vaccination, the patient had not been tested for COVID-19.; Reported Cause(s) of Death: chills; diarrhea; she could not walk; legs went numb; sepsis; bleed on her brain; the infection had spread to her heart valves; fever / fever went up over 103 F"
	"1373776-1"	"1373776-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"bleed on her brain; the infection had spread to her heart valves; she could not walk; legs went numb; sepsis; fever / fever went up over 103 F; chills; diarrhea; This is a spontaneous report received from a contactable consumer. A 61 years old female received the second single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot EP7533) on 30Mar2021 (at 61 years of age), in right arm, for COVID-19 immunisation. The patient received the first dose of BNT162B2 vaccine on 09Mar2021 (lot EN6202), at 61 years of age, in right arm. No other vaccines were given within 4 weeks prior to the COVID vaccine. Medical history included connective tissue disorder - scleroderma. The patient was not pregnant at the time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medication included methotrexate. On 30Mar2021, within a few hours of receiving the second vaccination, she had fever, chills and diarrhea. By 4:30 AM on 31Mar2021 she could not walk and her legs went numb. An ambulance was called and the EMTs had to carry her out of the house. She was taken to hospital where they started treating with antibiotics her for an infection but her fever went up over 103 F, so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms. Doctors diagnosed sepsis. They continued to do blood test and cultures but could not determine the cause. They did Magnetic Resonance Imaging (MRIs) as follow-ups because she was not responding. The fever never went down. She was awake for a few days (ventilator still in) and then started getting worse again. They did an MRI and found a bleed on her brain and the infection had spread to her heart valves. She died on 14Apr2021 after 15 days of hospital care and Intensive Care Unit (ICU) care. The events were reported with a fatal outcome. It was unknown if autopsy was performed. Since the vaccination, the patient had not been tested for COVID-19.; Reported Cause(s) of Death: chills; diarrhea; she could not walk; legs went numb; sepsis; bleed on her brain; the infection had spread to her heart valves; fever / fever went up over 103 F"
	"1373776-1"	"1373776-1"	"ENDOCARDITIS"	"10014665"	"60-64 years"	"60-64"	"bleed on her brain; the infection had spread to her heart valves; she could not walk; legs went numb; sepsis; fever / fever went up over 103 F; chills; diarrhea; This is a spontaneous report received from a contactable consumer. A 61 years old female received the second single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot EP7533) on 30Mar2021 (at 61 years of age), in right arm, for COVID-19 immunisation. The patient received the first dose of BNT162B2 vaccine on 09Mar2021 (lot EN6202), at 61 years of age, in right arm. No other vaccines were given within 4 weeks prior to the COVID vaccine. Medical history included connective tissue disorder - scleroderma. The patient was not pregnant at the time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medication included methotrexate. On 30Mar2021, within a few hours of receiving the second vaccination, she had fever, chills and diarrhea. By 4:30 AM on 31Mar2021 she could not walk and her legs went numb. An ambulance was called and the EMTs had to carry her out of the house. She was taken to hospital where they started treating with antibiotics her for an infection but her fever went up over 103 F, so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms. Doctors diagnosed sepsis. They continued to do blood test and cultures but could not determine the cause. They did Magnetic Resonance Imaging (MRIs) as follow-ups because she was not responding. The fever never went down. She was awake for a few days (ventilator still in) and then started getting worse again. They did an MRI and found a bleed on her brain and the infection had spread to her heart valves. She died on 14Apr2021 after 15 days of hospital care and Intensive Care Unit (ICU) care. The events were reported with a fatal outcome. It was unknown if autopsy was performed. Since the vaccination, the patient had not been tested for COVID-19.; Reported Cause(s) of Death: chills; diarrhea; she could not walk; legs went numb; sepsis; bleed on her brain; the infection had spread to her heart valves; fever / fever went up over 103 F"
	"1373776-1"	"1373776-1"	"GAIT DISTURBANCE"	"10017577"	"60-64 years"	"60-64"	"bleed on her brain; the infection had spread to her heart valves; she could not walk; legs went numb; sepsis; fever / fever went up over 103 F; chills; diarrhea; This is a spontaneous report received from a contactable consumer. A 61 years old female received the second single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot EP7533) on 30Mar2021 (at 61 years of age), in right arm, for COVID-19 immunisation. The patient received the first dose of BNT162B2 vaccine on 09Mar2021 (lot EN6202), at 61 years of age, in right arm. No other vaccines were given within 4 weeks prior to the COVID vaccine. Medical history included connective tissue disorder - scleroderma. The patient was not pregnant at the time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medication included methotrexate. On 30Mar2021, within a few hours of receiving the second vaccination, she had fever, chills and diarrhea. By 4:30 AM on 31Mar2021 she could not walk and her legs went numb. An ambulance was called and the EMTs had to carry her out of the house. She was taken to hospital where they started treating with antibiotics her for an infection but her fever went up over 103 F, so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms. Doctors diagnosed sepsis. They continued to do blood test and cultures but could not determine the cause. They did Magnetic Resonance Imaging (MRIs) as follow-ups because she was not responding. The fever never went down. She was awake for a few days (ventilator still in) and then started getting worse again. They did an MRI and found a bleed on her brain and the infection had spread to her heart valves. She died on 14Apr2021 after 15 days of hospital care and Intensive Care Unit (ICU) care. The events were reported with a fatal outcome. It was unknown if autopsy was performed. Since the vaccination, the patient had not been tested for COVID-19.; Reported Cause(s) of Death: chills; diarrhea; she could not walk; legs went numb; sepsis; bleed on her brain; the infection had spread to her heart valves; fever / fever went up over 103 F"
	"1373776-1"	"1373776-1"	"HYPOAESTHESIA"	"10020937"	"60-64 years"	"60-64"	"bleed on her brain; the infection had spread to her heart valves; she could not walk; legs went numb; sepsis; fever / fever went up over 103 F; chills; diarrhea; This is a spontaneous report received from a contactable consumer. A 61 years old female received the second single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot EP7533) on 30Mar2021 (at 61 years of age), in right arm, for COVID-19 immunisation. The patient received the first dose of BNT162B2 vaccine on 09Mar2021 (lot EN6202), at 61 years of age, in right arm. No other vaccines were given within 4 weeks prior to the COVID vaccine. Medical history included connective tissue disorder - scleroderma. The patient was not pregnant at the time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medication included methotrexate. On 30Mar2021, within a few hours of receiving the second vaccination, she had fever, chills and diarrhea. By 4:30 AM on 31Mar2021 she could not walk and her legs went numb. An ambulance was called and the EMTs had to carry her out of the house. She was taken to hospital where they started treating with antibiotics her for an infection but her fever went up over 103 F, so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms. Doctors diagnosed sepsis. They continued to do blood test and cultures but could not determine the cause. They did Magnetic Resonance Imaging (MRIs) as follow-ups because she was not responding. The fever never went down. She was awake for a few days (ventilator still in) and then started getting worse again. They did an MRI and found a bleed on her brain and the infection had spread to her heart valves. She died on 14Apr2021 after 15 days of hospital care and Intensive Care Unit (ICU) care. The events were reported with a fatal outcome. It was unknown if autopsy was performed. Since the vaccination, the patient had not been tested for COVID-19.; Reported Cause(s) of Death: chills; diarrhea; she could not walk; legs went numb; sepsis; bleed on her brain; the infection had spread to her heart valves; fever / fever went up over 103 F"
	"1373776-1"	"1373776-1"	"MAGNETIC RESONANCE IMAGING"	"10078223"	"60-64 years"	"60-64"	"bleed on her brain; the infection had spread to her heart valves; she could not walk; legs went numb; sepsis; fever / fever went up over 103 F; chills; diarrhea; This is a spontaneous report received from a contactable consumer. A 61 years old female received the second single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot EP7533) on 30Mar2021 (at 61 years of age), in right arm, for COVID-19 immunisation. The patient received the first dose of BNT162B2 vaccine on 09Mar2021 (lot EN6202), at 61 years of age, in right arm. No other vaccines were given within 4 weeks prior to the COVID vaccine. Medical history included connective tissue disorder - scleroderma. The patient was not pregnant at the time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medication included methotrexate. On 30Mar2021, within a few hours of receiving the second vaccination, she had fever, chills and diarrhea. By 4:30 AM on 31Mar2021 she could not walk and her legs went numb. An ambulance was called and the EMTs had to carry her out of the house. She was taken to hospital where they started treating with antibiotics her for an infection but her fever went up over 103 F, so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms. Doctors diagnosed sepsis. They continued to do blood test and cultures but could not determine the cause. They did Magnetic Resonance Imaging (MRIs) as follow-ups because she was not responding. The fever never went down. She was awake for a few days (ventilator still in) and then started getting worse again. They did an MRI and found a bleed on her brain and the infection had spread to her heart valves. She died on 14Apr2021 after 15 days of hospital care and Intensive Care Unit (ICU) care. The events were reported with a fatal outcome. It was unknown if autopsy was performed. Since the vaccination, the patient had not been tested for COVID-19.; Reported Cause(s) of Death: chills; diarrhea; she could not walk; legs went numb; sepsis; bleed on her brain; the infection had spread to her heart valves; fever / fever went up over 103 F"
	"1373776-1"	"1373776-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"bleed on her brain; the infection had spread to her heart valves; she could not walk; legs went numb; sepsis; fever / fever went up over 103 F; chills; diarrhea; This is a spontaneous report received from a contactable consumer. A 61 years old female received the second single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot EP7533) on 30Mar2021 (at 61 years of age), in right arm, for COVID-19 immunisation. The patient received the first dose of BNT162B2 vaccine on 09Mar2021 (lot EN6202), at 61 years of age, in right arm. No other vaccines were given within 4 weeks prior to the COVID vaccine. Medical history included connective tissue disorder - scleroderma. The patient was not pregnant at the time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medication included methotrexate. On 30Mar2021, within a few hours of receiving the second vaccination, she had fever, chills and diarrhea. By 4:30 AM on 31Mar2021 she could not walk and her legs went numb. An ambulance was called and the EMTs had to carry her out of the house. She was taken to hospital where they started treating with antibiotics her for an infection but her fever went up over 103 F, so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms. Doctors diagnosed sepsis. They continued to do blood test and cultures but could not determine the cause. They did Magnetic Resonance Imaging (MRIs) as follow-ups because she was not responding. The fever never went down. She was awake for a few days (ventilator still in) and then started getting worse again. They did an MRI and found a bleed on her brain and the infection had spread to her heart valves. She died on 14Apr2021 after 15 days of hospital care and Intensive Care Unit (ICU) care. The events were reported with a fatal outcome. It was unknown if autopsy was performed. Since the vaccination, the patient had not been tested for COVID-19.; Reported Cause(s) of Death: chills; diarrhea; she could not walk; legs went numb; sepsis; bleed on her brain; the infection had spread to her heart valves; fever / fever went up over 103 F"
	"1373776-1"	"1373776-1"	"SEPSIS"	"10040047"	"60-64 years"	"60-64"	"bleed on her brain; the infection had spread to her heart valves; she could not walk; legs went numb; sepsis; fever / fever went up over 103 F; chills; diarrhea; This is a spontaneous report received from a contactable consumer. A 61 years old female received the second single dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE; lot EP7533) on 30Mar2021 (at 61 years of age), in right arm, for COVID-19 immunisation. The patient received the first dose of BNT162B2 vaccine on 09Mar2021 (lot EN6202), at 61 years of age, in right arm. No other vaccines were given within 4 weeks prior to the COVID vaccine. Medical history included connective tissue disorder - scleroderma. The patient was not pregnant at the time of vaccination. Prior to vaccination, the patient was not diagnosed with COVID-19. Concomitant medication included methotrexate. On 30Mar2021, within a few hours of receiving the second vaccination, she had fever, chills and diarrhea. By 4:30 AM on 31Mar2021 she could not walk and her legs went numb. An ambulance was called and the EMTs had to carry her out of the house. She was taken to hospital where they started treating with antibiotics her for an infection but her fever went up over 103 F, so they ventilated her to try to control the fever. They did blood tests during that time and got the infections disease unit trying to figure out what was causing her symptoms. Doctors diagnosed sepsis. They continued to do blood test and cultures but could not determine the cause. They did Magnetic Resonance Imaging (MRIs) as follow-ups because she was not responding. The fever never went down. She was awake for a few days (ventilator still in) and then started getting worse again. They did an MRI and found a bleed on her brain and the infection had spread to her heart valves. She died on 14Apr2021 after 15 days of hospital care and Intensive Care Unit (ICU) care. The events were reported with a fatal outcome. It was unknown if autopsy was performed. Since the vaccination, the patient had not been tested for COVID-19.; Reported Cause(s) of Death: chills; diarrhea; she could not walk; legs went numb; sepsis; bleed on her brain; the infection had spread to her heart valves; fever / fever went up over 103 F"
	"1374110-1"	"1374110-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"death N17.9 - Acute renal failure, unspecified acute renal failure type"
	"1374110-1"	"1374110-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death N17.9 - Acute renal failure, unspecified acute renal failure type"
	"1374761-1"	"1374761-1"	"CARDIOMYOPATHY"	"10007636"	"60-64 years"	"60-64"	"COVID vaccine on 2/27/2021 & 3/27/2021 (Moderna); tested positive for COVID-19 by PCR on 5/28/2021; Medical records mention pneumonia, hypoxia, non-sustained ventricular tachycardia, altered mental status, cardiomyopathy, septic shock, and multiorgan failure; also tested positive for haemophilus influenza."
	"1374761-1"	"1374761-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"COVID vaccine on 2/27/2021 & 3/27/2021 (Moderna); tested positive for COVID-19 by PCR on 5/28/2021; Medical records mention pneumonia, hypoxia, non-sustained ventricular tachycardia, altered mental status, cardiomyopathy, septic shock, and multiorgan failure; also tested positive for haemophilus influenza."
	"1374761-1"	"1374761-1"	"HAEMOPHILUS INFECTION"	"10061190"	"60-64 years"	"60-64"	"COVID vaccine on 2/27/2021 & 3/27/2021 (Moderna); tested positive for COVID-19 by PCR on 5/28/2021; Medical records mention pneumonia, hypoxia, non-sustained ventricular tachycardia, altered mental status, cardiomyopathy, septic shock, and multiorgan failure; also tested positive for haemophilus influenza."
	"1374761-1"	"1374761-1"	"HAEMOPHILUS TEST POSITIVE"	"10070100"	"60-64 years"	"60-64"	"COVID vaccine on 2/27/2021 & 3/27/2021 (Moderna); tested positive for COVID-19 by PCR on 5/28/2021; Medical records mention pneumonia, hypoxia, non-sustained ventricular tachycardia, altered mental status, cardiomyopathy, septic shock, and multiorgan failure; also tested positive for haemophilus influenza."
	"1374761-1"	"1374761-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"COVID vaccine on 2/27/2021 & 3/27/2021 (Moderna); tested positive for COVID-19 by PCR on 5/28/2021; Medical records mention pneumonia, hypoxia, non-sustained ventricular tachycardia, altered mental status, cardiomyopathy, septic shock, and multiorgan failure; also tested positive for haemophilus influenza."
	"1374761-1"	"1374761-1"	"MENTAL STATUS CHANGES"	"10048294"	"60-64 years"	"60-64"	"COVID vaccine on 2/27/2021 & 3/27/2021 (Moderna); tested positive for COVID-19 by PCR on 5/28/2021; Medical records mention pneumonia, hypoxia, non-sustained ventricular tachycardia, altered mental status, cardiomyopathy, septic shock, and multiorgan failure; also tested positive for haemophilus influenza."
	"1374761-1"	"1374761-1"	"MULTIPLE ORGAN DYSFUNCTION SYNDROME"	"10077361"	"60-64 years"	"60-64"	"COVID vaccine on 2/27/2021 & 3/27/2021 (Moderna); tested positive for COVID-19 by PCR on 5/28/2021; Medical records mention pneumonia, hypoxia, non-sustained ventricular tachycardia, altered mental status, cardiomyopathy, septic shock, and multiorgan failure; also tested positive for haemophilus influenza."
	"1374761-1"	"1374761-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"COVID vaccine on 2/27/2021 & 3/27/2021 (Moderna); tested positive for COVID-19 by PCR on 5/28/2021; Medical records mention pneumonia, hypoxia, non-sustained ventricular tachycardia, altered mental status, cardiomyopathy, septic shock, and multiorgan failure; also tested positive for haemophilus influenza."
	"1374761-1"	"1374761-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"COVID vaccine on 2/27/2021 & 3/27/2021 (Moderna); tested positive for COVID-19 by PCR on 5/28/2021; Medical records mention pneumonia, hypoxia, non-sustained ventricular tachycardia, altered mental status, cardiomyopathy, septic shock, and multiorgan failure; also tested positive for haemophilus influenza."
	"1374761-1"	"1374761-1"	"SEPTIC SHOCK"	"10040070"	"60-64 years"	"60-64"	"COVID vaccine on 2/27/2021 & 3/27/2021 (Moderna); tested positive for COVID-19 by PCR on 5/28/2021; Medical records mention pneumonia, hypoxia, non-sustained ventricular tachycardia, altered mental status, cardiomyopathy, septic shock, and multiorgan failure; also tested positive for haemophilus influenza."
	"1374761-1"	"1374761-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"60-64 years"	"60-64"	"COVID vaccine on 2/27/2021 & 3/27/2021 (Moderna); tested positive for COVID-19 by PCR on 5/28/2021; Medical records mention pneumonia, hypoxia, non-sustained ventricular tachycardia, altered mental status, cardiomyopathy, septic shock, and multiorgan failure; also tested positive for haemophilus influenza."
	"1374761-1"	"1374761-1"	"VENTRICULAR TACHYCARDIA"	"10047302"	"60-64 years"	"60-64"	"COVID vaccine on 2/27/2021 & 3/27/2021 (Moderna); tested positive for COVID-19 by PCR on 5/28/2021; Medical records mention pneumonia, hypoxia, non-sustained ventricular tachycardia, altered mental status, cardiomyopathy, septic shock, and multiorgan failure; also tested positive for haemophilus influenza."
	"1375050-1"	"1375050-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Client was screened as per CDC guidelines and had no contraindications for receiving the vaccine on 4/14/2021. LCHD had no notice of any adverse issues. He did not present to the 2nd dose clinic and follow up phone calls revealed that he had died on 4/28/2021."
	"1375369-1"	"1375369-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Cardiac Arrest, DVT, AKA, Stroke"
	"1375369-1"	"1375369-1"	"CATHETERISATION CARDIAC ABNORMAL"	"10007816"	"60-64 years"	"60-64"	"Cardiac Arrest, DVT, AKA, Stroke"
	"1375369-1"	"1375369-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"60-64 years"	"60-64"	"Cardiac Arrest, DVT, AKA, Stroke"
	"1375369-1"	"1375369-1"	"CORONARY ARTERIAL STENT INSERTION"	"10052086"	"60-64 years"	"60-64"	"Cardiac Arrest, DVT, AKA, Stroke"
	"1375369-1"	"1375369-1"	"DEEP VEIN THROMBOSIS"	"10051055"	"60-64 years"	"60-64"	"Cardiac Arrest, DVT, AKA, Stroke"
	"1375369-1"	"1375369-1"	"LEG AMPUTATION"	"10024124"	"60-64 years"	"60-64"	"Cardiac Arrest, DVT, AKA, Stroke"
	"1375369-1"	"1375369-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Cardiac Arrest, DVT, AKA, Stroke"
	"1375369-1"	"1375369-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"Cardiac Arrest, DVT, AKA, Stroke"
	"1375369-1"	"1375369-1"	"PNEUMONIA STAPHYLOCOCCAL"	"10035734"	"60-64 years"	"60-64"	"Cardiac Arrest, DVT, AKA, Stroke"
	"1375369-1"	"1375369-1"	"WEANING FAILURE"	"10066829"	"60-64 years"	"60-64"	"Cardiac Arrest, DVT, AKA, Stroke"
	"1375797-1"	"1375797-1"	"MENINGITIS BACTERIAL"	"10027202"	"60-64 years"	"60-64"	"Sepsis/Bacterial Meningitis"
	"1375797-1"	"1375797-1"	"SEPSIS"	"10040047"	"60-64 years"	"60-64"	"Sepsis/Bacterial Meningitis"
	"1378451-1"	"1378451-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Unsure, Department followed up on her positive COVID results in 10/2020 and 11/2020.  It came to our attention last week that the reason stated for her death on 5/28/21 was due to COVID.  Due to having 2 positive tests late last fall and then seeing that she had been vaccinated for COVID in March and April 2021, I was instructed to complete a VAERS."
	"1378451-1"	"1378451-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Unsure, Department followed up on her positive COVID results in 10/2020 and 11/2020.  It came to our attention last week that the reason stated for her death on 5/28/21 was due to COVID.  Due to having 2 positive tests late last fall and then seeing that she had been vaccinated for COVID in March and April 2021, I was instructed to complete a VAERS."
	"1385038-1"	"1385038-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Patient stopped breathing at 6:15pm on 04/22/2021. Fire dept was called. He went into cardiac arrest and they took him to ICU. He died on 04/26/2021 in ICU."
	"1385038-1"	"1385038-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient stopped breathing at 6:15pm on 04/22/2021. Fire dept was called. He went into cardiac arrest and they took him to ICU. He died on 04/26/2021 in ICU."
	"1385038-1"	"1385038-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Patient stopped breathing at 6:15pm on 04/22/2021. Fire dept was called. He went into cardiac arrest and they took him to ICU. He died on 04/26/2021 in ICU."
	"1385038-1"	"1385038-1"	"RESPIRATORY ARREST"	"10038669"	"60-64 years"	"60-64"	"Patient stopped breathing at 6:15pm on 04/22/2021. Fire dept was called. He went into cardiac arrest and they took him to ICU. He died on 04/26/2021 in ICU."
	"1387512-1"	"1387512-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"Dizziness; Aches; Weak; Fever; Nausea; DIED; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (DIED) in a 62-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.     No Medical History information was reported.    On 06-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced DIZZINESS (Dizziness), PAIN (Aches), ASTHENIA (Weak), PYREXIA (Fever) and NAUSEA (Nausea). The patient died on 18-Feb-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, DIZZINESS (Dizziness), PAIN (Aches), ASTHENIA (Weak), PYREXIA (Fever) and NAUSEA (Nausea) outcome was unknown.        The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.       It was reported that the vaccine was not the cause, he had other medical issues too.  This is a case of sudden death in a 62-year-old male patient with unknown medical, who died 12 days after receiving first dose of vaccine. Very limited information has been provided at this time.   Most recent FOLLOW-UP information incorporated above includes: On 03-Jun-2021: New event (death) and narrative was updated.; Sender's Comments: This is a case of sudden death in a 62-year-old male patient with unknown medical, who died 12 days after receiving first dose of vaccine. Very limited information has been provided at this time.; Reported Cause(s) of Death: Unknown cause of death"
	"1387512-1"	"1387512-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Dizziness; Aches; Weak; Fever; Nausea; DIED; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (DIED) in a 62-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.     No Medical History information was reported.    On 06-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced DIZZINESS (Dizziness), PAIN (Aches), ASTHENIA (Weak), PYREXIA (Fever) and NAUSEA (Nausea). The patient died on 18-Feb-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, DIZZINESS (Dizziness), PAIN (Aches), ASTHENIA (Weak), PYREXIA (Fever) and NAUSEA (Nausea) outcome was unknown.        The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.       It was reported that the vaccine was not the cause, he had other medical issues too.  This is a case of sudden death in a 62-year-old male patient with unknown medical, who died 12 days after receiving first dose of vaccine. Very limited information has been provided at this time.   Most recent FOLLOW-UP information incorporated above includes: On 03-Jun-2021: New event (death) and narrative was updated.; Sender's Comments: This is a case of sudden death in a 62-year-old male patient with unknown medical, who died 12 days after receiving first dose of vaccine. Very limited information has been provided at this time.; Reported Cause(s) of Death: Unknown cause of death"
	"1387512-1"	"1387512-1"	"DIZZINESS"	"10013573"	"60-64 years"	"60-64"	"Dizziness; Aches; Weak; Fever; Nausea; DIED; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (DIED) in a 62-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.     No Medical History information was reported.    On 06-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced DIZZINESS (Dizziness), PAIN (Aches), ASTHENIA (Weak), PYREXIA (Fever) and NAUSEA (Nausea). The patient died on 18-Feb-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, DIZZINESS (Dizziness), PAIN (Aches), ASTHENIA (Weak), PYREXIA (Fever) and NAUSEA (Nausea) outcome was unknown.        The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.       It was reported that the vaccine was not the cause, he had other medical issues too.  This is a case of sudden death in a 62-year-old male patient with unknown medical, who died 12 days after receiving first dose of vaccine. Very limited information has been provided at this time.   Most recent FOLLOW-UP information incorporated above includes: On 03-Jun-2021: New event (death) and narrative was updated.; Sender's Comments: This is a case of sudden death in a 62-year-old male patient with unknown medical, who died 12 days after receiving first dose of vaccine. Very limited information has been provided at this time.; Reported Cause(s) of Death: Unknown cause of death"
	"1387512-1"	"1387512-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Dizziness; Aches; Weak; Fever; Nausea; DIED; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (DIED) in a 62-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.     No Medical History information was reported.    On 06-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced DIZZINESS (Dizziness), PAIN (Aches), ASTHENIA (Weak), PYREXIA (Fever) and NAUSEA (Nausea). The patient died on 18-Feb-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, DIZZINESS (Dizziness), PAIN (Aches), ASTHENIA (Weak), PYREXIA (Fever) and NAUSEA (Nausea) outcome was unknown.        The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.       It was reported that the vaccine was not the cause, he had other medical issues too.  This is a case of sudden death in a 62-year-old male patient with unknown medical, who died 12 days after receiving first dose of vaccine. Very limited information has been provided at this time.   Most recent FOLLOW-UP information incorporated above includes: On 03-Jun-2021: New event (death) and narrative was updated.; Sender's Comments: This is a case of sudden death in a 62-year-old male patient with unknown medical, who died 12 days after receiving first dose of vaccine. Very limited information has been provided at this time.; Reported Cause(s) of Death: Unknown cause of death"
	"1387512-1"	"1387512-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"Dizziness; Aches; Weak; Fever; Nausea; DIED; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (DIED) in a 62-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.     No Medical History information was reported.    On 06-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced DIZZINESS (Dizziness), PAIN (Aches), ASTHENIA (Weak), PYREXIA (Fever) and NAUSEA (Nausea). The patient died on 18-Feb-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, DIZZINESS (Dizziness), PAIN (Aches), ASTHENIA (Weak), PYREXIA (Fever) and NAUSEA (Nausea) outcome was unknown.        The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.       It was reported that the vaccine was not the cause, he had other medical issues too.  This is a case of sudden death in a 62-year-old male patient with unknown medical, who died 12 days after receiving first dose of vaccine. Very limited information has been provided at this time.   Most recent FOLLOW-UP information incorporated above includes: On 03-Jun-2021: New event (death) and narrative was updated.; Sender's Comments: This is a case of sudden death in a 62-year-old male patient with unknown medical, who died 12 days after receiving first dose of vaccine. Very limited information has been provided at this time.; Reported Cause(s) of Death: Unknown cause of death"
	"1387512-1"	"1387512-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Dizziness; Aches; Weak; Fever; Nausea; DIED; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (DIED) in a 62-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.     No Medical History information was reported.    On 06-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced DIZZINESS (Dizziness), PAIN (Aches), ASTHENIA (Weak), PYREXIA (Fever) and NAUSEA (Nausea). The patient died on 18-Feb-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, DIZZINESS (Dizziness), PAIN (Aches), ASTHENIA (Weak), PYREXIA (Fever) and NAUSEA (Nausea) outcome was unknown.        The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.       It was reported that the vaccine was not the cause, he had other medical issues too.  This is a case of sudden death in a 62-year-old male patient with unknown medical, who died 12 days after receiving first dose of vaccine. Very limited information has been provided at this time.   Most recent FOLLOW-UP information incorporated above includes: On 03-Jun-2021: New event (death) and narrative was updated.; Sender's Comments: This is a case of sudden death in a 62-year-old male patient with unknown medical, who died 12 days after receiving first dose of vaccine. Very limited information has been provided at this time.; Reported Cause(s) of Death: Unknown cause of death"
	"1388572-1"	"1388572-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"At around 5:30 a.m. on the day after 2nd Moderna dose, resident was found non-responsive with no vital signs.  CPR was performed.  Time of death 6:20 a.m.  There were no acute illnesses or changes in condition noted prior to receiving vaccine."
	"1388572-1"	"1388572-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"At around 5:30 a.m. on the day after 2nd Moderna dose, resident was found non-responsive with no vital signs.  CPR was performed.  Time of death 6:20 a.m.  There were no acute illnesses or changes in condition noted prior to receiving vaccine."
	"1388572-1"	"1388572-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"At around 5:30 a.m. on the day after 2nd Moderna dose, resident was found non-responsive with no vital signs.  CPR was performed.  Time of death 6:20 a.m.  There were no acute illnesses or changes in condition noted prior to receiving vaccine."
	"1391273-1"	"1391273-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Went unresponsive at home after experiencing diarrhea.  Pulses were lost at home and regained by EMS prior to transport to the emergency room.  Pulses lost again in the emergency room.  ACLS performed for approximately 40 minutes before pronouncement of death was made."
	"1391273-1"	"1391273-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"Went unresponsive at home after experiencing diarrhea.  Pulses were lost at home and regained by EMS prior to transport to the emergency room.  Pulses lost again in the emergency room.  ACLS performed for approximately 40 minutes before pronouncement of death was made."
	"1391273-1"	"1391273-1"	"PULSE ABSENT"	"10037469"	"60-64 years"	"60-64"	"Went unresponsive at home after experiencing diarrhea.  Pulses were lost at home and regained by EMS prior to transport to the emergency room.  Pulses lost again in the emergency room.  ACLS performed for approximately 40 minutes before pronouncement of death was made."
	"1391273-1"	"1391273-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Went unresponsive at home after experiencing diarrhea.  Pulses were lost at home and regained by EMS prior to transport to the emergency room.  Pulses lost again in the emergency room.  ACLS performed for approximately 40 minutes before pronouncement of death was made."
	"1391681-1"	"1391681-1"	"ANEURYSM"	"10002329"	"60-64 years"	"60-64"	"brain bleed/aneurysm"
	"1391681-1"	"1391681-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"60-64 years"	"60-64"	"brain bleed/aneurysm"
	"1395442-1"	"1395442-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"60-64 years"	"60-64"	"stroke and MI came in with symptoms of stroke but symptoms for 24 hours so did not receive tPa. MRI showed brainstem infarct. Statin was increased and started on plavix 75 mg daily for 3 weeks due to small stroke with low NIH. Patient came back in 3 days later due to STEMI and went  into cardiac arrest. patient died after 1 hour of resuscitation"
	"1395442-1"	"1395442-1"	"ANTICOAGULANT THERAPY"	"10053468"	"60-64 years"	"60-64"	"stroke and MI came in with symptoms of stroke but symptoms for 24 hours so did not receive tPa. MRI showed brainstem infarct. Statin was increased and started on plavix 75 mg daily for 3 weeks due to small stroke with low NIH. Patient came back in 3 days later due to STEMI and went  into cardiac arrest. patient died after 1 hour of resuscitation"
	"1395442-1"	"1395442-1"	"BRAIN STEM INFARCTION"	"10006147"	"60-64 years"	"60-64"	"stroke and MI came in with symptoms of stroke but symptoms for 24 hours so did not receive tPa. MRI showed brainstem infarct. Statin was increased and started on plavix 75 mg daily for 3 weeks due to small stroke with low NIH. Patient came back in 3 days later due to STEMI and went  into cardiac arrest. patient died after 1 hour of resuscitation"
	"1395442-1"	"1395442-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"stroke and MI came in with symptoms of stroke but symptoms for 24 hours so did not receive tPa. MRI showed brainstem infarct. Statin was increased and started on plavix 75 mg daily for 3 weeks due to small stroke with low NIH. Patient came back in 3 days later due to STEMI and went  into cardiac arrest. patient died after 1 hour of resuscitation"
	"1395442-1"	"1395442-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"60-64 years"	"60-64"	"stroke and MI came in with symptoms of stroke but symptoms for 24 hours so did not receive tPa. MRI showed brainstem infarct. Statin was increased and started on plavix 75 mg daily for 3 weeks due to small stroke with low NIH. Patient came back in 3 days later due to STEMI and went  into cardiac arrest. patient died after 1 hour of resuscitation"
	"1395442-1"	"1395442-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"stroke and MI came in with symptoms of stroke but symptoms for 24 hours so did not receive tPa. MRI showed brainstem infarct. Statin was increased and started on plavix 75 mg daily for 3 weeks due to small stroke with low NIH. Patient came back in 3 days later due to STEMI and went  into cardiac arrest. patient died after 1 hour of resuscitation"
	"1395442-1"	"1395442-1"	"MAGNETIC RESONANCE IMAGING ABNORMAL"	"10078224"	"60-64 years"	"60-64"	"stroke and MI came in with symptoms of stroke but symptoms for 24 hours so did not receive tPa. MRI showed brainstem infarct. Statin was increased and started on plavix 75 mg daily for 3 weeks due to small stroke with low NIH. Patient came back in 3 days later due to STEMI and went  into cardiac arrest. patient died after 1 hour of resuscitation"
	"1395442-1"	"1395442-1"	"MAGNETIC RESONANCE IMAGING HEAD"	"10085255"	"60-64 years"	"60-64"	"stroke and MI came in with symptoms of stroke but symptoms for 24 hours so did not receive tPa. MRI showed brainstem infarct. Statin was increased and started on plavix 75 mg daily for 3 weeks due to small stroke with low NIH. Patient came back in 3 days later due to STEMI and went  into cardiac arrest. patient died after 1 hour of resuscitation"
	"1395442-1"	"1395442-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"stroke and MI came in with symptoms of stroke but symptoms for 24 hours so did not receive tPa. MRI showed brainstem infarct. Statin was increased and started on plavix 75 mg daily for 3 weeks due to small stroke with low NIH. Patient came back in 3 days later due to STEMI and went  into cardiac arrest. patient died after 1 hour of resuscitation"
	"1395442-1"	"1395442-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"stroke and MI came in with symptoms of stroke but symptoms for 24 hours so did not receive tPa. MRI showed brainstem infarct. Statin was increased and started on plavix 75 mg daily for 3 weeks due to small stroke with low NIH. Patient came back in 3 days later due to STEMI and went  into cardiac arrest. patient died after 1 hour of resuscitation"
	"1399358-1"	"1399358-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Patient deceased 6/9/2021 from COVID pneumonia"
	"1399358-1"	"1399358-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient deceased 6/9/2021 from COVID pneumonia"
	"1399891-1"	"1399891-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""Please see ER physician note below. Patient later expired at 1337 on June 12th.  One day after receiving the COVID vaccine.   ER physician note:  Patient presents completely unresponsive, CPR in progress Patient's wife reports that this afternoon, they were lying in bed and he leaned over to her and said ""help me"".  He then became unresponsive.  She reports that she believed he may have aspirated because he has an issue with his esophagus where he is unable to adequately swallow food sometimes.  The family began CPR at home, and reports that EMS arrived approximately 10 minutes later. Patient arrived here at the ED around 1250.  CPR continued.  Patient given multiple rounds of epi and bicarb.  Patient intubated with an 8 at 21 cm with some cold liquid around the tube.  He was intubated at arrival.""
	"1399891-1"	"1399891-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	""Please see ER physician note below. Patient later expired at 1337 on June 12th.  One day after receiving the COVID vaccine.   ER physician note:  Patient presents completely unresponsive, CPR in progress Patient's wife reports that this afternoon, they were lying in bed and he leaned over to her and said ""help me"".  He then became unresponsive.  She reports that she believed he may have aspirated because he has an issue with his esophagus where he is unable to adequately swallow food sometimes.  The family began CPR at home, and reports that EMS arrived approximately 10 minutes later. Patient arrived here at the ED around 1250.  CPR continued.  Patient given multiple rounds of epi and bicarb.  Patient intubated with an 8 at 21 cm with some cold liquid around the tube.  He was intubated at arrival.""
	"1399891-1"	"1399891-1"	"RESPIRATORY VIRAL PANEL"	"10075165"	"60-64 years"	"60-64"	""Please see ER physician note below. Patient later expired at 1337 on June 12th.  One day after receiving the COVID vaccine.   ER physician note:  Patient presents completely unresponsive, CPR in progress Patient's wife reports that this afternoon, they were lying in bed and he leaned over to her and said ""help me"".  He then became unresponsive.  She reports that she believed he may have aspirated because he has an issue with his esophagus where he is unable to adequately swallow food sometimes.  The family began CPR at home, and reports that EMS arrived approximately 10 minutes later. Patient arrived here at the ED around 1250.  CPR continued.  Patient given multiple rounds of epi and bicarb.  Patient intubated with an 8 at 21 cm with some cold liquid around the tube.  He was intubated at arrival.""
	"1399891-1"	"1399891-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	""Please see ER physician note below. Patient later expired at 1337 on June 12th.  One day after receiving the COVID vaccine.   ER physician note:  Patient presents completely unresponsive, CPR in progress Patient's wife reports that this afternoon, they were lying in bed and he leaned over to her and said ""help me"".  He then became unresponsive.  She reports that she believed he may have aspirated because he has an issue with his esophagus where he is unable to adequately swallow food sometimes.  The family began CPR at home, and reports that EMS arrived approximately 10 minutes later. Patient arrived here at the ED around 1250.  CPR continued.  Patient given multiple rounds of epi and bicarb.  Patient intubated with an 8 at 21 cm with some cold liquid around the tube.  He was intubated at arrival.""
	"1399891-1"	"1399891-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	""Please see ER physician note below. Patient later expired at 1337 on June 12th.  One day after receiving the COVID vaccine.   ER physician note:  Patient presents completely unresponsive, CPR in progress Patient's wife reports that this afternoon, they were lying in bed and he leaned over to her and said ""help me"".  He then became unresponsive.  She reports that she believed he may have aspirated because he has an issue with his esophagus where he is unable to adequately swallow food sometimes.  The family began CPR at home, and reports that EMS arrived approximately 10 minutes later. Patient arrived here at the ED around 1250.  CPR continued.  Patient given multiple rounds of epi and bicarb.  Patient intubated with an 8 at 21 cm with some cold liquid around the tube.  He was intubated at arrival.""
	"1399891-1"	"1399891-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	""Please see ER physician note below. Patient later expired at 1337 on June 12th.  One day after receiving the COVID vaccine.   ER physician note:  Patient presents completely unresponsive, CPR in progress Patient's wife reports that this afternoon, they were lying in bed and he leaned over to her and said ""help me"".  He then became unresponsive.  She reports that she believed he may have aspirated because he has an issue with his esophagus where he is unable to adequately swallow food sometimes.  The family began CPR at home, and reports that EMS arrived approximately 10 minutes later. Patient arrived here at the ED around 1250.  CPR continued.  Patient given multiple rounds of epi and bicarb.  Patient intubated with an 8 at 21 cm with some cold liquid around the tube.  He was intubated at arrival.""
	"1400218-1"	"1400218-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient CTB"
	"1401971-1"	"1401971-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"Few days after receiving the vaccine around 4/25, my mother complained to me that she was feeling very weak and tired, she was unable to hold anything down. She also had a rash. She became weaker and weaker so suddenly and unable to even drink protein drinks.  She finally went to the ER on 5/4 because she could barely walk, unable to eat anything and was short of breath.  They diagnosed her with pneumonia and a possible lung mass. She was diagnosed simultaneously 10 days later with small cell lung cancer however she had no symptoms prior. She received first dose chemo on 5/20/21 and had a reaction to the chemo that the doctor stated was very rare. They then had to try a different type of chemo for second dose 2 days later. She progressively got worse suddenly after chemo dose #3 and was in renal failure the day following chemo completion. She died on 5/27/2021. Her primary death diagnosis was sepsis, pneumonia and small cell lung cancer. I am reporting this for my mother because the vaccine has not been tested on cancer or chemo patients. It can and should not be regarded as coincidental. It needs to be tracked in case there are future reports regarding cancer patients."
	"1401971-1"	"1401971-1"	"CHEMOTHERAPY"	"10061758"	"60-64 years"	"60-64"	"Few days after receiving the vaccine around 4/25, my mother complained to me that she was feeling very weak and tired, she was unable to hold anything down. She also had a rash. She became weaker and weaker so suddenly and unable to even drink protein drinks.  She finally went to the ER on 5/4 because she could barely walk, unable to eat anything and was short of breath.  They diagnosed her with pneumonia and a possible lung mass. She was diagnosed simultaneously 10 days later with small cell lung cancer however she had no symptoms prior. She received first dose chemo on 5/20/21 and had a reaction to the chemo that the doctor stated was very rare. They then had to try a different type of chemo for second dose 2 days later. She progressively got worse suddenly after chemo dose #3 and was in renal failure the day following chemo completion. She died on 5/27/2021. Her primary death diagnosis was sepsis, pneumonia and small cell lung cancer. I am reporting this for my mother because the vaccine has not been tested on cancer or chemo patients. It can and should not be regarded as coincidental. It needs to be tracked in case there are future reports regarding cancer patients."
	"1401971-1"	"1401971-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"Few days after receiving the vaccine around 4/25, my mother complained to me that she was feeling very weak and tired, she was unable to hold anything down. She also had a rash. She became weaker and weaker so suddenly and unable to even drink protein drinks.  She finally went to the ER on 5/4 because she could barely walk, unable to eat anything and was short of breath.  They diagnosed her with pneumonia and a possible lung mass. She was diagnosed simultaneously 10 days later with small cell lung cancer however she had no symptoms prior. She received first dose chemo on 5/20/21 and had a reaction to the chemo that the doctor stated was very rare. They then had to try a different type of chemo for second dose 2 days later. She progressively got worse suddenly after chemo dose #3 and was in renal failure the day following chemo completion. She died on 5/27/2021. Her primary death diagnosis was sepsis, pneumonia and small cell lung cancer. I am reporting this for my mother because the vaccine has not been tested on cancer or chemo patients. It can and should not be regarded as coincidental. It needs to be tracked in case there are future reports regarding cancer patients."
	"1401971-1"	"1401971-1"	"COMPUTERISED TOMOGRAM ABNORMAL"	"10010235"	"60-64 years"	"60-64"	"Few days after receiving the vaccine around 4/25, my mother complained to me that she was feeling very weak and tired, she was unable to hold anything down. She also had a rash. She became weaker and weaker so suddenly and unable to even drink protein drinks.  She finally went to the ER on 5/4 because she could barely walk, unable to eat anything and was short of breath.  They diagnosed her with pneumonia and a possible lung mass. She was diagnosed simultaneously 10 days later with small cell lung cancer however she had no symptoms prior. She received first dose chemo on 5/20/21 and had a reaction to the chemo that the doctor stated was very rare. They then had to try a different type of chemo for second dose 2 days later. She progressively got worse suddenly after chemo dose #3 and was in renal failure the day following chemo completion. She died on 5/27/2021. Her primary death diagnosis was sepsis, pneumonia and small cell lung cancer. I am reporting this for my mother because the vaccine has not been tested on cancer or chemo patients. It can and should not be regarded as coincidental. It needs to be tracked in case there are future reports regarding cancer patients."
	"1401971-1"	"1401971-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Few days after receiving the vaccine around 4/25, my mother complained to me that she was feeling very weak and tired, she was unable to hold anything down. She also had a rash. She became weaker and weaker so suddenly and unable to even drink protein drinks.  She finally went to the ER on 5/4 because she could barely walk, unable to eat anything and was short of breath.  They diagnosed her with pneumonia and a possible lung mass. She was diagnosed simultaneously 10 days later with small cell lung cancer however she had no symptoms prior. She received first dose chemo on 5/20/21 and had a reaction to the chemo that the doctor stated was very rare. They then had to try a different type of chemo for second dose 2 days later. She progressively got worse suddenly after chemo dose #3 and was in renal failure the day following chemo completion. She died on 5/27/2021. Her primary death diagnosis was sepsis, pneumonia and small cell lung cancer. I am reporting this for my mother because the vaccine has not been tested on cancer or chemo patients. It can and should not be regarded as coincidental. It needs to be tracked in case there are future reports regarding cancer patients."
	"1401971-1"	"1401971-1"	"DRUG HYPERSENSITIVITY"	"10013700"	"60-64 years"	"60-64"	"Few days after receiving the vaccine around 4/25, my mother complained to me that she was feeling very weak and tired, she was unable to hold anything down. She also had a rash. She became weaker and weaker so suddenly and unable to even drink protein drinks.  She finally went to the ER on 5/4 because she could barely walk, unable to eat anything and was short of breath.  They diagnosed her with pneumonia and a possible lung mass. She was diagnosed simultaneously 10 days later with small cell lung cancer however she had no symptoms prior. She received first dose chemo on 5/20/21 and had a reaction to the chemo that the doctor stated was very rare. They then had to try a different type of chemo for second dose 2 days later. She progressively got worse suddenly after chemo dose #3 and was in renal failure the day following chemo completion. She died on 5/27/2021. Her primary death diagnosis was sepsis, pneumonia and small cell lung cancer. I am reporting this for my mother because the vaccine has not been tested on cancer or chemo patients. It can and should not be regarded as coincidental. It needs to be tracked in case there are future reports regarding cancer patients."
	"1401971-1"	"1401971-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Few days after receiving the vaccine around 4/25, my mother complained to me that she was feeling very weak and tired, she was unable to hold anything down. She also had a rash. She became weaker and weaker so suddenly and unable to even drink protein drinks.  She finally went to the ER on 5/4 because she could barely walk, unable to eat anything and was short of breath.  They diagnosed her with pneumonia and a possible lung mass. She was diagnosed simultaneously 10 days later with small cell lung cancer however she had no symptoms prior. She received first dose chemo on 5/20/21 and had a reaction to the chemo that the doctor stated was very rare. They then had to try a different type of chemo for second dose 2 days later. She progressively got worse suddenly after chemo dose #3 and was in renal failure the day following chemo completion. She died on 5/27/2021. Her primary death diagnosis was sepsis, pneumonia and small cell lung cancer. I am reporting this for my mother because the vaccine has not been tested on cancer or chemo patients. It can and should not be regarded as coincidental. It needs to be tracked in case there are future reports regarding cancer patients."
	"1401971-1"	"1401971-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Few days after receiving the vaccine around 4/25, my mother complained to me that she was feeling very weak and tired, she was unable to hold anything down. She also had a rash. She became weaker and weaker so suddenly and unable to even drink protein drinks.  She finally went to the ER on 5/4 because she could barely walk, unable to eat anything and was short of breath.  They diagnosed her with pneumonia and a possible lung mass. She was diagnosed simultaneously 10 days later with small cell lung cancer however she had no symptoms prior. She received first dose chemo on 5/20/21 and had a reaction to the chemo that the doctor stated was very rare. They then had to try a different type of chemo for second dose 2 days later. She progressively got worse suddenly after chemo dose #3 and was in renal failure the day following chemo completion. She died on 5/27/2021. Her primary death diagnosis was sepsis, pneumonia and small cell lung cancer. I am reporting this for my mother because the vaccine has not been tested on cancer or chemo patients. It can and should not be regarded as coincidental. It needs to be tracked in case there are future reports regarding cancer patients."
	"1401971-1"	"1401971-1"	"FEEDING DISORDER"	"10061148"	"60-64 years"	"60-64"	"Few days after receiving the vaccine around 4/25, my mother complained to me that she was feeling very weak and tired, she was unable to hold anything down. She also had a rash. She became weaker and weaker so suddenly and unable to even drink protein drinks.  She finally went to the ER on 5/4 because she could barely walk, unable to eat anything and was short of breath.  They diagnosed her with pneumonia and a possible lung mass. She was diagnosed simultaneously 10 days later with small cell lung cancer however she had no symptoms prior. She received first dose chemo on 5/20/21 and had a reaction to the chemo that the doctor stated was very rare. They then had to try a different type of chemo for second dose 2 days later. She progressively got worse suddenly after chemo dose #3 and was in renal failure the day following chemo completion. She died on 5/27/2021. Her primary death diagnosis was sepsis, pneumonia and small cell lung cancer. I am reporting this for my mother because the vaccine has not been tested on cancer or chemo patients. It can and should not be regarded as coincidental. It needs to be tracked in case there are future reports regarding cancer patients."
	"1401971-1"	"1401971-1"	"GAIT DISTURBANCE"	"10017577"	"60-64 years"	"60-64"	"Few days after receiving the vaccine around 4/25, my mother complained to me that she was feeling very weak and tired, she was unable to hold anything down. She also had a rash. She became weaker and weaker so suddenly and unable to even drink protein drinks.  She finally went to the ER on 5/4 because she could barely walk, unable to eat anything and was short of breath.  They diagnosed her with pneumonia and a possible lung mass. She was diagnosed simultaneously 10 days later with small cell lung cancer however she had no symptoms prior. She received first dose chemo on 5/20/21 and had a reaction to the chemo that the doctor stated was very rare. They then had to try a different type of chemo for second dose 2 days later. She progressively got worse suddenly after chemo dose #3 and was in renal failure the day following chemo completion. She died on 5/27/2021. Her primary death diagnosis was sepsis, pneumonia and small cell lung cancer. I am reporting this for my mother because the vaccine has not been tested on cancer or chemo patients. It can and should not be regarded as coincidental. It needs to be tracked in case there are future reports regarding cancer patients."
	"1401971-1"	"1401971-1"	"LABORATORY TEST"	"10059938"	"60-64 years"	"60-64"	"Few days after receiving the vaccine around 4/25, my mother complained to me that she was feeling very weak and tired, she was unable to hold anything down. She also had a rash. She became weaker and weaker so suddenly and unable to even drink protein drinks.  She finally went to the ER on 5/4 because she could barely walk, unable to eat anything and was short of breath.  They diagnosed her with pneumonia and a possible lung mass. She was diagnosed simultaneously 10 days later with small cell lung cancer however she had no symptoms prior. She received first dose chemo on 5/20/21 and had a reaction to the chemo that the doctor stated was very rare. They then had to try a different type of chemo for second dose 2 days later. She progressively got worse suddenly after chemo dose #3 and was in renal failure the day following chemo completion. She died on 5/27/2021. Her primary death diagnosis was sepsis, pneumonia and small cell lung cancer. I am reporting this for my mother because the vaccine has not been tested on cancer or chemo patients. It can and should not be regarded as coincidental. It needs to be tracked in case there are future reports regarding cancer patients."
	"1401971-1"	"1401971-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"Few days after receiving the vaccine around 4/25, my mother complained to me that she was feeling very weak and tired, she was unable to hold anything down. She also had a rash. She became weaker and weaker so suddenly and unable to even drink protein drinks.  She finally went to the ER on 5/4 because she could barely walk, unable to eat anything and was short of breath.  They diagnosed her with pneumonia and a possible lung mass. She was diagnosed simultaneously 10 days later with small cell lung cancer however she had no symptoms prior. She received first dose chemo on 5/20/21 and had a reaction to the chemo that the doctor stated was very rare. They then had to try a different type of chemo for second dose 2 days later. She progressively got worse suddenly after chemo dose #3 and was in renal failure the day following chemo completion. She died on 5/27/2021. Her primary death diagnosis was sepsis, pneumonia and small cell lung cancer. I am reporting this for my mother because the vaccine has not been tested on cancer or chemo patients. It can and should not be regarded as coincidental. It needs to be tracked in case there are future reports regarding cancer patients."
	"1401971-1"	"1401971-1"	"RASH"	"10037844"	"60-64 years"	"60-64"	"Few days after receiving the vaccine around 4/25, my mother complained to me that she was feeling very weak and tired, she was unable to hold anything down. She also had a rash. She became weaker and weaker so suddenly and unable to even drink protein drinks.  She finally went to the ER on 5/4 because she could barely walk, unable to eat anything and was short of breath.  They diagnosed her with pneumonia and a possible lung mass. She was diagnosed simultaneously 10 days later with small cell lung cancer however she had no symptoms prior. She received first dose chemo on 5/20/21 and had a reaction to the chemo that the doctor stated was very rare. They then had to try a different type of chemo for second dose 2 days later. She progressively got worse suddenly after chemo dose #3 and was in renal failure the day following chemo completion. She died on 5/27/2021. Her primary death diagnosis was sepsis, pneumonia and small cell lung cancer. I am reporting this for my mother because the vaccine has not been tested on cancer or chemo patients. It can and should not be regarded as coincidental. It needs to be tracked in case there are future reports regarding cancer patients."
	"1401971-1"	"1401971-1"	"RENAL FAILURE"	"10038435"	"60-64 years"	"60-64"	"Few days after receiving the vaccine around 4/25, my mother complained to me that she was feeling very weak and tired, she was unable to hold anything down. She also had a rash. She became weaker and weaker so suddenly and unable to even drink protein drinks.  She finally went to the ER on 5/4 because she could barely walk, unable to eat anything and was short of breath.  They diagnosed her with pneumonia and a possible lung mass. She was diagnosed simultaneously 10 days later with small cell lung cancer however she had no symptoms prior. She received first dose chemo on 5/20/21 and had a reaction to the chemo that the doctor stated was very rare. They then had to try a different type of chemo for second dose 2 days later. She progressively got worse suddenly after chemo dose #3 and was in renal failure the day following chemo completion. She died on 5/27/2021. Her primary death diagnosis was sepsis, pneumonia and small cell lung cancer. I am reporting this for my mother because the vaccine has not been tested on cancer or chemo patients. It can and should not be regarded as coincidental. It needs to be tracked in case there are future reports regarding cancer patients."
	"1401971-1"	"1401971-1"	"SEPSIS"	"10040047"	"60-64 years"	"60-64"	"Few days after receiving the vaccine around 4/25, my mother complained to me that she was feeling very weak and tired, she was unable to hold anything down. She also had a rash. She became weaker and weaker so suddenly and unable to even drink protein drinks.  She finally went to the ER on 5/4 because she could barely walk, unable to eat anything and was short of breath.  They diagnosed her with pneumonia and a possible lung mass. She was diagnosed simultaneously 10 days later with small cell lung cancer however she had no symptoms prior. She received first dose chemo on 5/20/21 and had a reaction to the chemo that the doctor stated was very rare. They then had to try a different type of chemo for second dose 2 days later. She progressively got worse suddenly after chemo dose #3 and was in renal failure the day following chemo completion. She died on 5/27/2021. Her primary death diagnosis was sepsis, pneumonia and small cell lung cancer. I am reporting this for my mother because the vaccine has not been tested on cancer or chemo patients. It can and should not be regarded as coincidental. It needs to be tracked in case there are future reports regarding cancer patients."
	"1401971-1"	"1401971-1"	"SMALL CELL LUNG CANCER"	"10041067"	"60-64 years"	"60-64"	"Few days after receiving the vaccine around 4/25, my mother complained to me that she was feeling very weak and tired, she was unable to hold anything down. She also had a rash. She became weaker and weaker so suddenly and unable to even drink protein drinks.  She finally went to the ER on 5/4 because she could barely walk, unable to eat anything and was short of breath.  They diagnosed her with pneumonia and a possible lung mass. She was diagnosed simultaneously 10 days later with small cell lung cancer however she had no symptoms prior. She received first dose chemo on 5/20/21 and had a reaction to the chemo that the doctor stated was very rare. They then had to try a different type of chemo for second dose 2 days later. She progressively got worse suddenly after chemo dose #3 and was in renal failure the day following chemo completion. She died on 5/27/2021. Her primary death diagnosis was sepsis, pneumonia and small cell lung cancer. I am reporting this for my mother because the vaccine has not been tested on cancer or chemo patients. It can and should not be regarded as coincidental. It needs to be tracked in case there are future reports regarding cancer patients."
	"1402395-1"	"1402395-1"	"ANOSMIA"	"10002653"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1402395-1"	"1402395-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1402395-1"	"1402395-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1402395-1"	"1402395-1"	"CYANOSIS"	"10011703"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1402395-1"	"1402395-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1402395-1"	"1402395-1"	"DECREASED APPETITE"	"10061428"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1402395-1"	"1402395-1"	"DEEP VEIN THROMBOSIS"	"10051055"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1402395-1"	"1402395-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1402395-1"	"1402395-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1402395-1"	"1402395-1"	"FIBRIN D DIMER INCREASED"	"10016581"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1402395-1"	"1402395-1"	"HEPARIN-INDUCED THROMBOCYTOPENIA"	"10062506"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1402395-1"	"1402395-1"	"LYMPHOPENIA"	"10025327"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1402395-1"	"1402395-1"	"MULTIPLE ORGAN DYSFUNCTION SYNDROME"	"10077361"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1402395-1"	"1402395-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1402395-1"	"1402395-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1402395-1"	"1402395-1"	"RESPIRATORY DISTRESS"	"10038687"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1402395-1"	"1402395-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1402395-1"	"1402395-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1402395-1"	"1402395-1"	"SHOCK"	"10040560"	"60-64 years"	"60-64"	""2 days after vaccine developed diarrhea & body aches, then loss of smell and appetite.  ED visit 4/8/2021, lymphopenia noted, COVID PCR positive.  Returned to ED 4/11/2021 with SOB, oximetry low 70s, cyanotic, respiratory distress, elevated D dimer, CXR: COVID pneumonitis.  ""Deteriorated quickly despite maximal medical management"" per Discharge Summary.  Died 4/24/2021 from hypoxic respiratory failure and multiorgan failure, shock.  Had also developed heparin induced thrombocytopenia during treatment for DVT Right lower and upper extremities.""
	"1407818-1"	"1407818-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine."
	"1409932-1"	"1409932-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""The evening of his second shot, he collapsed.  He said he became light headed, but I believe he may have lost consciousness briefly.  He rand a low fever for 12 hours.  Afterwards, he complained that he had ""not felt right"" since the second shot.  He died of a heart attack on May 27, roughly one month after his second shot.""
	"1409932-1"	"1409932-1"	"DIZZINESS"	"10013573"	"60-64 years"	"60-64"	""The evening of his second shot, he collapsed.  He said he became light headed, but I believe he may have lost consciousness briefly.  He rand a low fever for 12 hours.  Afterwards, he complained that he had ""not felt right"" since the second shot.  He died of a heart attack on May 27, roughly one month after his second shot.""
	"1409932-1"	"1409932-1"	"FEELING ABNORMAL"	"10016322"	"60-64 years"	"60-64"	""The evening of his second shot, he collapsed.  He said he became light headed, but I believe he may have lost consciousness briefly.  He rand a low fever for 12 hours.  Afterwards, he complained that he had ""not felt right"" since the second shot.  He died of a heart attack on May 27, roughly one month after his second shot.""
	"1409932-1"	"1409932-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	""The evening of his second shot, he collapsed.  He said he became light headed, but I believe he may have lost consciousness briefly.  He rand a low fever for 12 hours.  Afterwards, he complained that he had ""not felt right"" since the second shot.  He died of a heart attack on May 27, roughly one month after his second shot.""
	"1409932-1"	"1409932-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	""The evening of his second shot, he collapsed.  He said he became light headed, but I believe he may have lost consciousness briefly.  He rand a low fever for 12 hours.  Afterwards, he complained that he had ""not felt right"" since the second shot.  He died of a heart attack on May 27, roughly one month after his second shot.""
	"1409932-1"	"1409932-1"	"SYNCOPE"	"10042772"	"60-64 years"	"60-64"	""The evening of his second shot, he collapsed.  He said he became light headed, but I believe he may have lost consciousness briefly.  He rand a low fever for 12 hours.  Afterwards, he complained that he had ""not felt right"" since the second shot.  He died of a heart attack on May 27, roughly one month after his second shot.""
	"1410203-1"	"1410203-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"pt developed pulmonary embolism and passed away  6/14/2021"
	"1410203-1"	"1410203-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"pt developed pulmonary embolism and passed away  6/14/2021"
	"1410366-1"	"1410366-1"	"CARDIAC FAILURE CONGESTIVE"	"10007559"	"60-64 years"	"60-64"	"Cough and fever as symptoms of COVID infection Cause of death: Congestive heart failure"
	"1410366-1"	"1410366-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Cough and fever as symptoms of COVID infection Cause of death: Congestive heart failure"
	"1410366-1"	"1410366-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Cough and fever as symptoms of COVID infection Cause of death: Congestive heart failure"
	"1410366-1"	"1410366-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Cough and fever as symptoms of COVID infection Cause of death: Congestive heart failure"
	"1410464-1"	"1410464-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient was diagnosed with COVID-19 on 6/13/2021 and subsequently died on 6/17/2021. Patient was considered to be fully vaccinated as of 3/24/2021 having received both doses of Pfizer."
	"1410464-1"	"1410464-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient was diagnosed with COVID-19 on 6/13/2021 and subsequently died on 6/17/2021. Patient was considered to be fully vaccinated as of 3/24/2021 having received both doses of Pfizer."
	"1410799-1"	"1410799-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"After first dose of vaccine on 4/23 complained of fatigue and tiredness.  After second dose on 5/26 complained of fatigue, dizziness, nausea and body aches.  Expired on 5/28."
	"1410799-1"	"1410799-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"After first dose of vaccine on 4/23 complained of fatigue and tiredness.  After second dose on 5/26 complained of fatigue, dizziness, nausea and body aches.  Expired on 5/28."
	"1410799-1"	"1410799-1"	"DIZZINESS"	"10013573"	"60-64 years"	"60-64"	"After first dose of vaccine on 4/23 complained of fatigue and tiredness.  After second dose on 5/26 complained of fatigue, dizziness, nausea and body aches.  Expired on 5/28."
	"1410799-1"	"1410799-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"After first dose of vaccine on 4/23 complained of fatigue and tiredness.  After second dose on 5/26 complained of fatigue, dizziness, nausea and body aches.  Expired on 5/28."
	"1410799-1"	"1410799-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"After first dose of vaccine on 4/23 complained of fatigue and tiredness.  After second dose on 5/26 complained of fatigue, dizziness, nausea and body aches.  Expired on 5/28."
	"1410799-1"	"1410799-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"After first dose of vaccine on 4/23 complained of fatigue and tiredness.  After second dose on 5/26 complained of fatigue, dizziness, nausea and body aches.  Expired on 5/28."
	"1413571-1"	"1413571-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"60-64 years"	"60-64"	"Stroke on the 23rd, hospilized for 10 days. Second stroke on the 12th. Died on the 18th."
	"1413571-1"	"1413571-1"	"COMPUTERISED TOMOGRAM"	"10010234"	"60-64 years"	"60-64"	"Stroke on the 23rd, hospilized for 10 days. Second stroke on the 12th. Died on the 18th."
	"1413571-1"	"1413571-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Stroke on the 23rd, hospilized for 10 days. Second stroke on the 12th. Died on the 18th."
	"1413571-1"	"1413571-1"	"MAGNETIC RESONANCE IMAGING"	"10078223"	"60-64 years"	"60-64"	"Stroke on the 23rd, hospilized for 10 days. Second stroke on the 12th. Died on the 18th."
	"1413571-1"	"1413571-1"	"X-RAY"	"10048064"	"60-64 years"	"60-64"	"Stroke on the 23rd, hospilized for 10 days. Second stroke on the 12th. Died on the 18th."
	"1413807-1"	"1413807-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Systemic: Death-Severe, Additional Details: Patient's wife called and told us that on the day that he passed (6/13/21), he did yard work all morning, then came in for a meal and to watch the soccer game. He then went to their bedroom to lay down and about 15 mins later she heard a strage noise and went check on him. Upon entering the room is when she found that he had passed. Cause of death is unknown"
	"1415083-1"	"1415083-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"My husband fell ill within hours of getting the first dose of the vaccine, he started running fever, chills, body aches-within 7 days he was admitted to the hospital and 12 hours after admission to the hospital  he was diagnosed with Covid Pneumonia. or they thought- his lungs were showing signs of being attacked. He had no illness, no fever, no underlying health concerns, no allergies, he was not over weight, he was not diabetic, he was still young and within 6 weeks of getting the vaccine he was dead. Doctors could do nothing to save his life. The Moderna vaccine killed my husband and it is killing other perfectly healthy people."
	"1415083-1"	"1415083-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"My husband fell ill within hours of getting the first dose of the vaccine, he started running fever, chills, body aches-within 7 days he was admitted to the hospital and 12 hours after admission to the hospital  he was diagnosed with Covid Pneumonia. or they thought- his lungs were showing signs of being attacked. He had no illness, no fever, no underlying health concerns, no allergies, he was not over weight, he was not diabetic, he was still young and within 6 weeks of getting the vaccine he was dead. Doctors could do nothing to save his life. The Moderna vaccine killed my husband and it is killing other perfectly healthy people."
	"1415083-1"	"1415083-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"My husband fell ill within hours of getting the first dose of the vaccine, he started running fever, chills, body aches-within 7 days he was admitted to the hospital and 12 hours after admission to the hospital  he was diagnosed with Covid Pneumonia. or they thought- his lungs were showing signs of being attacked. He had no illness, no fever, no underlying health concerns, no allergies, he was not over weight, he was not diabetic, he was still young and within 6 weeks of getting the vaccine he was dead. Doctors could do nothing to save his life. The Moderna vaccine killed my husband and it is killing other perfectly healthy people."
	"1415083-1"	"1415083-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"My husband fell ill within hours of getting the first dose of the vaccine, he started running fever, chills, body aches-within 7 days he was admitted to the hospital and 12 hours after admission to the hospital  he was diagnosed with Covid Pneumonia. or they thought- his lungs were showing signs of being attacked. He had no illness, no fever, no underlying health concerns, no allergies, he was not over weight, he was not diabetic, he was still young and within 6 weeks of getting the vaccine he was dead. Doctors could do nothing to save his life. The Moderna vaccine killed my husband and it is killing other perfectly healthy people."
	"1415083-1"	"1415083-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"My husband fell ill within hours of getting the first dose of the vaccine, he started running fever, chills, body aches-within 7 days he was admitted to the hospital and 12 hours after admission to the hospital  he was diagnosed with Covid Pneumonia. or they thought- his lungs were showing signs of being attacked. He had no illness, no fever, no underlying health concerns, no allergies, he was not over weight, he was not diabetic, he was still young and within 6 weeks of getting the vaccine he was dead. Doctors could do nothing to save his life. The Moderna vaccine killed my husband and it is killing other perfectly healthy people."
	"1415083-1"	"1415083-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"My husband fell ill within hours of getting the first dose of the vaccine, he started running fever, chills, body aches-within 7 days he was admitted to the hospital and 12 hours after admission to the hospital  he was diagnosed with Covid Pneumonia. or they thought- his lungs were showing signs of being attacked. He had no illness, no fever, no underlying health concerns, no allergies, he was not over weight, he was not diabetic, he was still young and within 6 weeks of getting the vaccine he was dead. Doctors could do nothing to save his life. The Moderna vaccine killed my husband and it is killing other perfectly healthy people."
	"1416476-1"	"1416476-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient died at home 3 weeks after receiving first dose of vaccine."
	"1417119-1"	"1417119-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"lightheadedness, weakness, Pain Narrative: A 63yo male with history of tobacco use, Cocaine dependence in remission, PTSD, Depression, Cirrhosis of Liver due to Chronic Hepatitis, Alcohol Dependence, Spinal Stenosis of Lumbar Region, Obesity, HTN, OA, COPD and OSA. It's documented he received Covid-19 vaccine on January 11, 2021, per protocol, without complications and was advised to stay on site for 15 minutes. Instructions about side effects and ADR reporting were also provided. He called hospital advice line on January 12, 2021 to report ADR symptoms of having LT arm pain that radiates to his back and chest which started on his way home after he received the vaccine. Also reported he felt weak, had diarrhea, nausea, chills and lightheadedness. He was advised by the call documenting nurse, to go the hospital ED, for evaluation. Per telephone note - Physician A/P documentation included that symptoms were discussed with the patient on January 12, 2021 @13:01 PM, patient was assured what he experienced was an expected reaction from the vaccine and it'd be safe to get his second scheduled shot On January 14 the patient called back to report feeling a little light headed, having muscle/ body ache and feeling weaker after the Covid-19 vaccine. Recommendation was made to go to the ER by the call taker Patient called on January 15, 2021 with a fever of 101.5 and asking if it maybe due to the vaccine March 17, 2021 the patient presented to the ED with chief complaint of Chest pain, was hypoxic and with a temp of 101.8, was started on O2 nasal cannula, saturation improved from 83% to 87% and with 5L to 90% He was diagnosed with Covid-19 and admitted to Critical Care. Psox remained above 92% on 6L HFNC The patient remained in MICU and passed away on February 4, 2021"
	"1417119-1"	"1417119-1"	"BACK PAIN"	"10003988"	"60-64 years"	"60-64"	"lightheadedness, weakness, Pain Narrative: A 63yo male with history of tobacco use, Cocaine dependence in remission, PTSD, Depression, Cirrhosis of Liver due to Chronic Hepatitis, Alcohol Dependence, Spinal Stenosis of Lumbar Region, Obesity, HTN, OA, COPD and OSA. It's documented he received Covid-19 vaccine on January 11, 2021, per protocol, without complications and was advised to stay on site for 15 minutes. Instructions about side effects and ADR reporting were also provided. He called hospital advice line on January 12, 2021 to report ADR symptoms of having LT arm pain that radiates to his back and chest which started on his way home after he received the vaccine. Also reported he felt weak, had diarrhea, nausea, chills and lightheadedness. He was advised by the call documenting nurse, to go the hospital ED, for evaluation. Per telephone note - Physician A/P documentation included that symptoms were discussed with the patient on January 12, 2021 @13:01 PM, patient was assured what he experienced was an expected reaction from the vaccine and it'd be safe to get his second scheduled shot On January 14 the patient called back to report feeling a little light headed, having muscle/ body ache and feeling weaker after the Covid-19 vaccine. Recommendation was made to go to the ER by the call taker Patient called on January 15, 2021 with a fever of 101.5 and asking if it maybe due to the vaccine March 17, 2021 the patient presented to the ED with chief complaint of Chest pain, was hypoxic and with a temp of 101.8, was started on O2 nasal cannula, saturation improved from 83% to 87% and with 5L to 90% He was diagnosed with Covid-19 and admitted to Critical Care. Psox remained above 92% on 6L HFNC The patient remained in MICU and passed away on February 4, 2021"
	"1417119-1"	"1417119-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"lightheadedness, weakness, Pain Narrative: A 63yo male with history of tobacco use, Cocaine dependence in remission, PTSD, Depression, Cirrhosis of Liver due to Chronic Hepatitis, Alcohol Dependence, Spinal Stenosis of Lumbar Region, Obesity, HTN, OA, COPD and OSA. It's documented he received Covid-19 vaccine on January 11, 2021, per protocol, without complications and was advised to stay on site for 15 minutes. Instructions about side effects and ADR reporting were also provided. He called hospital advice line on January 12, 2021 to report ADR symptoms of having LT arm pain that radiates to his back and chest which started on his way home after he received the vaccine. Also reported he felt weak, had diarrhea, nausea, chills and lightheadedness. He was advised by the call documenting nurse, to go the hospital ED, for evaluation. Per telephone note - Physician A/P documentation included that symptoms were discussed with the patient on January 12, 2021 @13:01 PM, patient was assured what he experienced was an expected reaction from the vaccine and it'd be safe to get his second scheduled shot On January 14 the patient called back to report feeling a little light headed, having muscle/ body ache and feeling weaker after the Covid-19 vaccine. Recommendation was made to go to the ER by the call taker Patient called on January 15, 2021 with a fever of 101.5 and asking if it maybe due to the vaccine March 17, 2021 the patient presented to the ED with chief complaint of Chest pain, was hypoxic and with a temp of 101.8, was started on O2 nasal cannula, saturation improved from 83% to 87% and with 5L to 90% He was diagnosed with Covid-19 and admitted to Critical Care. Psox remained above 92% on 6L HFNC The patient remained in MICU and passed away on February 4, 2021"
	"1417119-1"	"1417119-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"lightheadedness, weakness, Pain Narrative: A 63yo male with history of tobacco use, Cocaine dependence in remission, PTSD, Depression, Cirrhosis of Liver due to Chronic Hepatitis, Alcohol Dependence, Spinal Stenosis of Lumbar Region, Obesity, HTN, OA, COPD and OSA. It's documented he received Covid-19 vaccine on January 11, 2021, per protocol, without complications and was advised to stay on site for 15 minutes. Instructions about side effects and ADR reporting were also provided. He called hospital advice line on January 12, 2021 to report ADR symptoms of having LT arm pain that radiates to his back and chest which started on his way home after he received the vaccine. Also reported he felt weak, had diarrhea, nausea, chills and lightheadedness. He was advised by the call documenting nurse, to go the hospital ED, for evaluation. Per telephone note - Physician A/P documentation included that symptoms were discussed with the patient on January 12, 2021 @13:01 PM, patient was assured what he experienced was an expected reaction from the vaccine and it'd be safe to get his second scheduled shot On January 14 the patient called back to report feeling a little light headed, having muscle/ body ache and feeling weaker after the Covid-19 vaccine. Recommendation was made to go to the ER by the call taker Patient called on January 15, 2021 with a fever of 101.5 and asking if it maybe due to the vaccine March 17, 2021 the patient presented to the ED with chief complaint of Chest pain, was hypoxic and with a temp of 101.8, was started on O2 nasal cannula, saturation improved from 83% to 87% and with 5L to 90% He was diagnosed with Covid-19 and admitted to Critical Care. Psox remained above 92% on 6L HFNC The patient remained in MICU and passed away on February 4, 2021"
	"1417119-1"	"1417119-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"lightheadedness, weakness, Pain Narrative: A 63yo male with history of tobacco use, Cocaine dependence in remission, PTSD, Depression, Cirrhosis of Liver due to Chronic Hepatitis, Alcohol Dependence, Spinal Stenosis of Lumbar Region, Obesity, HTN, OA, COPD and OSA. It's documented he received Covid-19 vaccine on January 11, 2021, per protocol, without complications and was advised to stay on site for 15 minutes. Instructions about side effects and ADR reporting were also provided. He called hospital advice line on January 12, 2021 to report ADR symptoms of having LT arm pain that radiates to his back and chest which started on his way home after he received the vaccine. Also reported he felt weak, had diarrhea, nausea, chills and lightheadedness. He was advised by the call documenting nurse, to go the hospital ED, for evaluation. Per telephone note - Physician A/P documentation included that symptoms were discussed with the patient on January 12, 2021 @13:01 PM, patient was assured what he experienced was an expected reaction from the vaccine and it'd be safe to get his second scheduled shot On January 14 the patient called back to report feeling a little light headed, having muscle/ body ache and feeling weaker after the Covid-19 vaccine. Recommendation was made to go to the ER by the call taker Patient called on January 15, 2021 with a fever of 101.5 and asking if it maybe due to the vaccine March 17, 2021 the patient presented to the ED with chief complaint of Chest pain, was hypoxic and with a temp of 101.8, was started on O2 nasal cannula, saturation improved from 83% to 87% and with 5L to 90% He was diagnosed with Covid-19 and admitted to Critical Care. Psox remained above 92% on 6L HFNC The patient remained in MICU and passed away on February 4, 2021"
	"1417119-1"	"1417119-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"lightheadedness, weakness, Pain Narrative: A 63yo male with history of tobacco use, Cocaine dependence in remission, PTSD, Depression, Cirrhosis of Liver due to Chronic Hepatitis, Alcohol Dependence, Spinal Stenosis of Lumbar Region, Obesity, HTN, OA, COPD and OSA. It's documented he received Covid-19 vaccine on January 11, 2021, per protocol, without complications and was advised to stay on site for 15 minutes. Instructions about side effects and ADR reporting were also provided. He called hospital advice line on January 12, 2021 to report ADR symptoms of having LT arm pain that radiates to his back and chest which started on his way home after he received the vaccine. Also reported he felt weak, had diarrhea, nausea, chills and lightheadedness. He was advised by the call documenting nurse, to go the hospital ED, for evaluation. Per telephone note - Physician A/P documentation included that symptoms were discussed with the patient on January 12, 2021 @13:01 PM, patient was assured what he experienced was an expected reaction from the vaccine and it'd be safe to get his second scheduled shot On January 14 the patient called back to report feeling a little light headed, having muscle/ body ache and feeling weaker after the Covid-19 vaccine. Recommendation was made to go to the ER by the call taker Patient called on January 15, 2021 with a fever of 101.5 and asking if it maybe due to the vaccine March 17, 2021 the patient presented to the ED with chief complaint of Chest pain, was hypoxic and with a temp of 101.8, was started on O2 nasal cannula, saturation improved from 83% to 87% and with 5L to 90% He was diagnosed with Covid-19 and admitted to Critical Care. Psox remained above 92% on 6L HFNC The patient remained in MICU and passed away on February 4, 2021"
	"1417119-1"	"1417119-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"lightheadedness, weakness, Pain Narrative: A 63yo male with history of tobacco use, Cocaine dependence in remission, PTSD, Depression, Cirrhosis of Liver due to Chronic Hepatitis, Alcohol Dependence, Spinal Stenosis of Lumbar Region, Obesity, HTN, OA, COPD and OSA. It's documented he received Covid-19 vaccine on January 11, 2021, per protocol, without complications and was advised to stay on site for 15 minutes. Instructions about side effects and ADR reporting were also provided. He called hospital advice line on January 12, 2021 to report ADR symptoms of having LT arm pain that radiates to his back and chest which started on his way home after he received the vaccine. Also reported he felt weak, had diarrhea, nausea, chills and lightheadedness. He was advised by the call documenting nurse, to go the hospital ED, for evaluation. Per telephone note - Physician A/P documentation included that symptoms were discussed with the patient on January 12, 2021 @13:01 PM, patient was assured what he experienced was an expected reaction from the vaccine and it'd be safe to get his second scheduled shot On January 14 the patient called back to report feeling a little light headed, having muscle/ body ache and feeling weaker after the Covid-19 vaccine. Recommendation was made to go to the ER by the call taker Patient called on January 15, 2021 with a fever of 101.5 and asking if it maybe due to the vaccine March 17, 2021 the patient presented to the ED with chief complaint of Chest pain, was hypoxic and with a temp of 101.8, was started on O2 nasal cannula, saturation improved from 83% to 87% and with 5L to 90% He was diagnosed with Covid-19 and admitted to Critical Care. Psox remained above 92% on 6L HFNC The patient remained in MICU and passed away on February 4, 2021"
	"1417119-1"	"1417119-1"	"DIZZINESS"	"10013573"	"60-64 years"	"60-64"	"lightheadedness, weakness, Pain Narrative: A 63yo male with history of tobacco use, Cocaine dependence in remission, PTSD, Depression, Cirrhosis of Liver due to Chronic Hepatitis, Alcohol Dependence, Spinal Stenosis of Lumbar Region, Obesity, HTN, OA, COPD and OSA. It's documented he received Covid-19 vaccine on January 11, 2021, per protocol, without complications and was advised to stay on site for 15 minutes. Instructions about side effects and ADR reporting were also provided. He called hospital advice line on January 12, 2021 to report ADR symptoms of having LT arm pain that radiates to his back and chest which started on his way home after he received the vaccine. Also reported he felt weak, had diarrhea, nausea, chills and lightheadedness. He was advised by the call documenting nurse, to go the hospital ED, for evaluation. Per telephone note - Physician A/P documentation included that symptoms were discussed with the patient on January 12, 2021 @13:01 PM, patient was assured what he experienced was an expected reaction from the vaccine and it'd be safe to get his second scheduled shot On January 14 the patient called back to report feeling a little light headed, having muscle/ body ache and feeling weaker after the Covid-19 vaccine. Recommendation was made to go to the ER by the call taker Patient called on January 15, 2021 with a fever of 101.5 and asking if it maybe due to the vaccine March 17, 2021 the patient presented to the ED with chief complaint of Chest pain, was hypoxic and with a temp of 101.8, was started on O2 nasal cannula, saturation improved from 83% to 87% and with 5L to 90% He was diagnosed with Covid-19 and admitted to Critical Care. Psox remained above 92% on 6L HFNC The patient remained in MICU and passed away on February 4, 2021"
	"1417119-1"	"1417119-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"lightheadedness, weakness, Pain Narrative: A 63yo male with history of tobacco use, Cocaine dependence in remission, PTSD, Depression, Cirrhosis of Liver due to Chronic Hepatitis, Alcohol Dependence, Spinal Stenosis of Lumbar Region, Obesity, HTN, OA, COPD and OSA. It's documented he received Covid-19 vaccine on January 11, 2021, per protocol, without complications and was advised to stay on site for 15 minutes. Instructions about side effects and ADR reporting were also provided. He called hospital advice line on January 12, 2021 to report ADR symptoms of having LT arm pain that radiates to his back and chest which started on his way home after he received the vaccine. Also reported he felt weak, had diarrhea, nausea, chills and lightheadedness. He was advised by the call documenting nurse, to go the hospital ED, for evaluation. Per telephone note - Physician A/P documentation included that symptoms were discussed with the patient on January 12, 2021 @13:01 PM, patient was assured what he experienced was an expected reaction from the vaccine and it'd be safe to get his second scheduled shot On January 14 the patient called back to report feeling a little light headed, having muscle/ body ache and feeling weaker after the Covid-19 vaccine. Recommendation was made to go to the ER by the call taker Patient called on January 15, 2021 with a fever of 101.5 and asking if it maybe due to the vaccine March 17, 2021 the patient presented to the ED with chief complaint of Chest pain, was hypoxic and with a temp of 101.8, was started on O2 nasal cannula, saturation improved from 83% to 87% and with 5L to 90% He was diagnosed with Covid-19 and admitted to Critical Care. Psox remained above 92% on 6L HFNC The patient remained in MICU and passed away on February 4, 2021"
	"1417119-1"	"1417119-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"lightheadedness, weakness, Pain Narrative: A 63yo male with history of tobacco use, Cocaine dependence in remission, PTSD, Depression, Cirrhosis of Liver due to Chronic Hepatitis, Alcohol Dependence, Spinal Stenosis of Lumbar Region, Obesity, HTN, OA, COPD and OSA. It's documented he received Covid-19 vaccine on January 11, 2021, per protocol, without complications and was advised to stay on site for 15 minutes. Instructions about side effects and ADR reporting were also provided. He called hospital advice line on January 12, 2021 to report ADR symptoms of having LT arm pain that radiates to his back and chest which started on his way home after he received the vaccine. Also reported he felt weak, had diarrhea, nausea, chills and lightheadedness. He was advised by the call documenting nurse, to go the hospital ED, for evaluation. Per telephone note - Physician A/P documentation included that symptoms were discussed with the patient on January 12, 2021 @13:01 PM, patient was assured what he experienced was an expected reaction from the vaccine and it'd be safe to get his second scheduled shot On January 14 the patient called back to report feeling a little light headed, having muscle/ body ache and feeling weaker after the Covid-19 vaccine. Recommendation was made to go to the ER by the call taker Patient called on January 15, 2021 with a fever of 101.5 and asking if it maybe due to the vaccine March 17, 2021 the patient presented to the ED with chief complaint of Chest pain, was hypoxic and with a temp of 101.8, was started on O2 nasal cannula, saturation improved from 83% to 87% and with 5L to 90% He was diagnosed with Covid-19 and admitted to Critical Care. Psox remained above 92% on 6L HFNC The patient remained in MICU and passed away on February 4, 2021"
	"1417119-1"	"1417119-1"	"MYALGIA"	"10028411"	"60-64 years"	"60-64"	"lightheadedness, weakness, Pain Narrative: A 63yo male with history of tobacco use, Cocaine dependence in remission, PTSD, Depression, Cirrhosis of Liver due to Chronic Hepatitis, Alcohol Dependence, Spinal Stenosis of Lumbar Region, Obesity, HTN, OA, COPD and OSA. It's documented he received Covid-19 vaccine on January 11, 2021, per protocol, without complications and was advised to stay on site for 15 minutes. Instructions about side effects and ADR reporting were also provided. He called hospital advice line on January 12, 2021 to report ADR symptoms of having LT arm pain that radiates to his back and chest which started on his way home after he received the vaccine. Also reported he felt weak, had diarrhea, nausea, chills and lightheadedness. He was advised by the call documenting nurse, to go the hospital ED, for evaluation. Per telephone note - Physician A/P documentation included that symptoms were discussed with the patient on January 12, 2021 @13:01 PM, patient was assured what he experienced was an expected reaction from the vaccine and it'd be safe to get his second scheduled shot On January 14 the patient called back to report feeling a little light headed, having muscle/ body ache and feeling weaker after the Covid-19 vaccine. Recommendation was made to go to the ER by the call taker Patient called on January 15, 2021 with a fever of 101.5 and asking if it maybe due to the vaccine March 17, 2021 the patient presented to the ED with chief complaint of Chest pain, was hypoxic and with a temp of 101.8, was started on O2 nasal cannula, saturation improved from 83% to 87% and with 5L to 90% He was diagnosed with Covid-19 and admitted to Critical Care. Psox remained above 92% on 6L HFNC The patient remained in MICU and passed away on February 4, 2021"
	"1417119-1"	"1417119-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"lightheadedness, weakness, Pain Narrative: A 63yo male with history of tobacco use, Cocaine dependence in remission, PTSD, Depression, Cirrhosis of Liver due to Chronic Hepatitis, Alcohol Dependence, Spinal Stenosis of Lumbar Region, Obesity, HTN, OA, COPD and OSA. It's documented he received Covid-19 vaccine on January 11, 2021, per protocol, without complications and was advised to stay on site for 15 minutes. Instructions about side effects and ADR reporting were also provided. He called hospital advice line on January 12, 2021 to report ADR symptoms of having LT arm pain that radiates to his back and chest which started on his way home after he received the vaccine. Also reported he felt weak, had diarrhea, nausea, chills and lightheadedness. He was advised by the call documenting nurse, to go the hospital ED, for evaluation. Per telephone note - Physician A/P documentation included that symptoms were discussed with the patient on January 12, 2021 @13:01 PM, patient was assured what he experienced was an expected reaction from the vaccine and it'd be safe to get his second scheduled shot On January 14 the patient called back to report feeling a little light headed, having muscle/ body ache and feeling weaker after the Covid-19 vaccine. Recommendation was made to go to the ER by the call taker Patient called on January 15, 2021 with a fever of 101.5 and asking if it maybe due to the vaccine March 17, 2021 the patient presented to the ED with chief complaint of Chest pain, was hypoxic and with a temp of 101.8, was started on O2 nasal cannula, saturation improved from 83% to 87% and with 5L to 90% He was diagnosed with Covid-19 and admitted to Critical Care. Psox remained above 92% on 6L HFNC The patient remained in MICU and passed away on February 4, 2021"
	"1417119-1"	"1417119-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"lightheadedness, weakness, Pain Narrative: A 63yo male with history of tobacco use, Cocaine dependence in remission, PTSD, Depression, Cirrhosis of Liver due to Chronic Hepatitis, Alcohol Dependence, Spinal Stenosis of Lumbar Region, Obesity, HTN, OA, COPD and OSA. It's documented he received Covid-19 vaccine on January 11, 2021, per protocol, without complications and was advised to stay on site for 15 minutes. Instructions about side effects and ADR reporting were also provided. He called hospital advice line on January 12, 2021 to report ADR symptoms of having LT arm pain that radiates to his back and chest which started on his way home after he received the vaccine. Also reported he felt weak, had diarrhea, nausea, chills and lightheadedness. He was advised by the call documenting nurse, to go the hospital ED, for evaluation. Per telephone note - Physician A/P documentation included that symptoms were discussed with the patient on January 12, 2021 @13:01 PM, patient was assured what he experienced was an expected reaction from the vaccine and it'd be safe to get his second scheduled shot On January 14 the patient called back to report feeling a little light headed, having muscle/ body ache and feeling weaker after the Covid-19 vaccine. Recommendation was made to go to the ER by the call taker Patient called on January 15, 2021 with a fever of 101.5 and asking if it maybe due to the vaccine March 17, 2021 the patient presented to the ED with chief complaint of Chest pain, was hypoxic and with a temp of 101.8, was started on O2 nasal cannula, saturation improved from 83% to 87% and with 5L to 90% He was diagnosed with Covid-19 and admitted to Critical Care. Psox remained above 92% on 6L HFNC The patient remained in MICU and passed away on February 4, 2021"
	"1417119-1"	"1417119-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"lightheadedness, weakness, Pain Narrative: A 63yo male with history of tobacco use, Cocaine dependence in remission, PTSD, Depression, Cirrhosis of Liver due to Chronic Hepatitis, Alcohol Dependence, Spinal Stenosis of Lumbar Region, Obesity, HTN, OA, COPD and OSA. It's documented he received Covid-19 vaccine on January 11, 2021, per protocol, without complications and was advised to stay on site for 15 minutes. Instructions about side effects and ADR reporting were also provided. He called hospital advice line on January 12, 2021 to report ADR symptoms of having LT arm pain that radiates to his back and chest which started on his way home after he received the vaccine. Also reported he felt weak, had diarrhea, nausea, chills and lightheadedness. He was advised by the call documenting nurse, to go the hospital ED, for evaluation. Per telephone note - Physician A/P documentation included that symptoms were discussed with the patient on January 12, 2021 @13:01 PM, patient was assured what he experienced was an expected reaction from the vaccine and it'd be safe to get his second scheduled shot On January 14 the patient called back to report feeling a little light headed, having muscle/ body ache and feeling weaker after the Covid-19 vaccine. Recommendation was made to go to the ER by the call taker Patient called on January 15, 2021 with a fever of 101.5 and asking if it maybe due to the vaccine March 17, 2021 the patient presented to the ED with chief complaint of Chest pain, was hypoxic and with a temp of 101.8, was started on O2 nasal cannula, saturation improved from 83% to 87% and with 5L to 90% He was diagnosed with Covid-19 and admitted to Critical Care. Psox remained above 92% on 6L HFNC The patient remained in MICU and passed away on February 4, 2021"
	"1417119-1"	"1417119-1"	"PAIN IN EXTREMITY"	"10033425"	"60-64 years"	"60-64"	"lightheadedness, weakness, Pain Narrative: A 63yo male with history of tobacco use, Cocaine dependence in remission, PTSD, Depression, Cirrhosis of Liver due to Chronic Hepatitis, Alcohol Dependence, Spinal Stenosis of Lumbar Region, Obesity, HTN, OA, COPD and OSA. It's documented he received Covid-19 vaccine on January 11, 2021, per protocol, without complications and was advised to stay on site for 15 minutes. Instructions about side effects and ADR reporting were also provided. He called hospital advice line on January 12, 2021 to report ADR symptoms of having LT arm pain that radiates to his back and chest which started on his way home after he received the vaccine. Also reported he felt weak, had diarrhea, nausea, chills and lightheadedness. He was advised by the call documenting nurse, to go the hospital ED, for evaluation. Per telephone note - Physician A/P documentation included that symptoms were discussed with the patient on January 12, 2021 @13:01 PM, patient was assured what he experienced was an expected reaction from the vaccine and it'd be safe to get his second scheduled shot On January 14 the patient called back to report feeling a little light headed, having muscle/ body ache and feeling weaker after the Covid-19 vaccine. Recommendation was made to go to the ER by the call taker Patient called on January 15, 2021 with a fever of 101.5 and asking if it maybe due to the vaccine March 17, 2021 the patient presented to the ED with chief complaint of Chest pain, was hypoxic and with a temp of 101.8, was started on O2 nasal cannula, saturation improved from 83% to 87% and with 5L to 90% He was diagnosed with Covid-19 and admitted to Critical Care. Psox remained above 92% on 6L HFNC The patient remained in MICU and passed away on February 4, 2021"
	"1417119-1"	"1417119-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"lightheadedness, weakness, Pain Narrative: A 63yo male with history of tobacco use, Cocaine dependence in remission, PTSD, Depression, Cirrhosis of Liver due to Chronic Hepatitis, Alcohol Dependence, Spinal Stenosis of Lumbar Region, Obesity, HTN, OA, COPD and OSA. It's documented he received Covid-19 vaccine on January 11, 2021, per protocol, without complications and was advised to stay on site for 15 minutes. Instructions about side effects and ADR reporting were also provided. He called hospital advice line on January 12, 2021 to report ADR symptoms of having LT arm pain that radiates to his back and chest which started on his way home after he received the vaccine. Also reported he felt weak, had diarrhea, nausea, chills and lightheadedness. He was advised by the call documenting nurse, to go the hospital ED, for evaluation. Per telephone note - Physician A/P documentation included that symptoms were discussed with the patient on January 12, 2021 @13:01 PM, patient was assured what he experienced was an expected reaction from the vaccine and it'd be safe to get his second scheduled shot On January 14 the patient called back to report feeling a little light headed, having muscle/ body ache and feeling weaker after the Covid-19 vaccine. Recommendation was made to go to the ER by the call taker Patient called on January 15, 2021 with a fever of 101.5 and asking if it maybe due to the vaccine March 17, 2021 the patient presented to the ED with chief complaint of Chest pain, was hypoxic and with a temp of 101.8, was started on O2 nasal cannula, saturation improved from 83% to 87% and with 5L to 90% He was diagnosed with Covid-19 and admitted to Critical Care. Psox remained above 92% on 6L HFNC The patient remained in MICU and passed away on February 4, 2021"
	"1421063-1"	"1421063-1"	"ALCOHOLISM"	"10001639"	"60-64 years"	"60-64"	"PAF Seizure , ETOH dependency , Dyspnea"
	"1421063-1"	"1421063-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"PAF Seizure , ETOH dependency , Dyspnea"
	"1421063-1"	"1421063-1"	"SEIZURE"	"10039906"	"60-64 years"	"60-64"	"PAF Seizure , ETOH dependency , Dyspnea"
	"1421819-1"	"1421819-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Pt was vaccinated on 3/31/2021. His long time partner reported that he started feeling a little off 2 days post vaccination, he thought he had indigestion. Over the next few weeks he began feeling worse especially with exertion.  While at work on 4/19/2021 he told his friend that he hadn't been feeling well for 3 weeks. Shortly after reporting this he went into Cardiac arrest. He was transported to Medical Center, where he was pronounced dead. His partner reports he was healthy with the exception of hypertension. She reports he was thin, never smoked, didn't drink alcohol and rarely used marijuana.  She reports only a visual autopsy was performed and pt was cremated."
	"1421819-1"	"1421819-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pt was vaccinated on 3/31/2021. His long time partner reported that he started feeling a little off 2 days post vaccination, he thought he had indigestion. Over the next few weeks he began feeling worse especially with exertion.  While at work on 4/19/2021 he told his friend that he hadn't been feeling well for 3 weeks. Shortly after reporting this he went into Cardiac arrest. He was transported to Medical Center, where he was pronounced dead. His partner reports he was healthy with the exception of hypertension. She reports he was thin, never smoked, didn't drink alcohol and rarely used marijuana.  She reports only a visual autopsy was performed and pt was cremated."
	"1421819-1"	"1421819-1"	"FEELING ABNORMAL"	"10016322"	"60-64 years"	"60-64"	"Pt was vaccinated on 3/31/2021. His long time partner reported that he started feeling a little off 2 days post vaccination, he thought he had indigestion. Over the next few weeks he began feeling worse especially with exertion.  While at work on 4/19/2021 he told his friend that he hadn't been feeling well for 3 weeks. Shortly after reporting this he went into Cardiac arrest. He was transported to Medical Center, where he was pronounced dead. His partner reports he was healthy with the exception of hypertension. She reports he was thin, never smoked, didn't drink alcohol and rarely used marijuana.  She reports only a visual autopsy was performed and pt was cremated."
	"1423127-1"	"1423127-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"His dad took the shot and died 3 days later, mucked up his arteries, his heart; This is a spontaneous report from a contactable consumer (patient son).  A 64-year-old male patient received second dose of BNT162B2 on 15May2021 (at age of 64-year-old) at single dose for COVID-19 immunization. Medical history included Heart Condition (around 1997-1999), High Blood Pressure (all about the same time), Aneurysm (about 2017, 2015-2017 area. He wants to say 2015, because he was there when he found out about them) and open heart surgery (about 1997, 1995, somewhere around there). Concomitant medications were not reported. Historical vaccine included first dose of BNT162B2 on 05Apr2021 (at age of 64-year-old) for COVID-19 immunization. Family Medical History Relevant to AE(s): Caller states not that he knows of. All he knows from the emergency technician is that it looked like he went back to his car and his dog was in the car and he dropped dead. According to you guy's thing, it says muscle cramps, muscle pains and chest pains are all side effects of this and he does believe that the vaccine contributed to the chest pain which contributed to the heart attack that exploded his heart. He states his dad took the shot and died 3 days later (18May2021, also reported as died on Memorial day weekend. He died on Sunday). Caller stated the coroner's has already stated that he died by the coronavirus shot and mucked up his arteries, his heart. It is pretty sad. He was doing something he enjoyed, watching the races, gets up takes two steps, falls dead in his tracks. Vaccination Facility Type was hospital. He does not know Additional Vaccines Administered on Same Date of the Pfizer Suspect, but he highly doubts it. Events not require a visit to Emergency Room or Physician Office.   Information about lot/batch number is requested.; Reported Cause(s) of Death: His dad took the shot and died 3 days later, mucked up his arteries, his heart: Death"
	"1427402-1"	"1427402-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"6/23/2021 - pain at injection site, shortness of breath 6/24 /2021 - found dead in bed at 7AM"
	"1427402-1"	"1427402-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"6/23/2021 - pain at injection site, shortness of breath 6/24 /2021 - found dead in bed at 7AM"
	"1427402-1"	"1427402-1"	"INJECTION SITE PAIN"	"10022086"	"60-64 years"	"60-64"	"6/23/2021 - pain at injection site, shortness of breath 6/24 /2021 - found dead in bed at 7AM"
	"1428447-1"	"1428447-1"	"ASPIRATION"	"10003504"	"60-64 years"	"60-64"	""My dad suffered what I believe to be a blood clot in his lung on April 6th, directly related to the second pfizer covid vaccination. Though chronically ill, he was not sick at the time, which was 4 days after the vaccine. He walked up the stairs, collapsed at the top, walked again to the chair, collapsed and then made his way into the chair where he told me ""I can't breathe."" and then slumped over. My mom and I lifted his limp body up and noticed he was not breathing.  We moved him to the floor and started life support measures. About 5 minutes later the paramedics arrived.  They were eventually able to get his heart and breathing going again about 14 minutes later.  He was moved to critical care.  After it became apparent he suffered irreparable brain damage, I stopped the life support measures (ventilator) and he passed away shortly after on Friday the 9th. They were continuously removing blood from his lungs while he was there. There was no indication he would die prior to this incident. Though we attempted to tell the critical care doctors about his recent vaccination, they were not receptive to the suggestion that this may have caused the incident that proceeded his passing. My mom did try the heimlich and there were indications that he had breathed in vomit, but he had stopped breathing before this and therefore his cause of death WAS NOT aspiration. He also had fallen the day after the vaccination (Saturday) and the notes indicated his broken ribs were from the CPR measures but this is in error as well as he had broken his ribs in the fall. It is my opinion the broken ribs caused a bruise in the lungs, the vaccination caused excessive clotting, and when he was coughing shortly before the incident it loosened the clots that then caused a pulmonary embolism.""
	"1428447-1"	"1428447-1"	"BRAIN INJURY"	"10067967"	"60-64 years"	"60-64"	""My dad suffered what I believe to be a blood clot in his lung on April 6th, directly related to the second pfizer covid vaccination. Though chronically ill, he was not sick at the time, which was 4 days after the vaccine. He walked up the stairs, collapsed at the top, walked again to the chair, collapsed and then made his way into the chair where he told me ""I can't breathe."" and then slumped over. My mom and I lifted his limp body up and noticed he was not breathing.  We moved him to the floor and started life support measures. About 5 minutes later the paramedics arrived.  They were eventually able to get his heart and breathing going again about 14 minutes later.  He was moved to critical care.  After it became apparent he suffered irreparable brain damage, I stopped the life support measures (ventilator) and he passed away shortly after on Friday the 9th. They were continuously removing blood from his lungs while he was there. There was no indication he would die prior to this incident. Though we attempted to tell the critical care doctors about his recent vaccination, they were not receptive to the suggestion that this may have caused the incident that proceeded his passing. My mom did try the heimlich and there were indications that he had breathed in vomit, but he had stopped breathing before this and therefore his cause of death WAS NOT aspiration. He also had fallen the day after the vaccination (Saturday) and the notes indicated his broken ribs were from the CPR measures but this is in error as well as he had broken his ribs in the fall. It is my opinion the broken ribs caused a bruise in the lungs, the vaccination caused excessive clotting, and when he was coughing shortly before the incident it loosened the clots that then caused a pulmonary embolism.""
	"1428447-1"	"1428447-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	""My dad suffered what I believe to be a blood clot in his lung on April 6th, directly related to the second pfizer covid vaccination. Though chronically ill, he was not sick at the time, which was 4 days after the vaccine. He walked up the stairs, collapsed at the top, walked again to the chair, collapsed and then made his way into the chair where he told me ""I can't breathe."" and then slumped over. My mom and I lifted his limp body up and noticed he was not breathing.  We moved him to the floor and started life support measures. About 5 minutes later the paramedics arrived.  They were eventually able to get his heart and breathing going again about 14 minutes later.  He was moved to critical care.  After it became apparent he suffered irreparable brain damage, I stopped the life support measures (ventilator) and he passed away shortly after on Friday the 9th. They were continuously removing blood from his lungs while he was there. There was no indication he would die prior to this incident. Though we attempted to tell the critical care doctors about his recent vaccination, they were not receptive to the suggestion that this may have caused the incident that proceeded his passing. My mom did try the heimlich and there were indications that he had breathed in vomit, but he had stopped breathing before this and therefore his cause of death WAS NOT aspiration. He also had fallen the day after the vaccination (Saturday) and the notes indicated his broken ribs were from the CPR measures but this is in error as well as he had broken his ribs in the fall. It is my opinion the broken ribs caused a bruise in the lungs, the vaccination caused excessive clotting, and when he was coughing shortly before the incident it loosened the clots that then caused a pulmonary embolism.""
	"1428447-1"	"1428447-1"	"FALL"	"10016173"	"60-64 years"	"60-64"	""My dad suffered what I believe to be a blood clot in his lung on April 6th, directly related to the second pfizer covid vaccination. Though chronically ill, he was not sick at the time, which was 4 days after the vaccine. He walked up the stairs, collapsed at the top, walked again to the chair, collapsed and then made his way into the chair where he told me ""I can't breathe."" and then slumped over. My mom and I lifted his limp body up and noticed he was not breathing.  We moved him to the floor and started life support measures. About 5 minutes later the paramedics arrived.  They were eventually able to get his heart and breathing going again about 14 minutes later.  He was moved to critical care.  After it became apparent he suffered irreparable brain damage, I stopped the life support measures (ventilator) and he passed away shortly after on Friday the 9th. They were continuously removing blood from his lungs while he was there. There was no indication he would die prior to this incident. Though we attempted to tell the critical care doctors about his recent vaccination, they were not receptive to the suggestion that this may have caused the incident that proceeded his passing. My mom did try the heimlich and there were indications that he had breathed in vomit, but he had stopped breathing before this and therefore his cause of death WAS NOT aspiration. He also had fallen the day after the vaccination (Saturday) and the notes indicated his broken ribs were from the CPR measures but this is in error as well as he had broken his ribs in the fall. It is my opinion the broken ribs caused a bruise in the lungs, the vaccination caused excessive clotting, and when he was coughing shortly before the incident it loosened the clots that then caused a pulmonary embolism.""
	"1428447-1"	"1428447-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	""My dad suffered what I believe to be a blood clot in his lung on April 6th, directly related to the second pfizer covid vaccination. Though chronically ill, he was not sick at the time, which was 4 days after the vaccine. He walked up the stairs, collapsed at the top, walked again to the chair, collapsed and then made his way into the chair where he told me ""I can't breathe."" and then slumped over. My mom and I lifted his limp body up and noticed he was not breathing.  We moved him to the floor and started life support measures. About 5 minutes later the paramedics arrived.  They were eventually able to get his heart and breathing going again about 14 minutes later.  He was moved to critical care.  After it became apparent he suffered irreparable brain damage, I stopped the life support measures (ventilator) and he passed away shortly after on Friday the 9th. They were continuously removing blood from his lungs while he was there. There was no indication he would die prior to this incident. Though we attempted to tell the critical care doctors about his recent vaccination, they were not receptive to the suggestion that this may have caused the incident that proceeded his passing. My mom did try the heimlich and there were indications that he had breathed in vomit, but he had stopped breathing before this and therefore his cause of death WAS NOT aspiration. He also had fallen the day after the vaccination (Saturday) and the notes indicated his broken ribs were from the CPR measures but this is in error as well as he had broken his ribs in the fall. It is my opinion the broken ribs caused a bruise in the lungs, the vaccination caused excessive clotting, and when he was coughing shortly before the incident it loosened the clots that then caused a pulmonary embolism.""
	"1428447-1"	"1428447-1"	"LIFE SUPPORT"	"10024447"	"60-64 years"	"60-64"	""My dad suffered what I believe to be a blood clot in his lung on April 6th, directly related to the second pfizer covid vaccination. Though chronically ill, he was not sick at the time, which was 4 days after the vaccine. He walked up the stairs, collapsed at the top, walked again to the chair, collapsed and then made his way into the chair where he told me ""I can't breathe."" and then slumped over. My mom and I lifted his limp body up and noticed he was not breathing.  We moved him to the floor and started life support measures. About 5 minutes later the paramedics arrived.  They were eventually able to get his heart and breathing going again about 14 minutes later.  He was moved to critical care.  After it became apparent he suffered irreparable brain damage, I stopped the life support measures (ventilator) and he passed away shortly after on Friday the 9th. They were continuously removing blood from his lungs while he was there. There was no indication he would die prior to this incident. Though we attempted to tell the critical care doctors about his recent vaccination, they were not receptive to the suggestion that this may have caused the incident that proceeded his passing. My mom did try the heimlich and there were indications that he had breathed in vomit, but he had stopped breathing before this and therefore his cause of death WAS NOT aspiration. He also had fallen the day after the vaccination (Saturday) and the notes indicated his broken ribs were from the CPR measures but this is in error as well as he had broken his ribs in the fall. It is my opinion the broken ribs caused a bruise in the lungs, the vaccination caused excessive clotting, and when he was coughing shortly before the incident it loosened the clots that then caused a pulmonary embolism.""
	"1428447-1"	"1428447-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	""My dad suffered what I believe to be a blood clot in his lung on April 6th, directly related to the second pfizer covid vaccination. Though chronically ill, he was not sick at the time, which was 4 days after the vaccine. He walked up the stairs, collapsed at the top, walked again to the chair, collapsed and then made his way into the chair where he told me ""I can't breathe."" and then slumped over. My mom and I lifted his limp body up and noticed he was not breathing.  We moved him to the floor and started life support measures. About 5 minutes later the paramedics arrived.  They were eventually able to get his heart and breathing going again about 14 minutes later.  He was moved to critical care.  After it became apparent he suffered irreparable brain damage, I stopped the life support measures (ventilator) and he passed away shortly after on Friday the 9th. They were continuously removing blood from his lungs while he was there. There was no indication he would die prior to this incident. Though we attempted to tell the critical care doctors about his recent vaccination, they were not receptive to the suggestion that this may have caused the incident that proceeded his passing. My mom did try the heimlich and there were indications that he had breathed in vomit, but he had stopped breathing before this and therefore his cause of death WAS NOT aspiration. He also had fallen the day after the vaccination (Saturday) and the notes indicated his broken ribs were from the CPR measures but this is in error as well as he had broken his ribs in the fall. It is my opinion the broken ribs caused a bruise in the lungs, the vaccination caused excessive clotting, and when he was coughing shortly before the incident it loosened the clots that then caused a pulmonary embolism.""
	"1428447-1"	"1428447-1"	"RESPIRATORY ARREST"	"10038669"	"60-64 years"	"60-64"	""My dad suffered what I believe to be a blood clot in his lung on April 6th, directly related to the second pfizer covid vaccination. Though chronically ill, he was not sick at the time, which was 4 days after the vaccine. He walked up the stairs, collapsed at the top, walked again to the chair, collapsed and then made his way into the chair where he told me ""I can't breathe."" and then slumped over. My mom and I lifted his limp body up and noticed he was not breathing.  We moved him to the floor and started life support measures. About 5 minutes later the paramedics arrived.  They were eventually able to get his heart and breathing going again about 14 minutes later.  He was moved to critical care.  After it became apparent he suffered irreparable brain damage, I stopped the life support measures (ventilator) and he passed away shortly after on Friday the 9th. They were continuously removing blood from his lungs while he was there. There was no indication he would die prior to this incident. Though we attempted to tell the critical care doctors about his recent vaccination, they were not receptive to the suggestion that this may have caused the incident that proceeded his passing. My mom did try the heimlich and there were indications that he had breathed in vomit, but he had stopped breathing before this and therefore his cause of death WAS NOT aspiration. He also had fallen the day after the vaccination (Saturday) and the notes indicated his broken ribs were from the CPR measures but this is in error as well as he had broken his ribs in the fall. It is my opinion the broken ribs caused a bruise in the lungs, the vaccination caused excessive clotting, and when he was coughing shortly before the incident it loosened the clots that then caused a pulmonary embolism.""
	"1428447-1"	"1428447-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	""My dad suffered what I believe to be a blood clot in his lung on April 6th, directly related to the second pfizer covid vaccination. Though chronically ill, he was not sick at the time, which was 4 days after the vaccine. He walked up the stairs, collapsed at the top, walked again to the chair, collapsed and then made his way into the chair where he told me ""I can't breathe."" and then slumped over. My mom and I lifted his limp body up and noticed he was not breathing.  We moved him to the floor and started life support measures. About 5 minutes later the paramedics arrived.  They were eventually able to get his heart and breathing going again about 14 minutes later.  He was moved to critical care.  After it became apparent he suffered irreparable brain damage, I stopped the life support measures (ventilator) and he passed away shortly after on Friday the 9th. They were continuously removing blood from his lungs while he was there. There was no indication he would die prior to this incident. Though we attempted to tell the critical care doctors about his recent vaccination, they were not receptive to the suggestion that this may have caused the incident that proceeded his passing. My mom did try the heimlich and there were indications that he had breathed in vomit, but he had stopped breathing before this and therefore his cause of death WAS NOT aspiration. He also had fallen the day after the vaccination (Saturday) and the notes indicated his broken ribs were from the CPR measures but this is in error as well as he had broken his ribs in the fall. It is my opinion the broken ribs caused a bruise in the lungs, the vaccination caused excessive clotting, and when he was coughing shortly before the incident it loosened the clots that then caused a pulmonary embolism.""
	"1428447-1"	"1428447-1"	"RIB FRACTURE"	"10039117"	"60-64 years"	"60-64"	""My dad suffered what I believe to be a blood clot in his lung on April 6th, directly related to the second pfizer covid vaccination. Though chronically ill, he was not sick at the time, which was 4 days after the vaccine. He walked up the stairs, collapsed at the top, walked again to the chair, collapsed and then made his way into the chair where he told me ""I can't breathe."" and then slumped over. My mom and I lifted his limp body up and noticed he was not breathing.  We moved him to the floor and started life support measures. About 5 minutes later the paramedics arrived.  They were eventually able to get his heart and breathing going again about 14 minutes later.  He was moved to critical care.  After it became apparent he suffered irreparable brain damage, I stopped the life support measures (ventilator) and he passed away shortly after on Friday the 9th. They were continuously removing blood from his lungs while he was there. There was no indication he would die prior to this incident. Though we attempted to tell the critical care doctors about his recent vaccination, they were not receptive to the suggestion that this may have caused the incident that proceeded his passing. My mom did try the heimlich and there were indications that he had breathed in vomit, but he had stopped breathing before this and therefore his cause of death WAS NOT aspiration. He also had fallen the day after the vaccination (Saturday) and the notes indicated his broken ribs were from the CPR measures but this is in error as well as he had broken his ribs in the fall. It is my opinion the broken ribs caused a bruise in the lungs, the vaccination caused excessive clotting, and when he was coughing shortly before the incident it loosened the clots that then caused a pulmonary embolism.""
	"1429240-1"	"1429240-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death; Dysarthria; Lethargy; This case was received via FDA VAERS (Reference number: 1358542) on 15-Jun-2021 and was forwarded to Moderna on 15-Jun-2021.    This regulatory authority case was reported by an other health care professional and describes the occurrence of DEATH (Death), DYSARTHRIA (Dysarthria) and LETHARGY (Lethargy) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007C21A) for COVID-19 vaccination.     The patient's past medical history included Back surgery (History of multiple back surgeries including a rod placement.).    On 19-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-May-2021, the patient experienced DEATH (Death) (seriousness criteria death and medically significant), DYSARTHRIA (Dysarthria) (seriousness criterion death) and LETHARGY (Lethargy) (seriousness criterion death). The patient died on 27-May-2021. The cause of death was not reported. An autopsy was performed.        For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.   Concomitant medications were not provided. Treatment information was not reported. On 27 May 2021, autopsy was performed. As per the spouse, the autopsy results were pending.  Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.Very limited information regarding the events have been provided at this time.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.Very limited information regarding the events have been provided at this time.; Reported Cause(s) of Death: Unknown cause of death"
	"1429240-1"	"1429240-1"	"DYSARTHRIA"	"10013887"	"60-64 years"	"60-64"	"Death; Dysarthria; Lethargy; This case was received via FDA VAERS (Reference number: 1358542) on 15-Jun-2021 and was forwarded to Moderna on 15-Jun-2021.    This regulatory authority case was reported by an other health care professional and describes the occurrence of DEATH (Death), DYSARTHRIA (Dysarthria) and LETHARGY (Lethargy) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007C21A) for COVID-19 vaccination.     The patient's past medical history included Back surgery (History of multiple back surgeries including a rod placement.).    On 19-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-May-2021, the patient experienced DEATH (Death) (seriousness criteria death and medically significant), DYSARTHRIA (Dysarthria) (seriousness criterion death) and LETHARGY (Lethargy) (seriousness criterion death). The patient died on 27-May-2021. The cause of death was not reported. An autopsy was performed.        For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.   Concomitant medications were not provided. Treatment information was not reported. On 27 May 2021, autopsy was performed. As per the spouse, the autopsy results were pending.  Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.Very limited information regarding the events have been provided at this time.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.Very limited information regarding the events have been provided at this time.; Reported Cause(s) of Death: Unknown cause of death"
	"1429240-1"	"1429240-1"	"LETHARGY"	"10024264"	"60-64 years"	"60-64"	"Death; Dysarthria; Lethargy; This case was received via FDA VAERS (Reference number: 1358542) on 15-Jun-2021 and was forwarded to Moderna on 15-Jun-2021.    This regulatory authority case was reported by an other health care professional and describes the occurrence of DEATH (Death), DYSARTHRIA (Dysarthria) and LETHARGY (Lethargy) in a 64-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch no. 007C21A) for COVID-19 vaccination.     The patient's past medical history included Back surgery (History of multiple back surgeries including a rod placement.).    On 19-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 27-May-2021, the patient experienced DEATH (Death) (seriousness criteria death and medically significant), DYSARTHRIA (Dysarthria) (seriousness criterion death) and LETHARGY (Lethargy) (seriousness criterion death). The patient died on 27-May-2021. The cause of death was not reported. An autopsy was performed.        For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.   Concomitant medications were not provided. Treatment information was not reported. On 27 May 2021, autopsy was performed. As per the spouse, the autopsy results were pending.  Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.Very limited information regarding the events have been provided at this time.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.Very limited information regarding the events have been provided at this time.; Reported Cause(s) of Death: Unknown cause of death"
	"1429848-1"	"1429848-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"Chest pain which started 6/17, improved 6/19 and 6/20. Chest pain worsened 6/21 and persisted through the week. Became acutely short of breath and passed away 6/25 at hospital"
	"1429848-1"	"1429848-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Chest pain which started 6/17, improved 6/19 and 6/20. Chest pain worsened 6/21 and persisted through the week. Became acutely short of breath and passed away 6/25 at hospital"
	"1429848-1"	"1429848-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Chest pain which started 6/17, improved 6/19 and 6/20. Chest pain worsened 6/21 and persisted through the week. Became acutely short of breath and passed away 6/25 at hospital"
	"1430874-1"	"1430874-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death"
	"1430959-1"	"1430959-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Patient expired following cardiac arrest. COVID test indeterminate for infection."
	"1430959-1"	"1430959-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient expired following cardiac arrest. COVID test indeterminate for infection."
	"1430959-1"	"1430959-1"	"SARS-COV-2 TEST"	"10084354"	"60-64 years"	"60-64"	"Patient expired following cardiac arrest. COVID test indeterminate for infection."
	"1433147-1"	"1433147-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"My husband died suddenly, with no warning, in his sleep"
	"1433147-1"	"1433147-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"My husband died suddenly, with no warning, in his sleep"
	"1433147-1"	"1433147-1"	"SUDDEN DEATH"	"10042434"	"60-64 years"	"60-64"	"My husband died suddenly, with no warning, in his sleep"
	"1433663-1"	"1433663-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"60-64 years"	"60-64"	"Vaccinated person reported pain in his hands, nausea and chest pain approximately 48 hours post second Pfizer vaccine.   was diagnosed with a STEMI heart attack and then coded on April 26, 2021."
	"1433663-1"	"1433663-1"	"CARDIOVASCULAR EVALUATION"	"10053046"	"60-64 years"	"60-64"	"Vaccinated person reported pain in his hands, nausea and chest pain approximately 48 hours post second Pfizer vaccine.   was diagnosed with a STEMI heart attack and then coded on April 26, 2021."
	"1433663-1"	"1433663-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"Vaccinated person reported pain in his hands, nausea and chest pain approximately 48 hours post second Pfizer vaccine.   was diagnosed with a STEMI heart attack and then coded on April 26, 2021."
	"1433663-1"	"1433663-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Vaccinated person reported pain in his hands, nausea and chest pain approximately 48 hours post second Pfizer vaccine.   was diagnosed with a STEMI heart attack and then coded on April 26, 2021."
	"1433663-1"	"1433663-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Vaccinated person reported pain in his hands, nausea and chest pain approximately 48 hours post second Pfizer vaccine.   was diagnosed with a STEMI heart attack and then coded on April 26, 2021."
	"1433663-1"	"1433663-1"	"PAIN IN EXTREMITY"	"10033425"	"60-64 years"	"60-64"	"Vaccinated person reported pain in his hands, nausea and chest pain approximately 48 hours post second Pfizer vaccine.   was diagnosed with a STEMI heart attack and then coded on April 26, 2021."
	"1433663-1"	"1433663-1"	"STENT PLACEMENT"	"10048561"	"60-64 years"	"60-64"	"Vaccinated person reported pain in his hands, nausea and chest pain approximately 48 hours post second Pfizer vaccine.   was diagnosed with a STEMI heart attack and then coded on April 26, 2021."
	"1433878-1"	"1433878-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient passed away on 06/21/2021"
	"1437238-1"	"1437238-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"death N17.9 - AKI (acute kidney injury)"
	"1437238-1"	"1437238-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death N17.9 - AKI (acute kidney injury)"
	"1437342-1"	"1437342-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"60-64 years"	"60-64"	"Death  5/21/2021 Causes of death listed on death certificate 1) COVID-19  2) ARDS  Other: Lung Transplant for cystic fibrosis"
	"1437342-1"	"1437342-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"Death  5/21/2021 Causes of death listed on death certificate 1) COVID-19  2) ARDS  Other: Lung Transplant for cystic fibrosis"
	"1437342-1"	"1437342-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Death  5/21/2021 Causes of death listed on death certificate 1) COVID-19  2) ARDS  Other: Lung Transplant for cystic fibrosis"
	"1437342-1"	"1437342-1"	"CYSTIC FIBROSIS"	"10011762"	"60-64 years"	"60-64"	"Death  5/21/2021 Causes of death listed on death certificate 1) COVID-19  2) ARDS  Other: Lung Transplant for cystic fibrosis"
	"1437342-1"	"1437342-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death  5/21/2021 Causes of death listed on death certificate 1) COVID-19  2) ARDS  Other: Lung Transplant for cystic fibrosis"
	"1437342-1"	"1437342-1"	"SARS-COV-2 TEST"	"10084354"	"60-64 years"	"60-64"	"Death  5/21/2021 Causes of death listed on death certificate 1) COVID-19  2) ARDS  Other: Lung Transplant for cystic fibrosis"
	"1437654-1"	"1437654-1"	"ABDOMINAL PAIN UPPER"	"10000087"	"60-64 years"	"60-64"	"03/19/2021 wife had severe stomach pain, went to urgent care, referred to hospital for cat-scan, admitted to hospital for observation and tests, tests inconclusive, Monday, 03/22/2021 @ 02:42 wife declared dead."
	"1437654-1"	"1437654-1"	"COMPUTERISED TOMOGRAM"	"10010234"	"60-64 years"	"60-64"	"03/19/2021 wife had severe stomach pain, went to urgent care, referred to hospital for cat-scan, admitted to hospital for observation and tests, tests inconclusive, Monday, 03/22/2021 @ 02:42 wife declared dead."
	"1437654-1"	"1437654-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"03/19/2021 wife had severe stomach pain, went to urgent care, referred to hospital for cat-scan, admitted to hospital for observation and tests, tests inconclusive, Monday, 03/22/2021 @ 02:42 wife declared dead."
	"1437654-1"	"1437654-1"	"LABORATORY TEST"	"10059938"	"60-64 years"	"60-64"	"03/19/2021 wife had severe stomach pain, went to urgent care, referred to hospital for cat-scan, admitted to hospital for observation and tests, tests inconclusive, Monday, 03/22/2021 @ 02:42 wife declared dead."
	"1440399-1"	"1440399-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death"
	"1441825-1"	"1441825-1"	"ARTERIOSCLEROSIS"	"10003210"	"60-64 years"	"60-64"	"Patient died on March 13 2021."
	"1441825-1"	"1441825-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Patient died on March 13 2021."
	"1441825-1"	"1441825-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient died on March 13 2021."
	"1443104-1"	"1443104-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"60-64 years"	"60-64"	"States had mild stroke and passed away on 6/15/21 in his sleep"
	"1443104-1"	"1443104-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"States had mild stroke and passed away on 6/15/21 in his sleep"
	"1443104-1"	"1443104-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"States had mild stroke and passed away on 6/15/21 in his sleep"
	"1443528-1"	"1443528-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"My brother died 8 days after the vaccine due to a blood clot in his heart.  Death Certificate indicates blood clot in heart."
	"1443528-1"	"1443528-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"My brother died 8 days after the vaccine due to a blood clot in his heart.  Death Certificate indicates blood clot in heart."
	"1443528-1"	"1443528-1"	"INTRACARDIAC THROMBUS"	"10048620"	"60-64 years"	"60-64"	"My brother died 8 days after the vaccine due to a blood clot in his heart.  Death Certificate indicates blood clot in heart."
	"1443544-1"	"1443544-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient was hospitalized and died within 60 days of receiving a COVID vaccine series"
	"1446385-1"	"1446385-1"	"ABNORMAL BEHAVIOUR"	"10061422"	"60-64 years"	"60-64"	"She started to feel very sick almost immediately after taking it. She wasn't herself (according to her husband, aka my girlfriend's dad) and she died on March 20th, 2021. Yet somehow the EMT had the nerve to try and pretend it wasn't because of the experimental mRNA  thing you guys call a Vaccine."
	"1446385-1"	"1446385-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"She started to feel very sick almost immediately after taking it. She wasn't herself (according to her husband, aka my girlfriend's dad) and she died on March 20th, 2021. Yet somehow the EMT had the nerve to try and pretend it wasn't because of the experimental mRNA  thing you guys call a Vaccine."
	"1446385-1"	"1446385-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"She started to feel very sick almost immediately after taking it. She wasn't herself (according to her husband, aka my girlfriend's dad) and she died on March 20th, 2021. Yet somehow the EMT had the nerve to try and pretend it wasn't because of the experimental mRNA  thing you guys call a Vaccine."
	"1446611-1"	"1446611-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Sob, death"
	"1446611-1"	"1446611-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Sob, death"
	"1446639-1"	"1446639-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"ANTICOAGULANT THERAPY"	"10053468"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"ATRIAL FIBRILLATION"	"10003658"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"BIOPSY BONE MARROW"	"10004737"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"BIOPSY SKIN"	"10004873"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"BLOOD TEST"	"10061726"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"CHEST X-RAY"	"10008498"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"CHRONIC EOSINOPHILIC LEUKAEMIA"	"10065854"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"COLONOSCOPY"	"10010007"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"ELECTROCARDIOGRAM"	"10014362"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"ENDOSCOPY"	"10014805"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"EOSINOPHIL COUNT INCREASED"	"10014945"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"EOSINOPHILIA"	"10014950"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"GASTROINTESTINAL TUBE INSERTION"	"10053050"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"LARGE INTESTINAL ULCER"	"10023799"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"MAGNETIC RESONANCE IMAGING HEAD ABNORMAL"	"10085256"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"MUSCLE SPASMS"	"10028334"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"MYALGIA"	"10028411"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"OESOPHAGEAL ULCER"	"10030201"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"RASH"	"10037844"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"THROMBOSIS"	"10043607"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446639-1"	"1446639-1"	"WHITE BLOOD CELL COUNT INCREASED"	"10047943"	"60-64 years"	"60-64"	""My husband passed away June 3, 2021 resulting from complications which began a few hours after receiving his 2nd Moderna shot on April 29, 2021. He never tested positive for Covid19, however his first symptoms were the typical fever, muscle aches, rash. He declined daily from a host of mysterious symptoms including full body rash, blood clots, muscle spasms, atrial fibrillation, ulcers lining his esophagus and colon, and exorbitant WBC (157K) with extremely high eosinophils (90%). He was treated with a host of drugs including antibiotics, steroids, blood thinners, ivermectin and finally chemotherpay (Campath). His ICU team  included hematology, pulmonology, ... oncology and infectious disease. After an incredible amount of diagnostic testing ( daily routine blood work, EKGs, chest x-rays, CT scans, MRI, bone marrow biopsy, endoscopy, colonoscopy, skin biopsy, genetic testing) no definitive diagnosis could be made, however, he was given the possible diagnosis of chronic eosinophilia leukemia in late May. The big question among the medical staff was, ""Did the shot trigger something?"" He was eventually treated with the chemotherapy drug Campath, which reduced the WBC and EOs some, but his organs, especially, lungs had been very compromised by the high WBC and eosinophils. Several days after being placed on a ventilator and given a feeding tube at the end of May, a CT scan and MRI confirmed patient had suffered multiple strokes. He passed away a half hour after being taken off the ventilator the morning of June 3, 2021. His death certificate read:  A. cardiopulmonary arrest  B. acute hypoxic respiratory failure  C.  hypereosinophila""
	"1446746-1"	"1446746-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"She died"
	"1449792-1"	"1449792-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"passed away; short of breath; unwell & very unwell; extremely thirsty; dry mouth; This spontaneous case was reported by a pharmacist and describes the occurrence of DEATH (passed away) in a 64-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.     The patient's past medical history included Oxygen therapy (Required Oxygen Assistance in the office). Concurrent medical conditions included Diabetes and Brain tumor.   In February 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In February 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In May 2021, the patient experienced DYSPNOEA (short of breath), MALAISE (unwell & very unwell), THIRST (extremely thirsty) and DRY MOUTH (dry mouth). The patient died on 16-May-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, DYSPNOEA (short of breath), MALAISE (unwell & very unwell), THIRST (extremely thirsty) and DRY MOUTH (dry mouth) outcome was unknown.        For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.   Treatment information is not provided. Concomitant medication is not provided. Reporter states that the friend stated that the patient had other underlining conditions, patient needed oxygen assistance in the office,friend advised patient to go to the ER and Patient refused Action taken with mRNA-1273 in response to the events was not Applicable.  Company Comment: Very limited information regarding this events has been provided at this time.  Further information has been requested.; Sender's Comments: Very limited information regarding this events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: unknown cause of death"
	"1449792-1"	"1449792-1"	"DRY MOUTH"	"10013781"	"60-64 years"	"60-64"	"passed away; short of breath; unwell & very unwell; extremely thirsty; dry mouth; This spontaneous case was reported by a pharmacist and describes the occurrence of DEATH (passed away) in a 64-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.     The patient's past medical history included Oxygen therapy (Required Oxygen Assistance in the office). Concurrent medical conditions included Diabetes and Brain tumor.   In February 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In February 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In May 2021, the patient experienced DYSPNOEA (short of breath), MALAISE (unwell & very unwell), THIRST (extremely thirsty) and DRY MOUTH (dry mouth). The patient died on 16-May-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, DYSPNOEA (short of breath), MALAISE (unwell & very unwell), THIRST (extremely thirsty) and DRY MOUTH (dry mouth) outcome was unknown.        For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.   Treatment information is not provided. Concomitant medication is not provided. Reporter states that the friend stated that the patient had other underlining conditions, patient needed oxygen assistance in the office,friend advised patient to go to the ER and Patient refused Action taken with mRNA-1273 in response to the events was not Applicable.  Company Comment: Very limited information regarding this events has been provided at this time.  Further information has been requested.; Sender's Comments: Very limited information regarding this events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: unknown cause of death"
	"1449792-1"	"1449792-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"passed away; short of breath; unwell & very unwell; extremely thirsty; dry mouth; This spontaneous case was reported by a pharmacist and describes the occurrence of DEATH (passed away) in a 64-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.     The patient's past medical history included Oxygen therapy (Required Oxygen Assistance in the office). Concurrent medical conditions included Diabetes and Brain tumor.   In February 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In February 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In May 2021, the patient experienced DYSPNOEA (short of breath), MALAISE (unwell & very unwell), THIRST (extremely thirsty) and DRY MOUTH (dry mouth). The patient died on 16-May-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, DYSPNOEA (short of breath), MALAISE (unwell & very unwell), THIRST (extremely thirsty) and DRY MOUTH (dry mouth) outcome was unknown.        For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.   Treatment information is not provided. Concomitant medication is not provided. Reporter states that the friend stated that the patient had other underlining conditions, patient needed oxygen assistance in the office,friend advised patient to go to the ER and Patient refused Action taken with mRNA-1273 in response to the events was not Applicable.  Company Comment: Very limited information regarding this events has been provided at this time.  Further information has been requested.; Sender's Comments: Very limited information regarding this events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: unknown cause of death"
	"1449792-1"	"1449792-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"passed away; short of breath; unwell & very unwell; extremely thirsty; dry mouth; This spontaneous case was reported by a pharmacist and describes the occurrence of DEATH (passed away) in a 64-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.     The patient's past medical history included Oxygen therapy (Required Oxygen Assistance in the office). Concurrent medical conditions included Diabetes and Brain tumor.   In February 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In February 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In May 2021, the patient experienced DYSPNOEA (short of breath), MALAISE (unwell & very unwell), THIRST (extremely thirsty) and DRY MOUTH (dry mouth). The patient died on 16-May-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, DYSPNOEA (short of breath), MALAISE (unwell & very unwell), THIRST (extremely thirsty) and DRY MOUTH (dry mouth) outcome was unknown.        For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.   Treatment information is not provided. Concomitant medication is not provided. Reporter states that the friend stated that the patient had other underlining conditions, patient needed oxygen assistance in the office,friend advised patient to go to the ER and Patient refused Action taken with mRNA-1273 in response to the events was not Applicable.  Company Comment: Very limited information regarding this events has been provided at this time.  Further information has been requested.; Sender's Comments: Very limited information regarding this events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: unknown cause of death"
	"1449792-1"	"1449792-1"	"THIRST"	"10043458"	"60-64 years"	"60-64"	"passed away; short of breath; unwell & very unwell; extremely thirsty; dry mouth; This spontaneous case was reported by a pharmacist and describes the occurrence of DEATH (passed away) in a 64-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.     The patient's past medical history included Oxygen therapy (Required Oxygen Assistance in the office). Concurrent medical conditions included Diabetes and Brain tumor.   In February 2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. In February 2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. In May 2021, the patient experienced DYSPNOEA (short of breath), MALAISE (unwell & very unwell), THIRST (extremely thirsty) and DRY MOUTH (dry mouth). The patient died on 16-May-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, DYSPNOEA (short of breath), MALAISE (unwell & very unwell), THIRST (extremely thirsty) and DRY MOUTH (dry mouth) outcome was unknown.        For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.   Treatment information is not provided. Concomitant medication is not provided. Reporter states that the friend stated that the patient had other underlining conditions, patient needed oxygen assistance in the office,friend advised patient to go to the ER and Patient refused Action taken with mRNA-1273 in response to the events was not Applicable.  Company Comment: Very limited information regarding this events has been provided at this time.  Further information has been requested.; Sender's Comments: Very limited information regarding this events has been provided at this time.  Further information has been requested.; Reported Cause(s) of Death: unknown cause of death"
	"1454319-1"	"1454319-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Breakthrough COVID related death"
	"1454319-1"	"1454319-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Breakthrough COVID related death"
	"1454319-1"	"1454319-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"60-64 years"	"60-64"	"Breakthrough COVID related death"
	"1454681-1"	"1454681-1"	"ALANINE AMINOTRANSFERASE NORMAL"	"10001552"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"ALBUMIN GLOBULIN RATIO"	"10001562"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"ANION GAP"	"10002522"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"ASPARTATE AMINOTRANSFERASE NORMAL"	"10003482"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BASOPHIL PERCENTAGE"	"10059471"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BASOPHIL PERCENTAGE INCREASED"	"10052220"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BLOOD ALBUMIN DECREASED"	"10005287"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BLOOD ALKALINE PHOSPHATASE INCREASED"	"10059570"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BLOOD ALKALINE PHOSPHATASE NORMAL"	"10005310"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BLOOD BILIRUBIN NORMAL"	"10005367"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BLOOD CALCIUM DECREASED"	"10005395"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BLOOD CALCIUM NORMAL"	"10005397"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BLOOD CHLORIDE DECREASED"	"10005419"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BLOOD CHLORIDE INCREASED"	"10005420"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BLOOD CREATININE INCREASED"	"10005483"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BLOOD GLUCOSE NORMAL"	"10005558"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BLOOD MAGNESIUM"	"10005651"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BLOOD POTASSIUM DECREASED"	"10005724"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BLOOD POTASSIUM NORMAL"	"10005726"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BLOOD SODIUM DECREASED"	"10005802"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BLOOD SODIUM NORMAL"	"10005804"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BLOOD TEST"	"10061726"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BLOOD THYROID STIMULATING HORMONE"	"10005829"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"BLOOD UREA INCREASED"	"10005851"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"CARBON DIOXIDE DECREASED"	"10007223"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"CHEST X-RAY"	"10008498"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"DECREASED APPETITE"	"10061428"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"EOSINOPHIL COUNT INCREASED"	"10014945"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"EOSINOPHIL PERCENTAGE INCREASED"	"10052222"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"FULL BLOOD COUNT"	"10017411"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"GLOBULINS DECREASED"	"10058001"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"GLOMERULAR FILTRATION RATE"	"10018355"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"HAEMATOCRIT NORMAL"	"10018842"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"HAEMOGLOBIN NORMAL"	"10018890"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"LETHARGY"	"10024264"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"LYMPHOCYTE COUNT NORMAL"	"10025260"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"LYMPHOCYTE PERCENTAGE DECREASED"	"10052231"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"MEAN CELL HAEMOGLOBIN CONCENTRATION"	"10026990"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"MEAN CELL HAEMOGLOBIN NORMAL"	"10026997"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"MEAN CELL VOLUME INCREASED"	"10027004"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"METABOLIC FUNCTION TEST"	"10062191"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"MONOCYTE COUNT INCREASED"	"10027880"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"MONOCYTE COUNT NORMAL"	"10027882"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"MONOCYTE PERCENTAGE INCREASED"	"10052230"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"NEUTROPHIL COUNT NORMAL"	"10029370"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"NEUTROPHIL PERCENTAGE INCREASED"	"10052224"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"PLATELET COUNT NORMAL"	"10035530"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"PROTEIN TOTAL DECREASED"	"10037014"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"RED BLOOD CELL COUNT DECREASED"	"10038153"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"RED BLOOD CELL COUNT NORMAL"	"10038157"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"RED CELL DISTRIBUTION WIDTH INCREASED"	"10053920"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"THYROXINE FREE"	"10055157"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"VITAMIN B12 NORMAL"	"10047611"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"VITAMIN D"	"10050713"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"WEIGHT DECREASED"	"10047895"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1454681-1"	"1454681-1"	"WHITE BLOOD CELL COUNT"	"10047939"	"60-64 years"	"60-64"	"6/18/21: Guest experienced episode of hypoxia. Was able to be corrected with use of )2. Chest X-ray and bloodwork completed. 6/28/21: Seen by NP for weight loss. Ongoing issue prior to vaccine r/t poor appetite 7/1/21: Incident of hypoxia that required increase in 02, SOB, and lethargy. Sent to the hospital. Guest did end up passing at this hospital"
	"1457646-1"	"1457646-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"60-64 years"	"60-64"	"Confirmed that pt passed away 3/13/21, 5 days after 1st covid vaccine. Per relative who rec'd the autopsy report, pt had no obvious health problems prior to death, was a smoker, but otherwise very fit and active, healthy eater. On day of death, pt had gone hiking for a few hours on a camping trip, they were sitting around eating dinner and pt said he had to go to the bathroom and never came out. Pt's family feel sure something was triggered by vaccine. Relative I spoke to retrieved the autopsy results during the call and read them on the phone as they were reported on paper. Final dx on autopsy was: I. atherosclerosis, generalized, severe.  A. Atherosclerotic coronary artery disease   i. atherosclerosis, coronary arteries w/ 75% occlusion of LAD, 90% occlusion of L obtuse marginal and 80% occlusion circumflex coronary artery.    a. Ruptured acute myocardial infarction, transmural, posterior left ventricle       i. cardiac tamponade       ii. hemopericardium 350cc  COD listed as: ruptured, acute MI d/t atherosclerotic coronary artery disease, tox report was clear."
	"1457646-1"	"1457646-1"	"ARTERIOSCLEROSIS"	"10003210"	"60-64 years"	"60-64"	"Confirmed that pt passed away 3/13/21, 5 days after 1st covid vaccine. Per relative who rec'd the autopsy report, pt had no obvious health problems prior to death, was a smoker, but otherwise very fit and active, healthy eater. On day of death, pt had gone hiking for a few hours on a camping trip, they were sitting around eating dinner and pt said he had to go to the bathroom and never came out. Pt's family feel sure something was triggered by vaccine. Relative I spoke to retrieved the autopsy results during the call and read them on the phone as they were reported on paper. Final dx on autopsy was: I. atherosclerosis, generalized, severe.  A. Atherosclerotic coronary artery disease   i. atherosclerosis, coronary arteries w/ 75% occlusion of LAD, 90% occlusion of L obtuse marginal and 80% occlusion circumflex coronary artery.    a. Ruptured acute myocardial infarction, transmural, posterior left ventricle       i. cardiac tamponade       ii. hemopericardium 350cc  COD listed as: ruptured, acute MI d/t atherosclerotic coronary artery disease, tox report was clear."
	"1457646-1"	"1457646-1"	"ARTERIOSCLEROSIS CORONARY ARTERY"	"10003211"	"60-64 years"	"60-64"	"Confirmed that pt passed away 3/13/21, 5 days after 1st covid vaccine. Per relative who rec'd the autopsy report, pt had no obvious health problems prior to death, was a smoker, but otherwise very fit and active, healthy eater. On day of death, pt had gone hiking for a few hours on a camping trip, they were sitting around eating dinner and pt said he had to go to the bathroom and never came out. Pt's family feel sure something was triggered by vaccine. Relative I spoke to retrieved the autopsy results during the call and read them on the phone as they were reported on paper. Final dx on autopsy was: I. atherosclerosis, generalized, severe.  A. Atherosclerotic coronary artery disease   i. atherosclerosis, coronary arteries w/ 75% occlusion of LAD, 90% occlusion of L obtuse marginal and 80% occlusion circumflex coronary artery.    a. Ruptured acute myocardial infarction, transmural, posterior left ventricle       i. cardiac tamponade       ii. hemopericardium 350cc  COD listed as: ruptured, acute MI d/t atherosclerotic coronary artery disease, tox report was clear."
	"1457646-1"	"1457646-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Confirmed that pt passed away 3/13/21, 5 days after 1st covid vaccine. Per relative who rec'd the autopsy report, pt had no obvious health problems prior to death, was a smoker, but otherwise very fit and active, healthy eater. On day of death, pt had gone hiking for a few hours on a camping trip, they were sitting around eating dinner and pt said he had to go to the bathroom and never came out. Pt's family feel sure something was triggered by vaccine. Relative I spoke to retrieved the autopsy results during the call and read them on the phone as they were reported on paper. Final dx on autopsy was: I. atherosclerosis, generalized, severe.  A. Atherosclerotic coronary artery disease   i. atherosclerosis, coronary arteries w/ 75% occlusion of LAD, 90% occlusion of L obtuse marginal and 80% occlusion circumflex coronary artery.    a. Ruptured acute myocardial infarction, transmural, posterior left ventricle       i. cardiac tamponade       ii. hemopericardium 350cc  COD listed as: ruptured, acute MI d/t atherosclerotic coronary artery disease, tox report was clear."
	"1457646-1"	"1457646-1"	"CARDIAC TAMPONADE"	"10007610"	"60-64 years"	"60-64"	"Confirmed that pt passed away 3/13/21, 5 days after 1st covid vaccine. Per relative who rec'd the autopsy report, pt had no obvious health problems prior to death, was a smoker, but otherwise very fit and active, healthy eater. On day of death, pt had gone hiking for a few hours on a camping trip, they were sitting around eating dinner and pt said he had to go to the bathroom and never came out. Pt's family feel sure something was triggered by vaccine. Relative I spoke to retrieved the autopsy results during the call and read them on the phone as they were reported on paper. Final dx on autopsy was: I. atherosclerosis, generalized, severe.  A. Atherosclerotic coronary artery disease   i. atherosclerosis, coronary arteries w/ 75% occlusion of LAD, 90% occlusion of L obtuse marginal and 80% occlusion circumflex coronary artery.    a. Ruptured acute myocardial infarction, transmural, posterior left ventricle       i. cardiac tamponade       ii. hemopericardium 350cc  COD listed as: ruptured, acute MI d/t atherosclerotic coronary artery disease, tox report was clear."
	"1457646-1"	"1457646-1"	"CORONARY ARTERY DISEASE"	"10011078"	"60-64 years"	"60-64"	"Confirmed that pt passed away 3/13/21, 5 days after 1st covid vaccine. Per relative who rec'd the autopsy report, pt had no obvious health problems prior to death, was a smoker, but otherwise very fit and active, healthy eater. On day of death, pt had gone hiking for a few hours on a camping trip, they were sitting around eating dinner and pt said he had to go to the bathroom and never came out. Pt's family feel sure something was triggered by vaccine. Relative I spoke to retrieved the autopsy results during the call and read them on the phone as they were reported on paper. Final dx on autopsy was: I. atherosclerosis, generalized, severe.  A. Atherosclerotic coronary artery disease   i. atherosclerosis, coronary arteries w/ 75% occlusion of LAD, 90% occlusion of L obtuse marginal and 80% occlusion circumflex coronary artery.    a. Ruptured acute myocardial infarction, transmural, posterior left ventricle       i. cardiac tamponade       ii. hemopericardium 350cc  COD listed as: ruptured, acute MI d/t atherosclerotic coronary artery disease, tox report was clear."
	"1457646-1"	"1457646-1"	"CORONARY ARTERY OCCLUSION"	"10011086"	"60-64 years"	"60-64"	"Confirmed that pt passed away 3/13/21, 5 days after 1st covid vaccine. Per relative who rec'd the autopsy report, pt had no obvious health problems prior to death, was a smoker, but otherwise very fit and active, healthy eater. On day of death, pt had gone hiking for a few hours on a camping trip, they were sitting around eating dinner and pt said he had to go to the bathroom and never came out. Pt's family feel sure something was triggered by vaccine. Relative I spoke to retrieved the autopsy results during the call and read them on the phone as they were reported on paper. Final dx on autopsy was: I. atherosclerosis, generalized, severe.  A. Atherosclerotic coronary artery disease   i. atherosclerosis, coronary arteries w/ 75% occlusion of LAD, 90% occlusion of L obtuse marginal and 80% occlusion circumflex coronary artery.    a. Ruptured acute myocardial infarction, transmural, posterior left ventricle       i. cardiac tamponade       ii. hemopericardium 350cc  COD listed as: ruptured, acute MI d/t atherosclerotic coronary artery disease, tox report was clear."
	"1457646-1"	"1457646-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"Confirmed that pt passed away 3/13/21, 5 days after 1st covid vaccine. Per relative who rec'd the autopsy report, pt had no obvious health problems prior to death, was a smoker, but otherwise very fit and active, healthy eater. On day of death, pt had gone hiking for a few hours on a camping trip, they were sitting around eating dinner and pt said he had to go to the bathroom and never came out. Pt's family feel sure something was triggered by vaccine. Relative I spoke to retrieved the autopsy results during the call and read them on the phone as they were reported on paper. Final dx on autopsy was: I. atherosclerosis, generalized, severe.  A. Atherosclerotic coronary artery disease   i. atherosclerosis, coronary arteries w/ 75% occlusion of LAD, 90% occlusion of L obtuse marginal and 80% occlusion circumflex coronary artery.    a. Ruptured acute myocardial infarction, transmural, posterior left ventricle       i. cardiac tamponade       ii. hemopericardium 350cc  COD listed as: ruptured, acute MI d/t atherosclerotic coronary artery disease, tox report was clear."
	"1457646-1"	"1457646-1"	"MYOCARDIAL RUPTURE"	"10028604"	"60-64 years"	"60-64"	"Confirmed that pt passed away 3/13/21, 5 days after 1st covid vaccine. Per relative who rec'd the autopsy report, pt had no obvious health problems prior to death, was a smoker, but otherwise very fit and active, healthy eater. On day of death, pt had gone hiking for a few hours on a camping trip, they were sitting around eating dinner and pt said he had to go to the bathroom and never came out. Pt's family feel sure something was triggered by vaccine. Relative I spoke to retrieved the autopsy results during the call and read them on the phone as they were reported on paper. Final dx on autopsy was: I. atherosclerosis, generalized, severe.  A. Atherosclerotic coronary artery disease   i. atherosclerosis, coronary arteries w/ 75% occlusion of LAD, 90% occlusion of L obtuse marginal and 80% occlusion circumflex coronary artery.    a. Ruptured acute myocardial infarction, transmural, posterior left ventricle       i. cardiac tamponade       ii. hemopericardium 350cc  COD listed as: ruptured, acute MI d/t atherosclerotic coronary artery disease, tox report was clear."
	"1457646-1"	"1457646-1"	"PERICARDIAL HAEMORRHAGE"	"10034476"	"60-64 years"	"60-64"	"Confirmed that pt passed away 3/13/21, 5 days after 1st covid vaccine. Per relative who rec'd the autopsy report, pt had no obvious health problems prior to death, was a smoker, but otherwise very fit and active, healthy eater. On day of death, pt had gone hiking for a few hours on a camping trip, they were sitting around eating dinner and pt said he had to go to the bathroom and never came out. Pt's family feel sure something was triggered by vaccine. Relative I spoke to retrieved the autopsy results during the call and read them on the phone as they were reported on paper. Final dx on autopsy was: I. atherosclerosis, generalized, severe.  A. Atherosclerotic coronary artery disease   i. atherosclerosis, coronary arteries w/ 75% occlusion of LAD, 90% occlusion of L obtuse marginal and 80% occlusion circumflex coronary artery.    a. Ruptured acute myocardial infarction, transmural, posterior left ventricle       i. cardiac tamponade       ii. hemopericardium 350cc  COD listed as: ruptured, acute MI d/t atherosclerotic coronary artery disease, tox report was clear."
	"1457646-1"	"1457646-1"	"TOXICOLOGIC TEST NORMAL"	"10061383"	"60-64 years"	"60-64"	"Confirmed that pt passed away 3/13/21, 5 days after 1st covid vaccine. Per relative who rec'd the autopsy report, pt had no obvious health problems prior to death, was a smoker, but otherwise very fit and active, healthy eater. On day of death, pt had gone hiking for a few hours on a camping trip, they were sitting around eating dinner and pt said he had to go to the bathroom and never came out. Pt's family feel sure something was triggered by vaccine. Relative I spoke to retrieved the autopsy results during the call and read them on the phone as they were reported on paper. Final dx on autopsy was: I. atherosclerosis, generalized, severe.  A. Atherosclerotic coronary artery disease   i. atherosclerosis, coronary arteries w/ 75% occlusion of LAD, 90% occlusion of L obtuse marginal and 80% occlusion circumflex coronary artery.    a. Ruptured acute myocardial infarction, transmural, posterior left ventricle       i. cardiac tamponade       ii. hemopericardium 350cc  COD listed as: ruptured, acute MI d/t atherosclerotic coronary artery disease, tox report was clear."
	"1460326-1"	"1460326-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Medical Examiner at time of autopsy ordered Covid testing 06/30/2021 08:30 Nasal swab- reported SARS-CoV-2 RNA detected and confirmed at lab.   Cause of death: Complication of Covid-19  Other significant conditions:  Chronic A-Fib, HTN, Chronic systolic heart failure, COPD"
	"1460326-1"	"1460326-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Medical Examiner at time of autopsy ordered Covid testing 06/30/2021 08:30 Nasal swab- reported SARS-CoV-2 RNA detected and confirmed at lab.   Cause of death: Complication of Covid-19  Other significant conditions:  Chronic A-Fib, HTN, Chronic systolic heart failure, COPD"
	"1460326-1"	"1460326-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Medical Examiner at time of autopsy ordered Covid testing 06/30/2021 08:30 Nasal swab- reported SARS-CoV-2 RNA detected and confirmed at lab.   Cause of death: Complication of Covid-19  Other significant conditions:  Chronic A-Fib, HTN, Chronic systolic heart failure, COPD"
	"1460326-1"	"1460326-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Medical Examiner at time of autopsy ordered Covid testing 06/30/2021 08:30 Nasal swab- reported SARS-CoV-2 RNA detected and confirmed at lab.   Cause of death: Complication of Covid-19  Other significant conditions:  Chronic A-Fib, HTN, Chronic systolic heart failure, COPD"
	"1461745-1"	"1461745-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Developed pneumonia 5 days was hospitalized 2 days later and tested positive for covid pneumonia"
	"1461745-1"	"1461745-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Developed pneumonia 5 days was hospitalized 2 days later and tested positive for covid pneumonia"
	"1461745-1"	"1461745-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"Developed pneumonia 5 days was hospitalized 2 days later and tested positive for covid pneumonia"
	"1464276-1"	"1464276-1"	"ARRHYTHMIA"	"10003119"	"60-64 years"	"60-64"	"Death caused by probable cardiac arrhythmia on May 10, 2021. No previous heart symptoms. Had the normal reaction to the second dose (body aches, chills, low grade fever), but was recovering as of April 19.  First dose was administered 3/21/21. Second dose was administered 4/18/2021."
	"1464276-1"	"1464276-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Death caused by probable cardiac arrhythmia on May 10, 2021. No previous heart symptoms. Had the normal reaction to the second dose (body aches, chills, low grade fever), but was recovering as of April 19.  First dose was administered 3/21/21. Second dose was administered 4/18/2021."
	"1464276-1"	"1464276-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"Death caused by probable cardiac arrhythmia on May 10, 2021. No previous heart symptoms. Had the normal reaction to the second dose (body aches, chills, low grade fever), but was recovering as of April 19.  First dose was administered 3/21/21. Second dose was administered 4/18/2021."
	"1464276-1"	"1464276-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death caused by probable cardiac arrhythmia on May 10, 2021. No previous heart symptoms. Had the normal reaction to the second dose (body aches, chills, low grade fever), but was recovering as of April 19.  First dose was administered 3/21/21. Second dose was administered 4/18/2021."
	"1464276-1"	"1464276-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"Death caused by probable cardiac arrhythmia on May 10, 2021. No previous heart symptoms. Had the normal reaction to the second dose (body aches, chills, low grade fever), but was recovering as of April 19.  First dose was administered 3/21/21. Second dose was administered 4/18/2021."
	"1464276-1"	"1464276-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Death caused by probable cardiac arrhythmia on May 10, 2021. No previous heart symptoms. Had the normal reaction to the second dose (body aches, chills, low grade fever), but was recovering as of April 19.  First dose was administered 3/21/21. Second dose was administered 4/18/2021."
	"1470499-1"	"1470499-1"	"ACUTE MYELOID LEUKAEMIA"	"10000880"	"60-64 years"	"60-64"	"The patient received her COVID vaccine on March 17, 2021 at a local clinic. She developed bruises within days after the shot.  She pursued care and diagnosis and reporting with the vaccine administrator, but finally had to see PCP.  After multiple visits, the patient was sent to Hospital.  She was diagnosed with AML (hospitalized 5 days: April 6-10) and started chemotherapy (outpatient on April 19).  She returned to hospital on April 25 in distress and diagnosed with COVID.  The patient was put on a ventilator with pressor support on May 1 and passed away on May 10, 2021."
	"1470499-1"	"1470499-1"	"BIOPSY BONE MARROW ABNORMAL"	"10004738"	"60-64 years"	"60-64"	"The patient received her COVID vaccine on March 17, 2021 at a local clinic. She developed bruises within days after the shot.  She pursued care and diagnosis and reporting with the vaccine administrator, but finally had to see PCP.  After multiple visits, the patient was sent to Hospital.  She was diagnosed with AML (hospitalized 5 days: April 6-10) and started chemotherapy (outpatient on April 19).  She returned to hospital on April 25 in distress and diagnosed with COVID.  The patient was put on a ventilator with pressor support on May 1 and passed away on May 10, 2021."
	"1470499-1"	"1470499-1"	"CHEMOTHERAPY"	"10061758"	"60-64 years"	"60-64"	"The patient received her COVID vaccine on March 17, 2021 at a local clinic. She developed bruises within days after the shot.  She pursued care and diagnosis and reporting with the vaccine administrator, but finally had to see PCP.  After multiple visits, the patient was sent to Hospital.  She was diagnosed with AML (hospitalized 5 days: April 6-10) and started chemotherapy (outpatient on April 19).  She returned to hospital on April 25 in distress and diagnosed with COVID.  The patient was put on a ventilator with pressor support on May 1 and passed away on May 10, 2021."
	"1470499-1"	"1470499-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"The patient received her COVID vaccine on March 17, 2021 at a local clinic. She developed bruises within days after the shot.  She pursued care and diagnosis and reporting with the vaccine administrator, but finally had to see PCP.  After multiple visits, the patient was sent to Hospital.  She was diagnosed with AML (hospitalized 5 days: April 6-10) and started chemotherapy (outpatient on April 19).  She returned to hospital on April 25 in distress and diagnosed with COVID.  The patient was put on a ventilator with pressor support on May 1 and passed away on May 10, 2021."
	"1470499-1"	"1470499-1"	"CONTUSION"	"10050584"	"60-64 years"	"60-64"	"The patient received her COVID vaccine on March 17, 2021 at a local clinic. She developed bruises within days after the shot.  She pursued care and diagnosis and reporting with the vaccine administrator, but finally had to see PCP.  After multiple visits, the patient was sent to Hospital.  She was diagnosed with AML (hospitalized 5 days: April 6-10) and started chemotherapy (outpatient on April 19).  She returned to hospital on April 25 in distress and diagnosed with COVID.  The patient was put on a ventilator with pressor support on May 1 and passed away on May 10, 2021."
	"1470499-1"	"1470499-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"The patient received her COVID vaccine on March 17, 2021 at a local clinic. She developed bruises within days after the shot.  She pursued care and diagnosis and reporting with the vaccine administrator, but finally had to see PCP.  After multiple visits, the patient was sent to Hospital.  She was diagnosed with AML (hospitalized 5 days: April 6-10) and started chemotherapy (outpatient on April 19).  She returned to hospital on April 25 in distress and diagnosed with COVID.  The patient was put on a ventilator with pressor support on May 1 and passed away on May 10, 2021."
	"1470499-1"	"1470499-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"The patient received her COVID vaccine on March 17, 2021 at a local clinic. She developed bruises within days after the shot.  She pursued care and diagnosis and reporting with the vaccine administrator, but finally had to see PCP.  After multiple visits, the patient was sent to Hospital.  She was diagnosed with AML (hospitalized 5 days: April 6-10) and started chemotherapy (outpatient on April 19).  She returned to hospital on April 25 in distress and diagnosed with COVID.  The patient was put on a ventilator with pressor support on May 1 and passed away on May 10, 2021."
	"1470499-1"	"1470499-1"	"GRANULOCYTES ABNORMAL"	"10018685"	"60-64 years"	"60-64"	"The patient received her COVID vaccine on March 17, 2021 at a local clinic. She developed bruises within days after the shot.  She pursued care and diagnosis and reporting with the vaccine administrator, but finally had to see PCP.  After multiple visits, the patient was sent to Hospital.  She was diagnosed with AML (hospitalized 5 days: April 6-10) and started chemotherapy (outpatient on April 19).  She returned to hospital on April 25 in distress and diagnosed with COVID.  The patient was put on a ventilator with pressor support on May 1 and passed away on May 10, 2021."
	"1470499-1"	"1470499-1"	"HAEMOGLOBIN DECREASED"	"10018884"	"60-64 years"	"60-64"	"The patient received her COVID vaccine on March 17, 2021 at a local clinic. She developed bruises within days after the shot.  She pursued care and diagnosis and reporting with the vaccine administrator, but finally had to see PCP.  After multiple visits, the patient was sent to Hospital.  She was diagnosed with AML (hospitalized 5 days: April 6-10) and started chemotherapy (outpatient on April 19).  She returned to hospital on April 25 in distress and diagnosed with COVID.  The patient was put on a ventilator with pressor support on May 1 and passed away on May 10, 2021."
	"1470499-1"	"1470499-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"The patient received her COVID vaccine on March 17, 2021 at a local clinic. She developed bruises within days after the shot.  She pursued care and diagnosis and reporting with the vaccine administrator, but finally had to see PCP.  After multiple visits, the patient was sent to Hospital.  She was diagnosed with AML (hospitalized 5 days: April 6-10) and started chemotherapy (outpatient on April 19).  She returned to hospital on April 25 in distress and diagnosed with COVID.  The patient was put on a ventilator with pressor support on May 1 and passed away on May 10, 2021."
	"1470499-1"	"1470499-1"	"MYELOBLAST PERCENTAGE INCREASED"	"10052226"	"60-64 years"	"60-64"	"The patient received her COVID vaccine on March 17, 2021 at a local clinic. She developed bruises within days after the shot.  She pursued care and diagnosis and reporting with the vaccine administrator, but finally had to see PCP.  After multiple visits, the patient was sent to Hospital.  She was diagnosed with AML (hospitalized 5 days: April 6-10) and started chemotherapy (outpatient on April 19).  She returned to hospital on April 25 in distress and diagnosed with COVID.  The patient was put on a ventilator with pressor support on May 1 and passed away on May 10, 2021."
	"1470499-1"	"1470499-1"	"PACKED RED BLOOD CELL TRANSFUSION"	"10033359"	"60-64 years"	"60-64"	"The patient received her COVID vaccine on March 17, 2021 at a local clinic. She developed bruises within days after the shot.  She pursued care and diagnosis and reporting with the vaccine administrator, but finally had to see PCP.  After multiple visits, the patient was sent to Hospital.  She was diagnosed with AML (hospitalized 5 days: April 6-10) and started chemotherapy (outpatient on April 19).  She returned to hospital on April 25 in distress and diagnosed with COVID.  The patient was put on a ventilator with pressor support on May 1 and passed away on May 10, 2021."
	"1470499-1"	"1470499-1"	"PLATELET COUNT DECREASED"	"10035528"	"60-64 years"	"60-64"	"The patient received her COVID vaccine on March 17, 2021 at a local clinic. She developed bruises within days after the shot.  She pursued care and diagnosis and reporting with the vaccine administrator, but finally had to see PCP.  After multiple visits, the patient was sent to Hospital.  She was diagnosed with AML (hospitalized 5 days: April 6-10) and started chemotherapy (outpatient on April 19).  She returned to hospital on April 25 in distress and diagnosed with COVID.  The patient was put on a ventilator with pressor support on May 1 and passed away on May 10, 2021."
	"1470499-1"	"1470499-1"	"PLATELET TRANSFUSION"	"10035543"	"60-64 years"	"60-64"	"The patient received her COVID vaccine on March 17, 2021 at a local clinic. She developed bruises within days after the shot.  She pursued care and diagnosis and reporting with the vaccine administrator, but finally had to see PCP.  After multiple visits, the patient was sent to Hospital.  She was diagnosed with AML (hospitalized 5 days: April 6-10) and started chemotherapy (outpatient on April 19).  She returned to hospital on April 25 in distress and diagnosed with COVID.  The patient was put on a ventilator with pressor support on May 1 and passed away on May 10, 2021."
	"1470499-1"	"1470499-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"The patient received her COVID vaccine on March 17, 2021 at a local clinic. She developed bruises within days after the shot.  She pursued care and diagnosis and reporting with the vaccine administrator, but finally had to see PCP.  After multiple visits, the patient was sent to Hospital.  She was diagnosed with AML (hospitalized 5 days: April 6-10) and started chemotherapy (outpatient on April 19).  She returned to hospital on April 25 in distress and diagnosed with COVID.  The patient was put on a ventilator with pressor support on May 1 and passed away on May 10, 2021."
	"1470499-1"	"1470499-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"The patient received her COVID vaccine on March 17, 2021 at a local clinic. She developed bruises within days after the shot.  She pursued care and diagnosis and reporting with the vaccine administrator, but finally had to see PCP.  After multiple visits, the patient was sent to Hospital.  She was diagnosed with AML (hospitalized 5 days: April 6-10) and started chemotherapy (outpatient on April 19).  She returned to hospital on April 25 in distress and diagnosed with COVID.  The patient was put on a ventilator with pressor support on May 1 and passed away on May 10, 2021."
	"1470499-1"	"1470499-1"	"WHITE BLOOD CELL COUNT DECREASED"	"10047942"	"60-64 years"	"60-64"	"The patient received her COVID vaccine on March 17, 2021 at a local clinic. She developed bruises within days after the shot.  She pursued care and diagnosis and reporting with the vaccine administrator, but finally had to see PCP.  After multiple visits, the patient was sent to Hospital.  She was diagnosed with AML (hospitalized 5 days: April 6-10) and started chemotherapy (outpatient on April 19).  She returned to hospital on April 25 in distress and diagnosed with COVID.  The patient was put on a ventilator with pressor support on May 1 and passed away on May 10, 2021."
	"1470622-1"	"1470622-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Acute heart attack on 4/5/2021 that lead to death on 4/5/2021 at 9:58am."
	"1470622-1"	"1470622-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"Acute heart attack on 4/5/2021 that lead to death on 4/5/2021 at 9:58am."
	"1484651-1"	"1484651-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Daughter, came to clinic and informed participant, passed away on 6/2/21 from COVID complications at Hospital."
	"1484651-1"	"1484651-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Daughter, came to clinic and informed participant, passed away on 6/2/21 from COVID complications at Hospital."
	"1484665-1"	"1484665-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"COVID 19 Death - 7/17/2021 - Admitted to ICU from ED with symptoms of shortness of breath, productive cough, diarrhea, and chills. Started 1 week ago. COVID19 PCR positive while in ED. Diagnosed with COVID19 Pneumonia. Expired later on same day 7/17/2021."
	"1484665-1"	"1484665-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"COVID 19 Death - 7/17/2021 - Admitted to ICU from ED with symptoms of shortness of breath, productive cough, diarrhea, and chills. Started 1 week ago. COVID19 PCR positive while in ED. Diagnosed with COVID19 Pneumonia. Expired later on same day 7/17/2021."
	"1484665-1"	"1484665-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"COVID 19 Death - 7/17/2021 - Admitted to ICU from ED with symptoms of shortness of breath, productive cough, diarrhea, and chills. Started 1 week ago. COVID19 PCR positive while in ED. Diagnosed with COVID19 Pneumonia. Expired later on same day 7/17/2021."
	"1484665-1"	"1484665-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"COVID 19 Death - 7/17/2021 - Admitted to ICU from ED with symptoms of shortness of breath, productive cough, diarrhea, and chills. Started 1 week ago. COVID19 PCR positive while in ED. Diagnosed with COVID19 Pneumonia. Expired later on same day 7/17/2021."
	"1484665-1"	"1484665-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"COVID 19 Death - 7/17/2021 - Admitted to ICU from ED with symptoms of shortness of breath, productive cough, diarrhea, and chills. Started 1 week ago. COVID19 PCR positive while in ED. Diagnosed with COVID19 Pneumonia. Expired later on same day 7/17/2021."
	"1484665-1"	"1484665-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"COVID 19 Death - 7/17/2021 - Admitted to ICU from ED with symptoms of shortness of breath, productive cough, diarrhea, and chills. Started 1 week ago. COVID19 PCR positive while in ED. Diagnosed with COVID19 Pneumonia. Expired later on same day 7/17/2021."
	"1484665-1"	"1484665-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"COVID 19 Death - 7/17/2021 - Admitted to ICU from ED with symptoms of shortness of breath, productive cough, diarrhea, and chills. Started 1 week ago. COVID19 PCR positive while in ED. Diagnosed with COVID19 Pneumonia. Expired later on same day 7/17/2021."
	"1484665-1"	"1484665-1"	"PRODUCTIVE COUGH"	"10036790"	"60-64 years"	"60-64"	"COVID 19 Death - 7/17/2021 - Admitted to ICU from ED with symptoms of shortness of breath, productive cough, diarrhea, and chills. Started 1 week ago. COVID19 PCR positive while in ED. Diagnosed with COVID19 Pneumonia. Expired later on same day 7/17/2021."
	"1484665-1"	"1484665-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"COVID 19 Death - 7/17/2021 - Admitted to ICU from ED with symptoms of shortness of breath, productive cough, diarrhea, and chills. Started 1 week ago. COVID19 PCR positive while in ED. Diagnosed with COVID19 Pneumonia. Expired later on same day 7/17/2021."
	"1484677-1"	"1484677-1"	"ABDOMINAL PAIN UPPER"	"10000087"	"60-64 years"	"60-64"	"Daughter stated that patient passed on 07/06, a few weeks after getting her 1st vaccine.  Daughter stated that she noticed that her mother had stomach pains the day before and the day of passing. Daughter stated tat Mother had EKG test and heart inflammation was found. Patient passed due to heart inflammation."
	"1484677-1"	"1484677-1"	"CARDITIS"	"10062746"	"60-64 years"	"60-64"	"Daughter stated that patient passed on 07/06, a few weeks after getting her 1st vaccine.  Daughter stated that she noticed that her mother had stomach pains the day before and the day of passing. Daughter stated tat Mother had EKG test and heart inflammation was found. Patient passed due to heart inflammation."
	"1484677-1"	"1484677-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Daughter stated that patient passed on 07/06, a few weeks after getting her 1st vaccine.  Daughter stated that she noticed that her mother had stomach pains the day before and the day of passing. Daughter stated tat Mother had EKG test and heart inflammation was found. Patient passed due to heart inflammation."
	"1484677-1"	"1484677-1"	"ELECTROCARDIOGRAM ABNORMAL"	"10014363"	"60-64 years"	"60-64"	"Daughter stated that patient passed on 07/06, a few weeks after getting her 1st vaccine.  Daughter stated that she noticed that her mother had stomach pains the day before and the day of passing. Daughter stated tat Mother had EKG test and heart inflammation was found. Patient passed due to heart inflammation."
	"1484677-1"	"1484677-1"	"INFLAMMATION"	"10061218"	"60-64 years"	"60-64"	"Daughter stated that patient passed on 07/06, a few weeks after getting her 1st vaccine.  Daughter stated that she noticed that her mother had stomach pains the day before and the day of passing. Daughter stated tat Mother had EKG test and heart inflammation was found. Patient passed due to heart inflammation."
	"1484940-1"	"1484940-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"death  (non-ST elevated myocardial infarction)  (acute kidney injury)"
	"1484940-1"	"1484940-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"60-64 years"	"60-64"	"death  (non-ST elevated myocardial infarction)  (acute kidney injury)"
	"1484940-1"	"1484940-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death  (non-ST elevated myocardial infarction)  (acute kidney injury)"
	"1484966-1"	"1484966-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"death N17.9 - Acute kidney failure, unspecified E87.1 - Hypo-osmolality and hyponatremia"
	"1484966-1"	"1484966-1"	"BLOOD OSMOLARITY DECREASED"	"10005696"	"60-64 years"	"60-64"	"death N17.9 - Acute kidney failure, unspecified E87.1 - Hypo-osmolality and hyponatremia"
	"1484966-1"	"1484966-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death N17.9 - Acute kidney failure, unspecified E87.1 - Hypo-osmolality and hyponatremia"
	"1484966-1"	"1484966-1"	"HYPONATRAEMIA"	"10021036"	"60-64 years"	"60-64"	"death N17.9 - Acute kidney failure, unspecified E87.1 - Hypo-osmolality and hyponatremia"
	"1485039-1"	"1485039-1"	"CARDIAC DEATH"	"10049993"	"60-64 years"	"60-64"	"Patient died of a heart attack on 07/17/2020 while sleeping."
	"1485039-1"	"1485039-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"Patient died of a heart attack on 07/17/2020 while sleeping."
	"1485157-1"	"1485157-1"	"AMPHETAMINES"	"10063227"	"60-64 years"	"60-64"	"Death - coroner's report received on 7/15/2021.  Coroner Dr performed an autopsy and determined the cause of death as brochopneumonia.  Heart disease and drug use also contributed to his death.  The manner of death is natural."
	"1485157-1"	"1485157-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Death - coroner's report received on 7/15/2021.  Coroner Dr performed an autopsy and determined the cause of death as brochopneumonia.  Heart disease and drug use also contributed to his death.  The manner of death is natural."
	"1485157-1"	"1485157-1"	"BLOOD CANNABINOIDS"	"10061012"	"60-64 years"	"60-64"	"Death - coroner's report received on 7/15/2021.  Coroner Dr performed an autopsy and determined the cause of death as brochopneumonia.  Heart disease and drug use also contributed to his death.  The manner of death is natural."
	"1485157-1"	"1485157-1"	"BLOOD CHLORIDE"	"10005416"	"60-64 years"	"60-64"	"Death - coroner's report received on 7/15/2021.  Coroner Dr performed an autopsy and determined the cause of death as brochopneumonia.  Heart disease and drug use also contributed to his death.  The manner of death is natural."
	"1485157-1"	"1485157-1"	"BLOOD CREATININE"	"10005480"	"60-64 years"	"60-64"	"Death - coroner's report received on 7/15/2021.  Coroner Dr performed an autopsy and determined the cause of death as brochopneumonia.  Heart disease and drug use also contributed to his death.  The manner of death is natural."
	"1485157-1"	"1485157-1"	"BLOOD POTASSIUM"	"10005721"	"60-64 years"	"60-64"	"Death - coroner's report received on 7/15/2021.  Coroner Dr performed an autopsy and determined the cause of death as brochopneumonia.  Heart disease and drug use also contributed to his death.  The manner of death is natural."
	"1485157-1"	"1485157-1"	"BLOOD SODIUM"	"10005799"	"60-64 years"	"60-64"	"Death - coroner's report received on 7/15/2021.  Coroner Dr performed an autopsy and determined the cause of death as brochopneumonia.  Heart disease and drug use also contributed to his death.  The manner of death is natural."
	"1485157-1"	"1485157-1"	"BLOOD UREA"	"10005845"	"60-64 years"	"60-64"	"Death - coroner's report received on 7/15/2021.  Coroner Dr performed an autopsy and determined the cause of death as brochopneumonia.  Heart disease and drug use also contributed to his death.  The manner of death is natural."
	"1485157-1"	"1485157-1"	"CARDIAC DISORDER"	"10061024"	"60-64 years"	"60-64"	"Death - coroner's report received on 7/15/2021.  Coroner Dr performed an autopsy and determined the cause of death as brochopneumonia.  Heart disease and drug use also contributed to his death.  The manner of death is natural."
	"1485157-1"	"1485157-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death - coroner's report received on 7/15/2021.  Coroner Dr performed an autopsy and determined the cause of death as brochopneumonia.  Heart disease and drug use also contributed to his death.  The manner of death is natural."
	"1485157-1"	"1485157-1"	"DRUG ABUSE"	"10013654"	"60-64 years"	"60-64"	"Death - coroner's report received on 7/15/2021.  Coroner Dr performed an autopsy and determined the cause of death as brochopneumonia.  Heart disease and drug use also contributed to his death.  The manner of death is natural."
	"1485157-1"	"1485157-1"	"DRUG SCREEN"	"10050837"	"60-64 years"	"60-64"	"Death - coroner's report received on 7/15/2021.  Coroner Dr performed an autopsy and determined the cause of death as brochopneumonia.  Heart disease and drug use also contributed to his death.  The manner of death is natural."
	"1485157-1"	"1485157-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"Death - coroner's report received on 7/15/2021.  Coroner Dr performed an autopsy and determined the cause of death as brochopneumonia.  Heart disease and drug use also contributed to his death.  The manner of death is natural."
	"1486590-1"	"1486590-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Systemic: Patient was found at home passed away.  no autopsy was performed to determine cause of death-Severe, Additional Details: Patient received his vaccine from our pharmacy.  He waited for 15 minutes after vaccine and no adverse effects were reported.  Niece states he went home and was found passed away in his room two hours later"
	"1488518-1"	"1488518-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""Patient received first Moderna vaccine on April 28th. Did not complain of any adverse effects.  Patient received second Moderna vaccine on May 26th at approximately 11am. Spoke to son at 11pm that night and reported that she felt fine, her arm felt fine, the only complaint was ""mouth feels funky"" and she felt dehydrated. Was in typical spirits.  She passed on May 27th. Time of death cannot be confirmed as an autopsy was not completed but the assumption is between 6-9am. This would have been less than 24 hours after she received the second vaccine.""
	"1488518-1"	"1488518-1"	"DEHYDRATION"	"10012174"	"60-64 years"	"60-64"	""Patient received first Moderna vaccine on April 28th. Did not complain of any adverse effects.  Patient received second Moderna vaccine on May 26th at approximately 11am. Spoke to son at 11pm that night and reported that she felt fine, her arm felt fine, the only complaint was ""mouth feels funky"" and she felt dehydrated. Was in typical spirits.  She passed on May 27th. Time of death cannot be confirmed as an autopsy was not completed but the assumption is between 6-9am. This would have been less than 24 hours after she received the second vaccine.""
	"1488518-1"	"1488518-1"	"STOMATITIS"	"10042128"	"60-64 years"	"60-64"	""Patient received first Moderna vaccine on April 28th. Did not complain of any adverse effects.  Patient received second Moderna vaccine on May 26th at approximately 11am. Spoke to son at 11pm that night and reported that she felt fine, her arm felt fine, the only complaint was ""mouth feels funky"" and she felt dehydrated. Was in typical spirits.  She passed on May 27th. Time of death cannot be confirmed as an autopsy was not completed but the assumption is between 6-9am. This would have been less than 24 hours after she received the second vaccine.""
	"1490419-1"	"1490419-1"	"ABDOMINAL PAIN UPPER"	"10000087"	"60-64 years"	"60-64"	"Pain in upper abdomen, sudden cardiac arrest on 5/3/21"
	"1490419-1"	"1490419-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Pain in upper abdomen, sudden cardiac arrest on 5/3/21"
	"1490520-1"	"1490520-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"60-64 years"	"60-64"	"Patient presented with fatigue and SOB starting about a week after vaccination.  Was admitted to hospital SOB. No evidence of TTS.  Progressive ARDS and death in 2 weeks after admission.  Microbiology negative. No aetiology identified."
	"1490520-1"	"1490520-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient presented with fatigue and SOB starting about a week after vaccination.  Was admitted to hospital SOB. No evidence of TTS.  Progressive ARDS and death in 2 weeks after admission.  Microbiology negative. No aetiology identified."
	"1490520-1"	"1490520-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Patient presented with fatigue and SOB starting about a week after vaccination.  Was admitted to hospital SOB. No evidence of TTS.  Progressive ARDS and death in 2 weeks after admission.  Microbiology negative. No aetiology identified."
	"1490520-1"	"1490520-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Patient presented with fatigue and SOB starting about a week after vaccination.  Was admitted to hospital SOB. No evidence of TTS.  Progressive ARDS and death in 2 weeks after admission.  Microbiology negative. No aetiology identified."
	"1490520-1"	"1490520-1"	"MICROBIOLOGY TEST NORMAL"	"10067935"	"60-64 years"	"60-64"	"Patient presented with fatigue and SOB starting about a week after vaccination.  Was admitted to hospital SOB. No evidence of TTS.  Progressive ARDS and death in 2 weeks after admission.  Microbiology negative. No aetiology identified."
	"1493615-1"	"1493615-1"	"CARDIAC DISORDER"	"10061024"	"60-64 years"	"60-64"	""He had Covid 19 on Thanksgiving 2020 and recovered fully. Even though he now had natural antibodies, his Doctor convinced him that he needed the so called Covid 19 vaccine ""mRNA gene therapy"". On 04/29/2021, he was injected with the so called vaccine and that was the beginning of the end. On 05/10/2021, he was admitted to the Hospital with irregular heartbeat and trouble breathing. The Hospital could not get him stabilized so they transported him to another Hospital. He was there a couple of weeks or so and was now having issues with his kidneys and liver. It appeared the spike proteins had started to battle the rest of his viable organs. The hospital had to transport him to a nursing home facility because his number of days in the hospital per insurance had run out. Then on the evening of 06/13 or 14/ 2021, he became violently ill. He was taken to hospital again and was subsequently transferred back to another Hospital. The Spike proteins had now gone into overdrive attacking all his major organs. His liver, kidneys, lungs and heart were being attacked by the spike proteins created by this deadly vaccine. He was put on 24  hour dialysis and then had to be put on a ventilator. He died 06/24/2021.""
	"1493615-1"	"1493615-1"	"CRITICAL ILLNESS"	"10077264"	"60-64 years"	"60-64"	""He had Covid 19 on Thanksgiving 2020 and recovered fully. Even though he now had natural antibodies, his Doctor convinced him that he needed the so called Covid 19 vaccine ""mRNA gene therapy"". On 04/29/2021, he was injected with the so called vaccine and that was the beginning of the end. On 05/10/2021, he was admitted to the Hospital with irregular heartbeat and trouble breathing. The Hospital could not get him stabilized so they transported him to another Hospital. He was there a couple of weeks or so and was now having issues with his kidneys and liver. It appeared the spike proteins had started to battle the rest of his viable organs. The hospital had to transport him to a nursing home facility because his number of days in the hospital per insurance had run out. Then on the evening of 06/13 or 14/ 2021, he became violently ill. He was taken to hospital again and was subsequently transferred back to another Hospital. The Spike proteins had now gone into overdrive attacking all his major organs. His liver, kidneys, lungs and heart were being attacked by the spike proteins created by this deadly vaccine. He was put on 24  hour dialysis and then had to be put on a ventilator. He died 06/24/2021.""
	"1493615-1"	"1493615-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""He had Covid 19 on Thanksgiving 2020 and recovered fully. Even though he now had natural antibodies, his Doctor convinced him that he needed the so called Covid 19 vaccine ""mRNA gene therapy"". On 04/29/2021, he was injected with the so called vaccine and that was the beginning of the end. On 05/10/2021, he was admitted to the Hospital with irregular heartbeat and trouble breathing. The Hospital could not get him stabilized so they transported him to another Hospital. He was there a couple of weeks or so and was now having issues with his kidneys and liver. It appeared the spike proteins had started to battle the rest of his viable organs. The hospital had to transport him to a nursing home facility because his number of days in the hospital per insurance had run out. Then on the evening of 06/13 or 14/ 2021, he became violently ill. He was taken to hospital again and was subsequently transferred back to another Hospital. The Spike proteins had now gone into overdrive attacking all his major organs. His liver, kidneys, lungs and heart were being attacked by the spike proteins created by this deadly vaccine. He was put on 24  hour dialysis and then had to be put on a ventilator. He died 06/24/2021.""
	"1493615-1"	"1493615-1"	"DIALYSIS"	"10061105"	"60-64 years"	"60-64"	""He had Covid 19 on Thanksgiving 2020 and recovered fully. Even though he now had natural antibodies, his Doctor convinced him that he needed the so called Covid 19 vaccine ""mRNA gene therapy"". On 04/29/2021, he was injected with the so called vaccine and that was the beginning of the end. On 05/10/2021, he was admitted to the Hospital with irregular heartbeat and trouble breathing. The Hospital could not get him stabilized so they transported him to another Hospital. He was there a couple of weeks or so and was now having issues with his kidneys and liver. It appeared the spike proteins had started to battle the rest of his viable organs. The hospital had to transport him to a nursing home facility because his number of days in the hospital per insurance had run out. Then on the evening of 06/13 or 14/ 2021, he became violently ill. He was taken to hospital again and was subsequently transferred back to another Hospital. The Spike proteins had now gone into overdrive attacking all his major organs. His liver, kidneys, lungs and heart were being attacked by the spike proteins created by this deadly vaccine. He was put on 24  hour dialysis and then had to be put on a ventilator. He died 06/24/2021.""
	"1493615-1"	"1493615-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	""He had Covid 19 on Thanksgiving 2020 and recovered fully. Even though he now had natural antibodies, his Doctor convinced him that he needed the so called Covid 19 vaccine ""mRNA gene therapy"". On 04/29/2021, he was injected with the so called vaccine and that was the beginning of the end. On 05/10/2021, he was admitted to the Hospital with irregular heartbeat and trouble breathing. The Hospital could not get him stabilized so they transported him to another Hospital. He was there a couple of weeks or so and was now having issues with his kidneys and liver. It appeared the spike proteins had started to battle the rest of his viable organs. The hospital had to transport him to a nursing home facility because his number of days in the hospital per insurance had run out. Then on the evening of 06/13 or 14/ 2021, he became violently ill. He was taken to hospital again and was subsequently transferred back to another Hospital. The Spike proteins had now gone into overdrive attacking all his major organs. His liver, kidneys, lungs and heart were being attacked by the spike proteins created by this deadly vaccine. He was put on 24  hour dialysis and then had to be put on a ventilator. He died 06/24/2021.""
	"1493615-1"	"1493615-1"	"HEART RATE IRREGULAR"	"10019304"	"60-64 years"	"60-64"	""He had Covid 19 on Thanksgiving 2020 and recovered fully. Even though he now had natural antibodies, his Doctor convinced him that he needed the so called Covid 19 vaccine ""mRNA gene therapy"". On 04/29/2021, he was injected with the so called vaccine and that was the beginning of the end. On 05/10/2021, he was admitted to the Hospital with irregular heartbeat and trouble breathing. The Hospital could not get him stabilized so they transported him to another Hospital. He was there a couple of weeks or so and was now having issues with his kidneys and liver. It appeared the spike proteins had started to battle the rest of his viable organs. The hospital had to transport him to a nursing home facility because his number of days in the hospital per insurance had run out. Then on the evening of 06/13 or 14/ 2021, he became violently ill. He was taken to hospital again and was subsequently transferred back to another Hospital. The Spike proteins had now gone into overdrive attacking all his major organs. His liver, kidneys, lungs and heart were being attacked by the spike proteins created by this deadly vaccine. He was put on 24  hour dialysis and then had to be put on a ventilator. He died 06/24/2021.""
	"1493615-1"	"1493615-1"	"LIVER DISORDER"	"10024670"	"60-64 years"	"60-64"	""He had Covid 19 on Thanksgiving 2020 and recovered fully. Even though he now had natural antibodies, his Doctor convinced him that he needed the so called Covid 19 vaccine ""mRNA gene therapy"". On 04/29/2021, he was injected with the so called vaccine and that was the beginning of the end. On 05/10/2021, he was admitted to the Hospital with irregular heartbeat and trouble breathing. The Hospital could not get him stabilized so they transported him to another Hospital. He was there a couple of weeks or so and was now having issues with his kidneys and liver. It appeared the spike proteins had started to battle the rest of his viable organs. The hospital had to transport him to a nursing home facility because his number of days in the hospital per insurance had run out. Then on the evening of 06/13 or 14/ 2021, he became violently ill. He was taken to hospital again and was subsequently transferred back to another Hospital. The Spike proteins had now gone into overdrive attacking all his major organs. His liver, kidneys, lungs and heart were being attacked by the spike proteins created by this deadly vaccine. He was put on 24  hour dialysis and then had to be put on a ventilator. He died 06/24/2021.""
	"1493615-1"	"1493615-1"	"LUNG DISORDER"	"10025082"	"60-64 years"	"60-64"	""He had Covid 19 on Thanksgiving 2020 and recovered fully. Even though he now had natural antibodies, his Doctor convinced him that he needed the so called Covid 19 vaccine ""mRNA gene therapy"". On 04/29/2021, he was injected with the so called vaccine and that was the beginning of the end. On 05/10/2021, he was admitted to the Hospital with irregular heartbeat and trouble breathing. The Hospital could not get him stabilized so they transported him to another Hospital. He was there a couple of weeks or so and was now having issues with his kidneys and liver. It appeared the spike proteins had started to battle the rest of his viable organs. The hospital had to transport him to a nursing home facility because his number of days in the hospital per insurance had run out. Then on the evening of 06/13 or 14/ 2021, he became violently ill. He was taken to hospital again and was subsequently transferred back to another Hospital. The Spike proteins had now gone into overdrive attacking all his major organs. His liver, kidneys, lungs and heart were being attacked by the spike proteins created by this deadly vaccine. He was put on 24  hour dialysis and then had to be put on a ventilator. He died 06/24/2021.""
	"1493615-1"	"1493615-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	""He had Covid 19 on Thanksgiving 2020 and recovered fully. Even though he now had natural antibodies, his Doctor convinced him that he needed the so called Covid 19 vaccine ""mRNA gene therapy"". On 04/29/2021, he was injected with the so called vaccine and that was the beginning of the end. On 05/10/2021, he was admitted to the Hospital with irregular heartbeat and trouble breathing. The Hospital could not get him stabilized so they transported him to another Hospital. He was there a couple of weeks or so and was now having issues with his kidneys and liver. It appeared the spike proteins had started to battle the rest of his viable organs. The hospital had to transport him to a nursing home facility because his number of days in the hospital per insurance had run out. Then on the evening of 06/13 or 14/ 2021, he became violently ill. He was taken to hospital again and was subsequently transferred back to another Hospital. The Spike proteins had now gone into overdrive attacking all his major organs. His liver, kidneys, lungs and heart were being attacked by the spike proteins created by this deadly vaccine. He was put on 24  hour dialysis and then had to be put on a ventilator. He died 06/24/2021.""
	"1493615-1"	"1493615-1"	"RENAL DISORDER"	"10038428"	"60-64 years"	"60-64"	""He had Covid 19 on Thanksgiving 2020 and recovered fully. Even though he now had natural antibodies, his Doctor convinced him that he needed the so called Covid 19 vaccine ""mRNA gene therapy"". On 04/29/2021, he was injected with the so called vaccine and that was the beginning of the end. On 05/10/2021, he was admitted to the Hospital with irregular heartbeat and trouble breathing. The Hospital could not get him stabilized so they transported him to another Hospital. He was there a couple of weeks or so and was now having issues with his kidneys and liver. It appeared the spike proteins had started to battle the rest of his viable organs. The hospital had to transport him to a nursing home facility because his number of days in the hospital per insurance had run out. Then on the evening of 06/13 or 14/ 2021, he became violently ill. He was taken to hospital again and was subsequently transferred back to another Hospital. The Spike proteins had now gone into overdrive attacking all his major organs. His liver, kidneys, lungs and heart were being attacked by the spike proteins created by this deadly vaccine. He was put on 24  hour dialysis and then had to be put on a ventilator. He died 06/24/2021.""
	"1493717-1"	"1493717-1"	"UNEVALUABLE EVENT"	"10062355"	"60-64 years"	"60-64"	"Patient had an ED visit and/or hospitalization within 6 weeks of receiving COVID vaccine."
	"1500614-1"	"1500614-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"myocardial infarction; Fluid; Shortness of breath; Chest pain; This is a spontaneous report from a contactable nurse (patient's wife). A 64-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0180), via an unspecified route of administration, administered in left arm on 11Jun2021 10:00 (64-year-old at time of vaccination) as single dose for COVID-19 immunization. The patient's medical history included diagnosed allergies, compromised immune status, respiratory illness, genetic/chromosomal abnormalities, endocrine abnormalities (including diabetes) and obesity. There was no family medical history relevant to adverse event. There were no concomitant medications. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0186), via an unspecified route of administration, administered in left arm on 21May2021 (64-year-old at time of vaccination) for COVID-19 immunization. There were no vaccines administered on same date with the Pfizer vaccine considered as suspect. There were no other vaccinations within four weeks prior to the first administration date of the suspect vaccine. The patient experienced chest pain on 17Jun2021, fluid and shortness of breath on 25Jun2021, and myocardial infarction on an unspecified date. Patient's wife (a registered nurse, recently retired) just wanted to report this. She can't say that it is the vaccine or anything. Her husband received the second COVID-19 Vaccine on 11Jun2021 and he died at the emergency room 2 weeks later of a cardiac event. She couldn't do the report online because it was making her the one she was reporting on. Chest pain: She took him to the emergency room on 25Jun2021. He had been having chest pain that he reported to her that Monday before. He told her that it actually started the Thursday before on 17Jun2021. He had some chest pain that felt a little better over the weekend, then Monday it was worse. He wasn't a complainer, but he was obviously having chest pain. He was very stubborn and so he just kind of let it progress and it got worse during the week. He wouldn't go to the doctor. She kept telling him she read about myocarditis mostly with adolescent males. She thought what if it is something like that. Time of Onset of Chest pain: He reported it on Monday that he had chest pain on Thursday. She became aware when he woke up at 06:30 on 21Jun2021 and she knew something was wrong when he went for the Ibuprofen. Fluid and shortness of breath: The day she took him to the emergency room the chest pain had worsened and he had fluid and shortness of breath. The fluid and shortness of breath started on 25Jun2021. Death: He died on 25Jun2021. The cause of death was a myocardial infarction. They didn't do an autopsy. The reason they gave for not being able to do an autopsy was they were overwhelmed with drug overdoses and homicides. Indication for COVID-19 Vaccine: He didn't want it, but he needed to go back to the office and didn't want to wear a mask. Adverse events required a visit to emergency room. Investigations: She doesn't have his medical records yet. Essentially they were recording him. She can't believe she got him in in a wheelchair. Immediately they were doing resuscitation efforts. Relevant Tests was reported as none. The outcome of myocardial infarction was fatal; outcome of other events was unknown. The patient died on 25Jun2021.  No autopsy was performed. The cause of death was a myocardial infarction. Causality: the reporting nurse has no opinion. She just thinks that the patient didn't randomly die any of his other 64 years. It may be a coincidence.; Sender's Comments: The event myocardial infarction with fatal outcome is considered unrelated to suspect product (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0180). The compromised immune status, respiratory illness, genetic/chromosomal abnormalities, endocrine abnormalities (including diabetes) and obesity may explain as alternative cause.; Reported Cause(s) of Death: Myocardial infarction"
	"1500614-1"	"1500614-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"myocardial infarction; Fluid; Shortness of breath; Chest pain; This is a spontaneous report from a contactable nurse (patient's wife). A 64-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0180), via an unspecified route of administration, administered in left arm on 11Jun2021 10:00 (64-year-old at time of vaccination) as single dose for COVID-19 immunization. The patient's medical history included diagnosed allergies, compromised immune status, respiratory illness, genetic/chromosomal abnormalities, endocrine abnormalities (including diabetes) and obesity. There was no family medical history relevant to adverse event. There were no concomitant medications. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0186), via an unspecified route of administration, administered in left arm on 21May2021 (64-year-old at time of vaccination) for COVID-19 immunization. There were no vaccines administered on same date with the Pfizer vaccine considered as suspect. There were no other vaccinations within four weeks prior to the first administration date of the suspect vaccine. The patient experienced chest pain on 17Jun2021, fluid and shortness of breath on 25Jun2021, and myocardial infarction on an unspecified date. Patient's wife (a registered nurse, recently retired) just wanted to report this. She can't say that it is the vaccine or anything. Her husband received the second COVID-19 Vaccine on 11Jun2021 and he died at the emergency room 2 weeks later of a cardiac event. She couldn't do the report online because it was making her the one she was reporting on. Chest pain: She took him to the emergency room on 25Jun2021. He had been having chest pain that he reported to her that Monday before. He told her that it actually started the Thursday before on 17Jun2021. He had some chest pain that felt a little better over the weekend, then Monday it was worse. He wasn't a complainer, but he was obviously having chest pain. He was very stubborn and so he just kind of let it progress and it got worse during the week. He wouldn't go to the doctor. She kept telling him she read about myocarditis mostly with adolescent males. She thought what if it is something like that. Time of Onset of Chest pain: He reported it on Monday that he had chest pain on Thursday. She became aware when he woke up at 06:30 on 21Jun2021 and she knew something was wrong when he went for the Ibuprofen. Fluid and shortness of breath: The day she took him to the emergency room the chest pain had worsened and he had fluid and shortness of breath. The fluid and shortness of breath started on 25Jun2021. Death: He died on 25Jun2021. The cause of death was a myocardial infarction. They didn't do an autopsy. The reason they gave for not being able to do an autopsy was they were overwhelmed with drug overdoses and homicides. Indication for COVID-19 Vaccine: He didn't want it, but he needed to go back to the office and didn't want to wear a mask. Adverse events required a visit to emergency room. Investigations: She doesn't have his medical records yet. Essentially they were recording him. She can't believe she got him in in a wheelchair. Immediately they were doing resuscitation efforts. Relevant Tests was reported as none. The outcome of myocardial infarction was fatal; outcome of other events was unknown. The patient died on 25Jun2021.  No autopsy was performed. The cause of death was a myocardial infarction. Causality: the reporting nurse has no opinion. She just thinks that the patient didn't randomly die any of his other 64 years. It may be a coincidence.; Sender's Comments: The event myocardial infarction with fatal outcome is considered unrelated to suspect product (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0180). The compromised immune status, respiratory illness, genetic/chromosomal abnormalities, endocrine abnormalities (including diabetes) and obesity may explain as alternative cause.; Reported Cause(s) of Death: Myocardial infarction"
	"1500614-1"	"1500614-1"	"FLUID RETENTION"	"10016807"	"60-64 years"	"60-64"	"myocardial infarction; Fluid; Shortness of breath; Chest pain; This is a spontaneous report from a contactable nurse (patient's wife). A 64-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0180), via an unspecified route of administration, administered in left arm on 11Jun2021 10:00 (64-year-old at time of vaccination) as single dose for COVID-19 immunization. The patient's medical history included diagnosed allergies, compromised immune status, respiratory illness, genetic/chromosomal abnormalities, endocrine abnormalities (including diabetes) and obesity. There was no family medical history relevant to adverse event. There were no concomitant medications. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0186), via an unspecified route of administration, administered in left arm on 21May2021 (64-year-old at time of vaccination) for COVID-19 immunization. There were no vaccines administered on same date with the Pfizer vaccine considered as suspect. There were no other vaccinations within four weeks prior to the first administration date of the suspect vaccine. The patient experienced chest pain on 17Jun2021, fluid and shortness of breath on 25Jun2021, and myocardial infarction on an unspecified date. Patient's wife (a registered nurse, recently retired) just wanted to report this. She can't say that it is the vaccine or anything. Her husband received the second COVID-19 Vaccine on 11Jun2021 and he died at the emergency room 2 weeks later of a cardiac event. She couldn't do the report online because it was making her the one she was reporting on. Chest pain: She took him to the emergency room on 25Jun2021. He had been having chest pain that he reported to her that Monday before. He told her that it actually started the Thursday before on 17Jun2021. He had some chest pain that felt a little better over the weekend, then Monday it was worse. He wasn't a complainer, but he was obviously having chest pain. He was very stubborn and so he just kind of let it progress and it got worse during the week. He wouldn't go to the doctor. She kept telling him she read about myocarditis mostly with adolescent males. She thought what if it is something like that. Time of Onset of Chest pain: He reported it on Monday that he had chest pain on Thursday. She became aware when he woke up at 06:30 on 21Jun2021 and she knew something was wrong when he went for the Ibuprofen. Fluid and shortness of breath: The day she took him to the emergency room the chest pain had worsened and he had fluid and shortness of breath. The fluid and shortness of breath started on 25Jun2021. Death: He died on 25Jun2021. The cause of death was a myocardial infarction. They didn't do an autopsy. The reason they gave for not being able to do an autopsy was they were overwhelmed with drug overdoses and homicides. Indication for COVID-19 Vaccine: He didn't want it, but he needed to go back to the office and didn't want to wear a mask. Adverse events required a visit to emergency room. Investigations: She doesn't have his medical records yet. Essentially they were recording him. She can't believe she got him in in a wheelchair. Immediately they were doing resuscitation efforts. Relevant Tests was reported as none. The outcome of myocardial infarction was fatal; outcome of other events was unknown. The patient died on 25Jun2021.  No autopsy was performed. The cause of death was a myocardial infarction. Causality: the reporting nurse has no opinion. She just thinks that the patient didn't randomly die any of his other 64 years. It may be a coincidence.; Sender's Comments: The event myocardial infarction with fatal outcome is considered unrelated to suspect product (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0180). The compromised immune status, respiratory illness, genetic/chromosomal abnormalities, endocrine abnormalities (including diabetes) and obesity may explain as alternative cause.; Reported Cause(s) of Death: Myocardial infarction"
	"1500614-1"	"1500614-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"myocardial infarction; Fluid; Shortness of breath; Chest pain; This is a spontaneous report from a contactable nurse (patient's wife). A 64-year-old male patient received the second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0180), via an unspecified route of administration, administered in left arm on 11Jun2021 10:00 (64-year-old at time of vaccination) as single dose for COVID-19 immunization. The patient's medical history included diagnosed allergies, compromised immune status, respiratory illness, genetic/chromosomal abnormalities, endocrine abnormalities (including diabetes) and obesity. There was no family medical history relevant to adverse event. There were no concomitant medications. The patient previously received the first dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0186), via an unspecified route of administration, administered in left arm on 21May2021 (64-year-old at time of vaccination) for COVID-19 immunization. There were no vaccines administered on same date with the Pfizer vaccine considered as suspect. There were no other vaccinations within four weeks prior to the first administration date of the suspect vaccine. The patient experienced chest pain on 17Jun2021, fluid and shortness of breath on 25Jun2021, and myocardial infarction on an unspecified date. Patient's wife (a registered nurse, recently retired) just wanted to report this. She can't say that it is the vaccine or anything. Her husband received the second COVID-19 Vaccine on 11Jun2021 and he died at the emergency room 2 weeks later of a cardiac event. She couldn't do the report online because it was making her the one she was reporting on. Chest pain: She took him to the emergency room on 25Jun2021. He had been having chest pain that he reported to her that Monday before. He told her that it actually started the Thursday before on 17Jun2021. He had some chest pain that felt a little better over the weekend, then Monday it was worse. He wasn't a complainer, but he was obviously having chest pain. He was very stubborn and so he just kind of let it progress and it got worse during the week. He wouldn't go to the doctor. She kept telling him she read about myocarditis mostly with adolescent males. She thought what if it is something like that. Time of Onset of Chest pain: He reported it on Monday that he had chest pain on Thursday. She became aware when he woke up at 06:30 on 21Jun2021 and she knew something was wrong when he went for the Ibuprofen. Fluid and shortness of breath: The day she took him to the emergency room the chest pain had worsened and he had fluid and shortness of breath. The fluid and shortness of breath started on 25Jun2021. Death: He died on 25Jun2021. The cause of death was a myocardial infarction. They didn't do an autopsy. The reason they gave for not being able to do an autopsy was they were overwhelmed with drug overdoses and homicides. Indication for COVID-19 Vaccine: He didn't want it, but he needed to go back to the office and didn't want to wear a mask. Adverse events required a visit to emergency room. Investigations: She doesn't have his medical records yet. Essentially they were recording him. She can't believe she got him in in a wheelchair. Immediately they were doing resuscitation efforts. Relevant Tests was reported as none. The outcome of myocardial infarction was fatal; outcome of other events was unknown. The patient died on 25Jun2021.  No autopsy was performed. The cause of death was a myocardial infarction. Causality: the reporting nurse has no opinion. She just thinks that the patient didn't randomly die any of his other 64 years. It may be a coincidence.; Sender's Comments: The event myocardial infarction with fatal outcome is considered unrelated to suspect product (PFIZER-BIONTECH COVID-19 VACCINE, Lot Number: EW0180). The compromised immune status, respiratory illness, genetic/chromosomal abnormalities, endocrine abnormalities (including diabetes) and obesity may explain as alternative cause.; Reported Cause(s) of Death: Myocardial infarction"
	"1500766-1"	"1500766-1"	"AMNESIA"	"10001949"	"60-64 years"	"60-64"	"Loss of balance, loss of memory, blood clots, hospitalization, brain surgery, death"
	"1500766-1"	"1500766-1"	"BALANCE DISORDER"	"10049848"	"60-64 years"	"60-64"	"Loss of balance, loss of memory, blood clots, hospitalization, brain surgery, death"
	"1500766-1"	"1500766-1"	"BRAIN OPERATION"	"10061732"	"60-64 years"	"60-64"	"Loss of balance, loss of memory, blood clots, hospitalization, brain surgery, death"
	"1500766-1"	"1500766-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Loss of balance, loss of memory, blood clots, hospitalization, brain surgery, death"
	"1500766-1"	"1500766-1"	"THROMBOSIS"	"10043607"	"60-64 years"	"60-64"	"Loss of balance, loss of memory, blood clots, hospitalization, brain surgery, death"
	"1502042-1"	"1502042-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"Death  7/25/21 N17.9 - AKI (acute kidney injury) K92.2 - Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type"
	"1502042-1"	"1502042-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death  7/25/21 N17.9 - AKI (acute kidney injury) K92.2 - Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type"
	"1502042-1"	"1502042-1"	"GASTROINTESTINAL HAEMORRHAGE"	"10017955"	"60-64 years"	"60-64"	"Death  7/25/21 N17.9 - AKI (acute kidney injury) K92.2 - Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type"
	"1502062-1"	"1502062-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death E87.1 - Hyponatremia J18.9 - Pneumonia, unspecified organism E87.1 - Hypo-osmolality and hyponatremia D69.6 - Thrombocytopenia, unspecified"
	"1502062-1"	"1502062-1"	"HYPONATRAEMIA"	"10021036"	"60-64 years"	"60-64"	"death E87.1 - Hyponatremia J18.9 - Pneumonia, unspecified organism E87.1 - Hypo-osmolality and hyponatremia D69.6 - Thrombocytopenia, unspecified"
	"1502062-1"	"1502062-1"	"HYPOOSMOLAR STATE"	"10074867"	"60-64 years"	"60-64"	"death E87.1 - Hyponatremia J18.9 - Pneumonia, unspecified organism E87.1 - Hypo-osmolality and hyponatremia D69.6 - Thrombocytopenia, unspecified"
	"1502062-1"	"1502062-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"death E87.1 - Hyponatremia J18.9 - Pneumonia, unspecified organism E87.1 - Hypo-osmolality and hyponatremia D69.6 - Thrombocytopenia, unspecified"
	"1502062-1"	"1502062-1"	"THROMBOCYTOPENIA"	"10043554"	"60-64 years"	"60-64"	"death E87.1 - Hyponatremia J18.9 - Pneumonia, unspecified organism E87.1 - Hypo-osmolality and hyponatremia D69.6 - Thrombocytopenia, unspecified"
	"1502145-1"	"1502145-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"death N17.9 - Acute renal injury J18.9 - Multifocal pneumonia"
	"1502145-1"	"1502145-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death N17.9 - Acute renal injury J18.9 - Multifocal pneumonia"
	"1502145-1"	"1502145-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"death N17.9 - Acute renal injury J18.9 - Multifocal pneumonia"
	"1502302-1"	"1502302-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"tested positive and died after being fully vaccinated"
	"1502302-1"	"1502302-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"tested positive and died after being fully vaccinated"
	"1502302-1"	"1502302-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"tested positive and died after being fully vaccinated"
	"1505544-1"	"1505544-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"patient passed away"
	"1505902-1"	"1505902-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Resident was fully vaccinated.  Tested positive for covid on 7/2/2021.  Had two subsequent covid tests which were negative.  Did pass away on 7/24/2021 but not from covid."
	"1505902-1"	"1505902-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Resident was fully vaccinated.  Tested positive for covid on 7/2/2021.  Had two subsequent covid tests which were negative.  Did pass away on 7/24/2021 but not from covid."
	"1505902-1"	"1505902-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Resident was fully vaccinated.  Tested positive for covid on 7/2/2021.  Had two subsequent covid tests which were negative.  Did pass away on 7/24/2021 but not from covid."
	"1506767-1"	"1506767-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death"
	"1512430-1"	"1512430-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient past away."
	"1512430-1"	"1512430-1"	"MEDICAL PROCEDURE"	"10077673"	"60-64 years"	"60-64"	"Patient past away."
	"1512650-1"	"1512650-1"	"SUDDEN DEATH"	"10042434"	"60-64 years"	"60-64"	"Patient told family members he received second dose of Pfizer-BioNTech COVID19 vaccine on April 18, 2021.  Sheriff's Department contacted next of kin on morning of April 20, 2021 stating that patient had died suddenly on April 19, 2021."
	"1516529-1"	"1516529-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death on 5-10-2021"
	"1522982-1"	"1522982-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient passed away on 07/25/2021."
	"1523257-1"	"1523257-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"PATIENT DID NOT COMPLAIN ABOUT ANY SIDE EFFECT. HOWEVER, DAUGHTER REPORTED THAT PATIENT WAS FOUND DEAD AT HER HOUSE LAST NIGHT 08/02/21"
	"1526529-1"	"1526529-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Became lethargic and had malaise, called 911 and could only be heard breathing on the line. When EMS arrived, she was deceased."
	"1526529-1"	"1526529-1"	"LETHARGY"	"10024264"	"60-64 years"	"60-64"	"Became lethargic and had malaise, called 911 and could only be heard breathing on the line. When EMS arrived, she was deceased."
	"1526529-1"	"1526529-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"Became lethargic and had malaise, called 911 and could only be heard breathing on the line. When EMS arrived, she was deceased."
	"1528880-1"	"1528880-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"60-64 years"	"60-64"	"death I21.4 - NSTEMI (non-ST elevated myocardial infarction) (CMS/HCC) J18.9 - Pneumonia due to infectious organism, unspecified laterality, unspecified part of lung"
	"1528880-1"	"1528880-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death I21.4 - NSTEMI (non-ST elevated myocardial infarction) (CMS/HCC) J18.9 - Pneumonia due to infectious organism, unspecified laterality, unspecified part of lung"
	"1528880-1"	"1528880-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"death I21.4 - NSTEMI (non-ST elevated myocardial infarction) (CMS/HCC) J18.9 - Pneumonia due to infectious organism, unspecified laterality, unspecified part of lung"
	"1529868-1"	"1529868-1"	"SUDDEN CARDIAC DEATH"	"10049418"	"60-64 years"	"60-64"	"SUDDEN CARDIAC DEATH"
	"1532021-1"	"1532021-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA Patient received Janssen Vaccine on 4/30/2021. Presented to ED on 7/9/2021 with Altered Mental Status and Shortness of Breath. Admitted with Respiratory failure. Patient admitted 7/9/21 for COVID-19 pneumonia. Intubated 7/10 and completed treatment with decadron and remdesivir daily (7/9 - 7/13). Treated with ceftriaxone and azithromycin. Patient expired on 7/26/2021."
	"1532021-1"	"1532021-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA Patient received Janssen Vaccine on 4/30/2021. Presented to ED on 7/9/2021 with Altered Mental Status and Shortness of Breath. Admitted with Respiratory failure. Patient admitted 7/9/21 for COVID-19 pneumonia. Intubated 7/10 and completed treatment with decadron and remdesivir daily (7/9 - 7/13). Treated with ceftriaxone and azithromycin. Patient expired on 7/26/2021."
	"1532021-1"	"1532021-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA Patient received Janssen Vaccine on 4/30/2021. Presented to ED on 7/9/2021 with Altered Mental Status and Shortness of Breath. Admitted with Respiratory failure. Patient admitted 7/9/21 for COVID-19 pneumonia. Intubated 7/10 and completed treatment with decadron and remdesivir daily (7/9 - 7/13). Treated with ceftriaxone and azithromycin. Patient expired on 7/26/2021."
	"1532021-1"	"1532021-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA Patient received Janssen Vaccine on 4/30/2021. Presented to ED on 7/9/2021 with Altered Mental Status and Shortness of Breath. Admitted with Respiratory failure. Patient admitted 7/9/21 for COVID-19 pneumonia. Intubated 7/10 and completed treatment with decadron and remdesivir daily (7/9 - 7/13). Treated with ceftriaxone and azithromycin. Patient expired on 7/26/2021."
	"1532021-1"	"1532021-1"	"MENTAL STATUS CHANGES"	"10048294"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA Patient received Janssen Vaccine on 4/30/2021. Presented to ED on 7/9/2021 with Altered Mental Status and Shortness of Breath. Admitted with Respiratory failure. Patient admitted 7/9/21 for COVID-19 pneumonia. Intubated 7/10 and completed treatment with decadron and remdesivir daily (7/9 - 7/13). Treated with ceftriaxone and azithromycin. Patient expired on 7/26/2021."
	"1532021-1"	"1532021-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA Patient received Janssen Vaccine on 4/30/2021. Presented to ED on 7/9/2021 with Altered Mental Status and Shortness of Breath. Admitted with Respiratory failure. Patient admitted 7/9/21 for COVID-19 pneumonia. Intubated 7/10 and completed treatment with decadron and remdesivir daily (7/9 - 7/13). Treated with ceftriaxone and azithromycin. Patient expired on 7/26/2021."
	"1532021-1"	"1532021-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA Patient received Janssen Vaccine on 4/30/2021. Presented to ED on 7/9/2021 with Altered Mental Status and Shortness of Breath. Admitted with Respiratory failure. Patient admitted 7/9/21 for COVID-19 pneumonia. Intubated 7/10 and completed treatment with decadron and remdesivir daily (7/9 - 7/13). Treated with ceftriaxone and azithromycin. Patient expired on 7/26/2021."
	"1535066-1"	"1535066-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Perforated bowel that was sudden and caused sepsis."
	"1535066-1"	"1535066-1"	"INTESTINAL PERFORATION"	"10022694"	"60-64 years"	"60-64"	"Perforated bowel that was sudden and caused sepsis."
	"1535066-1"	"1535066-1"	"SEPSIS"	"10040047"	"60-64 years"	"60-64"	"Perforated bowel that was sudden and caused sepsis."
	"1535278-1"	"1535278-1"	"ANAL INCONTINENCE"	"10077605"	"60-64 years"	"60-64"	""""brain fog,"" blurred vision, extreme mucous, body aches, fatigue, bowel incontinence""
	"1535278-1"	"1535278-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	""""brain fog,"" blurred vision, extreme mucous, body aches, fatigue, bowel incontinence""
	"1535278-1"	"1535278-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	""""brain fog,"" blurred vision, extreme mucous, body aches, fatigue, bowel incontinence""
	"1535278-1"	"1535278-1"	"FEELING ABNORMAL"	"10016322"	"60-64 years"	"60-64"	""""brain fog,"" blurred vision, extreme mucous, body aches, fatigue, bowel incontinence""
	"1535278-1"	"1535278-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	""""brain fog,"" blurred vision, extreme mucous, body aches, fatigue, bowel incontinence""
	"1535278-1"	"1535278-1"	"SECRETION DISCHARGE"	"10053459"	"60-64 years"	"60-64"	""""brain fog,"" blurred vision, extreme mucous, body aches, fatigue, bowel incontinence""
	"1535278-1"	"1535278-1"	"VISION BLURRED"	"10047513"	"60-64 years"	"60-64"	""""brain fog,"" blurred vision, extreme mucous, body aches, fatigue, bowel incontinence""
	"1535282-1"	"1535282-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Increased SOB"
	"1535282-1"	"1535282-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"Increased SOB"
	"1535282-1"	"1535282-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Increased SOB"
	"1535284-1"	"1535284-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Cough, congestion"
	"1535284-1"	"1535284-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Cough, congestion"
	"1535284-1"	"1535284-1"	"RESPIRATORY TRACT CONGESTION"	"10052251"	"60-64 years"	"60-64"	"Cough, congestion"
	"1536043-1"	"1536043-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Death from Covid-19"
	"1536043-1"	"1536043-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death from Covid-19"
	"1536432-1"	"1536432-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"March 18 2021 my mom received her first Pfizer vaccine followed by her second on 4/03/2021. After she received it she started having an overall feeling of not well. Tired, fatigue, headache, and complained to her doctor on multiple occasions. Since 12/09/2020 she had only went to the doctor one time on 02/08/2021. After the first dose until her death she had gone to her doctor many times, on 03/30, 04/01, 04/21, 04/28, 05/25. That may not be a complete list of every visit."
	"1536432-1"	"1536432-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"March 18 2021 my mom received her first Pfizer vaccine followed by her second on 4/03/2021. After she received it she started having an overall feeling of not well. Tired, fatigue, headache, and complained to her doctor on multiple occasions. Since 12/09/2020 she had only went to the doctor one time on 02/08/2021. After the first dose until her death she had gone to her doctor many times, on 03/30, 04/01, 04/21, 04/28, 05/25. That may not be a complete list of every visit."
	"1536432-1"	"1536432-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"March 18 2021 my mom received her first Pfizer vaccine followed by her second on 4/03/2021. After she received it she started having an overall feeling of not well. Tired, fatigue, headache, and complained to her doctor on multiple occasions. Since 12/09/2020 she had only went to the doctor one time on 02/08/2021. After the first dose until her death she had gone to her doctor many times, on 03/30, 04/01, 04/21, 04/28, 05/25. That may not be a complete list of every visit."
	"1536432-1"	"1536432-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"March 18 2021 my mom received her first Pfizer vaccine followed by her second on 4/03/2021. After she received it she started having an overall feeling of not well. Tired, fatigue, headache, and complained to her doctor on multiple occasions. Since 12/09/2020 she had only went to the doctor one time on 02/08/2021. After the first dose until her death she had gone to her doctor many times, on 03/30, 04/01, 04/21, 04/28, 05/25. That may not be a complete list of every visit."
	"1536432-1"	"1536432-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"March 18 2021 my mom received her first Pfizer vaccine followed by her second on 4/03/2021. After she received it she started having an overall feeling of not well. Tired, fatigue, headache, and complained to her doctor on multiple occasions. Since 12/09/2020 she had only went to the doctor one time on 02/08/2021. After the first dose until her death she had gone to her doctor many times, on 03/30, 04/01, 04/21, 04/28, 05/25. That may not be a complete list of every visit."
	"1536432-1"	"1536432-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"March 18 2021 my mom received her first Pfizer vaccine followed by her second on 4/03/2021. After she received it she started having an overall feeling of not well. Tired, fatigue, headache, and complained to her doctor on multiple occasions. Since 12/09/2020 she had only went to the doctor one time on 02/08/2021. After the first dose until her death she had gone to her doctor many times, on 03/30, 04/01, 04/21, 04/28, 05/25. That may not be a complete list of every visit."
	"1536432-1"	"1536432-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"March 18 2021 my mom received her first Pfizer vaccine followed by her second on 4/03/2021. After she received it she started having an overall feeling of not well. Tired, fatigue, headache, and complained to her doctor on multiple occasions. Since 12/09/2020 she had only went to the doctor one time on 02/08/2021. After the first dose until her death she had gone to her doctor many times, on 03/30, 04/01, 04/21, 04/28, 05/25. That may not be a complete list of every visit."
	"1540547-1"	"1540547-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient Died"
	"1540970-1"	"1540970-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Tested positive for COVID-19 on 7/28/21, admitted to the hospital on 8/3/21 with a date of death of 8/8/2021 via cardiac arrest."
	"1540970-1"	"1540970-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Tested positive for COVID-19 on 7/28/21, admitted to the hospital on 8/3/21 with a date of death of 8/8/2021 via cardiac arrest."
	"1540970-1"	"1540970-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Tested positive for COVID-19 on 7/28/21, admitted to the hospital on 8/3/21 with a date of death of 8/8/2021 via cardiac arrest."
	"1540970-1"	"1540970-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Tested positive for COVID-19 on 7/28/21, admitted to the hospital on 8/3/21 with a date of death of 8/8/2021 via cardiac arrest."
	"1542096-1"	"1542096-1"	"BRAIN OEDEMA"	"10048962"	"60-64 years"	"60-64"	"CVA WITH SEVERE CEREBRAL EDEMA"
	"1542096-1"	"1542096-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"60-64 years"	"60-64"	"CVA WITH SEVERE CEREBRAL EDEMA"
	"1542098-1"	"1542098-1"	"DROWNING"	"10013647"	"60-64 years"	"60-64"	"DROWNING"
	"1542104-1"	"1542104-1"	"SUDDEN CARDIAC DEATH"	"10049418"	"60-64 years"	"60-64"	"SUDDEN CARDIAC DEATH"
	"1544928-1"	"1544928-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"60-64 years"	"60-64"	"AMI"
	"1544932-1"	"1544932-1"	"UROSEPSIS"	"10048709"	"60-64 years"	"60-64"	"UROSEPSIS"
	"1544937-1"	"1544937-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"CARDIAC ARREST"
	"1558466-1"	"1558466-1"	"ARTERIAL OCCLUSIVE DISEASE"	"10062599"	"60-64 years"	"60-64"	"Felt fatigued the day before adverse event, died in his sleep of arterial occlusion"
	"1558466-1"	"1558466-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Felt fatigued the day before adverse event, died in his sleep of arterial occlusion"
	"1558466-1"	"1558466-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Felt fatigued the day before adverse event, died in his sleep of arterial occlusion"
	"1558466-1"	"1558466-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Felt fatigued the day before adverse event, died in his sleep of arterial occlusion"
	"1578498-1"	"1578498-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"DEATH"
	"1578963-1"	"1578963-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Unexplained death.   Patient was found dead near his front door with car keys still in his hand.  Pacemaker had recently been checked and was working fine, so it was not a heart attack."
	"1591253-1"	"1591253-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient passed away on 08/07/2021."
	"1623756-1"	"1623756-1"	"BACK PAIN"	"10003988"	"60-64 years"	"60-64"	"12 hours, back pain."
	"1623874-1"	"1623874-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Died the day after receiving the vaccine"
	"1624176-1"	"1624176-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Respiratory failure due to Covid pneumonia; Hospitalized 7 days; deceased"
	"1624176-1"	"1624176-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Respiratory failure due to Covid pneumonia; Hospitalized 7 days; deceased"
	"1624176-1"	"1624176-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	"Respiratory failure due to Covid pneumonia; Hospitalized 7 days; deceased"
	"1624176-1"	"1624176-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Respiratory failure due to Covid pneumonia; Hospitalized 7 days; deceased"
	"1625270-1"	"1625270-1"	"ACUTE HEPATIC FAILURE"	"10000804"	"60-64 years"	"60-64"	"4 month after completing immunization series patient noted with SMA, SMV, and cerebral venous thrombus. Report from outside hospital show that the SMA had collateralization in August suggestive of a chronic occlusion  s/p thrombectomy with TPA infusion the patient develped ALF and died on 8/23"
	"1625270-1"	"1625270-1"	"ANTICOAGULANT THERAPY"	"10053468"	"60-64 years"	"60-64"	"4 month after completing immunization series patient noted with SMA, SMV, and cerebral venous thrombus. Report from outside hospital show that the SMA had collateralization in August suggestive of a chronic occlusion  s/p thrombectomy with TPA infusion the patient develped ALF and died on 8/23"
	"1625270-1"	"1625270-1"	"CEREBRAL VENOUS THROMBOSIS"	"10008138"	"60-64 years"	"60-64"	"4 month after completing immunization series patient noted with SMA, SMV, and cerebral venous thrombus. Report from outside hospital show that the SMA had collateralization in August suggestive of a chronic occlusion  s/p thrombectomy with TPA infusion the patient develped ALF and died on 8/23"
	"1625270-1"	"1625270-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"4 month after completing immunization series patient noted with SMA, SMV, and cerebral venous thrombus. Report from outside hospital show that the SMA had collateralization in August suggestive of a chronic occlusion  s/p thrombectomy with TPA infusion the patient develped ALF and died on 8/23"
	"1625270-1"	"1625270-1"	"INFUSION"	"10060345"	"60-64 years"	"60-64"	"4 month after completing immunization series patient noted with SMA, SMV, and cerebral venous thrombus. Report from outside hospital show that the SMA had collateralization in August suggestive of a chronic occlusion  s/p thrombectomy with TPA infusion the patient develped ALF and died on 8/23"
	"1625270-1"	"1625270-1"	"MESENTERIC VENOUS OCCLUSION"	"10027403"	"60-64 years"	"60-64"	"4 month after completing immunization series patient noted with SMA, SMV, and cerebral venous thrombus. Report from outside hospital show that the SMA had collateralization in August suggestive of a chronic occlusion  s/p thrombectomy with TPA infusion the patient develped ALF and died on 8/23"
	"1625270-1"	"1625270-1"	"SUPERIOR MESENTERIC ARTERY SYNDROME"	"10054156"	"60-64 years"	"60-64"	"4 month after completing immunization series patient noted with SMA, SMV, and cerebral venous thrombus. Report from outside hospital show that the SMA had collateralization in August suggestive of a chronic occlusion  s/p thrombectomy with TPA infusion the patient develped ALF and died on 8/23"
	"1625270-1"	"1625270-1"	"THROMBECTOMY"	"10043530"	"60-64 years"	"60-64"	"4 month after completing immunization series patient noted with SMA, SMV, and cerebral venous thrombus. Report from outside hospital show that the SMA had collateralization in August suggestive of a chronic occlusion  s/p thrombectomy with TPA infusion the patient develped ALF and died on 8/23"
	"1628061-1"	"1628061-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"60-64 years"	"60-64"	"Moderna COVID-19 Vaccine EUA Patient received Moderna COVID Vaccines on 1/30/2021 and 2/27/2021.  Patient presented to the ED and was admitted on 8/02/2021 for lab abnormalities (high uric acid and glucose).  Patient had a previous admission due to AKI and hyponatremia.  Patient tested positive for COVID-19 on 8/3/2021.  Patient's symptoms for COVID-19 were mild/asymptomatic with reports of runny nose, sore throat and mild cough.  While in the hospital, patient was treated with remdesivir.  Patient expired on 8/14/21."
	"1628061-1"	"1628061-1"	"BLOOD URIC ACID INCREASED"	"10005861"	"60-64 years"	"60-64"	"Moderna COVID-19 Vaccine EUA Patient received Moderna COVID Vaccines on 1/30/2021 and 2/27/2021.  Patient presented to the ED and was admitted on 8/02/2021 for lab abnormalities (high uric acid and glucose).  Patient had a previous admission due to AKI and hyponatremia.  Patient tested positive for COVID-19 on 8/3/2021.  Patient's symptoms for COVID-19 were mild/asymptomatic with reports of runny nose, sore throat and mild cough.  While in the hospital, patient was treated with remdesivir.  Patient expired on 8/14/21."
	"1628061-1"	"1628061-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Moderna COVID-19 Vaccine EUA Patient received Moderna COVID Vaccines on 1/30/2021 and 2/27/2021.  Patient presented to the ED and was admitted on 8/02/2021 for lab abnormalities (high uric acid and glucose).  Patient had a previous admission due to AKI and hyponatremia.  Patient tested positive for COVID-19 on 8/3/2021.  Patient's symptoms for COVID-19 were mild/asymptomatic with reports of runny nose, sore throat and mild cough.  While in the hospital, patient was treated with remdesivir.  Patient expired on 8/14/21."
	"1628061-1"	"1628061-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Moderna COVID-19 Vaccine EUA Patient received Moderna COVID Vaccines on 1/30/2021 and 2/27/2021.  Patient presented to the ED and was admitted on 8/02/2021 for lab abnormalities (high uric acid and glucose).  Patient had a previous admission due to AKI and hyponatremia.  Patient tested positive for COVID-19 on 8/3/2021.  Patient's symptoms for COVID-19 were mild/asymptomatic with reports of runny nose, sore throat and mild cough.  While in the hospital, patient was treated with remdesivir.  Patient expired on 8/14/21."
	"1628061-1"	"1628061-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Moderna COVID-19 Vaccine EUA Patient received Moderna COVID Vaccines on 1/30/2021 and 2/27/2021.  Patient presented to the ED and was admitted on 8/02/2021 for lab abnormalities (high uric acid and glucose).  Patient had a previous admission due to AKI and hyponatremia.  Patient tested positive for COVID-19 on 8/3/2021.  Patient's symptoms for COVID-19 were mild/asymptomatic with reports of runny nose, sore throat and mild cough.  While in the hospital, patient was treated with remdesivir.  Patient expired on 8/14/21."
	"1628061-1"	"1628061-1"	"LABORATORY TEST ABNORMAL"	"10023547"	"60-64 years"	"60-64"	"Moderna COVID-19 Vaccine EUA Patient received Moderna COVID Vaccines on 1/30/2021 and 2/27/2021.  Patient presented to the ED and was admitted on 8/02/2021 for lab abnormalities (high uric acid and glucose).  Patient had a previous admission due to AKI and hyponatremia.  Patient tested positive for COVID-19 on 8/3/2021.  Patient's symptoms for COVID-19 were mild/asymptomatic with reports of runny nose, sore throat and mild cough.  While in the hospital, patient was treated with remdesivir.  Patient expired on 8/14/21."
	"1628061-1"	"1628061-1"	"OROPHARYNGEAL PAIN"	"10068319"	"60-64 years"	"60-64"	"Moderna COVID-19 Vaccine EUA Patient received Moderna COVID Vaccines on 1/30/2021 and 2/27/2021.  Patient presented to the ED and was admitted on 8/02/2021 for lab abnormalities (high uric acid and glucose).  Patient had a previous admission due to AKI and hyponatremia.  Patient tested positive for COVID-19 on 8/3/2021.  Patient's symptoms for COVID-19 were mild/asymptomatic with reports of runny nose, sore throat and mild cough.  While in the hospital, patient was treated with remdesivir.  Patient expired on 8/14/21."
	"1628061-1"	"1628061-1"	"RHINORRHOEA"	"10039101"	"60-64 years"	"60-64"	"Moderna COVID-19 Vaccine EUA Patient received Moderna COVID Vaccines on 1/30/2021 and 2/27/2021.  Patient presented to the ED and was admitted on 8/02/2021 for lab abnormalities (high uric acid and glucose).  Patient had a previous admission due to AKI and hyponatremia.  Patient tested positive for COVID-19 on 8/3/2021.  Patient's symptoms for COVID-19 were mild/asymptomatic with reports of runny nose, sore throat and mild cough.  While in the hospital, patient was treated with remdesivir.  Patient expired on 8/14/21."
	"1628061-1"	"1628061-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Moderna COVID-19 Vaccine EUA Patient received Moderna COVID Vaccines on 1/30/2021 and 2/27/2021.  Patient presented to the ED and was admitted on 8/02/2021 for lab abnormalities (high uric acid and glucose).  Patient had a previous admission due to AKI and hyponatremia.  Patient tested positive for COVID-19 on 8/3/2021.  Patient's symptoms for COVID-19 were mild/asymptomatic with reports of runny nose, sore throat and mild cough.  While in the hospital, patient was treated with remdesivir.  Patient expired on 8/14/21."
	"1628493-1"	"1628493-1"	"BILEVEL POSITIVE AIRWAY PRESSURE"	"10064530"	"60-64 years"	"60-64"	"Pt is currently hospitalized and was admitted on 07/06/2021 due to COVID-19. Updated pt symptoms and pre-existing medical conditions. Pt has a PMH of arthritis, DM, GERD, HLD, and HTN. Pt complained of chills, aches, and pains, constipation, shortness of breath, and dry cough. Per medical records, patient developed rapid worsening hypoxia despite BiPAP support and was intubated on 07/13/2021 and proned. Patient died."
	"1628493-1"	"1628493-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"Pt is currently hospitalized and was admitted on 07/06/2021 due to COVID-19. Updated pt symptoms and pre-existing medical conditions. Pt has a PMH of arthritis, DM, GERD, HLD, and HTN. Pt complained of chills, aches, and pains, constipation, shortness of breath, and dry cough. Per medical records, patient developed rapid worsening hypoxia despite BiPAP support and was intubated on 07/13/2021 and proned. Patient died."
	"1628493-1"	"1628493-1"	"CONSTIPATION"	"10010774"	"60-64 years"	"60-64"	"Pt is currently hospitalized and was admitted on 07/06/2021 due to COVID-19. Updated pt symptoms and pre-existing medical conditions. Pt has a PMH of arthritis, DM, GERD, HLD, and HTN. Pt complained of chills, aches, and pains, constipation, shortness of breath, and dry cough. Per medical records, patient developed rapid worsening hypoxia despite BiPAP support and was intubated on 07/13/2021 and proned. Patient died."
	"1628493-1"	"1628493-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Pt is currently hospitalized and was admitted on 07/06/2021 due to COVID-19. Updated pt symptoms and pre-existing medical conditions. Pt has a PMH of arthritis, DM, GERD, HLD, and HTN. Pt complained of chills, aches, and pains, constipation, shortness of breath, and dry cough. Per medical records, patient developed rapid worsening hypoxia despite BiPAP support and was intubated on 07/13/2021 and proned. Patient died."
	"1628493-1"	"1628493-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Pt is currently hospitalized and was admitted on 07/06/2021 due to COVID-19. Updated pt symptoms and pre-existing medical conditions. Pt has a PMH of arthritis, DM, GERD, HLD, and HTN. Pt complained of chills, aches, and pains, constipation, shortness of breath, and dry cough. Per medical records, patient developed rapid worsening hypoxia despite BiPAP support and was intubated on 07/13/2021 and proned. Patient died."
	"1628493-1"	"1628493-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pt is currently hospitalized and was admitted on 07/06/2021 due to COVID-19. Updated pt symptoms and pre-existing medical conditions. Pt has a PMH of arthritis, DM, GERD, HLD, and HTN. Pt complained of chills, aches, and pains, constipation, shortness of breath, and dry cough. Per medical records, patient developed rapid worsening hypoxia despite BiPAP support and was intubated on 07/13/2021 and proned. Patient died."
	"1628493-1"	"1628493-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Pt is currently hospitalized and was admitted on 07/06/2021 due to COVID-19. Updated pt symptoms and pre-existing medical conditions. Pt has a PMH of arthritis, DM, GERD, HLD, and HTN. Pt complained of chills, aches, and pains, constipation, shortness of breath, and dry cough. Per medical records, patient developed rapid worsening hypoxia despite BiPAP support and was intubated on 07/13/2021 and proned. Patient died."
	"1628493-1"	"1628493-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Pt is currently hospitalized and was admitted on 07/06/2021 due to COVID-19. Updated pt symptoms and pre-existing medical conditions. Pt has a PMH of arthritis, DM, GERD, HLD, and HTN. Pt complained of chills, aches, and pains, constipation, shortness of breath, and dry cough. Per medical records, patient developed rapid worsening hypoxia despite BiPAP support and was intubated on 07/13/2021 and proned. Patient died."
	"1628493-1"	"1628493-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"Pt is currently hospitalized and was admitted on 07/06/2021 due to COVID-19. Updated pt symptoms and pre-existing medical conditions. Pt has a PMH of arthritis, DM, GERD, HLD, and HTN. Pt complained of chills, aches, and pains, constipation, shortness of breath, and dry cough. Per medical records, patient developed rapid worsening hypoxia despite BiPAP support and was intubated on 07/13/2021 and proned. Patient died."
	"1628493-1"	"1628493-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"Pt is currently hospitalized and was admitted on 07/06/2021 due to COVID-19. Updated pt symptoms and pre-existing medical conditions. Pt has a PMH of arthritis, DM, GERD, HLD, and HTN. Pt complained of chills, aches, and pains, constipation, shortness of breath, and dry cough. Per medical records, patient developed rapid worsening hypoxia despite BiPAP support and was intubated on 07/13/2021 and proned. Patient died."
	"1628493-1"	"1628493-1"	"PRONE POSITION"	"10074744"	"60-64 years"	"60-64"	"Pt is currently hospitalized and was admitted on 07/06/2021 due to COVID-19. Updated pt symptoms and pre-existing medical conditions. Pt has a PMH of arthritis, DM, GERD, HLD, and HTN. Pt complained of chills, aches, and pains, constipation, shortness of breath, and dry cough. Per medical records, patient developed rapid worsening hypoxia despite BiPAP support and was intubated on 07/13/2021 and proned. Patient died."
	"1628647-1"	"1628647-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death"
	"1640942-1"	"1640942-1"	"CHEST X-RAY"	"10008498"	"60-64 years"	"60-64"	"Confusion"
	"1640942-1"	"1640942-1"	"CONFUSIONAL STATE"	"10010305"	"60-64 years"	"60-64"	"Confusion"
	"1640942-1"	"1640942-1"	"SARS-COV-2 TEST"	"10084354"	"60-64 years"	"60-64"	"Confusion"
	"1641054-1"	"1641054-1"	"CHEST X-RAY"	"10008498"	"60-64 years"	"60-64"	"Came to ER with SOBx1 month worse around midnight, cough x 1 month."
	"1641054-1"	"1641054-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Came to ER with SOBx1 month worse around midnight, cough x 1 month."
	"1641054-1"	"1641054-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Came to ER with SOBx1 month worse around midnight, cough x 1 month."
	"1641054-1"	"1641054-1"	"SARS-COV-2 TEST"	"10084354"	"60-64 years"	"60-64"	"Came to ER with SOBx1 month worse around midnight, cough x 1 month."
	"1641348-1"	"1641348-1"	"CHEST X-RAY"	"10008498"	"60-64 years"	"60-64"	"Body aches, headaches, fevers, chills."
	"1641348-1"	"1641348-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"Body aches, headaches, fevers, chills."
	"1641348-1"	"1641348-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"Body aches, headaches, fevers, chills."
	"1641348-1"	"1641348-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"Body aches, headaches, fevers, chills."
	"1641348-1"	"1641348-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Body aches, headaches, fevers, chills."
	"1641348-1"	"1641348-1"	"SARS-COV-2 TEST"	"10084354"	"60-64 years"	"60-64"	"Body aches, headaches, fevers, chills."
	"1641497-1"	"1641497-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"Pt came to ER with SOB, cough, difficulty breathing onset 1 day ago."
	"1641497-1"	"1641497-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Pt came to ER with SOB, cough, difficulty breathing onset 1 day ago."
	"1641497-1"	"1641497-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Pt came to ER with SOB, cough, difficulty breathing onset 1 day ago."
	"1641497-1"	"1641497-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Pt came to ER with SOB, cough, difficulty breathing onset 1 day ago."
	"1641497-1"	"1641497-1"	"LUNG OPACITY"	"10081792"	"60-64 years"	"60-64"	"Pt came to ER with SOB, cough, difficulty breathing onset 1 day ago."
	"1641497-1"	"1641497-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Pt came to ER with SOB, cough, difficulty breathing onset 1 day ago."
	"1641544-1"	"1641544-1"	"BILEVEL POSITIVE AIRWAY PRESSURE"	"10064530"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 05/07/21. Hospitalized from 08/07/21 - 08/23/21. Below is copied from discharge (death ) summary:"
	"1641544-1"	"1641544-1"	"BLOOD CREATININE INCREASED"	"10005483"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 05/07/21. Hospitalized from 08/07/21 - 08/23/21. Below is copied from discharge (death ) summary:"
	"1641544-1"	"1641544-1"	"BREATH SOUNDS ABSENT"	"10062285"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 05/07/21. Hospitalized from 08/07/21 - 08/23/21. Below is copied from discharge (death ) summary:"
	"1641544-1"	"1641544-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 05/07/21. Hospitalized from 08/07/21 - 08/23/21. Below is copied from discharge (death ) summary:"
	"1641544-1"	"1641544-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 05/07/21. Hospitalized from 08/07/21 - 08/23/21. Below is copied from discharge (death ) summary:"
	"1641544-1"	"1641544-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 05/07/21. Hospitalized from 08/07/21 - 08/23/21. Below is copied from discharge (death ) summary:"
	"1641544-1"	"1641544-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 05/07/21. Hospitalized from 08/07/21 - 08/23/21. Below is copied from discharge (death ) summary:"
	"1641544-1"	"1641544-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 05/07/21. Hospitalized from 08/07/21 - 08/23/21. Below is copied from discharge (death ) summary:"
	"1641544-1"	"1641544-1"	"HAEMOGLOBIN DECREASED"	"10018884"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 05/07/21. Hospitalized from 08/07/21 - 08/23/21. Below is copied from discharge (death ) summary:"
	"1641544-1"	"1641544-1"	"HYPERKALAEMIA"	"10020646"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 05/07/21. Hospitalized from 08/07/21 - 08/23/21. Below is copied from discharge (death ) summary:"
	"1641544-1"	"1641544-1"	"HYPOTENSION"	"10021097"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 05/07/21. Hospitalized from 08/07/21 - 08/23/21. Below is copied from discharge (death ) summary:"
	"1641544-1"	"1641544-1"	"NEUTROPENIA"	"10029354"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 05/07/21. Hospitalized from 08/07/21 - 08/23/21. Below is copied from discharge (death ) summary:"
	"1641544-1"	"1641544-1"	"PULSE ABSENT"	"10037469"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 05/07/21. Hospitalized from 08/07/21 - 08/23/21. Below is copied from discharge (death ) summary:"
	"1641544-1"	"1641544-1"	"PUPIL FIXED"	"10037515"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 05/07/21. Hospitalized from 08/07/21 - 08/23/21. Below is copied from discharge (death ) summary:"
	"1641544-1"	"1641544-1"	"RENAL IMPAIRMENT"	"10062237"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 05/07/21. Hospitalized from 08/07/21 - 08/23/21. Below is copied from discharge (death ) summary:"
	"1641544-1"	"1641544-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 05/07/21. Hospitalized from 08/07/21 - 08/23/21. Below is copied from discharge (death ) summary:"
	"1641544-1"	"1641544-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 05/07/21. Hospitalized from 08/07/21 - 08/23/21. Below is copied from discharge (death ) summary:"
	"1641544-1"	"1641544-1"	"WHITE BLOOD CELL COUNT INCREASED"	"10047943"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. She received Pfizer vaccine (2nd dose in series) on 05/07/21. Hospitalized from 08/07/21 - 08/23/21. Below is copied from discharge (death ) summary:"
	"1644357-1"	"1644357-1"	"BACK PAIN"	"10003988"	"60-64 years"	"60-64"	"Chest pain/Heart attack symptoms; Patient did not seem himself; Fatal heart attack; Shortness of breath; Pressure in his jaw; Stabbing pain in his back; Headache; This spontaneous case was reported by a patient family member or friend and describes the occurrence of MYOCARDIAL INFARCTION (Fatal heart attack), CHEST PAIN (Chest pain/Heart attack symptoms), DYSPNOEA (Shortness of breath), JOINT STIFFNESS (Pressure in his jaw), BACK PAIN (Stabbing pain in his back) and HEADACHE (Headache) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 026C21A and 001C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concomitant products included ASPIRIN [ACETYLSALICYLIC ACID], AMLODIPINE and LOSARTAN for an unknown indication.   On 24-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-May-2021, 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 CHEST PAIN (Chest pain/Heart attack symptoms) (seriousness criterion hospitalization). On 24-May-2021, the patient experienced DYSPNOEA (Shortness of breath) (seriousness criterion hospitalization), JOINT STIFFNESS (Pressure in his jaw) (seriousness criterion hospitalization), BACK PAIN (Stabbing pain in his back) (seriousness criterion hospitalization) and HEADACHE (Headache) (seriousness criterion hospitalization). On 29-May-2021, the patient experienced MYOCARDIAL INFARCTION (Fatal heart attack) (seriousness criteria death and medically significant). On an unknown date, the patient experienced FEELING ABNORMAL (Patient did not seem himself). The patient was hospitalized from 24-May-2021 to 26-May-2021 due to CHEST PAIN. The patient died on 29-May-2021. The reported cause of death was fatal heart attack. It is unknown if an autopsy was performed. At the time of death, CHEST PAIN (Chest pain/Heart attack symptoms), DYSPNOEA (Shortness of breath), JOINT STIFFNESS (Pressure in his jaw), BACK PAIN (Stabbing pain in his back), HEADACHE (Headache) and FEELING ABNORMAL (Patient did not seem himself) outcome was unknown.            Treatment information was not provided.  This is a case of a 64 yo Male who died of a Myocardial Infarction 7 days after receiving the second dose. Very limited information regarding these events have been provided at this time. Patient's symptoms of jaw pain, pressure I his head and chest pain prior to vaccination may be a confounding factor to the events. No further information is expected.   This case was linked to MOD-2021-287620 (Patient Link).; Sender's Comments: This is a case of a 64 yo Male who died of a Myocardial Infarction 7 days after receiving the second dose. Very limited information regarding these events have been provided at this time. Patient's symptoms of jaw pain, pressure I his head and chest pain prior to vaccination may be a confounding factor to the events. No further information is expected.; Reported Cause(s) of Death: Fatal Heart attack"
	"1644357-1"	"1644357-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"Chest pain/Heart attack symptoms; Patient did not seem himself; Fatal heart attack; Shortness of breath; Pressure in his jaw; Stabbing pain in his back; Headache; This spontaneous case was reported by a patient family member or friend and describes the occurrence of MYOCARDIAL INFARCTION (Fatal heart attack), CHEST PAIN (Chest pain/Heart attack symptoms), DYSPNOEA (Shortness of breath), JOINT STIFFNESS (Pressure in his jaw), BACK PAIN (Stabbing pain in his back) and HEADACHE (Headache) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 026C21A and 001C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concomitant products included ASPIRIN [ACETYLSALICYLIC ACID], AMLODIPINE and LOSARTAN for an unknown indication.   On 24-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-May-2021, 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 CHEST PAIN (Chest pain/Heart attack symptoms) (seriousness criterion hospitalization). On 24-May-2021, the patient experienced DYSPNOEA (Shortness of breath) (seriousness criterion hospitalization), JOINT STIFFNESS (Pressure in his jaw) (seriousness criterion hospitalization), BACK PAIN (Stabbing pain in his back) (seriousness criterion hospitalization) and HEADACHE (Headache) (seriousness criterion hospitalization). On 29-May-2021, the patient experienced MYOCARDIAL INFARCTION (Fatal heart attack) (seriousness criteria death and medically significant). On an unknown date, the patient experienced FEELING ABNORMAL (Patient did not seem himself). The patient was hospitalized from 24-May-2021 to 26-May-2021 due to CHEST PAIN. The patient died on 29-May-2021. The reported cause of death was fatal heart attack. It is unknown if an autopsy was performed. At the time of death, CHEST PAIN (Chest pain/Heart attack symptoms), DYSPNOEA (Shortness of breath), JOINT STIFFNESS (Pressure in his jaw), BACK PAIN (Stabbing pain in his back), HEADACHE (Headache) and FEELING ABNORMAL (Patient did not seem himself) outcome was unknown.            Treatment information was not provided.  This is a case of a 64 yo Male who died of a Myocardial Infarction 7 days after receiving the second dose. Very limited information regarding these events have been provided at this time. Patient's symptoms of jaw pain, pressure I his head and chest pain prior to vaccination may be a confounding factor to the events. No further information is expected.   This case was linked to MOD-2021-287620 (Patient Link).; Sender's Comments: This is a case of a 64 yo Male who died of a Myocardial Infarction 7 days after receiving the second dose. Very limited information regarding these events have been provided at this time. Patient's symptoms of jaw pain, pressure I his head and chest pain prior to vaccination may be a confounding factor to the events. No further information is expected.; Reported Cause(s) of Death: Fatal Heart attack"
	"1644357-1"	"1644357-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Chest pain/Heart attack symptoms; Patient did not seem himself; Fatal heart attack; Shortness of breath; Pressure in his jaw; Stabbing pain in his back; Headache; This spontaneous case was reported by a patient family member or friend and describes the occurrence of MYOCARDIAL INFARCTION (Fatal heart attack), CHEST PAIN (Chest pain/Heart attack symptoms), DYSPNOEA (Shortness of breath), JOINT STIFFNESS (Pressure in his jaw), BACK PAIN (Stabbing pain in his back) and HEADACHE (Headache) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 026C21A and 001C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concomitant products included ASPIRIN [ACETYLSALICYLIC ACID], AMLODIPINE and LOSARTAN for an unknown indication.   On 24-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-May-2021, 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 CHEST PAIN (Chest pain/Heart attack symptoms) (seriousness criterion hospitalization). On 24-May-2021, the patient experienced DYSPNOEA (Shortness of breath) (seriousness criterion hospitalization), JOINT STIFFNESS (Pressure in his jaw) (seriousness criterion hospitalization), BACK PAIN (Stabbing pain in his back) (seriousness criterion hospitalization) and HEADACHE (Headache) (seriousness criterion hospitalization). On 29-May-2021, the patient experienced MYOCARDIAL INFARCTION (Fatal heart attack) (seriousness criteria death and medically significant). On an unknown date, the patient experienced FEELING ABNORMAL (Patient did not seem himself). The patient was hospitalized from 24-May-2021 to 26-May-2021 due to CHEST PAIN. The patient died on 29-May-2021. The reported cause of death was fatal heart attack. It is unknown if an autopsy was performed. At the time of death, CHEST PAIN (Chest pain/Heart attack symptoms), DYSPNOEA (Shortness of breath), JOINT STIFFNESS (Pressure in his jaw), BACK PAIN (Stabbing pain in his back), HEADACHE (Headache) and FEELING ABNORMAL (Patient did not seem himself) outcome was unknown.            Treatment information was not provided.  This is a case of a 64 yo Male who died of a Myocardial Infarction 7 days after receiving the second dose. Very limited information regarding these events have been provided at this time. Patient's symptoms of jaw pain, pressure I his head and chest pain prior to vaccination may be a confounding factor to the events. No further information is expected.   This case was linked to MOD-2021-287620 (Patient Link).; Sender's Comments: This is a case of a 64 yo Male who died of a Myocardial Infarction 7 days after receiving the second dose. Very limited information regarding these events have been provided at this time. Patient's symptoms of jaw pain, pressure I his head and chest pain prior to vaccination may be a confounding factor to the events. No further information is expected.; Reported Cause(s) of Death: Fatal Heart attack"
	"1644357-1"	"1644357-1"	"FEELING ABNORMAL"	"10016322"	"60-64 years"	"60-64"	"Chest pain/Heart attack symptoms; Patient did not seem himself; Fatal heart attack; Shortness of breath; Pressure in his jaw; Stabbing pain in his back; Headache; This spontaneous case was reported by a patient family member or friend and describes the occurrence of MYOCARDIAL INFARCTION (Fatal heart attack), CHEST PAIN (Chest pain/Heart attack symptoms), DYSPNOEA (Shortness of breath), JOINT STIFFNESS (Pressure in his jaw), BACK PAIN (Stabbing pain in his back) and HEADACHE (Headache) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 026C21A and 001C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concomitant products included ASPIRIN [ACETYLSALICYLIC ACID], AMLODIPINE and LOSARTAN for an unknown indication.   On 24-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-May-2021, 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 CHEST PAIN (Chest pain/Heart attack symptoms) (seriousness criterion hospitalization). On 24-May-2021, the patient experienced DYSPNOEA (Shortness of breath) (seriousness criterion hospitalization), JOINT STIFFNESS (Pressure in his jaw) (seriousness criterion hospitalization), BACK PAIN (Stabbing pain in his back) (seriousness criterion hospitalization) and HEADACHE (Headache) (seriousness criterion hospitalization). On 29-May-2021, the patient experienced MYOCARDIAL INFARCTION (Fatal heart attack) (seriousness criteria death and medically significant). On an unknown date, the patient experienced FEELING ABNORMAL (Patient did not seem himself). The patient was hospitalized from 24-May-2021 to 26-May-2021 due to CHEST PAIN. The patient died on 29-May-2021. The reported cause of death was fatal heart attack. It is unknown if an autopsy was performed. At the time of death, CHEST PAIN (Chest pain/Heart attack symptoms), DYSPNOEA (Shortness of breath), JOINT STIFFNESS (Pressure in his jaw), BACK PAIN (Stabbing pain in his back), HEADACHE (Headache) and FEELING ABNORMAL (Patient did not seem himself) outcome was unknown.            Treatment information was not provided.  This is a case of a 64 yo Male who died of a Myocardial Infarction 7 days after receiving the second dose. Very limited information regarding these events have been provided at this time. Patient's symptoms of jaw pain, pressure I his head and chest pain prior to vaccination may be a confounding factor to the events. No further information is expected.   This case was linked to MOD-2021-287620 (Patient Link).; Sender's Comments: This is a case of a 64 yo Male who died of a Myocardial Infarction 7 days after receiving the second dose. Very limited information regarding these events have been provided at this time. Patient's symptoms of jaw pain, pressure I his head and chest pain prior to vaccination may be a confounding factor to the events. No further information is expected.; Reported Cause(s) of Death: Fatal Heart attack"
	"1644357-1"	"1644357-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"Chest pain/Heart attack symptoms; Patient did not seem himself; Fatal heart attack; Shortness of breath; Pressure in his jaw; Stabbing pain in his back; Headache; This spontaneous case was reported by a patient family member or friend and describes the occurrence of MYOCARDIAL INFARCTION (Fatal heart attack), CHEST PAIN (Chest pain/Heart attack symptoms), DYSPNOEA (Shortness of breath), JOINT STIFFNESS (Pressure in his jaw), BACK PAIN (Stabbing pain in his back) and HEADACHE (Headache) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 026C21A and 001C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concomitant products included ASPIRIN [ACETYLSALICYLIC ACID], AMLODIPINE and LOSARTAN for an unknown indication.   On 24-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-May-2021, 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 CHEST PAIN (Chest pain/Heart attack symptoms) (seriousness criterion hospitalization). On 24-May-2021, the patient experienced DYSPNOEA (Shortness of breath) (seriousness criterion hospitalization), JOINT STIFFNESS (Pressure in his jaw) (seriousness criterion hospitalization), BACK PAIN (Stabbing pain in his back) (seriousness criterion hospitalization) and HEADACHE (Headache) (seriousness criterion hospitalization). On 29-May-2021, the patient experienced MYOCARDIAL INFARCTION (Fatal heart attack) (seriousness criteria death and medically significant). On an unknown date, the patient experienced FEELING ABNORMAL (Patient did not seem himself). The patient was hospitalized from 24-May-2021 to 26-May-2021 due to CHEST PAIN. The patient died on 29-May-2021. The reported cause of death was fatal heart attack. It is unknown if an autopsy was performed. At the time of death, CHEST PAIN (Chest pain/Heart attack symptoms), DYSPNOEA (Shortness of breath), JOINT STIFFNESS (Pressure in his jaw), BACK PAIN (Stabbing pain in his back), HEADACHE (Headache) and FEELING ABNORMAL (Patient did not seem himself) outcome was unknown.            Treatment information was not provided.  This is a case of a 64 yo Male who died of a Myocardial Infarction 7 days after receiving the second dose. Very limited information regarding these events have been provided at this time. Patient's symptoms of jaw pain, pressure I his head and chest pain prior to vaccination may be a confounding factor to the events. No further information is expected.   This case was linked to MOD-2021-287620 (Patient Link).; Sender's Comments: This is a case of a 64 yo Male who died of a Myocardial Infarction 7 days after receiving the second dose. Very limited information regarding these events have been provided at this time. Patient's symptoms of jaw pain, pressure I his head and chest pain prior to vaccination may be a confounding factor to the events. No further information is expected.; Reported Cause(s) of Death: Fatal Heart attack"
	"1644357-1"	"1644357-1"	"JOINT STIFFNESS"	"10023230"	"60-64 years"	"60-64"	"Chest pain/Heart attack symptoms; Patient did not seem himself; Fatal heart attack; Shortness of breath; Pressure in his jaw; Stabbing pain in his back; Headache; This spontaneous case was reported by a patient family member or friend and describes the occurrence of MYOCARDIAL INFARCTION (Fatal heart attack), CHEST PAIN (Chest pain/Heart attack symptoms), DYSPNOEA (Shortness of breath), JOINT STIFFNESS (Pressure in his jaw), BACK PAIN (Stabbing pain in his back) and HEADACHE (Headache) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 026C21A and 001C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concomitant products included ASPIRIN [ACETYLSALICYLIC ACID], AMLODIPINE and LOSARTAN for an unknown indication.   On 24-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-May-2021, 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 CHEST PAIN (Chest pain/Heart attack symptoms) (seriousness criterion hospitalization). On 24-May-2021, the patient experienced DYSPNOEA (Shortness of breath) (seriousness criterion hospitalization), JOINT STIFFNESS (Pressure in his jaw) (seriousness criterion hospitalization), BACK PAIN (Stabbing pain in his back) (seriousness criterion hospitalization) and HEADACHE (Headache) (seriousness criterion hospitalization). On 29-May-2021, the patient experienced MYOCARDIAL INFARCTION (Fatal heart attack) (seriousness criteria death and medically significant). On an unknown date, the patient experienced FEELING ABNORMAL (Patient did not seem himself). The patient was hospitalized from 24-May-2021 to 26-May-2021 due to CHEST PAIN. The patient died on 29-May-2021. The reported cause of death was fatal heart attack. It is unknown if an autopsy was performed. At the time of death, CHEST PAIN (Chest pain/Heart attack symptoms), DYSPNOEA (Shortness of breath), JOINT STIFFNESS (Pressure in his jaw), BACK PAIN (Stabbing pain in his back), HEADACHE (Headache) and FEELING ABNORMAL (Patient did not seem himself) outcome was unknown.            Treatment information was not provided.  This is a case of a 64 yo Male who died of a Myocardial Infarction 7 days after receiving the second dose. Very limited information regarding these events have been provided at this time. Patient's symptoms of jaw pain, pressure I his head and chest pain prior to vaccination may be a confounding factor to the events. No further information is expected.   This case was linked to MOD-2021-287620 (Patient Link).; Sender's Comments: This is a case of a 64 yo Male who died of a Myocardial Infarction 7 days after receiving the second dose. Very limited information regarding these events have been provided at this time. Patient's symptoms of jaw pain, pressure I his head and chest pain prior to vaccination may be a confounding factor to the events. No further information is expected.; Reported Cause(s) of Death: Fatal Heart attack"
	"1644357-1"	"1644357-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"Chest pain/Heart attack symptoms; Patient did not seem himself; Fatal heart attack; Shortness of breath; Pressure in his jaw; Stabbing pain in his back; Headache; This spontaneous case was reported by a patient family member or friend and describes the occurrence of MYOCARDIAL INFARCTION (Fatal heart attack), CHEST PAIN (Chest pain/Heart attack symptoms), DYSPNOEA (Shortness of breath), JOINT STIFFNESS (Pressure in his jaw), BACK PAIN (Stabbing pain in his back) and HEADACHE (Headache) in a 64-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 026C21A and 001C21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concomitant products included ASPIRIN [ACETYLSALICYLIC ACID], AMLODIPINE and LOSARTAN for an unknown indication.   On 24-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 22-May-2021, 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 CHEST PAIN (Chest pain/Heart attack symptoms) (seriousness criterion hospitalization). On 24-May-2021, the patient experienced DYSPNOEA (Shortness of breath) (seriousness criterion hospitalization), JOINT STIFFNESS (Pressure in his jaw) (seriousness criterion hospitalization), BACK PAIN (Stabbing pain in his back) (seriousness criterion hospitalization) and HEADACHE (Headache) (seriousness criterion hospitalization). On 29-May-2021, the patient experienced MYOCARDIAL INFARCTION (Fatal heart attack) (seriousness criteria death and medically significant). On an unknown date, the patient experienced FEELING ABNORMAL (Patient did not seem himself). The patient was hospitalized from 24-May-2021 to 26-May-2021 due to CHEST PAIN. The patient died on 29-May-2021. The reported cause of death was fatal heart attack. It is unknown if an autopsy was performed. At the time of death, CHEST PAIN (Chest pain/Heart attack symptoms), DYSPNOEA (Shortness of breath), JOINT STIFFNESS (Pressure in his jaw), BACK PAIN (Stabbing pain in his back), HEADACHE (Headache) and FEELING ABNORMAL (Patient did not seem himself) outcome was unknown.            Treatment information was not provided.  This is a case of a 64 yo Male who died of a Myocardial Infarction 7 days after receiving the second dose. Very limited information regarding these events have been provided at this time. Patient's symptoms of jaw pain, pressure I his head and chest pain prior to vaccination may be a confounding factor to the events. No further information is expected.   This case was linked to MOD-2021-287620 (Patient Link).; Sender's Comments: This is a case of a 64 yo Male who died of a Myocardial Infarction 7 days after receiving the second dose. Very limited information regarding these events have been provided at this time. Patient's symptoms of jaw pain, pressure I his head and chest pain prior to vaccination may be a confounding factor to the events. No further information is expected.; Reported Cause(s) of Death: Fatal Heart attack"
	"1646411-1"	"1646411-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"he passed away within 48 hours; This is a spontaneous report from a contactable consumer. A 64-year-old male patient received bnt162b2 (Pfizer-Biontech Covid-19 vaccine), dose 1 via an unspecified route of administration, administered in Arm Right on 09Feb2021 15:30 (Batch/Lot Number: em9809) as dose 1, single for covid-19 immunisation. The patient has no medical history. Concomitant medication included atorvastatin calcium (LIPITOR) taken for an unspecified indication, start and stop date were not reported. The patient did not receive any other vaccines within 4 weeks prior to the COVID vaccine. On 11Feb2021, 12:00, the patient passed away within 48 hours. The patient received defibrillation as treatment for the event. Prior to vaccination, the patient was not diagnosed with COVID-19 and since the vaccination, the patient has not been tested for COVID-19. The patient died on 11Feb2021 due to cardiac disorder. An autopsy was not performed.; Reported Cause(s) of Death: Cardiac"
	"1654025-1"	"1654025-1"	"ABNORMAL BEHAVIOUR"	"10061422"	"60-64 years"	"60-64"	"Injection was given with no immediate outward sign of an adverse affect.  I, as her sister, noticed an affect when I tried to talk to her on the phone calling from California.  She hardly talked which was unusual since we talked or texted everyday.  She said she did not feel like texting.  From that Sunday (1/10/21) through Thursday (1/14/21), she only texted one time.  On Thursday, she said it hurt to text, that her mind could not figure out how to text.  From that time on, she had many, many times when she could or would not text.  She could not figure out how to operate her phone.  She got more and more UTI infections and was hospitalized in acute facilities from then on, numerous times.  She even said people were trying to kill her.  She went downhill cognitively as well as physically until she passed on 8/07/21."
	"1654025-1"	"1654025-1"	"COGNITIVE DISORDER"	"10057668"	"60-64 years"	"60-64"	"Injection was given with no immediate outward sign of an adverse affect.  I, as her sister, noticed an affect when I tried to talk to her on the phone calling from California.  She hardly talked which was unusual since we talked or texted everyday.  She said she did not feel like texting.  From that Sunday (1/10/21) through Thursday (1/14/21), she only texted one time.  On Thursday, she said it hurt to text, that her mind could not figure out how to text.  From that time on, she had many, many times when she could or would not text.  She could not figure out how to operate her phone.  She got more and more UTI infections and was hospitalized in acute facilities from then on, numerous times.  She even said people were trying to kill her.  She went downhill cognitively as well as physically until she passed on 8/07/21."
	"1654025-1"	"1654025-1"	"CONFUSIONAL STATE"	"10010305"	"60-64 years"	"60-64"	"Injection was given with no immediate outward sign of an adverse affect.  I, as her sister, noticed an affect when I tried to talk to her on the phone calling from California.  She hardly talked which was unusual since we talked or texted everyday.  She said she did not feel like texting.  From that Sunday (1/10/21) through Thursday (1/14/21), she only texted one time.  On Thursday, she said it hurt to text, that her mind could not figure out how to text.  From that time on, she had many, many times when she could or would not text.  She could not figure out how to operate her phone.  She got more and more UTI infections and was hospitalized in acute facilities from then on, numerous times.  She even said people were trying to kill her.  She went downhill cognitively as well as physically until she passed on 8/07/21."
	"1654025-1"	"1654025-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Injection was given with no immediate outward sign of an adverse affect.  I, as her sister, noticed an affect when I tried to talk to her on the phone calling from California.  She hardly talked which was unusual since we talked or texted everyday.  She said she did not feel like texting.  From that Sunday (1/10/21) through Thursday (1/14/21), she only texted one time.  On Thursday, she said it hurt to text, that her mind could not figure out how to text.  From that time on, she had many, many times when she could or would not text.  She could not figure out how to operate her phone.  She got more and more UTI infections and was hospitalized in acute facilities from then on, numerous times.  She even said people were trying to kill her.  She went downhill cognitively as well as physically until she passed on 8/07/21."
	"1654025-1"	"1654025-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"60-64 years"	"60-64"	"Injection was given with no immediate outward sign of an adverse affect.  I, as her sister, noticed an affect when I tried to talk to her on the phone calling from California.  She hardly talked which was unusual since we talked or texted everyday.  She said she did not feel like texting.  From that Sunday (1/10/21) through Thursday (1/14/21), she only texted one time.  On Thursday, she said it hurt to text, that her mind could not figure out how to text.  From that time on, she had many, many times when she could or would not text.  She could not figure out how to operate her phone.  She got more and more UTI infections and was hospitalized in acute facilities from then on, numerous times.  She even said people were trying to kill her.  She went downhill cognitively as well as physically until she passed on 8/07/21."
	"1654025-1"	"1654025-1"	"HALLUCINATION"	"10019063"	"60-64 years"	"60-64"	"Injection was given with no immediate outward sign of an adverse affect.  I, as her sister, noticed an affect when I tried to talk to her on the phone calling from California.  She hardly talked which was unusual since we talked or texted everyday.  She said she did not feel like texting.  From that Sunday (1/10/21) through Thursday (1/14/21), she only texted one time.  On Thursday, she said it hurt to text, that her mind could not figure out how to text.  From that time on, she had many, many times when she could or would not text.  She could not figure out how to operate her phone.  She got more and more UTI infections and was hospitalized in acute facilities from then on, numerous times.  She even said people were trying to kill her.  She went downhill cognitively as well as physically until she passed on 8/07/21."
	"1654025-1"	"1654025-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"Injection was given with no immediate outward sign of an adverse affect.  I, as her sister, noticed an affect when I tried to talk to her on the phone calling from California.  She hardly talked which was unusual since we talked or texted everyday.  She said she did not feel like texting.  From that Sunday (1/10/21) through Thursday (1/14/21), she only texted one time.  On Thursday, she said it hurt to text, that her mind could not figure out how to text.  From that time on, she had many, many times when she could or would not text.  She could not figure out how to operate her phone.  She got more and more UTI infections and was hospitalized in acute facilities from then on, numerous times.  She even said people were trying to kill her.  She went downhill cognitively as well as physically until she passed on 8/07/21."
	"1654025-1"	"1654025-1"	"URINARY TRACT INFECTION"	"10046571"	"60-64 years"	"60-64"	"Injection was given with no immediate outward sign of an adverse affect.  I, as her sister, noticed an affect when I tried to talk to her on the phone calling from California.  She hardly talked which was unusual since we talked or texted everyday.  She said she did not feel like texting.  From that Sunday (1/10/21) through Thursday (1/14/21), she only texted one time.  On Thursday, she said it hurt to text, that her mind could not figure out how to text.  From that time on, she had many, many times when she could or would not text.  She could not figure out how to operate her phone.  She got more and more UTI infections and was hospitalized in acute facilities from then on, numerous times.  She even said people were trying to kill her.  She went downhill cognitively as well as physically until she passed on 8/07/21."
	"1655103-1"	"1655103-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Died; Felt bad all day Saturday and Sunday/wasn't feeling good; This is a spontaneous report from a contactable consumer or other non hcp. A 63-years-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot number and expiry date was not reported), via an unspecified route of administration on 09Apr2021(at the age of 63- year-old) as dose 2, single for covid-19 immunization. Medical history included Smoker user from an unknown date and unknown if ongoing. The patient's concomitant medications were not reported. History of all previous immunization with the Pfizer vaccine considered as suspect and Additional Vaccines Administered on Same Date of the Pfizer Suspect was reported as none. The patient did not receive any other vaccines within four weeks prior to the vaccination. AE(s) following prior vaccinations were none. Family Medical History Relevant to AE(s) and Relevant Tests were reported as none. Patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot number and expiry date was not reported), via an unspecified route of administration on 11Mar2021 as dose 1, single for covid-19 immunization. Reporter stated his wife received the first dose on 10Mar and the second on 09Apr2021, which was a Friday evening. He stated she felt bad all-day Saturday(10Apr2021) and Sunday, and she was going to go to the doctor on Monday. The patient went to sleep that night and the last time she spoke to anyone was 11:00 or 11:30 that evening, 11Apr2021. Then no one could get a hold of the patient and was found dead on 12Apr2021. The reporter believed that the patient died that night of 11Apr2021. The patient did not visit to emergency room or physician office. The patient died on 12Apr2021. An autopsy was not performed.   No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Reported Cause(s) of Death: Died"
	"1655103-1"	"1655103-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"Died; Felt bad all day Saturday and Sunday/wasn't feeling good; This is a spontaneous report from a contactable consumer or other non hcp. A 63-years-old female patient received second dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot number and expiry date was not reported), via an unspecified route of administration on 09Apr2021(at the age of 63- year-old) as dose 2, single for covid-19 immunization. Medical history included Smoker user from an unknown date and unknown if ongoing. The patient's concomitant medications were not reported. History of all previous immunization with the Pfizer vaccine considered as suspect and Additional Vaccines Administered on Same Date of the Pfizer Suspect was reported as none. The patient did not receive any other vaccines within four weeks prior to the vaccination. AE(s) following prior vaccinations were none. Family Medical History Relevant to AE(s) and Relevant Tests were reported as none. Patient previously received first dose of bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE, formulation: Solution for injection, Lot number and expiry date was not reported), via an unspecified route of administration on 11Mar2021 as dose 1, single for covid-19 immunization. Reporter stated his wife received the first dose on 10Mar and the second on 09Apr2021, which was a Friday evening. He stated she felt bad all-day Saturday(10Apr2021) and Sunday, and she was going to go to the doctor on Monday. The patient went to sleep that night and the last time she spoke to anyone was 11:00 or 11:30 that evening, 11Apr2021. Then no one could get a hold of the patient and was found dead on 12Apr2021. The reporter believed that the patient died that night of 11Apr2021. The patient did not visit to emergency room or physician office. The patient died on 12Apr2021. An autopsy was not performed.   No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Reported Cause(s) of Death: Died"
	"1655833-1"	"1655833-1"	"ACUTE CARDIAC EVENT"	"10081099"	"60-64 years"	"60-64"	"8/15/21: Patient arrived at the ER due to sudden collapse. EMS was called at 1349 and on arrival the patient was in asystole and apneic.  Patient underwent emergent right frontal ventriculostomy.  COVID-19 PCR came back positive on 8/15/21. Serum creatinine on admission was 1.39 which has gotten worse at 2.67.  Patient intubated/mechanically ventilated, sedated; on 3 vasopressors. Stage 5 [Hunt and Hess] SAH associated with diffuse brain edema/herniation. 8/17/21: patient expired.  Note: Spouse did not report symptoms of COVID-19 prior to cardiac  event. Unknown if COVID-19 was symptomatic or asymptomatic due to patients unresponsive at admission.  Please note: Spouse reports 2 doses of Pfizer vaccine in March 2021. Patient received first dose Pfizer vaccine on 3/31/2021 Lot # EN6198 and the second dose on 4/21/2021 Lot # ER8732"
	"1655833-1"	"1655833-1"	"APNOEIC ATTACK"	"10002977"	"60-64 years"	"60-64"	"8/15/21: Patient arrived at the ER due to sudden collapse. EMS was called at 1349 and on arrival the patient was in asystole and apneic.  Patient underwent emergent right frontal ventriculostomy.  COVID-19 PCR came back positive on 8/15/21. Serum creatinine on admission was 1.39 which has gotten worse at 2.67.  Patient intubated/mechanically ventilated, sedated; on 3 vasopressors. Stage 5 [Hunt and Hess] SAH associated with diffuse brain edema/herniation. 8/17/21: patient expired.  Note: Spouse did not report symptoms of COVID-19 prior to cardiac  event. Unknown if COVID-19 was symptomatic or asymptomatic due to patients unresponsive at admission.  Please note: Spouse reports 2 doses of Pfizer vaccine in March 2021. Patient received first dose Pfizer vaccine on 3/31/2021 Lot # EN6198 and the second dose on 4/21/2021 Lot # ER8732"
	"1655833-1"	"1655833-1"	"BLOOD CREATINE INCREASED"	"10005464"	"60-64 years"	"60-64"	"8/15/21: Patient arrived at the ER due to sudden collapse. EMS was called at 1349 and on arrival the patient was in asystole and apneic.  Patient underwent emergent right frontal ventriculostomy.  COVID-19 PCR came back positive on 8/15/21. Serum creatinine on admission was 1.39 which has gotten worse at 2.67.  Patient intubated/mechanically ventilated, sedated; on 3 vasopressors. Stage 5 [Hunt and Hess] SAH associated with diffuse brain edema/herniation. 8/17/21: patient expired.  Note: Spouse did not report symptoms of COVID-19 prior to cardiac  event. Unknown if COVID-19 was symptomatic or asymptomatic due to patients unresponsive at admission.  Please note: Spouse reports 2 doses of Pfizer vaccine in March 2021. Patient received first dose Pfizer vaccine on 3/31/2021 Lot # EN6198 and the second dose on 4/21/2021 Lot # ER8732"
	"1655833-1"	"1655833-1"	"BRAIN HERNIATION"	"10006126"	"60-64 years"	"60-64"	"8/15/21: Patient arrived at the ER due to sudden collapse. EMS was called at 1349 and on arrival the patient was in asystole and apneic.  Patient underwent emergent right frontal ventriculostomy.  COVID-19 PCR came back positive on 8/15/21. Serum creatinine on admission was 1.39 which has gotten worse at 2.67.  Patient intubated/mechanically ventilated, sedated; on 3 vasopressors. Stage 5 [Hunt and Hess] SAH associated with diffuse brain edema/herniation. 8/17/21: patient expired.  Note: Spouse did not report symptoms of COVID-19 prior to cardiac  event. Unknown if COVID-19 was symptomatic or asymptomatic due to patients unresponsive at admission.  Please note: Spouse reports 2 doses of Pfizer vaccine in March 2021. Patient received first dose Pfizer vaccine on 3/31/2021 Lot # EN6198 and the second dose on 4/21/2021 Lot # ER8732"
	"1655833-1"	"1655833-1"	"BRAIN OEDEMA"	"10048962"	"60-64 years"	"60-64"	"8/15/21: Patient arrived at the ER due to sudden collapse. EMS was called at 1349 and on arrival the patient was in asystole and apneic.  Patient underwent emergent right frontal ventriculostomy.  COVID-19 PCR came back positive on 8/15/21. Serum creatinine on admission was 1.39 which has gotten worse at 2.67.  Patient intubated/mechanically ventilated, sedated; on 3 vasopressors. Stage 5 [Hunt and Hess] SAH associated with diffuse brain edema/herniation. 8/17/21: patient expired.  Note: Spouse did not report symptoms of COVID-19 prior to cardiac  event. Unknown if COVID-19 was symptomatic or asymptomatic due to patients unresponsive at admission.  Please note: Spouse reports 2 doses of Pfizer vaccine in March 2021. Patient received first dose Pfizer vaccine on 3/31/2021 Lot # EN6198 and the second dose on 4/21/2021 Lot # ER8732"
	"1655833-1"	"1655833-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"8/15/21: Patient arrived at the ER due to sudden collapse. EMS was called at 1349 and on arrival the patient was in asystole and apneic.  Patient underwent emergent right frontal ventriculostomy.  COVID-19 PCR came back positive on 8/15/21. Serum creatinine on admission was 1.39 which has gotten worse at 2.67.  Patient intubated/mechanically ventilated, sedated; on 3 vasopressors. Stage 5 [Hunt and Hess] SAH associated with diffuse brain edema/herniation. 8/17/21: patient expired.  Note: Spouse did not report symptoms of COVID-19 prior to cardiac  event. Unknown if COVID-19 was symptomatic or asymptomatic due to patients unresponsive at admission.  Please note: Spouse reports 2 doses of Pfizer vaccine in March 2021. Patient received first dose Pfizer vaccine on 3/31/2021 Lot # EN6198 and the second dose on 4/21/2021 Lot # ER8732"
	"1655833-1"	"1655833-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"8/15/21: Patient arrived at the ER due to sudden collapse. EMS was called at 1349 and on arrival the patient was in asystole and apneic.  Patient underwent emergent right frontal ventriculostomy.  COVID-19 PCR came back positive on 8/15/21. Serum creatinine on admission was 1.39 which has gotten worse at 2.67.  Patient intubated/mechanically ventilated, sedated; on 3 vasopressors. Stage 5 [Hunt and Hess] SAH associated with diffuse brain edema/herniation. 8/17/21: patient expired.  Note: Spouse did not report symptoms of COVID-19 prior to cardiac  event. Unknown if COVID-19 was symptomatic or asymptomatic due to patients unresponsive at admission.  Please note: Spouse reports 2 doses of Pfizer vaccine in March 2021. Patient received first dose Pfizer vaccine on 3/31/2021 Lot # EN6198 and the second dose on 4/21/2021 Lot # ER8732"
	"1655833-1"	"1655833-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"8/15/21: Patient arrived at the ER due to sudden collapse. EMS was called at 1349 and on arrival the patient was in asystole and apneic.  Patient underwent emergent right frontal ventriculostomy.  COVID-19 PCR came back positive on 8/15/21. Serum creatinine on admission was 1.39 which has gotten worse at 2.67.  Patient intubated/mechanically ventilated, sedated; on 3 vasopressors. Stage 5 [Hunt and Hess] SAH associated with diffuse brain edema/herniation. 8/17/21: patient expired.  Note: Spouse did not report symptoms of COVID-19 prior to cardiac  event. Unknown if COVID-19 was symptomatic or asymptomatic due to patients unresponsive at admission.  Please note: Spouse reports 2 doses of Pfizer vaccine in March 2021. Patient received first dose Pfizer vaccine on 3/31/2021 Lot # EN6198 and the second dose on 4/21/2021 Lot # ER8732"
	"1655833-1"	"1655833-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"8/15/21: Patient arrived at the ER due to sudden collapse. EMS was called at 1349 and on arrival the patient was in asystole and apneic.  Patient underwent emergent right frontal ventriculostomy.  COVID-19 PCR came back positive on 8/15/21. Serum creatinine on admission was 1.39 which has gotten worse at 2.67.  Patient intubated/mechanically ventilated, sedated; on 3 vasopressors. Stage 5 [Hunt and Hess] SAH associated with diffuse brain edema/herniation. 8/17/21: patient expired.  Note: Spouse did not report symptoms of COVID-19 prior to cardiac  event. Unknown if COVID-19 was symptomatic or asymptomatic due to patients unresponsive at admission.  Please note: Spouse reports 2 doses of Pfizer vaccine in March 2021. Patient received first dose Pfizer vaccine on 3/31/2021 Lot # EN6198 and the second dose on 4/21/2021 Lot # ER8732"
	"1655833-1"	"1655833-1"	"HUNT AND HESS SCALE"	"10083810"	"60-64 years"	"60-64"	"8/15/21: Patient arrived at the ER due to sudden collapse. EMS was called at 1349 and on arrival the patient was in asystole and apneic.  Patient underwent emergent right frontal ventriculostomy.  COVID-19 PCR came back positive on 8/15/21. Serum creatinine on admission was 1.39 which has gotten worse at 2.67.  Patient intubated/mechanically ventilated, sedated; on 3 vasopressors. Stage 5 [Hunt and Hess] SAH associated with diffuse brain edema/herniation. 8/17/21: patient expired.  Note: Spouse did not report symptoms of COVID-19 prior to cardiac  event. Unknown if COVID-19 was symptomatic or asymptomatic due to patients unresponsive at admission.  Please note: Spouse reports 2 doses of Pfizer vaccine in March 2021. Patient received first dose Pfizer vaccine on 3/31/2021 Lot # EN6198 and the second dose on 4/21/2021 Lot # ER8732"
	"1655833-1"	"1655833-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"8/15/21: Patient arrived at the ER due to sudden collapse. EMS was called at 1349 and on arrival the patient was in asystole and apneic.  Patient underwent emergent right frontal ventriculostomy.  COVID-19 PCR came back positive on 8/15/21. Serum creatinine on admission was 1.39 which has gotten worse at 2.67.  Patient intubated/mechanically ventilated, sedated; on 3 vasopressors. Stage 5 [Hunt and Hess] SAH associated with diffuse brain edema/herniation. 8/17/21: patient expired.  Note: Spouse did not report symptoms of COVID-19 prior to cardiac  event. Unknown if COVID-19 was symptomatic or asymptomatic due to patients unresponsive at admission.  Please note: Spouse reports 2 doses of Pfizer vaccine in March 2021. Patient received first dose Pfizer vaccine on 3/31/2021 Lot # EN6198 and the second dose on 4/21/2021 Lot # ER8732"
	"1655833-1"	"1655833-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"8/15/21: Patient arrived at the ER due to sudden collapse. EMS was called at 1349 and on arrival the patient was in asystole and apneic.  Patient underwent emergent right frontal ventriculostomy.  COVID-19 PCR came back positive on 8/15/21. Serum creatinine on admission was 1.39 which has gotten worse at 2.67.  Patient intubated/mechanically ventilated, sedated; on 3 vasopressors. Stage 5 [Hunt and Hess] SAH associated with diffuse brain edema/herniation. 8/17/21: patient expired.  Note: Spouse did not report symptoms of COVID-19 prior to cardiac  event. Unknown if COVID-19 was symptomatic or asymptomatic due to patients unresponsive at admission.  Please note: Spouse reports 2 doses of Pfizer vaccine in March 2021. Patient received first dose Pfizer vaccine on 3/31/2021 Lot # EN6198 and the second dose on 4/21/2021 Lot # ER8732"
	"1655833-1"	"1655833-1"	"SUBARACHNOID HAEMORRHAGE"	"10042316"	"60-64 years"	"60-64"	"8/15/21: Patient arrived at the ER due to sudden collapse. EMS was called at 1349 and on arrival the patient was in asystole and apneic.  Patient underwent emergent right frontal ventriculostomy.  COVID-19 PCR came back positive on 8/15/21. Serum creatinine on admission was 1.39 which has gotten worse at 2.67.  Patient intubated/mechanically ventilated, sedated; on 3 vasopressors. Stage 5 [Hunt and Hess] SAH associated with diffuse brain edema/herniation. 8/17/21: patient expired.  Note: Spouse did not report symptoms of COVID-19 prior to cardiac  event. Unknown if COVID-19 was symptomatic or asymptomatic due to patients unresponsive at admission.  Please note: Spouse reports 2 doses of Pfizer vaccine in March 2021. Patient received first dose Pfizer vaccine on 3/31/2021 Lot # EN6198 and the second dose on 4/21/2021 Lot # ER8732"
	"1655833-1"	"1655833-1"	"SYNCOPE"	"10042772"	"60-64 years"	"60-64"	"8/15/21: Patient arrived at the ER due to sudden collapse. EMS was called at 1349 and on arrival the patient was in asystole and apneic.  Patient underwent emergent right frontal ventriculostomy.  COVID-19 PCR came back positive on 8/15/21. Serum creatinine on admission was 1.39 which has gotten worse at 2.67.  Patient intubated/mechanically ventilated, sedated; on 3 vasopressors. Stage 5 [Hunt and Hess] SAH associated with diffuse brain edema/herniation. 8/17/21: patient expired.  Note: Spouse did not report symptoms of COVID-19 prior to cardiac  event. Unknown if COVID-19 was symptomatic or asymptomatic due to patients unresponsive at admission.  Please note: Spouse reports 2 doses of Pfizer vaccine in March 2021. Patient received first dose Pfizer vaccine on 3/31/2021 Lot # EN6198 and the second dose on 4/21/2021 Lot # ER8732"
	"1655833-1"	"1655833-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"8/15/21: Patient arrived at the ER due to sudden collapse. EMS was called at 1349 and on arrival the patient was in asystole and apneic.  Patient underwent emergent right frontal ventriculostomy.  COVID-19 PCR came back positive on 8/15/21. Serum creatinine on admission was 1.39 which has gotten worse at 2.67.  Patient intubated/mechanically ventilated, sedated; on 3 vasopressors. Stage 5 [Hunt and Hess] SAH associated with diffuse brain edema/herniation. 8/17/21: patient expired.  Note: Spouse did not report symptoms of COVID-19 prior to cardiac  event. Unknown if COVID-19 was symptomatic or asymptomatic due to patients unresponsive at admission.  Please note: Spouse reports 2 doses of Pfizer vaccine in March 2021. Patient received first dose Pfizer vaccine on 3/31/2021 Lot # EN6198 and the second dose on 4/21/2021 Lot # ER8732"
	"1655833-1"	"1655833-1"	"VENTRICULAR CISTERNOSTOMY"	"10047286"	"60-64 years"	"60-64"	"8/15/21: Patient arrived at the ER due to sudden collapse. EMS was called at 1349 and on arrival the patient was in asystole and apneic.  Patient underwent emergent right frontal ventriculostomy.  COVID-19 PCR came back positive on 8/15/21. Serum creatinine on admission was 1.39 which has gotten worse at 2.67.  Patient intubated/mechanically ventilated, sedated; on 3 vasopressors. Stage 5 [Hunt and Hess] SAH associated with diffuse brain edema/herniation. 8/17/21: patient expired.  Note: Spouse did not report symptoms of COVID-19 prior to cardiac  event. Unknown if COVID-19 was symptomatic or asymptomatic due to patients unresponsive at admission.  Please note: Spouse reports 2 doses of Pfizer vaccine in March 2021. Patient received first dose Pfizer vaccine on 3/31/2021 Lot # EN6198 and the second dose on 4/21/2021 Lot # ER8732"
	"1658487-1"	"1658487-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"I am the epidemiologist reporting on behalf of 60 year old male patient. The patient received two doses of the Moderna vaccine on 5/17 and 6/14. On 8/9/21, the patient tested positive via a PCR test for COVID-19 (vaccine breakthrough). The patient died on 8/26 and the cause of death is listed as ?Cardiac arrest, myocardial infarction, gangrene LLE, Covid pneumonia.? Pre-existing conditions are listed as DIABETES MELLITUS, CARDIOVASCULAR DISEASE."
	"1658487-1"	"1658487-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"I am the epidemiologist reporting on behalf of 60 year old male patient. The patient received two doses of the Moderna vaccine on 5/17 and 6/14. On 8/9/21, the patient tested positive via a PCR test for COVID-19 (vaccine breakthrough). The patient died on 8/26 and the cause of death is listed as ?Cardiac arrest, myocardial infarction, gangrene LLE, Covid pneumonia.? Pre-existing conditions are listed as DIABETES MELLITUS, CARDIOVASCULAR DISEASE."
	"1658487-1"	"1658487-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"I am the epidemiologist reporting on behalf of 60 year old male patient. The patient received two doses of the Moderna vaccine on 5/17 and 6/14. On 8/9/21, the patient tested positive via a PCR test for COVID-19 (vaccine breakthrough). The patient died on 8/26 and the cause of death is listed as ?Cardiac arrest, myocardial infarction, gangrene LLE, Covid pneumonia.? Pre-existing conditions are listed as DIABETES MELLITUS, CARDIOVASCULAR DISEASE."
	"1658487-1"	"1658487-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"I am the epidemiologist reporting on behalf of 60 year old male patient. The patient received two doses of the Moderna vaccine on 5/17 and 6/14. On 8/9/21, the patient tested positive via a PCR test for COVID-19 (vaccine breakthrough). The patient died on 8/26 and the cause of death is listed as ?Cardiac arrest, myocardial infarction, gangrene LLE, Covid pneumonia.? Pre-existing conditions are listed as DIABETES MELLITUS, CARDIOVASCULAR DISEASE."
	"1658487-1"	"1658487-1"	"GANGRENE"	"10017711"	"60-64 years"	"60-64"	"I am the epidemiologist reporting on behalf of 60 year old male patient. The patient received two doses of the Moderna vaccine on 5/17 and 6/14. On 8/9/21, the patient tested positive via a PCR test for COVID-19 (vaccine breakthrough). The patient died on 8/26 and the cause of death is listed as ?Cardiac arrest, myocardial infarction, gangrene LLE, Covid pneumonia.? Pre-existing conditions are listed as DIABETES MELLITUS, CARDIOVASCULAR DISEASE."
	"1658487-1"	"1658487-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"I am the epidemiologist reporting on behalf of 60 year old male patient. The patient received two doses of the Moderna vaccine on 5/17 and 6/14. On 8/9/21, the patient tested positive via a PCR test for COVID-19 (vaccine breakthrough). The patient died on 8/26 and the cause of death is listed as ?Cardiac arrest, myocardial infarction, gangrene LLE, Covid pneumonia.? Pre-existing conditions are listed as DIABETES MELLITUS, CARDIOVASCULAR DISEASE."
	"1658487-1"	"1658487-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"I am the epidemiologist reporting on behalf of 60 year old male patient. The patient received two doses of the Moderna vaccine on 5/17 and 6/14. On 8/9/21, the patient tested positive via a PCR test for COVID-19 (vaccine breakthrough). The patient died on 8/26 and the cause of death is listed as ?Cardiac arrest, myocardial infarction, gangrene LLE, Covid pneumonia.? Pre-existing conditions are listed as DIABETES MELLITUS, CARDIOVASCULAR DISEASE."
	"1658487-1"	"1658487-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"60-64 years"	"60-64"	"I am the epidemiologist reporting on behalf of 60 year old male patient. The patient received two doses of the Moderna vaccine on 5/17 and 6/14. On 8/9/21, the patient tested positive via a PCR test for COVID-19 (vaccine breakthrough). The patient died on 8/26 and the cause of death is listed as ?Cardiac arrest, myocardial infarction, gangrene LLE, Covid pneumonia.? Pre-existing conditions are listed as DIABETES MELLITUS, CARDIOVASCULAR DISEASE."
	"1658828-1"	"1658828-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Hospitalization with COVID-19 Reported per vaccine EUA"
	"1658911-1"	"1658911-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient passed away on 07/25/2021."
	"1659134-1"	"1659134-1"	"CLOSTRIDIUM TEST POSITIVE"	"10070027"	"60-64 years"	"60-64"	"Janssen (J&J) COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 04/01/2021. Patient presented to ED with complaints of shortness of breath x 3 days. On arrival he was placed on high flow nasal cannula. Patient was mechanically ventilated on 8/5/2021 due to worsening hypoxia. Patient received dexamethasone & remdesivir. Patient was transferred to hospital on 8/5/2021. Patient received methylprednisolone, cefepime, meropenem, metronidazole, & vancomycin IV and PO. Hospital course progressed without meaningful recovery of lung function.  On 8/24/2021, family decided to move to comfort care. Patient expired on 8/24/2021."
	"1659134-1"	"1659134-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Janssen (J&J) COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 04/01/2021. Patient presented to ED with complaints of shortness of breath x 3 days. On arrival he was placed on high flow nasal cannula. Patient was mechanically ventilated on 8/5/2021 due to worsening hypoxia. Patient received dexamethasone & remdesivir. Patient was transferred to hospital on 8/5/2021. Patient received methylprednisolone, cefepime, meropenem, metronidazole, & vancomycin IV and PO. Hospital course progressed without meaningful recovery of lung function.  On 8/24/2021, family decided to move to comfort care. Patient expired on 8/24/2021."
	"1659134-1"	"1659134-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Janssen (J&J) COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 04/01/2021. Patient presented to ED with complaints of shortness of breath x 3 days. On arrival he was placed on high flow nasal cannula. Patient was mechanically ventilated on 8/5/2021 due to worsening hypoxia. Patient received dexamethasone & remdesivir. Patient was transferred to hospital on 8/5/2021. Patient received methylprednisolone, cefepime, meropenem, metronidazole, & vancomycin IV and PO. Hospital course progressed without meaningful recovery of lung function.  On 8/24/2021, family decided to move to comfort care. Patient expired on 8/24/2021."
	"1659134-1"	"1659134-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Janssen (J&J) COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 04/01/2021. Patient presented to ED with complaints of shortness of breath x 3 days. On arrival he was placed on high flow nasal cannula. Patient was mechanically ventilated on 8/5/2021 due to worsening hypoxia. Patient received dexamethasone & remdesivir. Patient was transferred to hospital on 8/5/2021. Patient received methylprednisolone, cefepime, meropenem, metronidazole, & vancomycin IV and PO. Hospital course progressed without meaningful recovery of lung function.  On 8/24/2021, family decided to move to comfort care. Patient expired on 8/24/2021."
	"1659134-1"	"1659134-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"Janssen (J&J) COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 04/01/2021. Patient presented to ED with complaints of shortness of breath x 3 days. On arrival he was placed on high flow nasal cannula. Patient was mechanically ventilated on 8/5/2021 due to worsening hypoxia. Patient received dexamethasone & remdesivir. Patient was transferred to hospital on 8/5/2021. Patient received methylprednisolone, cefepime, meropenem, metronidazole, & vancomycin IV and PO. Hospital course progressed without meaningful recovery of lung function.  On 8/24/2021, family decided to move to comfort care. Patient expired on 8/24/2021."
	"1659134-1"	"1659134-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Janssen (J&J) COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 04/01/2021. Patient presented to ED with complaints of shortness of breath x 3 days. On arrival he was placed on high flow nasal cannula. Patient was mechanically ventilated on 8/5/2021 due to worsening hypoxia. Patient received dexamethasone & remdesivir. Patient was transferred to hospital on 8/5/2021. Patient received methylprednisolone, cefepime, meropenem, metronidazole, & vancomycin IV and PO. Hospital course progressed without meaningful recovery of lung function.  On 8/24/2021, family decided to move to comfort care. Patient expired on 8/24/2021."
	"1659134-1"	"1659134-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Janssen (J&J) COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 04/01/2021. Patient presented to ED with complaints of shortness of breath x 3 days. On arrival he was placed on high flow nasal cannula. Patient was mechanically ventilated on 8/5/2021 due to worsening hypoxia. Patient received dexamethasone & remdesivir. Patient was transferred to hospital on 8/5/2021. Patient received methylprednisolone, cefepime, meropenem, metronidazole, & vancomycin IV and PO. Hospital course progressed without meaningful recovery of lung function.  On 8/24/2021, family decided to move to comfort care. Patient expired on 8/24/2021."
	"1659148-1"	"1659148-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient died of COVID-19 illness on 08/01/2021"
	"1659148-1"	"1659148-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient died of COVID-19 illness on 08/01/2021"
	"1659148-1"	"1659148-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Patient died of COVID-19 illness on 08/01/2021"
	"1659269-1"	"1659269-1"	"BACTERAEMIA"	"10003997"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer BionNTech Vaccine on 06/18/2021 and 07/24/2021. Patient presented to ED on 8/1/21 for shortness of breath. Pt tested positive for COVID-19 on 7/30/21 and was positive for cough x 3 days. Pt was in respiratory distress in ED with worsening hypoxia requiring higher HFNC O2.Upon admission to the hospital she rapidly declined and required intubation and mechanical ventilation. Patient recieved lovenox for dvt ppx, decadron, remdesivir, and vancomycin. Her course was complicated by MSSA pneumonia and bacteremia.  She had persistent bacteremia and her lines were exchanged.She decompensated on the cont. ventilator and required continued paralytics and proning. Patient did not recover. Family decided to withdraw care and patient was extubated. Patient expired on 8/20/21."
	"1659269-1"	"1659269-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer BionNTech Vaccine on 06/18/2021 and 07/24/2021. Patient presented to ED on 8/1/21 for shortness of breath. Pt tested positive for COVID-19 on 7/30/21 and was positive for cough x 3 days. Pt was in respiratory distress in ED with worsening hypoxia requiring higher HFNC O2.Upon admission to the hospital she rapidly declined and required intubation and mechanical ventilation. Patient recieved lovenox for dvt ppx, decadron, remdesivir, and vancomycin. Her course was complicated by MSSA pneumonia and bacteremia.  She had persistent bacteremia and her lines were exchanged.She decompensated on the cont. ventilator and required continued paralytics and proning. Patient did not recover. Family decided to withdraw care and patient was extubated. Patient expired on 8/20/21."
	"1659269-1"	"1659269-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer BionNTech Vaccine on 06/18/2021 and 07/24/2021. Patient presented to ED on 8/1/21 for shortness of breath. Pt tested positive for COVID-19 on 7/30/21 and was positive for cough x 3 days. Pt was in respiratory distress in ED with worsening hypoxia requiring higher HFNC O2.Upon admission to the hospital she rapidly declined and required intubation and mechanical ventilation. Patient recieved lovenox for dvt ppx, decadron, remdesivir, and vancomycin. Her course was complicated by MSSA pneumonia and bacteremia.  She had persistent bacteremia and her lines were exchanged.She decompensated on the cont. ventilator and required continued paralytics and proning. Patient did not recover. Family decided to withdraw care and patient was extubated. Patient expired on 8/20/21."
	"1659269-1"	"1659269-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer BionNTech Vaccine on 06/18/2021 and 07/24/2021. Patient presented to ED on 8/1/21 for shortness of breath. Pt tested positive for COVID-19 on 7/30/21 and was positive for cough x 3 days. Pt was in respiratory distress in ED with worsening hypoxia requiring higher HFNC O2.Upon admission to the hospital she rapidly declined and required intubation and mechanical ventilation. Patient recieved lovenox for dvt ppx, decadron, remdesivir, and vancomycin. Her course was complicated by MSSA pneumonia and bacteremia.  She had persistent bacteremia and her lines were exchanged.She decompensated on the cont. ventilator and required continued paralytics and proning. Patient did not recover. Family decided to withdraw care and patient was extubated. Patient expired on 8/20/21."
	"1659269-1"	"1659269-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer BionNTech Vaccine on 06/18/2021 and 07/24/2021. Patient presented to ED on 8/1/21 for shortness of breath. Pt tested positive for COVID-19 on 7/30/21 and was positive for cough x 3 days. Pt was in respiratory distress in ED with worsening hypoxia requiring higher HFNC O2.Upon admission to the hospital she rapidly declined and required intubation and mechanical ventilation. Patient recieved lovenox for dvt ppx, decadron, remdesivir, and vancomycin. Her course was complicated by MSSA pneumonia and bacteremia.  She had persistent bacteremia and her lines were exchanged.She decompensated on the cont. ventilator and required continued paralytics and proning. Patient did not recover. Family decided to withdraw care and patient was extubated. Patient expired on 8/20/21."
	"1659269-1"	"1659269-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer BionNTech Vaccine on 06/18/2021 and 07/24/2021. Patient presented to ED on 8/1/21 for shortness of breath. Pt tested positive for COVID-19 on 7/30/21 and was positive for cough x 3 days. Pt was in respiratory distress in ED with worsening hypoxia requiring higher HFNC O2.Upon admission to the hospital she rapidly declined and required intubation and mechanical ventilation. Patient recieved lovenox for dvt ppx, decadron, remdesivir, and vancomycin. Her course was complicated by MSSA pneumonia and bacteremia.  She had persistent bacteremia and her lines were exchanged.She decompensated on the cont. ventilator and required continued paralytics and proning. Patient did not recover. Family decided to withdraw care and patient was extubated. Patient expired on 8/20/21."
	"1659269-1"	"1659269-1"	"EXTUBATION"	"10015894"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer BionNTech Vaccine on 06/18/2021 and 07/24/2021. Patient presented to ED on 8/1/21 for shortness of breath. Pt tested positive for COVID-19 on 7/30/21 and was positive for cough x 3 days. Pt was in respiratory distress in ED with worsening hypoxia requiring higher HFNC O2.Upon admission to the hospital she rapidly declined and required intubation and mechanical ventilation. Patient recieved lovenox for dvt ppx, decadron, remdesivir, and vancomycin. Her course was complicated by MSSA pneumonia and bacteremia.  She had persistent bacteremia and her lines were exchanged.She decompensated on the cont. ventilator and required continued paralytics and proning. Patient did not recover. Family decided to withdraw care and patient was extubated. Patient expired on 8/20/21."
	"1659269-1"	"1659269-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer BionNTech Vaccine on 06/18/2021 and 07/24/2021. Patient presented to ED on 8/1/21 for shortness of breath. Pt tested positive for COVID-19 on 7/30/21 and was positive for cough x 3 days. Pt was in respiratory distress in ED with worsening hypoxia requiring higher HFNC O2.Upon admission to the hospital she rapidly declined and required intubation and mechanical ventilation. Patient recieved lovenox for dvt ppx, decadron, remdesivir, and vancomycin. Her course was complicated by MSSA pneumonia and bacteremia.  She had persistent bacteremia and her lines were exchanged.She decompensated on the cont. ventilator and required continued paralytics and proning. Patient did not recover. Family decided to withdraw care and patient was extubated. Patient expired on 8/20/21."
	"1659269-1"	"1659269-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer BionNTech Vaccine on 06/18/2021 and 07/24/2021. Patient presented to ED on 8/1/21 for shortness of breath. Pt tested positive for COVID-19 on 7/30/21 and was positive for cough x 3 days. Pt was in respiratory distress in ED with worsening hypoxia requiring higher HFNC O2.Upon admission to the hospital she rapidly declined and required intubation and mechanical ventilation. Patient recieved lovenox for dvt ppx, decadron, remdesivir, and vancomycin. Her course was complicated by MSSA pneumonia and bacteremia.  She had persistent bacteremia and her lines were exchanged.She decompensated on the cont. ventilator and required continued paralytics and proning. Patient did not recover. Family decided to withdraw care and patient was extubated. Patient expired on 8/20/21."
	"1659269-1"	"1659269-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer BionNTech Vaccine on 06/18/2021 and 07/24/2021. Patient presented to ED on 8/1/21 for shortness of breath. Pt tested positive for COVID-19 on 7/30/21 and was positive for cough x 3 days. Pt was in respiratory distress in ED with worsening hypoxia requiring higher HFNC O2.Upon admission to the hospital she rapidly declined and required intubation and mechanical ventilation. Patient recieved lovenox for dvt ppx, decadron, remdesivir, and vancomycin. Her course was complicated by MSSA pneumonia and bacteremia.  She had persistent bacteremia and her lines were exchanged.She decompensated on the cont. ventilator and required continued paralytics and proning. Patient did not recover. Family decided to withdraw care and patient was extubated. Patient expired on 8/20/21."
	"1659269-1"	"1659269-1"	"PNEUMONIA STAPHYLOCOCCAL"	"10035734"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer BionNTech Vaccine on 06/18/2021 and 07/24/2021. Patient presented to ED on 8/1/21 for shortness of breath. Pt tested positive for COVID-19 on 7/30/21 and was positive for cough x 3 days. Pt was in respiratory distress in ED with worsening hypoxia requiring higher HFNC O2.Upon admission to the hospital she rapidly declined and required intubation and mechanical ventilation. Patient recieved lovenox for dvt ppx, decadron, remdesivir, and vancomycin. Her course was complicated by MSSA pneumonia and bacteremia.  She had persistent bacteremia and her lines were exchanged.She decompensated on the cont. ventilator and required continued paralytics and proning. Patient did not recover. Family decided to withdraw care and patient was extubated. Patient expired on 8/20/21."
	"1659269-1"	"1659269-1"	"RESPIRATORY DISTRESS"	"10038687"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer BionNTech Vaccine on 06/18/2021 and 07/24/2021. Patient presented to ED on 8/1/21 for shortness of breath. Pt tested positive for COVID-19 on 7/30/21 and was positive for cough x 3 days. Pt was in respiratory distress in ED with worsening hypoxia requiring higher HFNC O2.Upon admission to the hospital she rapidly declined and required intubation and mechanical ventilation. Patient recieved lovenox for dvt ppx, decadron, remdesivir, and vancomycin. Her course was complicated by MSSA pneumonia and bacteremia.  She had persistent bacteremia and her lines were exchanged.She decompensated on the cont. ventilator and required continued paralytics and proning. Patient did not recover. Family decided to withdraw care and patient was extubated. Patient expired on 8/20/21."
	"1659269-1"	"1659269-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer BionNTech Vaccine on 06/18/2021 and 07/24/2021. Patient presented to ED on 8/1/21 for shortness of breath. Pt tested positive for COVID-19 on 7/30/21 and was positive for cough x 3 days. Pt was in respiratory distress in ED with worsening hypoxia requiring higher HFNC O2.Upon admission to the hospital she rapidly declined and required intubation and mechanical ventilation. Patient recieved lovenox for dvt ppx, decadron, remdesivir, and vancomycin. Her course was complicated by MSSA pneumonia and bacteremia.  She had persistent bacteremia and her lines were exchanged.She decompensated on the cont. ventilator and required continued paralytics and proning. Patient did not recover. Family decided to withdraw care and patient was extubated. Patient expired on 8/20/21."
	"1659313-1"	"1659313-1"	"BLOOD TEST"	"10061726"	"60-64 years"	"60-64"	"She had a heart attack and died.  Vaccine received on 5/7/2021, per notes chest pain began 5/8/2021, presented to the ED on 5/11/2021, diagnosed with anterior STEMI, directly to cath lab where she had a PEA and then V fib arrest.  She passed away on 5/12/2021."
	"1659313-1"	"1659313-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"She had a heart attack and died.  Vaccine received on 5/7/2021, per notes chest pain began 5/8/2021, presented to the ED on 5/11/2021, diagnosed with anterior STEMI, directly to cath lab where she had a PEA and then V fib arrest.  She passed away on 5/12/2021."
	"1659313-1"	"1659313-1"	"CATHETERISATION CARDIAC"	"10007815"	"60-64 years"	"60-64"	"She had a heart attack and died.  Vaccine received on 5/7/2021, per notes chest pain began 5/8/2021, presented to the ED on 5/11/2021, diagnosed with anterior STEMI, directly to cath lab where she had a PEA and then V fib arrest.  She passed away on 5/12/2021."
	"1659313-1"	"1659313-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"She had a heart attack and died.  Vaccine received on 5/7/2021, per notes chest pain began 5/8/2021, presented to the ED on 5/11/2021, diagnosed with anterior STEMI, directly to cath lab where she had a PEA and then V fib arrest.  She passed away on 5/12/2021."
	"1659313-1"	"1659313-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"She had a heart attack and died.  Vaccine received on 5/7/2021, per notes chest pain began 5/8/2021, presented to the ED on 5/11/2021, diagnosed with anterior STEMI, directly to cath lab where she had a PEA and then V fib arrest.  She passed away on 5/12/2021."
	"1659313-1"	"1659313-1"	"ELECTROCARDIOGRAM"	"10014362"	"60-64 years"	"60-64"	"She had a heart attack and died.  Vaccine received on 5/7/2021, per notes chest pain began 5/8/2021, presented to the ED on 5/11/2021, diagnosed with anterior STEMI, directly to cath lab where she had a PEA and then V fib arrest.  She passed away on 5/12/2021."
	"1659313-1"	"1659313-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"She had a heart attack and died.  Vaccine received on 5/7/2021, per notes chest pain began 5/8/2021, presented to the ED on 5/11/2021, diagnosed with anterior STEMI, directly to cath lab where she had a PEA and then V fib arrest.  She passed away on 5/12/2021."
	"1659313-1"	"1659313-1"	"PULSELESS ELECTRICAL ACTIVITY"	"10058151"	"60-64 years"	"60-64"	"She had a heart attack and died.  Vaccine received on 5/7/2021, per notes chest pain began 5/8/2021, presented to the ED on 5/11/2021, diagnosed with anterior STEMI, directly to cath lab where she had a PEA and then V fib arrest.  She passed away on 5/12/2021."
	"1659313-1"	"1659313-1"	"VENTRICULAR FIBRILLATION"	"10047290"	"60-64 years"	"60-64"	"She had a heart attack and died.  Vaccine received on 5/7/2021, per notes chest pain began 5/8/2021, presented to the ED on 5/11/2021, diagnosed with anterior STEMI, directly to cath lab where she had a PEA and then V fib arrest.  She passed away on 5/12/2021."
	"1659931-1"	"1659931-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Day after shot she began to feel, nausea, hurting,  lying in bed a lot, refused to go to doctor thought she would get better. Husband left home about 15 minutes to find her dead sitting on chair, right lower leg hard and cold to touch, purple in color, blood in bilateral nares and upper body white."
	"1659931-1"	"1659931-1"	"EPISTAXIS"	"10015090"	"60-64 years"	"60-64"	"Day after shot she began to feel, nausea, hurting,  lying in bed a lot, refused to go to doctor thought she would get better. Husband left home about 15 minutes to find her dead sitting on chair, right lower leg hard and cold to touch, purple in color, blood in bilateral nares and upper body white."
	"1659931-1"	"1659931-1"	"INDURATION"	"10060708"	"60-64 years"	"60-64"	"Day after shot she began to feel, nausea, hurting,  lying in bed a lot, refused to go to doctor thought she would get better. Husband left home about 15 minutes to find her dead sitting on chair, right lower leg hard and cold to touch, purple in color, blood in bilateral nares and upper body white."
	"1659931-1"	"1659931-1"	"MOBILITY DECREASED"	"10048334"	"60-64 years"	"60-64"	"Day after shot she began to feel, nausea, hurting,  lying in bed a lot, refused to go to doctor thought she would get better. Husband left home about 15 minutes to find her dead sitting on chair, right lower leg hard and cold to touch, purple in color, blood in bilateral nares and upper body white."
	"1659931-1"	"1659931-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Day after shot she began to feel, nausea, hurting,  lying in bed a lot, refused to go to doctor thought she would get better. Husband left home about 15 minutes to find her dead sitting on chair, right lower leg hard and cold to touch, purple in color, blood in bilateral nares and upper body white."
	"1659931-1"	"1659931-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"Day after shot she began to feel, nausea, hurting,  lying in bed a lot, refused to go to doctor thought she would get better. Husband left home about 15 minutes to find her dead sitting on chair, right lower leg hard and cold to touch, purple in color, blood in bilateral nares and upper body white."
	"1659931-1"	"1659931-1"	"PALLOR"	"10033546"	"60-64 years"	"60-64"	"Day after shot she began to feel, nausea, hurting,  lying in bed a lot, refused to go to doctor thought she would get better. Husband left home about 15 minutes to find her dead sitting on chair, right lower leg hard and cold to touch, purple in color, blood in bilateral nares and upper body white."
	"1659931-1"	"1659931-1"	"PERIPHERAL COLDNESS"	"10034568"	"60-64 years"	"60-64"	"Day after shot she began to feel, nausea, hurting,  lying in bed a lot, refused to go to doctor thought she would get better. Husband left home about 15 minutes to find her dead sitting on chair, right lower leg hard and cold to touch, purple in color, blood in bilateral nares and upper body white."
	"1659931-1"	"1659931-1"	"SKIN DISCOLOURATION"	"10040829"	"60-64 years"	"60-64"	"Day after shot she began to feel, nausea, hurting,  lying in bed a lot, refused to go to doctor thought she would get better. Husband left home about 15 minutes to find her dead sitting on chair, right lower leg hard and cold to touch, purple in color, blood in bilateral nares and upper body white."
	"1662698-1"	"1662698-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"ANAEMIA"	"10002034"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"ATRIAL FIBRILLATION"	"10003658"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"BILEVEL POSITIVE AIRWAY PRESSURE"	"10064530"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"DELIRIUM"	"10012218"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"HYPOTENSION"	"10021097"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"LUNG INFILTRATION"	"10025102"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"LUNG OPACITY"	"10081792"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"PANIC REACTION"	"10033670"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"PNEUMONIA BACTERIAL"	"10060946"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"SEPTIC SHOCK"	"10040070"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1662698-1"	"1662698-1"	"SLEEP APNOEA SYNDROME"	"10040979"	"60-64 years"	"60-64"	"Admission Date: 8/22/2021   Date of Death: 8/31/2021 actual Time of Death: 9:35 am   Autopsy Scheduled/Performed: No   Manner of Death: Natural   Cause of Death:   COVID-19 pneumonia 9 days   - interval between onset and death Acute hypoxic respiratory failure Obstructive sleep apnea on respiratory support patient has not been compliant with weight prior to this hospital stay Chronic osteomyelitis Quadriplegia   Hospital Course:  Patient presented with increased weakness hypoxia and hypotension.  Patient has history of chronic osteomyelitis and also he has quadriplegia.  Patient was admitted started on broad spectrum antibiotics and shortly after admission he required pressors so he was transferred to the intensivist service.  Patient also required significant amount of oxygen and that was providing using BiPAP.  Once the patient was off of pressors he was transitioned to hospitalist service.  Patient developed A. fib with rapid ventricular response cardiology service was consulted and also he was treated with amiodarone.  Patient developed worsening infiltrates with increased opacification of the left lung.  Initial testing in the emergency room turned back positive for coronavirus.  Patient did have the 2 doses of vaccine given approximately 6 months ago.  Pulmonology service was consulted due to opacification of the left lung but patient refused bronchoscopy.  To note even prior to this hospital stay patient has been declining regarding ability to function.  Minimal activity was causing significant shortness of breath.  Patient continued to deteriorate and he became hypoxic despite using BiPAP on a maximum settings with FiO2 of 100%.  In view of her rapid deterioration patient was intubated but after discussing with family it became clear that patient does not want to be on prolonged mechanical ventilation and that would have been the best outcome in view of his previous deterioration in pulmonary function on top of his pneumonia and COVID-19 disease.  Patient was extubated the same day and he died shortly after being extubated.  Discharge Diagnoses:  Acute hypoxic respiratory failure secondary to COVID-19 pneumonia and bacterial pneumonia worsened by patient quadriplegia and decreased cough reflex   Septic shock likely source multilobar pneumonia other possibilities UTI with chronic enduring catheter and chronic osteomyelitis   COVID-19/SARS-CoV-2 viral infection patient treated with remdesivir and dexamethasone   Partial quadriplegia from an old accident with neurogenic bladder and also with colostomy   Anemia acute on chronic acute component likely related to present illness   ICU delirium"
	"1663204-1"	"1663204-1"	"ABDOMINAL PAIN"	"10000081"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/13/2021. On 8/6/2021, pt presented to ED with increasing diffuse abdominal pain that started 3 days prior. Pt reports he was diagnosed with COVID-19 on 8/5/21 and had increasing shortness of breath with cough and headache which began 8/1/21. CT showed acute uncomplicated appendicitis and confirmed patchy ground-glass opacities within the bilateral lung bases consistent with COVID pneumonia. He was given 1 g of Tylenol, 1 g of IV Rocephin, 6 mg of Decadron, 500 mg of IV Flagyl, 2 doses of 4 mg of morphine, 4 mg of Zofran and 40 mg of IV Protonix in the ED. Pt also received remdesivir. He developled hypoxia on HFNC 50/50 sating 84-87%. pO2 49. Patient was able to maintain sats in the lower 90's CXR showed worsening pulmonary edema and he was given 20mg IV lasix. Patient transferred to MICU service for worsening respiratory status on 8/13. Patient was intubated and started on proning protocol. He continued to require pressors and sedation with propofol, versed, and dilaudid. Palliative was consulted and discussed with family comfort care. Patient expired on 8/24/21."
	"1663204-1"	"1663204-1"	"APPENDICITIS"	"10003011"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/13/2021. On 8/6/2021, pt presented to ED with increasing diffuse abdominal pain that started 3 days prior. Pt reports he was diagnosed with COVID-19 on 8/5/21 and had increasing shortness of breath with cough and headache which began 8/1/21. CT showed acute uncomplicated appendicitis and confirmed patchy ground-glass opacities within the bilateral lung bases consistent with COVID pneumonia. He was given 1 g of Tylenol, 1 g of IV Rocephin, 6 mg of Decadron, 500 mg of IV Flagyl, 2 doses of 4 mg of morphine, 4 mg of Zofran and 40 mg of IV Protonix in the ED. Pt also received remdesivir. He developled hypoxia on HFNC 50/50 sating 84-87%. pO2 49. Patient was able to maintain sats in the lower 90's CXR showed worsening pulmonary edema and he was given 20mg IV lasix. Patient transferred to MICU service for worsening respiratory status on 8/13. Patient was intubated and started on proning protocol. He continued to require pressors and sedation with propofol, versed, and dilaudid. Palliative was consulted and discussed with family comfort care. Patient expired on 8/24/21."
	"1663204-1"	"1663204-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/13/2021. On 8/6/2021, pt presented to ED with increasing diffuse abdominal pain that started 3 days prior. Pt reports he was diagnosed with COVID-19 on 8/5/21 and had increasing shortness of breath with cough and headache which began 8/1/21. CT showed acute uncomplicated appendicitis and confirmed patchy ground-glass opacities within the bilateral lung bases consistent with COVID pneumonia. He was given 1 g of Tylenol, 1 g of IV Rocephin, 6 mg of Decadron, 500 mg of IV Flagyl, 2 doses of 4 mg of morphine, 4 mg of Zofran and 40 mg of IV Protonix in the ED. Pt also received remdesivir. He developled hypoxia on HFNC 50/50 sating 84-87%. pO2 49. Patient was able to maintain sats in the lower 90's CXR showed worsening pulmonary edema and he was given 20mg IV lasix. Patient transferred to MICU service for worsening respiratory status on 8/13. Patient was intubated and started on proning protocol. He continued to require pressors and sedation with propofol, versed, and dilaudid. Palliative was consulted and discussed with family comfort care. Patient expired on 8/24/21."
	"1663204-1"	"1663204-1"	"COMPUTERISED TOMOGRAM THORAX ABNORMAL"	"10057799"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/13/2021. On 8/6/2021, pt presented to ED with increasing diffuse abdominal pain that started 3 days prior. Pt reports he was diagnosed with COVID-19 on 8/5/21 and had increasing shortness of breath with cough and headache which began 8/1/21. CT showed acute uncomplicated appendicitis and confirmed patchy ground-glass opacities within the bilateral lung bases consistent with COVID pneumonia. He was given 1 g of Tylenol, 1 g of IV Rocephin, 6 mg of Decadron, 500 mg of IV Flagyl, 2 doses of 4 mg of morphine, 4 mg of Zofran and 40 mg of IV Protonix in the ED. Pt also received remdesivir. He developled hypoxia on HFNC 50/50 sating 84-87%. pO2 49. Patient was able to maintain sats in the lower 90's CXR showed worsening pulmonary edema and he was given 20mg IV lasix. Patient transferred to MICU service for worsening respiratory status on 8/13. Patient was intubated and started on proning protocol. He continued to require pressors and sedation with propofol, versed, and dilaudid. Palliative was consulted and discussed with family comfort care. Patient expired on 8/24/21."
	"1663204-1"	"1663204-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/13/2021. On 8/6/2021, pt presented to ED with increasing diffuse abdominal pain that started 3 days prior. Pt reports he was diagnosed with COVID-19 on 8/5/21 and had increasing shortness of breath with cough and headache which began 8/1/21. CT showed acute uncomplicated appendicitis and confirmed patchy ground-glass opacities within the bilateral lung bases consistent with COVID pneumonia. He was given 1 g of Tylenol, 1 g of IV Rocephin, 6 mg of Decadron, 500 mg of IV Flagyl, 2 doses of 4 mg of morphine, 4 mg of Zofran and 40 mg of IV Protonix in the ED. Pt also received remdesivir. He developled hypoxia on HFNC 50/50 sating 84-87%. pO2 49. Patient was able to maintain sats in the lower 90's CXR showed worsening pulmonary edema and he was given 20mg IV lasix. Patient transferred to MICU service for worsening respiratory status on 8/13. Patient was intubated and started on proning protocol. He continued to require pressors and sedation with propofol, versed, and dilaudid. Palliative was consulted and discussed with family comfort care. Patient expired on 8/24/21."
	"1663204-1"	"1663204-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/13/2021. On 8/6/2021, pt presented to ED with increasing diffuse abdominal pain that started 3 days prior. Pt reports he was diagnosed with COVID-19 on 8/5/21 and had increasing shortness of breath with cough and headache which began 8/1/21. CT showed acute uncomplicated appendicitis and confirmed patchy ground-glass opacities within the bilateral lung bases consistent with COVID pneumonia. He was given 1 g of Tylenol, 1 g of IV Rocephin, 6 mg of Decadron, 500 mg of IV Flagyl, 2 doses of 4 mg of morphine, 4 mg of Zofran and 40 mg of IV Protonix in the ED. Pt also received remdesivir. He developled hypoxia on HFNC 50/50 sating 84-87%. pO2 49. Patient was able to maintain sats in the lower 90's CXR showed worsening pulmonary edema and he was given 20mg IV lasix. Patient transferred to MICU service for worsening respiratory status on 8/13. Patient was intubated and started on proning protocol. He continued to require pressors and sedation with propofol, versed, and dilaudid. Palliative was consulted and discussed with family comfort care. Patient expired on 8/24/21."
	"1663204-1"	"1663204-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/13/2021. On 8/6/2021, pt presented to ED with increasing diffuse abdominal pain that started 3 days prior. Pt reports he was diagnosed with COVID-19 on 8/5/21 and had increasing shortness of breath with cough and headache which began 8/1/21. CT showed acute uncomplicated appendicitis and confirmed patchy ground-glass opacities within the bilateral lung bases consistent with COVID pneumonia. He was given 1 g of Tylenol, 1 g of IV Rocephin, 6 mg of Decadron, 500 mg of IV Flagyl, 2 doses of 4 mg of morphine, 4 mg of Zofran and 40 mg of IV Protonix in the ED. Pt also received remdesivir. He developled hypoxia on HFNC 50/50 sating 84-87%. pO2 49. Patient was able to maintain sats in the lower 90's CXR showed worsening pulmonary edema and he was given 20mg IV lasix. Patient transferred to MICU service for worsening respiratory status on 8/13. Patient was intubated and started on proning protocol. He continued to require pressors and sedation with propofol, versed, and dilaudid. Palliative was consulted and discussed with family comfort care. Patient expired on 8/24/21."
	"1663204-1"	"1663204-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/13/2021. On 8/6/2021, pt presented to ED with increasing diffuse abdominal pain that started 3 days prior. Pt reports he was diagnosed with COVID-19 on 8/5/21 and had increasing shortness of breath with cough and headache which began 8/1/21. CT showed acute uncomplicated appendicitis and confirmed patchy ground-glass opacities within the bilateral lung bases consistent with COVID pneumonia. He was given 1 g of Tylenol, 1 g of IV Rocephin, 6 mg of Decadron, 500 mg of IV Flagyl, 2 doses of 4 mg of morphine, 4 mg of Zofran and 40 mg of IV Protonix in the ED. Pt also received remdesivir. He developled hypoxia on HFNC 50/50 sating 84-87%. pO2 49. Patient was able to maintain sats in the lower 90's CXR showed worsening pulmonary edema and he was given 20mg IV lasix. Patient transferred to MICU service for worsening respiratory status on 8/13. Patient was intubated and started on proning protocol. He continued to require pressors and sedation with propofol, versed, and dilaudid. Palliative was consulted and discussed with family comfort care. Patient expired on 8/24/21."
	"1663204-1"	"1663204-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/13/2021. On 8/6/2021, pt presented to ED with increasing diffuse abdominal pain that started 3 days prior. Pt reports he was diagnosed with COVID-19 on 8/5/21 and had increasing shortness of breath with cough and headache which began 8/1/21. CT showed acute uncomplicated appendicitis and confirmed patchy ground-glass opacities within the bilateral lung bases consistent with COVID pneumonia. He was given 1 g of Tylenol, 1 g of IV Rocephin, 6 mg of Decadron, 500 mg of IV Flagyl, 2 doses of 4 mg of morphine, 4 mg of Zofran and 40 mg of IV Protonix in the ED. Pt also received remdesivir. He developled hypoxia on HFNC 50/50 sating 84-87%. pO2 49. Patient was able to maintain sats in the lower 90's CXR showed worsening pulmonary edema and he was given 20mg IV lasix. Patient transferred to MICU service for worsening respiratory status on 8/13. Patient was intubated and started on proning protocol. He continued to require pressors and sedation with propofol, versed, and dilaudid. Palliative was consulted and discussed with family comfort care. Patient expired on 8/24/21."
	"1663204-1"	"1663204-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/13/2021. On 8/6/2021, pt presented to ED with increasing diffuse abdominal pain that started 3 days prior. Pt reports he was diagnosed with COVID-19 on 8/5/21 and had increasing shortness of breath with cough and headache which began 8/1/21. CT showed acute uncomplicated appendicitis and confirmed patchy ground-glass opacities within the bilateral lung bases consistent with COVID pneumonia. He was given 1 g of Tylenol, 1 g of IV Rocephin, 6 mg of Decadron, 500 mg of IV Flagyl, 2 doses of 4 mg of morphine, 4 mg of Zofran and 40 mg of IV Protonix in the ED. Pt also received remdesivir. He developled hypoxia on HFNC 50/50 sating 84-87%. pO2 49. Patient was able to maintain sats in the lower 90's CXR showed worsening pulmonary edema and he was given 20mg IV lasix. Patient transferred to MICU service for worsening respiratory status on 8/13. Patient was intubated and started on proning protocol. He continued to require pressors and sedation with propofol, versed, and dilaudid. Palliative was consulted and discussed with family comfort care. Patient expired on 8/24/21."
	"1663204-1"	"1663204-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/13/2021. On 8/6/2021, pt presented to ED with increasing diffuse abdominal pain that started 3 days prior. Pt reports he was diagnosed with COVID-19 on 8/5/21 and had increasing shortness of breath with cough and headache which began 8/1/21. CT showed acute uncomplicated appendicitis and confirmed patchy ground-glass opacities within the bilateral lung bases consistent with COVID pneumonia. He was given 1 g of Tylenol, 1 g of IV Rocephin, 6 mg of Decadron, 500 mg of IV Flagyl, 2 doses of 4 mg of morphine, 4 mg of Zofran and 40 mg of IV Protonix in the ED. Pt also received remdesivir. He developled hypoxia on HFNC 50/50 sating 84-87%. pO2 49. Patient was able to maintain sats in the lower 90's CXR showed worsening pulmonary edema and he was given 20mg IV lasix. Patient transferred to MICU service for worsening respiratory status on 8/13. Patient was intubated and started on proning protocol. He continued to require pressors and sedation with propofol, versed, and dilaudid. Palliative was consulted and discussed with family comfort care. Patient expired on 8/24/21."
	"1663204-1"	"1663204-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/13/2021. On 8/6/2021, pt presented to ED with increasing diffuse abdominal pain that started 3 days prior. Pt reports he was diagnosed with COVID-19 on 8/5/21 and had increasing shortness of breath with cough and headache which began 8/1/21. CT showed acute uncomplicated appendicitis and confirmed patchy ground-glass opacities within the bilateral lung bases consistent with COVID pneumonia. He was given 1 g of Tylenol, 1 g of IV Rocephin, 6 mg of Decadron, 500 mg of IV Flagyl, 2 doses of 4 mg of morphine, 4 mg of Zofran and 40 mg of IV Protonix in the ED. Pt also received remdesivir. He developled hypoxia on HFNC 50/50 sating 84-87%. pO2 49. Patient was able to maintain sats in the lower 90's CXR showed worsening pulmonary edema and he was given 20mg IV lasix. Patient transferred to MICU service for worsening respiratory status on 8/13. Patient was intubated and started on proning protocol. He continued to require pressors and sedation with propofol, versed, and dilaudid. Palliative was consulted and discussed with family comfort care. Patient expired on 8/24/21."
	"1663204-1"	"1663204-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/13/2021. On 8/6/2021, pt presented to ED with increasing diffuse abdominal pain that started 3 days prior. Pt reports he was diagnosed with COVID-19 on 8/5/21 and had increasing shortness of breath with cough and headache which began 8/1/21. CT showed acute uncomplicated appendicitis and confirmed patchy ground-glass opacities within the bilateral lung bases consistent with COVID pneumonia. He was given 1 g of Tylenol, 1 g of IV Rocephin, 6 mg of Decadron, 500 mg of IV Flagyl, 2 doses of 4 mg of morphine, 4 mg of Zofran and 40 mg of IV Protonix in the ED. Pt also received remdesivir. He developled hypoxia on HFNC 50/50 sating 84-87%. pO2 49. Patient was able to maintain sats in the lower 90's CXR showed worsening pulmonary edema and he was given 20mg IV lasix. Patient transferred to MICU service for worsening respiratory status on 8/13. Patient was intubated and started on proning protocol. He continued to require pressors and sedation with propofol, versed, and dilaudid. Palliative was consulted and discussed with family comfort care. Patient expired on 8/24/21."
	"1663204-1"	"1663204-1"	"LUNG OPACITY"	"10081792"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/13/2021. On 8/6/2021, pt presented to ED with increasing diffuse abdominal pain that started 3 days prior. Pt reports he was diagnosed with COVID-19 on 8/5/21 and had increasing shortness of breath with cough and headache which began 8/1/21. CT showed acute uncomplicated appendicitis and confirmed patchy ground-glass opacities within the bilateral lung bases consistent with COVID pneumonia. He was given 1 g of Tylenol, 1 g of IV Rocephin, 6 mg of Decadron, 500 mg of IV Flagyl, 2 doses of 4 mg of morphine, 4 mg of Zofran and 40 mg of IV Protonix in the ED. Pt also received remdesivir. He developled hypoxia on HFNC 50/50 sating 84-87%. pO2 49. Patient was able to maintain sats in the lower 90's CXR showed worsening pulmonary edema and he was given 20mg IV lasix. Patient transferred to MICU service for worsening respiratory status on 8/13. Patient was intubated and started on proning protocol. He continued to require pressors and sedation with propofol, versed, and dilaudid. Palliative was consulted and discussed with family comfort care. Patient expired on 8/24/21."
	"1663204-1"	"1663204-1"	"PULMONARY OEDEMA"	"10037423"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/13/2021. On 8/6/2021, pt presented to ED with increasing diffuse abdominal pain that started 3 days prior. Pt reports he was diagnosed with COVID-19 on 8/5/21 and had increasing shortness of breath with cough and headache which began 8/1/21. CT showed acute uncomplicated appendicitis and confirmed patchy ground-glass opacities within the bilateral lung bases consistent with COVID pneumonia. He was given 1 g of Tylenol, 1 g of IV Rocephin, 6 mg of Decadron, 500 mg of IV Flagyl, 2 doses of 4 mg of morphine, 4 mg of Zofran and 40 mg of IV Protonix in the ED. Pt also received remdesivir. He developled hypoxia on HFNC 50/50 sating 84-87%. pO2 49. Patient was able to maintain sats in the lower 90's CXR showed worsening pulmonary edema and he was given 20mg IV lasix. Patient transferred to MICU service for worsening respiratory status on 8/13. Patient was intubated and started on proning protocol. He continued to require pressors and sedation with propofol, versed, and dilaudid. Palliative was consulted and discussed with family comfort care. Patient expired on 8/24/21."
	"1663204-1"	"1663204-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/13/2021. On 8/6/2021, pt presented to ED with increasing diffuse abdominal pain that started 3 days prior. Pt reports he was diagnosed with COVID-19 on 8/5/21 and had increasing shortness of breath with cough and headache which began 8/1/21. CT showed acute uncomplicated appendicitis and confirmed patchy ground-glass opacities within the bilateral lung bases consistent with COVID pneumonia. He was given 1 g of Tylenol, 1 g of IV Rocephin, 6 mg of Decadron, 500 mg of IV Flagyl, 2 doses of 4 mg of morphine, 4 mg of Zofran and 40 mg of IV Protonix in the ED. Pt also received remdesivir. He developled hypoxia on HFNC 50/50 sating 84-87%. pO2 49. Patient was able to maintain sats in the lower 90's CXR showed worsening pulmonary edema and he was given 20mg IV lasix. Patient transferred to MICU service for worsening respiratory status on 8/13. Patient was intubated and started on proning protocol. He continued to require pressors and sedation with propofol, versed, and dilaudid. Palliative was consulted and discussed with family comfort care. Patient expired on 8/24/21."
	"1663204-1"	"1663204-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 03/13/2021. On 8/6/2021, pt presented to ED with increasing diffuse abdominal pain that started 3 days prior. Pt reports he was diagnosed with COVID-19 on 8/5/21 and had increasing shortness of breath with cough and headache which began 8/1/21. CT showed acute uncomplicated appendicitis and confirmed patchy ground-glass opacities within the bilateral lung bases consistent with COVID pneumonia. He was given 1 g of Tylenol, 1 g of IV Rocephin, 6 mg of Decadron, 500 mg of IV Flagyl, 2 doses of 4 mg of morphine, 4 mg of Zofran and 40 mg of IV Protonix in the ED. Pt also received remdesivir. He developled hypoxia on HFNC 50/50 sating 84-87%. pO2 49. Patient was able to maintain sats in the lower 90's CXR showed worsening pulmonary edema and he was given 20mg IV lasix. Patient transferred to MICU service for worsening respiratory status on 8/13. Patient was intubated and started on proning protocol. He continued to require pressors and sedation with propofol, versed, and dilaudid. Palliative was consulted and discussed with family comfort care. Patient expired on 8/24/21."
	"1666166-1"	"1666166-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"DEATH"
	"1666378-1"	"1666378-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"Patient admitted to Hospital with acute hypoxic respiratory failure secondary to viral pneumonia from COVID-19 and exacerbation of COPD.  Worsening of symptoms prompted Average Volume-Assured Pressure Support.  Ventilation did not seem an option d/t HX of severe inflammatory interstitial lung disease."
	"1666378-1"	"1666378-1"	"CHRONIC OBSTRUCTIVE PULMONARY DISEASE"	"10009033"	"60-64 years"	"60-64"	"Patient admitted to Hospital with acute hypoxic respiratory failure secondary to viral pneumonia from COVID-19 and exacerbation of COPD.  Worsening of symptoms prompted Average Volume-Assured Pressure Support.  Ventilation did not seem an option d/t HX of severe inflammatory interstitial lung disease."
	"1666378-1"	"1666378-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"Patient admitted to Hospital with acute hypoxic respiratory failure secondary to viral pneumonia from COVID-19 and exacerbation of COPD.  Worsening of symptoms prompted Average Volume-Assured Pressure Support.  Ventilation did not seem an option d/t HX of severe inflammatory interstitial lung disease."
	"1666378-1"	"1666378-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient admitted to Hospital with acute hypoxic respiratory failure secondary to viral pneumonia from COVID-19 and exacerbation of COPD.  Worsening of symptoms prompted Average Volume-Assured Pressure Support.  Ventilation did not seem an option d/t HX of severe inflammatory interstitial lung disease."
	"1666378-1"	"1666378-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Patient admitted to Hospital with acute hypoxic respiratory failure secondary to viral pneumonia from COVID-19 and exacerbation of COPD.  Worsening of symptoms prompted Average Volume-Assured Pressure Support.  Ventilation did not seem an option d/t HX of severe inflammatory interstitial lung disease."
	"1666378-1"	"1666378-1"	"PNEUMONIA VIRAL"	"10035737"	"60-64 years"	"60-64"	"Patient admitted to Hospital with acute hypoxic respiratory failure secondary to viral pneumonia from COVID-19 and exacerbation of COPD.  Worsening of symptoms prompted Average Volume-Assured Pressure Support.  Ventilation did not seem an option d/t HX of severe inflammatory interstitial lung disease."
	"1666664-1"	"1666664-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"ANTICOAGULANT THERAPY"	"10053468"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"BLOOD GASES ABNORMAL"	"10005539"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"BLOOD PRESSURE DECREASED"	"10005734"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"CHEST TUBE INSERTION"	"10050522"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"LABORATORY TEST NORMAL"	"10054052"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"MICROCYTIC ANAEMIA"	"10027538"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"PO2"	"10035766"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"TACHYARRHYTHMIA"	"10049447"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"THALASSAEMIA"	"10043388"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1666664-1"	"1666664-1"	"TRANSAMINASES INCREASED"	"10054889"	"60-64 years"	"60-64"	"Patient received 2nd dose of COVID vaccine on 3/20/21, then tested positive for COVID on 8/12/21 & 8/19/21  Hospitalization Admit Date/Time: 8/19/2021  9:06 AM Discharge Date: 8/30/2021 Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 64 yo M with thalassemia and mechanical AV on warfarin who is presenting due to fatigue, cough, fever, and low oxygen saturation.  On 8/10, pt started with mild symptoms of cough and fatigue that was generally manageable at home. He tested + for COVID on 8/12. On 8/14, started having fever (Tmax 102-103F) managed supportively. On 8/19, the pt was noted to be in the 80s in his pulse oximeter. He denied having shortness of breath but with a worsened cough. Hypoxia prompted presentation to the ED.    Of note, pt is a generally healthy man except for a history of congenital AV disease warranting Ross procedure in 1998 and a mechanical AV replacement in 2018. He exercises regularly. Vaccinated with Pfizer 2/2021.  The patient had been managed on the medicine team with progressively worsening chest x-rays and hypoxia requiring HFNC at settings high enough to require ICU care.   Our service was consulted to evaluate the patient for ICU admission.    On exam, he is calm, conversant and ATO x 3.  ABG demonstrates profound hypoxia with a pO2 of 51 with a recheck of 53.  He is hemodynamically stable.  The remainder of his labs are relatively normal.  We discussed these findings and his wishes to proceed with intubation, be FULL CODE and consents to tracheostomy if this is required.  His wife was called with the above discussion as well and the patient conversed with her at length before intubation.         AHRF/ARDS d/t COVID-19 requiring MV c/b Air Leak - pt was vaccinated man with Pfizer vaccine 2/21 - Treated with Dexamethasone 08/19- 08/29 for total of 10 days, with PPI prophylaxis Completed remdisavir (08/19 - 23) - admitted to MICU on day 11 of hospitalization, pO2 53 prior to intubation, PF ration prior to intubation 51 with severe ARDS - received Vanc/Cef for HAP coverage started 8/28 - Dex ARDS for 3d - Diuresed for pulmonary toilet   Transaminitis - improving at time of death - likely d/t severe acute viral illness vs remdesivir   CHD w/ Mech AVR on AC (warfarin at home) - received heparin gtt while in MICU   Chronic Microcytic Anemia d/t Thalassemia  - monitored Hb  At approximately 5:30 p.m. on 08/30/2021 code blue was called on patient, high-quality compressions were initiated, nursing had reported that prior to cardiac arrest the patient developed tachyarrhythmia followed by precipitous drop in blood pressure followed by hypoxia, rhythm was consistently asystole, patient patient received approximately 17-18 rounds of compressions, doses of epinephrine every 3-5 minutes, bilateral chest tubes were placed due to concern for tension pneumothorax as patient had pre-existing pneumomediastinum with diffuse subcutaneous emphysema, hypoxia improved mildly after chest tubes were placed but return of spontaneous circulation was not achieved, patient also received multiple rounds bicarbonate, calcium, insulin and dextrose during the code, resuscitation was attempted for a total of 35 minutes when out of medical futility with overall poor neurologic prognosis the code was stopped, family had just arrived at the time of stopping resuscitation, patient's family was informed and they voiced understanding of what had happened and the patient had expired, family thank team for excellent care despite outcome, time of death 1805"
	"1674908-1"	"1674908-1"	"ANTICOAGULANT THERAPY"	"10053468"	"60-64 years"	"60-64"	"Patient with no prior heparin exposure. Started on prophylactic heparin (5000U TID SQ) following lobectomy. Developed severe HIT with optic density 2.8. Placed on argatroban after diagnosis, which was prompted by PE. Please note, patient immediately on heparin ppx following surgery and ambulatory. No history of coagulopathy in family or personally. Platelets never rose despite a week of therapeutic argatroban without any pauses in drip or sub therapeutic ranges. At 7 days after initiation of drip, the patient had a second PE and expired.   I know it's a long time out from his vaccine but wondering if prior vaccination and subsequent heparin may be a trigger for HIT."
	"1674908-1"	"1674908-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient with no prior heparin exposure. Started on prophylactic heparin (5000U TID SQ) following lobectomy. Developed severe HIT with optic density 2.8. Placed on argatroban after diagnosis, which was prompted by PE. Please note, patient immediately on heparin ppx following surgery and ambulatory. No history of coagulopathy in family or personally. Platelets never rose despite a week of therapeutic argatroban without any pauses in drip or sub therapeutic ranges. At 7 days after initiation of drip, the patient had a second PE and expired.   I know it's a long time out from his vaccine but wondering if prior vaccination and subsequent heparin may be a trigger for HIT."
	"1674908-1"	"1674908-1"	"HEPARIN-INDUCED THROMBOCYTOPENIA"	"10062506"	"60-64 years"	"60-64"	"Patient with no prior heparin exposure. Started on prophylactic heparin (5000U TID SQ) following lobectomy. Developed severe HIT with optic density 2.8. Placed on argatroban after diagnosis, which was prompted by PE. Please note, patient immediately on heparin ppx following surgery and ambulatory. No history of coagulopathy in family or personally. Platelets never rose despite a week of therapeutic argatroban without any pauses in drip or sub therapeutic ranges. At 7 days after initiation of drip, the patient had a second PE and expired.   I know it's a long time out from his vaccine but wondering if prior vaccination and subsequent heparin may be a trigger for HIT."
	"1674908-1"	"1674908-1"	"LUNG LOBECTOMY"	"10024741"	"60-64 years"	"60-64"	"Patient with no prior heparin exposure. Started on prophylactic heparin (5000U TID SQ) following lobectomy. Developed severe HIT with optic density 2.8. Placed on argatroban after diagnosis, which was prompted by PE. Please note, patient immediately on heparin ppx following surgery and ambulatory. No history of coagulopathy in family or personally. Platelets never rose despite a week of therapeutic argatroban without any pauses in drip or sub therapeutic ranges. At 7 days after initiation of drip, the patient had a second PE and expired.   I know it's a long time out from his vaccine but wondering if prior vaccination and subsequent heparin may be a trigger for HIT."
	"1674908-1"	"1674908-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"Patient with no prior heparin exposure. Started on prophylactic heparin (5000U TID SQ) following lobectomy. Developed severe HIT with optic density 2.8. Placed on argatroban after diagnosis, which was prompted by PE. Please note, patient immediately on heparin ppx following surgery and ambulatory. No history of coagulopathy in family or personally. Platelets never rose despite a week of therapeutic argatroban without any pauses in drip or sub therapeutic ranges. At 7 days after initiation of drip, the patient had a second PE and expired.   I know it's a long time out from his vaccine but wondering if prior vaccination and subsequent heparin may be a trigger for HIT."
	"1675107-1"	"1675107-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"He died , found dead after 24 hours, Closed casket, no foul play.   I  am unable to get an autopsy."
	"1675587-1"	"1675587-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Immune response, COVID-19 pneumonia. Patient told the pharmacist giving vaccine he was not feeling well. They did not test him for COVID and gave vaccine anyway. It is unknown if he officially had COVID-19, but he became sick almost immediately after getting the vaccine. Taken to hospital by ambulance on 08/06/2021, put on a ventilator on 08/13/2021 and died on 08/31/2021."
	"1675587-1"	"1675587-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Immune response, COVID-19 pneumonia. Patient told the pharmacist giving vaccine he was not feeling well. They did not test him for COVID and gave vaccine anyway. It is unknown if he officially had COVID-19, but he became sick almost immediately after getting the vaccine. Taken to hospital by ambulance on 08/06/2021, put on a ventilator on 08/13/2021 and died on 08/31/2021."
	"1675587-1"	"1675587-1"	"LABORATORY TEST"	"10059938"	"60-64 years"	"60-64"	"Immune response, COVID-19 pneumonia. Patient told the pharmacist giving vaccine he was not feeling well. They did not test him for COVID and gave vaccine anyway. It is unknown if he officially had COVID-19, but he became sick almost immediately after getting the vaccine. Taken to hospital by ambulance on 08/06/2021, put on a ventilator on 08/13/2021 and died on 08/31/2021."
	"1675587-1"	"1675587-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"Immune response, COVID-19 pneumonia. Patient told the pharmacist giving vaccine he was not feeling well. They did not test him for COVID and gave vaccine anyway. It is unknown if he officially had COVID-19, but he became sick almost immediately after getting the vaccine. Taken to hospital by ambulance on 08/06/2021, put on a ventilator on 08/13/2021 and died on 08/31/2021."
	"1675587-1"	"1675587-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Immune response, COVID-19 pneumonia. Patient told the pharmacist giving vaccine he was not feeling well. They did not test him for COVID and gave vaccine anyway. It is unknown if he officially had COVID-19, but he became sick almost immediately after getting the vaccine. Taken to hospital by ambulance on 08/06/2021, put on a ventilator on 08/13/2021 and died on 08/31/2021."
	"1675849-1"	"1675849-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"60-64 years"	"60-64"	"Day after vaccination fell backwards in parking lot trying to get into car. Hit head. Taken to ER.  CT/MRI of brain showing evidence of 3rd ventricle and left lateral ventricle intracranial hemorrhage."
	"1675849-1"	"1675849-1"	"FALL"	"10016173"	"60-64 years"	"60-64"	"Day after vaccination fell backwards in parking lot trying to get into car. Hit head. Taken to ER.  CT/MRI of brain showing evidence of 3rd ventricle and left lateral ventricle intracranial hemorrhage."
	"1675849-1"	"1675849-1"	"HAEMORRHAGE INTRACRANIAL"	"10018985"	"60-64 years"	"60-64"	"Day after vaccination fell backwards in parking lot trying to get into car. Hit head. Taken to ER.  CT/MRI of brain showing evidence of 3rd ventricle and left lateral ventricle intracranial hemorrhage."
	"1675849-1"	"1675849-1"	"HEAD INJURY"	"10019196"	"60-64 years"	"60-64"	"Day after vaccination fell backwards in parking lot trying to get into car. Hit head. Taken to ER.  CT/MRI of brain showing evidence of 3rd ventricle and left lateral ventricle intracranial hemorrhage."
	"1675849-1"	"1675849-1"	"INTRACRANIAL MASS"	"10077667"	"60-64 years"	"60-64"	"Day after vaccination fell backwards in parking lot trying to get into car. Hit head. Taken to ER.  CT/MRI of brain showing evidence of 3rd ventricle and left lateral ventricle intracranial hemorrhage."
	"1675849-1"	"1675849-1"	"INTRAVENTRICULAR HAEMORRHAGE"	"10022840"	"60-64 years"	"60-64"	"Day after vaccination fell backwards in parking lot trying to get into car. Hit head. Taken to ER.  CT/MRI of brain showing evidence of 3rd ventricle and left lateral ventricle intracranial hemorrhage."
	"1675849-1"	"1675849-1"	"MAGNETIC RESONANCE IMAGING HEAD ABNORMAL"	"10085256"	"60-64 years"	"60-64"	"Day after vaccination fell backwards in parking lot trying to get into car. Hit head. Taken to ER.  CT/MRI of brain showing evidence of 3rd ventricle and left lateral ventricle intracranial hemorrhage."
	"1675849-1"	"1675849-1"	"METASTASES TO MENINGES"	"10051696"	"60-64 years"	"60-64"	"Day after vaccination fell backwards in parking lot trying to get into car. Hit head. Taken to ER.  CT/MRI of brain showing evidence of 3rd ventricle and left lateral ventricle intracranial hemorrhage."
	"1676783-1"	"1676783-1"	"BASILAR ARTERY OCCLUSION"	"10048963"	"60-64 years"	"60-64"	"MRI brain showed large ischemic stroke involving brainstem, bilateral cerebellum, occipital and thalamic region due to basilar artery occlusion."
	"1676783-1"	"1676783-1"	"BRAIN STEM INFARCTION"	"10006147"	"60-64 years"	"60-64"	"MRI brain showed large ischemic stroke involving brainstem, bilateral cerebellum, occipital and thalamic region due to basilar artery occlusion."
	"1676783-1"	"1676783-1"	"BRAIN STEM STROKE"	"10068644"	"60-64 years"	"60-64"	"MRI brain showed large ischemic stroke involving brainstem, bilateral cerebellum, occipital and thalamic region due to basilar artery occlusion."
	"1676783-1"	"1676783-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"60-64 years"	"60-64"	"MRI brain showed large ischemic stroke involving brainstem, bilateral cerebellum, occipital and thalamic region due to basilar artery occlusion."
	"1676783-1"	"1676783-1"	"ISCHAEMIC STROKE"	"10061256"	"60-64 years"	"60-64"	"MRI brain showed large ischemic stroke involving brainstem, bilateral cerebellum, occipital and thalamic region due to basilar artery occlusion."
	"1676783-1"	"1676783-1"	"MAGNETIC RESONANCE IMAGING HEAD ABNORMAL"	"10085256"	"60-64 years"	"60-64"	"MRI brain showed large ischemic stroke involving brainstem, bilateral cerebellum, occipital and thalamic region due to basilar artery occlusion."
	"1676783-1"	"1676783-1"	"THALAMIC INFARCTION"	"10064961"	"60-64 years"	"60-64"	"MRI brain showed large ischemic stroke involving brainstem, bilateral cerebellum, occipital and thalamic region due to basilar artery occlusion."
	"1678327-1"	"1678327-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"ANTICOAGULANT THERAPY"	"10053468"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"BILEVEL POSITIVE AIRWAY PRESSURE"	"10064530"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"BLOOD BETA-D-GLUCAN"	"10068725"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"BLOOD BICARBONATE NORMAL"	"10005361"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"BLOOD CREATININE INCREASED"	"10005483"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"BLOOD CULTURE"	"10005485"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"BLOOD GLUCOSE NORMAL"	"10005558"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"BLOOD LACTATE DEHYDROGENASE"	"10005626"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"BLOOD PH NORMAL"	"10005709"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"BRAIN NATRIURETIC PEPTIDE"	"10053406"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"C-REACTIVE PROTEIN"	"10006824"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"CHEMOTHERAPY"	"10061758"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"CHRONIC OBSTRUCTIVE PULMONARY DISEASE"	"10009033"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"CLOSTRIDIUM TEST NEGATIVE"	"10070271"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"COLECTOMY"	"10061778"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"COMPUTERISED TOMOGRAM THORAX ABNORMAL"	"10057799"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"DIFFERENTIAL WHITE BLOOD CELL COUNT"	"10012784"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"ECHOCARDIOGRAM"	"10014113"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"EJECTION FRACTION"	"10050527"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"ELECTROCARDIOGRAM NORMAL"	"10014373"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"FIBRIN D DIMER"	"10016577"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"FULL BLOOD COUNT"	"10017411"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"FUNGAL TEST"	"10070457"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"HAEMOGLOBIN DECREASED"	"10018884"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"HEPATIC MASS"	"10057110"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"HYPERGLYCAEMIA"	"10020635"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"HYPERTENSION"	"10020772"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"ILEOSTOMY"	"10021321"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"IMMUNODEFICIENCY"	"10061598"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"INFECTION"	"10021789"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"LABORATORY TEST"	"10059938"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"LEGIONELLA TEST"	"10070410"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"LEUKOCYTOSIS"	"10024378"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"LUNG OPACITY"	"10081792"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"NEUTROPENIA"	"10029354"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"NEUTROPHIL COUNT DECREASED"	"10029366"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"OBESITY"	"10029883"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"PANCYTOPENIA"	"10033661"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"PCO2 NORMAL"	"10058983"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"PLATELET COUNT NORMAL"	"10035530"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"PNEUMONIA BACTERIAL"	"10060946"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"PO2 DECREASED"	"10035768"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"POLYURIA"	"10036142"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"POSITRON EMISSION TOMOGRAM ABNORMAL"	"10036221"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"PROCALCITONIN"	"10064051"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"PRONE POSITION"	"10074744"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"RESPIRATORY TRACT CONGESTION"	"10052251"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"SEPTIC SHOCK"	"10040070"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"SERUM FERRITIN"	"10040246"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"SHOCK"	"10040560"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"SLEEP APNOEA SYNDROME"	"10040979"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"STREPTOCOCCUS TEST"	"10070414"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"SUPINE POSITION"	"10074742"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"TROPONIN"	"10061576"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"ULTRASOUND DOPPLER"	"10045412"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"URINE ANALYSIS"	"10046614"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678327-1"	"1678327-1"	"WHITE BLOOD CELL COUNT DECREASED"	"10047942"	"60-64 years"	"60-64"	"Patient received second dose of COVID vaccine on 3/31/2021, tested positive for COVID on 8/14/21.  8/14/21: History Of Present Illness Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.  On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.  CXR shows patchy opacities in both lungs that could be edema pneumonia and atypical infection.  COVID19 was positive. IM consulted for admission.   Assessment and plan: 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021), and metastatic colon cancer on chemotherapy presents to ED with dyspnea.  Pt reports having a cough and congestion that started last Thursday (8/5).  Pt reports feeling more fatigue as well which he thought was related to cycle 2 of FOLFIRI that he just completed.  Pt was evaluated by his PCP on 8/5 and started on cough medicine with Cefdinir.  Pt was not tested for COVID19 at that time.  Pt reports his symptoms became progressively worse with dyspnea even at rest over the last 3 days.  Pt reports he has been checking his SpO2 at home with saturations as low as 81% on room air yesterday.  Pt reports fever at night as high as 102.  Pt denies nausea, vomiting, diarrhea, abdominal pain, dysuria, sore throat, chest pain, heart palpitations, travel, or known sick contacts.  Pt received the COVID19 vaccine a few months ago.       Acute Hypoxic Respiratory Failure likely 2/2 COVID19 in Immunocompromised with Neutropenia  Obstructive Sleep Apnea  ?COPD  -On presentation to the ED, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2.  Pt then weaned back down to 4L nasal cannula with SpO2 90% on admission.   Wife placing pt back on BiPAP with home setting for the night -pH 7.4, PCO2 36, PO2 50, and HCO3 22 -WBC 2118 with ANC 1590 -Troponin 18--- >19 -EKG without acute ST changes  -COVID 19 positive on 8/13/21 -BNP, procal, LDH, CRP, d dimer, and ferritin pending  -CBC with diff, ferritin, LDH, d dimer, and CRP daily with AM labs  -Pt given Vanc and Cefepime in the ED, will hold further antibiotics for now.  Strep pneumo, legionella, and blood cx pending  -Pt started on Decadron 6mg daily and Remdesivir per protocol -Titrate O2 to maintain SpO2 > 95% -MDI with spacer given COVID PRN  -Airborne, contact and eye protection precautions   Metastatic Colon Cancer on Chemotherapy -Follows with Oncology  -s/p colectomy then end ileostomy  -s/p 6 cycles FOLFOX -PET in June with liver and poss mediastinal node  -Started on FOLFIRI with bevacizumab added Cycle #2 on 8/3/21 (with plans for ECHO Q3 months) -Consult Oncology as needed    Pancytopenia  -Hgb 11.0, Platelets 153K, and WBC 2118 with ANC 1590 -Etiology likely 2/2 chemotherapy  -Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Acute Kidney Injury  -sCr 1.37, baseline ~1.0 to 1.1 -UA pending  -Avoid NSAID/Nephrotoxin -Renal dose medications -Strict I&O -Repeat BMP in the AM    Type II Diabetes with Hyperglycemia -Glucose was 123 on admission  -Pt on Metformin and Victoza at home  -FSBS AC/HS with correctional insulin -Consistent carb diet      CAD  -s/p cardiac stents x 6, last 2 placed in 2020 -ECHO 8/2021 with EF 50-60% -Resume home ASA, Plavix, and statin -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now  -Resume home Spironolactone    Hypertension  -SBP 100's on admission -Will hold home Losartan in setting of AKI, resume as appropriate -Will resume home Bisoprolol for now    Obesity  -BMI 36.96 -Complicates all aspects of care  9/3/21: Discharge Summary Hospitalization Admit Date/Time: 8/13/2021  9:57 PM Admitting Attending:  Discharge Date: 9/3/21 Discharge Attending Physician: Md  Referring provider name and address:  No referring provider defined for this encounter.   Chief Concern, Brief History of Present Illness, and Hospital Course Patient is a 61 y.o. male with a PMH of depression, insomnia, GERD, hypothyroidism, COPD, OSA on BiPAP at bedtime, DMII, HTN, HLD, CAD s/p PCI with stents x 6 (last 8/2021) at CB, Familial Hydrocalcicuric Hypercalcemia and metastatic colon cancer on chemotherapy presents to UK ED with dyspnea on 8/13, found to be COVID + 8/14.  Per chart review, patient called his medical oncologist with worsening respiratory symptoms and he was advised to come to ER for workup for fever and possible COVID symptoms. Of note, patient did receive Pfizer COVID Vaccine [3/6, 3/31]. Patient thought his increasing fatigue and weakness was related to cycle 2 of FOLFIRI that he just completed.     On presentation to the ED on 8/13, pt with SpO2 in the low 80's. Pt was placed on 6L nasal cannula with slight improvement with SpO2 88-90%.  Pt then placed on his home BiPAP that he wear at night with improvement of his SpO2. CT PE remarkable for GGO and consolidations most consistent with multifocal infection. During the afternoon of 8/14, MICU was consulted for increasing oxygenation requirements. On examination patient is on HFNC  40L/60% with a nonrebreather. Sats 88-91%. Increased work of breathing appreciated. Admitted to MICU for further management and evaluation.   After admission to ICU, he remained on HFNC.  He was diuresed and started on broad spectrum antibiotics with Vanc and Cefepime and dexamethasone 6mg.  On 8/17, he had a hypoxic event after coughing, and was placed on 100% BiPAP with improvement in hypoxia.  However, later  in the afternoon on 8/17, he was intubated for hypoxia.  He was started on low dose vasopressors after intubation and increased to dexa/ARDS.  He completed 7-day course of empiric Cefepime for secondary bacterial PNA on 8/20.  He completed dexa/ARDS on 8/26.  He has been intermittently diuresed.  He was proned on 8/25 due to severe ARDS and decreased PF ratio.  He was supined on 8/27.   On 8/28, he spiked a fever and had worsened leukocytosis (from 15k to 40k) along with shock.  He was re-cultured and started on empiric broad-spectrum Vanc and Zosyn.  He had increased ileostomy output at that time, therefore C. Diff sample was obtained, however was negative.  Levophed drip was started for septic shock.  He has had persistent fever despite Tylenol and worsening leukocytosis and without source, therefore venous duplex and beta glucan and fungal serologies obtained on 8/29.    RESOLVED ISSUES:   Pancytopenia (POA) (Resolved) - Etiology likely due to chemotherapy  - Continue to trend, transfuse Hgb < 7 and platelets < 10,000   Given severity of patient's respiratory failure/ARDS secondary to COVID-19 pneumonia he will be unable to receive any chemotherapy for the foreseeable future.  Heme Onc was consulted and without chemotherapy his aggressive metastatic colon cancer will likely cause him to pass away.  Extensive discussions with his wife and she wishes to make him comfortable and terminally extubate with our inpatient hospice team. Time of Death: 9/3/21 10:52pm"
	"1678809-1"	"1678809-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"HOSPITALIZED WITH COVID PNEUMONIA 8/19/2021, ICU AND INTUBATED 8/24/2021, DEATH 9/3/2021"
	"1678809-1"	"1678809-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"HOSPITALIZED WITH COVID PNEUMONIA 8/19/2021, ICU AND INTUBATED 8/24/2021, DEATH 9/3/2021"
	"1678809-1"	"1678809-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"HOSPITALIZED WITH COVID PNEUMONIA 8/19/2021, ICU AND INTUBATED 8/24/2021, DEATH 9/3/2021"
	"1678809-1"	"1678809-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"HOSPITALIZED WITH COVID PNEUMONIA 8/19/2021, ICU AND INTUBATED 8/24/2021, DEATH 9/3/2021"
	"1678944-1"	"1678944-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"hx of renal transplant, hypoxia, positive COVID test"
	"1678944-1"	"1678944-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"hx of renal transplant, hypoxia, positive COVID test"
	"1678944-1"	"1678944-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"hx of renal transplant, hypoxia, positive COVID test"
	"1679762-1"	"1679762-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Received the vaccine at approx 8:45 am on 8/27.  Spent the day at the house with his son and claimed to be feeling totally fine throughout the day.  Was last seen alive by his son at 2:30 pm and advised that he felt fine at that time.  He was found deceased at 4:00 pm by his son sitting in his workshop with his tools still in his hands and sitting upright."
	"1681700-1"	"1681700-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"After the first dose he complained of bloody stool, severe vomiting, high fever and flu-like symptoms.   His symptoms occurred within a few hours of receiving his first dose and lasted approximately 21 days. He said he felt ?run down,? and similar feelings of dehydration and exhaustion.  He had the above side effects with second dose but complained that the magnitude of symptoms were much worse and bloody stool increased. He complained of feeling as if he was going to ?pass out,? upon instances of brief aerobic activity.   Upon the"
	"1681700-1"	"1681700-1"	"DEHYDRATION"	"10012174"	"60-64 years"	"60-64"	"After the first dose he complained of bloody stool, severe vomiting, high fever and flu-like symptoms.   His symptoms occurred within a few hours of receiving his first dose and lasted approximately 21 days. He said he felt ?run down,? and similar feelings of dehydration and exhaustion.  He had the above side effects with second dose but complained that the magnitude of symptoms were much worse and bloody stool increased. He complained of feeling as if he was going to ?pass out,? upon instances of brief aerobic activity.   Upon the"
	"1681700-1"	"1681700-1"	"DIZZINESS"	"10013573"	"60-64 years"	"60-64"	"After the first dose he complained of bloody stool, severe vomiting, high fever and flu-like symptoms.   His symptoms occurred within a few hours of receiving his first dose and lasted approximately 21 days. He said he felt ?run down,? and similar feelings of dehydration and exhaustion.  He had the above side effects with second dose but complained that the magnitude of symptoms were much worse and bloody stool increased. He complained of feeling as if he was going to ?pass out,? upon instances of brief aerobic activity.   Upon the"
	"1681700-1"	"1681700-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"After the first dose he complained of bloody stool, severe vomiting, high fever and flu-like symptoms.   His symptoms occurred within a few hours of receiving his first dose and lasted approximately 21 days. He said he felt ?run down,? and similar feelings of dehydration and exhaustion.  He had the above side effects with second dose but complained that the magnitude of symptoms were much worse and bloody stool increased. He complained of feeling as if he was going to ?pass out,? upon instances of brief aerobic activity.   Upon the"
	"1681700-1"	"1681700-1"	"HAEMATOCHEZIA"	"10018836"	"60-64 years"	"60-64"	"After the first dose he complained of bloody stool, severe vomiting, high fever and flu-like symptoms.   His symptoms occurred within a few hours of receiving his first dose and lasted approximately 21 days. He said he felt ?run down,? and similar feelings of dehydration and exhaustion.  He had the above side effects with second dose but complained that the magnitude of symptoms were much worse and bloody stool increased. He complained of feeling as if he was going to ?pass out,? upon instances of brief aerobic activity.   Upon the"
	"1681700-1"	"1681700-1"	"INFLUENZA LIKE ILLNESS"	"10022004"	"60-64 years"	"60-64"	"After the first dose he complained of bloody stool, severe vomiting, high fever and flu-like symptoms.   His symptoms occurred within a few hours of receiving his first dose and lasted approximately 21 days. He said he felt ?run down,? and similar feelings of dehydration and exhaustion.  He had the above side effects with second dose but complained that the magnitude of symptoms were much worse and bloody stool increased. He complained of feeling as if he was going to ?pass out,? upon instances of brief aerobic activity.   Upon the"
	"1681700-1"	"1681700-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"After the first dose he complained of bloody stool, severe vomiting, high fever and flu-like symptoms.   His symptoms occurred within a few hours of receiving his first dose and lasted approximately 21 days. He said he felt ?run down,? and similar feelings of dehydration and exhaustion.  He had the above side effects with second dose but complained that the magnitude of symptoms were much worse and bloody stool increased. He complained of feeling as if he was going to ?pass out,? upon instances of brief aerobic activity.   Upon the"
	"1681700-1"	"1681700-1"	"URINE ANALYSIS"	"10046614"	"60-64 years"	"60-64"	"After the first dose he complained of bloody stool, severe vomiting, high fever and flu-like symptoms.   His symptoms occurred within a few hours of receiving his first dose and lasted approximately 21 days. He said he felt ?run down,? and similar feelings of dehydration and exhaustion.  He had the above side effects with second dose but complained that the magnitude of symptoms were much worse and bloody stool increased. He complained of feeling as if he was going to ?pass out,? upon instances of brief aerobic activity.   Upon the"
	"1681700-1"	"1681700-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"After the first dose he complained of bloody stool, severe vomiting, high fever and flu-like symptoms.   His symptoms occurred within a few hours of receiving his first dose and lasted approximately 21 days. He said he felt ?run down,? and similar feelings of dehydration and exhaustion.  He had the above side effects with second dose but complained that the magnitude of symptoms were much worse and bloody stool increased. He complained of feeling as if he was going to ?pass out,? upon instances of brief aerobic activity.   Upon the"
	"1682490-1"	"1682490-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"60-64 years"	"60-64"	"I am the epidemiologist reporting on behalf of 61-year-old female patient. The patient received two doses of the Pfizer vaccine on 1/29/21 and 2/19/21. The patient tested positive for COVID-19 on 8/10/21 via PCR. The patient died 9/1/21 and the cause of death is listed as ?ARDS Covid-19?. I do not have further information regarding immunodeficiency status or underlying health conditions."
	"1682490-1"	"1682490-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"I am the epidemiologist reporting on behalf of 61-year-old female patient. The patient received two doses of the Pfizer vaccine on 1/29/21 and 2/19/21. The patient tested positive for COVID-19 on 8/10/21 via PCR. The patient died 9/1/21 and the cause of death is listed as ?ARDS Covid-19?. I do not have further information regarding immunodeficiency status or underlying health conditions."
	"1682490-1"	"1682490-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"I am the epidemiologist reporting on behalf of 61-year-old female patient. The patient received two doses of the Pfizer vaccine on 1/29/21 and 2/19/21. The patient tested positive for COVID-19 on 8/10/21 via PCR. The patient died 9/1/21 and the cause of death is listed as ?ARDS Covid-19?. I do not have further information regarding immunodeficiency status or underlying health conditions."
	"1682490-1"	"1682490-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"I am the epidemiologist reporting on behalf of 61-year-old female patient. The patient received two doses of the Pfizer vaccine on 1/29/21 and 2/19/21. The patient tested positive for COVID-19 on 8/10/21 via PCR. The patient died 9/1/21 and the cause of death is listed as ?ARDS Covid-19?. I do not have further information regarding immunodeficiency status or underlying health conditions."
	"1683498-1"	"1683498-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/8/2021. Presented to ED on 8/11/2021 with complaints of shortness of breath for last 7 days. Supplemental oxygen was initiated in the ED. Admitted with COVID 19 pneumonia with ARDS and ongoing respiratory failure. On 8/22/2021 patient had cardiorespiratory arrest and required mechanical ventilation. Medications administered during hospitalization include: dexamethasone, cefepime, levofloxacin, micafungin, and remdesivir. Support withdrawn after discussion with family about poor prognosis. Patient expired at  on 9/1/2021."
	"1683498-1"	"1683498-1"	"BLOOD CULTURE POSITIVE"	"10005488"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/8/2021. Presented to ED on 8/11/2021 with complaints of shortness of breath for last 7 days. Supplemental oxygen was initiated in the ED. Admitted with COVID 19 pneumonia with ARDS and ongoing respiratory failure. On 8/22/2021 patient had cardiorespiratory arrest and required mechanical ventilation. Medications administered during hospitalization include: dexamethasone, cefepime, levofloxacin, micafungin, and remdesivir. Support withdrawn after discussion with family about poor prognosis. Patient expired at  on 9/1/2021."
	"1683498-1"	"1683498-1"	"CANDIDA TEST POSITIVE"	"10070451"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/8/2021. Presented to ED on 8/11/2021 with complaints of shortness of breath for last 7 days. Supplemental oxygen was initiated in the ED. Admitted with COVID 19 pneumonia with ARDS and ongoing respiratory failure. On 8/22/2021 patient had cardiorespiratory arrest and required mechanical ventilation. Medications administered during hospitalization include: dexamethasone, cefepime, levofloxacin, micafungin, and remdesivir. Support withdrawn after discussion with family about poor prognosis. Patient expired at  on 9/1/2021."
	"1683498-1"	"1683498-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/8/2021. Presented to ED on 8/11/2021 with complaints of shortness of breath for last 7 days. Supplemental oxygen was initiated in the ED. Admitted with COVID 19 pneumonia with ARDS and ongoing respiratory failure. On 8/22/2021 patient had cardiorespiratory arrest and required mechanical ventilation. Medications administered during hospitalization include: dexamethasone, cefepime, levofloxacin, micafungin, and remdesivir. Support withdrawn after discussion with family about poor prognosis. Patient expired at  on 9/1/2021."
	"1683498-1"	"1683498-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/8/2021. Presented to ED on 8/11/2021 with complaints of shortness of breath for last 7 days. Supplemental oxygen was initiated in the ED. Admitted with COVID 19 pneumonia with ARDS and ongoing respiratory failure. On 8/22/2021 patient had cardiorespiratory arrest and required mechanical ventilation. Medications administered during hospitalization include: dexamethasone, cefepime, levofloxacin, micafungin, and remdesivir. Support withdrawn after discussion with family about poor prognosis. Patient expired at  on 9/1/2021."
	"1683498-1"	"1683498-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/8/2021. Presented to ED on 8/11/2021 with complaints of shortness of breath for last 7 days. Supplemental oxygen was initiated in the ED. Admitted with COVID 19 pneumonia with ARDS and ongoing respiratory failure. On 8/22/2021 patient had cardiorespiratory arrest and required mechanical ventilation. Medications administered during hospitalization include: dexamethasone, cefepime, levofloxacin, micafungin, and remdesivir. Support withdrawn after discussion with family about poor prognosis. Patient expired at  on 9/1/2021."
	"1683498-1"	"1683498-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/8/2021. Presented to ED on 8/11/2021 with complaints of shortness of breath for last 7 days. Supplemental oxygen was initiated in the ED. Admitted with COVID 19 pneumonia with ARDS and ongoing respiratory failure. On 8/22/2021 patient had cardiorespiratory arrest and required mechanical ventilation. Medications administered during hospitalization include: dexamethasone, cefepime, levofloxacin, micafungin, and remdesivir. Support withdrawn after discussion with family about poor prognosis. Patient expired at  on 9/1/2021."
	"1683498-1"	"1683498-1"	"CULTURE URINE"	"10011638"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/8/2021. Presented to ED on 8/11/2021 with complaints of shortness of breath for last 7 days. Supplemental oxygen was initiated in the ED. Admitted with COVID 19 pneumonia with ARDS and ongoing respiratory failure. On 8/22/2021 patient had cardiorespiratory arrest and required mechanical ventilation. Medications administered during hospitalization include: dexamethasone, cefepime, levofloxacin, micafungin, and remdesivir. Support withdrawn after discussion with family about poor prognosis. Patient expired at  on 9/1/2021."
	"1683498-1"	"1683498-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/8/2021. Presented to ED on 8/11/2021 with complaints of shortness of breath for last 7 days. Supplemental oxygen was initiated in the ED. Admitted with COVID 19 pneumonia with ARDS and ongoing respiratory failure. On 8/22/2021 patient had cardiorespiratory arrest and required mechanical ventilation. Medications administered during hospitalization include: dexamethasone, cefepime, levofloxacin, micafungin, and remdesivir. Support withdrawn after discussion with family about poor prognosis. Patient expired at  on 9/1/2021."
	"1683498-1"	"1683498-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/8/2021. Presented to ED on 8/11/2021 with complaints of shortness of breath for last 7 days. Supplemental oxygen was initiated in the ED. Admitted with COVID 19 pneumonia with ARDS and ongoing respiratory failure. On 8/22/2021 patient had cardiorespiratory arrest and required mechanical ventilation. Medications administered during hospitalization include: dexamethasone, cefepime, levofloxacin, micafungin, and remdesivir. Support withdrawn after discussion with family about poor prognosis. Patient expired at  on 9/1/2021."
	"1683498-1"	"1683498-1"	"LUNG OPACITY"	"10081792"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/8/2021. Presented to ED on 8/11/2021 with complaints of shortness of breath for last 7 days. Supplemental oxygen was initiated in the ED. Admitted with COVID 19 pneumonia with ARDS and ongoing respiratory failure. On 8/22/2021 patient had cardiorespiratory arrest and required mechanical ventilation. Medications administered during hospitalization include: dexamethasone, cefepime, levofloxacin, micafungin, and remdesivir. Support withdrawn after discussion with family about poor prognosis. Patient expired at  on 9/1/2021."
	"1683498-1"	"1683498-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/8/2021. Presented to ED on 8/11/2021 with complaints of shortness of breath for last 7 days. Supplemental oxygen was initiated in the ED. Admitted with COVID 19 pneumonia with ARDS and ongoing respiratory failure. On 8/22/2021 patient had cardiorespiratory arrest and required mechanical ventilation. Medications administered during hospitalization include: dexamethasone, cefepime, levofloxacin, micafungin, and remdesivir. Support withdrawn after discussion with family about poor prognosis. Patient expired at  on 9/1/2021."
	"1683498-1"	"1683498-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/8/2021. Presented to ED on 8/11/2021 with complaints of shortness of breath for last 7 days. Supplemental oxygen was initiated in the ED. Admitted with COVID 19 pneumonia with ARDS and ongoing respiratory failure. On 8/22/2021 patient had cardiorespiratory arrest and required mechanical ventilation. Medications administered during hospitalization include: dexamethasone, cefepime, levofloxacin, micafungin, and remdesivir. Support withdrawn after discussion with family about poor prognosis. Patient expired at  on 9/1/2021."
	"1683498-1"	"1683498-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/8/2021. Presented to ED on 8/11/2021 with complaints of shortness of breath for last 7 days. Supplemental oxygen was initiated in the ED. Admitted with COVID 19 pneumonia with ARDS and ongoing respiratory failure. On 8/22/2021 patient had cardiorespiratory arrest and required mechanical ventilation. Medications administered during hospitalization include: dexamethasone, cefepime, levofloxacin, micafungin, and remdesivir. Support withdrawn after discussion with family about poor prognosis. Patient expired at  on 9/1/2021."
	"1684977-1"	"1684977-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"1st vaccine given on 1/20/21, 2nd dose given on 2/9/21;  tested positive for COVID-19 via PCR on 8/16/2021; admitted to hospital on 8/31/21 with acute respiratory failure secondary to COVID, also had superimposed bacterial pneumonia, severe fever, and died on 9/5/21."
	"1684977-1"	"1684977-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"1st vaccine given on 1/20/21, 2nd dose given on 2/9/21;  tested positive for COVID-19 via PCR on 8/16/2021; admitted to hospital on 8/31/21 with acute respiratory failure secondary to COVID, also had superimposed bacterial pneumonia, severe fever, and died on 9/5/21."
	"1684977-1"	"1684977-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"1st vaccine given on 1/20/21, 2nd dose given on 2/9/21;  tested positive for COVID-19 via PCR on 8/16/2021; admitted to hospital on 8/31/21 with acute respiratory failure secondary to COVID, also had superimposed bacterial pneumonia, severe fever, and died on 9/5/21."
	"1684977-1"	"1684977-1"	"PNEUMONIA BACTERIAL"	"10060946"	"60-64 years"	"60-64"	"1st vaccine given on 1/20/21, 2nd dose given on 2/9/21;  tested positive for COVID-19 via PCR on 8/16/2021; admitted to hospital on 8/31/21 with acute respiratory failure secondary to COVID, also had superimposed bacterial pneumonia, severe fever, and died on 9/5/21."
	"1684977-1"	"1684977-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"1st vaccine given on 1/20/21, 2nd dose given on 2/9/21;  tested positive for COVID-19 via PCR on 8/16/2021; admitted to hospital on 8/31/21 with acute respiratory failure secondary to COVID, also had superimposed bacterial pneumonia, severe fever, and died on 9/5/21."
	"1684977-1"	"1684977-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"1st vaccine given on 1/20/21, 2nd dose given on 2/9/21;  tested positive for COVID-19 via PCR on 8/16/2021; admitted to hospital on 8/31/21 with acute respiratory failure secondary to COVID, also had superimposed bacterial pneumonia, severe fever, and died on 9/5/21."
	"1684977-1"	"1684977-1"	"SUPERINFECTION"	"10042566"	"60-64 years"	"60-64"	"1st vaccine given on 1/20/21, 2nd dose given on 2/9/21;  tested positive for COVID-19 via PCR on 8/16/2021; admitted to hospital on 8/31/21 with acute respiratory failure secondary to COVID, also had superimposed bacterial pneumonia, severe fever, and died on 9/5/21."
	"1685045-1"	"1685045-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"DIARRHEA, POSITIVE COVID TEST, HX OF DIABETES AND HTN; SEIZURE DISORDER"
	"1685045-1"	"1685045-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"DIARRHEA, POSITIVE COVID TEST, HX OF DIABETES AND HTN; SEIZURE DISORDER"
	"1685045-1"	"1685045-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"DIARRHEA, POSITIVE COVID TEST, HX OF DIABETES AND HTN; SEIZURE DISORDER"
	"1685430-1"	"1685430-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"unknown"
	"1685648-1"	"1685648-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685648-1"	"1685648-1"	"BLOOD CULTURE POSITIVE"	"10005488"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685648-1"	"1685648-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685648-1"	"1685648-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685648-1"	"1685648-1"	"DIALYSIS"	"10061105"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685648-1"	"1685648-1"	"DISSEMINATED INTRAVASCULAR COAGULATION"	"10013442"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685648-1"	"1685648-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685648-1"	"1685648-1"	"ENTEROBACTER BACTERAEMIA"	"10058857"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685648-1"	"1685648-1"	"ENTEROBACTER TEST POSITIVE"	"10070023"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685648-1"	"1685648-1"	"GASTROINTESTINAL HAEMORRHAGE"	"10017955"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685648-1"	"1685648-1"	"INAPPROPRIATE SCHEDULE OF PRODUCT ADMINISTRATION"	"10081572"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685648-1"	"1685648-1"	"INTERNATIONAL NORMALISED RATIO DECREASED"	"10022594"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685648-1"	"1685648-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685648-1"	"1685648-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685648-1"	"1685648-1"	"PLATELET COUNT DECREASED"	"10035528"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685648-1"	"1685648-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685648-1"	"1685648-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685648-1"	"1685648-1"	"SEIZURE"	"10039906"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685648-1"	"1685648-1"	"SHOCK"	"10040560"	"60-64 years"	"60-64"	"Pfizer-BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 5/24/2021 and 7/1/2021. Patient previously hospitalized for COVID-19 8/11/2021 to 8/15/2021 where he received remdesivir an. Presented to ED on 8/23/2021 with complaints of difficulty breathing. BiPAP was initiated in ED. Patient oxygenation continued to decompensate and eventually required mechanical ventilation. Patient developed seizures, shock, GI bleeding, DIC, and acute kidney failure requiring dialysis. Patient had enterobacter bacteremia. Patient received dexamethasone, ceftriaxone, cefepime, methylprednisolone, azithromycin, and vancomycin. After discussion with family, care was withdrawn on 9/1/2021 and patient expired at 1442."
	"1685705-1"	"1685705-1"	"BACTERAEMIA"	"10003997"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"BACTERIAL TEST"	"10068074"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"HAEMODIALYSIS"	"10018875"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"MYALGIA"	"10028411"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"RENAL IMPAIRMENT"	"10062237"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"SEPSIS"	"10040047"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"SEPTIC SHOCK"	"10040070"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"STAPHYLOCOCCUS TEST POSITIVE"	"10070052"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"ULTRASOUND KIDNEY NORMAL"	"10045423"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1685705-1"	"1685705-1"	"VASCULAR CATHETERISATION"	"10074169"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 3/11/2021. Presented to ED on 8/25/2021 with a 9-10 day history of coughing, fevers, diarrhea, fatigue, hypoxia, myalgiam and chills. She was started on Dexamethasone on 8/26 and continued this through her hospital course.  Eventually her oxygen requirements escalated and she required intubation on 8/27/21 due to persistent significant hypoxia despite maximum non-invasive interventions. A trialysis catheter was also placed for her and nephrology was consulted due to urgent need for dialysis as her kidney function continued to deteriorate since admission. Renal ultrasound did not show any hydronephrosis or obstructive processes.  On 8/27 she had 3L removed via HD. She required paralytics, sedation, and pain control while on the ventilator. On 8/27/21, her code status was changed to DNAR/COT. Eventually, she developed septic shock and was found later to be bacteremic (GPC in clusters) with a positive MRSA PCR nares. The culture did not have a final result by the time of her passing. She was started on broad spectrum antibiotics on 8/30 at the time of her becoming more septic.  On 8/31, the patient's MAPs and oxygen saturations continued to decrease despite maximal therapy (including four vasopressors). The patient passed away at 0630 on 8/31/21."
	"1689261-1"	"1689261-1"	"ABDOMINAL PAIN"	"10000081"	"60-64 years"	"60-64"	"Patient had her 1st dose of the vaccine on Friday 8/20. Over the next day the patient developed nausea, vomiting and abdominal pain. The pain continued until the patient presented to the emergency department on 08/22. Patient was found to have emphysematous gastritis. She was started on antibiotics and admitted to the intensive care unit. The patient also had significant elevation in liver enzymes. She developed altered mental status and eventually respiratory failure and was unable to protect her airway. Further radiologic examinations showed perforated viscus and diffuse pneumoperitoneum. Patient died on 08/24."
	"1689261-1"	"1689261-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"Patient had her 1st dose of the vaccine on Friday 8/20. Over the next day the patient developed nausea, vomiting and abdominal pain. The pain continued until the patient presented to the emergency department on 08/22. Patient was found to have emphysematous gastritis. She was started on antibiotics and admitted to the intensive care unit. The patient also had significant elevation in liver enzymes. She developed altered mental status and eventually respiratory failure and was unable to protect her airway. Further radiologic examinations showed perforated viscus and diffuse pneumoperitoneum. Patient died on 08/24."
	"1689261-1"	"1689261-1"	"ARTERIAL OCCLUSIVE DISEASE"	"10062599"	"60-64 years"	"60-64"	"Patient had her 1st dose of the vaccine on Friday 8/20. Over the next day the patient developed nausea, vomiting and abdominal pain. The pain continued until the patient presented to the emergency department on 08/22. Patient was found to have emphysematous gastritis. She was started on antibiotics and admitted to the intensive care unit. The patient also had significant elevation in liver enzymes. She developed altered mental status and eventually respiratory failure and was unable to protect her airway. Further radiologic examinations showed perforated viscus and diffuse pneumoperitoneum. Patient died on 08/24."
	"1689261-1"	"1689261-1"	"COMPUTERISED TOMOGRAM ABDOMEN ABNORMAL"	"10057798"	"60-64 years"	"60-64"	"Patient had her 1st dose of the vaccine on Friday 8/20. Over the next day the patient developed nausea, vomiting and abdominal pain. The pain continued until the patient presented to the emergency department on 08/22. Patient was found to have emphysematous gastritis. She was started on antibiotics and admitted to the intensive care unit. The patient also had significant elevation in liver enzymes. She developed altered mental status and eventually respiratory failure and was unable to protect her airway. Further radiologic examinations showed perforated viscus and diffuse pneumoperitoneum. Patient died on 08/24."
	"1689261-1"	"1689261-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient had her 1st dose of the vaccine on Friday 8/20. Over the next day the patient developed nausea, vomiting and abdominal pain. The pain continued until the patient presented to the emergency department on 08/22. Patient was found to have emphysematous gastritis. She was started on antibiotics and admitted to the intensive care unit. The patient also had significant elevation in liver enzymes. She developed altered mental status and eventually respiratory failure and was unable to protect her airway. Further radiologic examinations showed perforated viscus and diffuse pneumoperitoneum. Patient died on 08/24."
	"1689261-1"	"1689261-1"	"DUODENITIS"	"10013864"	"60-64 years"	"60-64"	"Patient had her 1st dose of the vaccine on Friday 8/20. Over the next day the patient developed nausea, vomiting and abdominal pain. The pain continued until the patient presented to the emergency department on 08/22. Patient was found to have emphysematous gastritis. She was started on antibiotics and admitted to the intensive care unit. The patient also had significant elevation in liver enzymes. She developed altered mental status and eventually respiratory failure and was unable to protect her airway. Further radiologic examinations showed perforated viscus and diffuse pneumoperitoneum. Patient died on 08/24."
	"1689261-1"	"1689261-1"	"GASTRITIS BACTERIAL"	"10061971"	"60-64 years"	"60-64"	"Patient had her 1st dose of the vaccine on Friday 8/20. Over the next day the patient developed nausea, vomiting and abdominal pain. The pain continued until the patient presented to the emergency department on 08/22. Patient was found to have emphysematous gastritis. She was started on antibiotics and admitted to the intensive care unit. The patient also had significant elevation in liver enzymes. She developed altered mental status and eventually respiratory failure and was unable to protect her airway. Further radiologic examinations showed perforated viscus and diffuse pneumoperitoneum. Patient died on 08/24."
	"1689261-1"	"1689261-1"	"HEPATIC ENZYME INCREASED"	"10060795"	"60-64 years"	"60-64"	"Patient had her 1st dose of the vaccine on Friday 8/20. Over the next day the patient developed nausea, vomiting and abdominal pain. The pain continued until the patient presented to the emergency department on 08/22. Patient was found to have emphysematous gastritis. She was started on antibiotics and admitted to the intensive care unit. The patient also had significant elevation in liver enzymes. She developed altered mental status and eventually respiratory failure and was unable to protect her airway. Further radiologic examinations showed perforated viscus and diffuse pneumoperitoneum. Patient died on 08/24."
	"1689261-1"	"1689261-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Patient had her 1st dose of the vaccine on Friday 8/20. Over the next day the patient developed nausea, vomiting and abdominal pain. The pain continued until the patient presented to the emergency department on 08/22. Patient was found to have emphysematous gastritis. She was started on antibiotics and admitted to the intensive care unit. The patient also had significant elevation in liver enzymes. She developed altered mental status and eventually respiratory failure and was unable to protect her airway. Further radiologic examinations showed perforated viscus and diffuse pneumoperitoneum. Patient died on 08/24."
	"1689261-1"	"1689261-1"	"INTESTINAL PERFORATION"	"10022694"	"60-64 years"	"60-64"	"Patient had her 1st dose of the vaccine on Friday 8/20. Over the next day the patient developed nausea, vomiting and abdominal pain. The pain continued until the patient presented to the emergency department on 08/22. Patient was found to have emphysematous gastritis. She was started on antibiotics and admitted to the intensive care unit. The patient also had significant elevation in liver enzymes. She developed altered mental status and eventually respiratory failure and was unable to protect her airway. Further radiologic examinations showed perforated viscus and diffuse pneumoperitoneum. Patient died on 08/24."
	"1689261-1"	"1689261-1"	"MENTAL STATUS CHANGES"	"10048294"	"60-64 years"	"60-64"	"Patient had her 1st dose of the vaccine on Friday 8/20. Over the next day the patient developed nausea, vomiting and abdominal pain. The pain continued until the patient presented to the emergency department on 08/22. Patient was found to have emphysematous gastritis. She was started on antibiotics and admitted to the intensive care unit. The patient also had significant elevation in liver enzymes. She developed altered mental status and eventually respiratory failure and was unable to protect her airway. Further radiologic examinations showed perforated viscus and diffuse pneumoperitoneum. Patient died on 08/24."
	"1689261-1"	"1689261-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Patient had her 1st dose of the vaccine on Friday 8/20. Over the next day the patient developed nausea, vomiting and abdominal pain. The pain continued until the patient presented to the emergency department on 08/22. Patient was found to have emphysematous gastritis. She was started on antibiotics and admitted to the intensive care unit. The patient also had significant elevation in liver enzymes. She developed altered mental status and eventually respiratory failure and was unable to protect her airway. Further radiologic examinations showed perforated viscus and diffuse pneumoperitoneum. Patient died on 08/24."
	"1689261-1"	"1689261-1"	"PANCREATITIS"	"10033645"	"60-64 years"	"60-64"	"Patient had her 1st dose of the vaccine on Friday 8/20. Over the next day the patient developed nausea, vomiting and abdominal pain. The pain continued until the patient presented to the emergency department on 08/22. Patient was found to have emphysematous gastritis. She was started on antibiotics and admitted to the intensive care unit. The patient also had significant elevation in liver enzymes. She developed altered mental status and eventually respiratory failure and was unable to protect her airway. Further radiologic examinations showed perforated viscus and diffuse pneumoperitoneum. Patient died on 08/24."
	"1689261-1"	"1689261-1"	"PNEUMOPERITONEUM"	"10048299"	"60-64 years"	"60-64"	"Patient had her 1st dose of the vaccine on Friday 8/20. Over the next day the patient developed nausea, vomiting and abdominal pain. The pain continued until the patient presented to the emergency department on 08/22. Patient was found to have emphysematous gastritis. She was started on antibiotics and admitted to the intensive care unit. The patient also had significant elevation in liver enzymes. She developed altered mental status and eventually respiratory failure and was unable to protect her airway. Further radiologic examinations showed perforated viscus and diffuse pneumoperitoneum. Patient died on 08/24."
	"1689261-1"	"1689261-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	"Patient had her 1st dose of the vaccine on Friday 8/20. Over the next day the patient developed nausea, vomiting and abdominal pain. The pain continued until the patient presented to the emergency department on 08/22. Patient was found to have emphysematous gastritis. She was started on antibiotics and admitted to the intensive care unit. The patient also had significant elevation in liver enzymes. She developed altered mental status and eventually respiratory failure and was unable to protect her airway. Further radiologic examinations showed perforated viscus and diffuse pneumoperitoneum. Patient died on 08/24."
	"1689261-1"	"1689261-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"Patient had her 1st dose of the vaccine on Friday 8/20. Over the next day the patient developed nausea, vomiting and abdominal pain. The pain continued until the patient presented to the emergency department on 08/22. Patient was found to have emphysematous gastritis. She was started on antibiotics and admitted to the intensive care unit. The patient also had significant elevation in liver enzymes. She developed altered mental status and eventually respiratory failure and was unable to protect her airway. Further radiologic examinations showed perforated viscus and diffuse pneumoperitoneum. Patient died on 08/24."
	"1694688-1"	"1694688-1"	"BACK PAIN"	"10003988"	"60-64 years"	"60-64"	"This case meets vaccine breakthrough criteria .  PT ADMITTED FOR EVALUATION OF MELENA, CONFUSION, COUGH, BACK PAIN. PT PASSED AWAY 9/13/21"
	"1694688-1"	"1694688-1"	"CONFUSIONAL STATE"	"10010305"	"60-64 years"	"60-64"	"This case meets vaccine breakthrough criteria .  PT ADMITTED FOR EVALUATION OF MELENA, CONFUSION, COUGH, BACK PAIN. PT PASSED AWAY 9/13/21"
	"1694688-1"	"1694688-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"This case meets vaccine breakthrough criteria .  PT ADMITTED FOR EVALUATION OF MELENA, CONFUSION, COUGH, BACK PAIN. PT PASSED AWAY 9/13/21"
	"1694688-1"	"1694688-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"This case meets vaccine breakthrough criteria .  PT ADMITTED FOR EVALUATION OF MELENA, CONFUSION, COUGH, BACK PAIN. PT PASSED AWAY 9/13/21"
	"1694688-1"	"1694688-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"This case meets vaccine breakthrough criteria .  PT ADMITTED FOR EVALUATION OF MELENA, CONFUSION, COUGH, BACK PAIN. PT PASSED AWAY 9/13/21"
	"1694688-1"	"1694688-1"	"MELAENA"	"10027141"	"60-64 years"	"60-64"	"This case meets vaccine breakthrough criteria .  PT ADMITTED FOR EVALUATION OF MELENA, CONFUSION, COUGH, BACK PAIN. PT PASSED AWAY 9/13/21"
	"1694688-1"	"1694688-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"This case meets vaccine breakthrough criteria .  PT ADMITTED FOR EVALUATION OF MELENA, CONFUSION, COUGH, BACK PAIN. PT PASSED AWAY 9/13/21"
	"1694688-1"	"1694688-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"60-64 years"	"60-64"	"This case meets vaccine breakthrough criteria .  PT ADMITTED FOR EVALUATION OF MELENA, CONFUSION, COUGH, BACK PAIN. PT PASSED AWAY 9/13/21"
	"1694712-1"	"1694712-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"cough, hx of diabetes, long term immunosuppression;  positive COVID test, pneumonia"
	"1694712-1"	"1694712-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"cough, hx of diabetes, long term immunosuppression;  positive COVID test, pneumonia"
	"1694712-1"	"1694712-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"cough, hx of diabetes, long term immunosuppression;  positive COVID test, pneumonia"
	"1694712-1"	"1694712-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"cough, hx of diabetes, long term immunosuppression;  positive COVID test, pneumonia"
	"1696115-1"	"1696115-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient hospitalized and died due to COVID-19. Patient was fully vaccinated."
	"1696115-1"	"1696115-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient hospitalized and died due to COVID-19. Patient was fully vaccinated."
	"1696271-1"	"1696271-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pt had vaccine on 9/9. Four days later he presented at local emergency room with blood clots in both legs. He died at the hospital the same day."
	"1696271-1"	"1696271-1"	"THROMBOSIS"	"10043607"	"60-64 years"	"60-64"	"Pt had vaccine on 9/9. Four days later he presented at local emergency room with blood clots in both legs. He died at the hospital the same day."
	"1696273-1"	"1696273-1"	"CHEST X-RAY"	"10008498"	"60-64 years"	"60-64"	"Pt sent to ER via EMS for AMS and hypotension, cool to touch."
	"1696273-1"	"1696273-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Pt sent to ER via EMS for AMS and hypotension, cool to touch."
	"1696273-1"	"1696273-1"	"HYPOTENSION"	"10021097"	"60-64 years"	"60-64"	"Pt sent to ER via EMS for AMS and hypotension, cool to touch."
	"1696273-1"	"1696273-1"	"LABORATORY TEST"	"10059938"	"60-64 years"	"60-64"	"Pt sent to ER via EMS for AMS and hypotension, cool to touch."
	"1696273-1"	"1696273-1"	"MENTAL STATUS CHANGES"	"10048294"	"60-64 years"	"60-64"	"Pt sent to ER via EMS for AMS and hypotension, cool to touch."
	"1696273-1"	"1696273-1"	"PERIPHERAL COLDNESS"	"10034568"	"60-64 years"	"60-64"	"Pt sent to ER via EMS for AMS and hypotension, cool to touch."
	"1696273-1"	"1696273-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Pt sent to ER via EMS for AMS and hypotension, cool to touch."
	"1696480-1"	"1696480-1"	"BLOOD GASES"	"10005537"	"60-64 years"	"60-64"	"Covid positive week prior to admission, SOB, central line placement, intubation, vasopressors, patient expired"
	"1696480-1"	"1696480-1"	"CENTRAL VENOUS CATHETERISATION"	"10053377"	"60-64 years"	"60-64"	"Covid positive week prior to admission, SOB, central line placement, intubation, vasopressors, patient expired"
	"1696480-1"	"1696480-1"	"CHEST X-RAY"	"10008498"	"60-64 years"	"60-64"	"Covid positive week prior to admission, SOB, central line placement, intubation, vasopressors, patient expired"
	"1696480-1"	"1696480-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Covid positive week prior to admission, SOB, central line placement, intubation, vasopressors, patient expired"
	"1696480-1"	"1696480-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Covid positive week prior to admission, SOB, central line placement, intubation, vasopressors, patient expired"
	"1696480-1"	"1696480-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Covid positive week prior to admission, SOB, central line placement, intubation, vasopressors, patient expired"
	"1696480-1"	"1696480-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Covid positive week prior to admission, SOB, central line placement, intubation, vasopressors, patient expired"
	"1696554-1"	"1696554-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"Patient was recently hospitalized for left BKA from 7/19-8/27 and transferred to rehab. Patient coded and passed away on 9/01. Death doesn't not seemed attributed to vaccine based on patient's PMH."
	"1696554-1"	"1696554-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient was recently hospitalized for left BKA from 7/19-8/27 and transferred to rehab. Patient coded and passed away on 9/01. Death doesn't not seemed attributed to vaccine based on patient's PMH."
	"1696633-1"	"1696633-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Received his first COVID vaccine on Saturday September 4th.  He complained to family about feeling ill afterwards.  He was found deceased on 9/8/2021."
	"1696633-1"	"1696633-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"Received his first COVID vaccine on Saturday September 4th.  He complained to family about feeling ill afterwards.  He was found deceased on 9/8/2021."
	"1696875-1"	"1696875-1"	"AMYOTROPHIC LATERAL SCLEROSIS"	"10002026"	"60-64 years"	"60-64"	"Patient developed ALS shortly after his vaccine. He passed away within 4 months. It is unclear whether or not there is any relation to his development of ALS and his taking the vaccine - other than the association of timing.  His wife felt strongly that this should be reported."
	"1696875-1"	"1696875-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient developed ALS shortly after his vaccine. He passed away within 4 months. It is unclear whether or not there is any relation to his development of ALS and his taking the vaccine - other than the association of timing.  His wife felt strongly that this should be reported."
	"1696875-1"	"1696875-1"	"ELECTROMYOGRAM"	"10014430"	"60-64 years"	"60-64"	"Patient developed ALS shortly after his vaccine. He passed away within 4 months. It is unclear whether or not there is any relation to his development of ALS and his taking the vaccine - other than the association of timing.  His wife felt strongly that this should be reported."
	"1696875-1"	"1696875-1"	"MAGNETIC RESONANCE IMAGING SPINAL"	"10083133"	"60-64 years"	"60-64"	"Patient developed ALS shortly after his vaccine. He passed away within 4 months. It is unclear whether or not there is any relation to his development of ALS and his taking the vaccine - other than the association of timing.  His wife felt strongly that this should be reported."
	"1696875-1"	"1696875-1"	"NERVE CONDUCTION STUDIES"	"10053318"	"60-64 years"	"60-64"	"Patient developed ALS shortly after his vaccine. He passed away within 4 months. It is unclear whether or not there is any relation to his development of ALS and his taking the vaccine - other than the association of timing.  His wife felt strongly that this should be reported."
	"1697379-1"	"1697379-1"	"ADENOCARCINOMA"	"10001141"	"60-64 years"	"60-64"	"On 5/19, there were two lumps grew on his left neck.   He visited his family doctor on 6/2, and some exams were done.  He got the exam report on 6/3.  It showed that his hemoglobin dropped to around 12, and he is severely dehydrated.    Second Covid shot on 6/6/2021,  2 weeks later, he couldn't walk any more due to weakness and pain, around 6/21/2021.   He went to the family doctor on 7/7, and did more test.  His hemoglobin dropped to around 11 as the result showed on 7/8.  He was sent to the emergency room at  Hospital on 7/14.  He found 1 lump in his brain and he was admitted to the hospital immediately.   He was diagnosed lymphoma. There was no treatment.  He was transferred on 7/15.  They found 3 lumps in his brain.  There was no treatment.  He was then diagnosed Goblet Cell Adenocarcinoma.   He was then transferred on 7/15 at 3am.   He had open skull surgery on 7/28, and there 7 tumors in his brain, 1 in his right eye, and numerous in his body.  No treatment.  He passed away on 8/19."
	"1697379-1"	"1697379-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"On 5/19, there were two lumps grew on his left neck.   He visited his family doctor on 6/2, and some exams were done.  He got the exam report on 6/3.  It showed that his hemoglobin dropped to around 12, and he is severely dehydrated.    Second Covid shot on 6/6/2021,  2 weeks later, he couldn't walk any more due to weakness and pain, around 6/21/2021.   He went to the family doctor on 7/7, and did more test.  His hemoglobin dropped to around 11 as the result showed on 7/8.  He was sent to the emergency room at  Hospital on 7/14.  He found 1 lump in his brain and he was admitted to the hospital immediately.   He was diagnosed lymphoma. There was no treatment.  He was transferred on 7/15.  They found 3 lumps in his brain.  There was no treatment.  He was then diagnosed Goblet Cell Adenocarcinoma.   He was then transferred on 7/15 at 3am.   He had open skull surgery on 7/28, and there 7 tumors in his brain, 1 in his right eye, and numerous in his body.  No treatment.  He passed away on 8/19."
	"1697379-1"	"1697379-1"	"BRAIN NEOPLASM"	"10061019"	"60-64 years"	"60-64"	"On 5/19, there were two lumps grew on his left neck.   He visited his family doctor on 6/2, and some exams were done.  He got the exam report on 6/3.  It showed that his hemoglobin dropped to around 12, and he is severely dehydrated.    Second Covid shot on 6/6/2021,  2 weeks later, he couldn't walk any more due to weakness and pain, around 6/21/2021.   He went to the family doctor on 7/7, and did more test.  His hemoglobin dropped to around 11 as the result showed on 7/8.  He was sent to the emergency room at  Hospital on 7/14.  He found 1 lump in his brain and he was admitted to the hospital immediately.   He was diagnosed lymphoma. There was no treatment.  He was transferred on 7/15.  They found 3 lumps in his brain.  There was no treatment.  He was then diagnosed Goblet Cell Adenocarcinoma.   He was then transferred on 7/15 at 3am.   He had open skull surgery on 7/28, and there 7 tumors in his brain, 1 in his right eye, and numerous in his body.  No treatment.  He passed away on 8/19."
	"1697379-1"	"1697379-1"	"BRAIN OPERATION"	"10061732"	"60-64 years"	"60-64"	"On 5/19, there were two lumps grew on his left neck.   He visited his family doctor on 6/2, and some exams were done.  He got the exam report on 6/3.  It showed that his hemoglobin dropped to around 12, and he is severely dehydrated.    Second Covid shot on 6/6/2021,  2 weeks later, he couldn't walk any more due to weakness and pain, around 6/21/2021.   He went to the family doctor on 7/7, and did more test.  His hemoglobin dropped to around 11 as the result showed on 7/8.  He was sent to the emergency room at  Hospital on 7/14.  He found 1 lump in his brain and he was admitted to the hospital immediately.   He was diagnosed lymphoma. There was no treatment.  He was transferred on 7/15.  They found 3 lumps in his brain.  There was no treatment.  He was then diagnosed Goblet Cell Adenocarcinoma.   He was then transferred on 7/15 at 3am.   He had open skull surgery on 7/28, and there 7 tumors in his brain, 1 in his right eye, and numerous in his body.  No treatment.  He passed away on 8/19."
	"1697379-1"	"1697379-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"On 5/19, there were two lumps grew on his left neck.   He visited his family doctor on 6/2, and some exams were done.  He got the exam report on 6/3.  It showed that his hemoglobin dropped to around 12, and he is severely dehydrated.    Second Covid shot on 6/6/2021,  2 weeks later, he couldn't walk any more due to weakness and pain, around 6/21/2021.   He went to the family doctor on 7/7, and did more test.  His hemoglobin dropped to around 11 as the result showed on 7/8.  He was sent to the emergency room at  Hospital on 7/14.  He found 1 lump in his brain and he was admitted to the hospital immediately.   He was diagnosed lymphoma. There was no treatment.  He was transferred on 7/15.  They found 3 lumps in his brain.  There was no treatment.  He was then diagnosed Goblet Cell Adenocarcinoma.   He was then transferred on 7/15 at 3am.   He had open skull surgery on 7/28, and there 7 tumors in his brain, 1 in his right eye, and numerous in his body.  No treatment.  He passed away on 8/19."
	"1697379-1"	"1697379-1"	"DEHYDRATION"	"10012174"	"60-64 years"	"60-64"	"On 5/19, there were two lumps grew on his left neck.   He visited his family doctor on 6/2, and some exams were done.  He got the exam report on 6/3.  It showed that his hemoglobin dropped to around 12, and he is severely dehydrated.    Second Covid shot on 6/6/2021,  2 weeks later, he couldn't walk any more due to weakness and pain, around 6/21/2021.   He went to the family doctor on 7/7, and did more test.  His hemoglobin dropped to around 11 as the result showed on 7/8.  He was sent to the emergency room at  Hospital on 7/14.  He found 1 lump in his brain and he was admitted to the hospital immediately.   He was diagnosed lymphoma. There was no treatment.  He was transferred on 7/15.  They found 3 lumps in his brain.  There was no treatment.  He was then diagnosed Goblet Cell Adenocarcinoma.   He was then transferred on 7/15 at 3am.   He had open skull surgery on 7/28, and there 7 tumors in his brain, 1 in his right eye, and numerous in his body.  No treatment.  He passed away on 8/19."
	"1697379-1"	"1697379-1"	"GAIT INABILITY"	"10017581"	"60-64 years"	"60-64"	"On 5/19, there were two lumps grew on his left neck.   He visited his family doctor on 6/2, and some exams were done.  He got the exam report on 6/3.  It showed that his hemoglobin dropped to around 12, and he is severely dehydrated.    Second Covid shot on 6/6/2021,  2 weeks later, he couldn't walk any more due to weakness and pain, around 6/21/2021.   He went to the family doctor on 7/7, and did more test.  His hemoglobin dropped to around 11 as the result showed on 7/8.  He was sent to the emergency room at  Hospital on 7/14.  He found 1 lump in his brain and he was admitted to the hospital immediately.   He was diagnosed lymphoma. There was no treatment.  He was transferred on 7/15.  They found 3 lumps in his brain.  There was no treatment.  He was then diagnosed Goblet Cell Adenocarcinoma.   He was then transferred on 7/15 at 3am.   He had open skull surgery on 7/28, and there 7 tumors in his brain, 1 in his right eye, and numerous in his body.  No treatment.  He passed away on 8/19."
	"1697379-1"	"1697379-1"	"HAEMOGLOBIN DECREASED"	"10018884"	"60-64 years"	"60-64"	"On 5/19, there were two lumps grew on his left neck.   He visited his family doctor on 6/2, and some exams were done.  He got the exam report on 6/3.  It showed that his hemoglobin dropped to around 12, and he is severely dehydrated.    Second Covid shot on 6/6/2021,  2 weeks later, he couldn't walk any more due to weakness and pain, around 6/21/2021.   He went to the family doctor on 7/7, and did more test.  His hemoglobin dropped to around 11 as the result showed on 7/8.  He was sent to the emergency room at  Hospital on 7/14.  He found 1 lump in his brain and he was admitted to the hospital immediately.   He was diagnosed lymphoma. There was no treatment.  He was transferred on 7/15.  They found 3 lumps in his brain.  There was no treatment.  He was then diagnosed Goblet Cell Adenocarcinoma.   He was then transferred on 7/15 at 3am.   He had open skull surgery on 7/28, and there 7 tumors in his brain, 1 in his right eye, and numerous in his body.  No treatment.  He passed away on 8/19."
	"1697379-1"	"1697379-1"	"INTRACRANIAL MASS"	"10077667"	"60-64 years"	"60-64"	"On 5/19, there were two lumps grew on his left neck.   He visited his family doctor on 6/2, and some exams were done.  He got the exam report on 6/3.  It showed that his hemoglobin dropped to around 12, and he is severely dehydrated.    Second Covid shot on 6/6/2021,  2 weeks later, he couldn't walk any more due to weakness and pain, around 6/21/2021.   He went to the family doctor on 7/7, and did more test.  His hemoglobin dropped to around 11 as the result showed on 7/8.  He was sent to the emergency room at  Hospital on 7/14.  He found 1 lump in his brain and he was admitted to the hospital immediately.   He was diagnosed lymphoma. There was no treatment.  He was transferred on 7/15.  They found 3 lumps in his brain.  There was no treatment.  He was then diagnosed Goblet Cell Adenocarcinoma.   He was then transferred on 7/15 at 3am.   He had open skull surgery on 7/28, and there 7 tumors in his brain, 1 in his right eye, and numerous in his body.  No treatment.  He passed away on 8/19."
	"1697379-1"	"1697379-1"	"LABORATORY TEST"	"10059938"	"60-64 years"	"60-64"	"On 5/19, there were two lumps grew on his left neck.   He visited his family doctor on 6/2, and some exams were done.  He got the exam report on 6/3.  It showed that his hemoglobin dropped to around 12, and he is severely dehydrated.    Second Covid shot on 6/6/2021,  2 weeks later, he couldn't walk any more due to weakness and pain, around 6/21/2021.   He went to the family doctor on 7/7, and did more test.  His hemoglobin dropped to around 11 as the result showed on 7/8.  He was sent to the emergency room at  Hospital on 7/14.  He found 1 lump in his brain and he was admitted to the hospital immediately.   He was diagnosed lymphoma. There was no treatment.  He was transferred on 7/15.  They found 3 lumps in his brain.  There was no treatment.  He was then diagnosed Goblet Cell Adenocarcinoma.   He was then transferred on 7/15 at 3am.   He had open skull surgery on 7/28, and there 7 tumors in his brain, 1 in his right eye, and numerous in his body.  No treatment.  He passed away on 8/19."
	"1697379-1"	"1697379-1"	"LYMPHOMA"	"10025310"	"60-64 years"	"60-64"	"On 5/19, there were two lumps grew on his left neck.   He visited his family doctor on 6/2, and some exams were done.  He got the exam report on 6/3.  It showed that his hemoglobin dropped to around 12, and he is severely dehydrated.    Second Covid shot on 6/6/2021,  2 weeks later, he couldn't walk any more due to weakness and pain, around 6/21/2021.   He went to the family doctor on 7/7, and did more test.  His hemoglobin dropped to around 11 as the result showed on 7/8.  He was sent to the emergency room at  Hospital on 7/14.  He found 1 lump in his brain and he was admitted to the hospital immediately.   He was diagnosed lymphoma. There was no treatment.  He was transferred on 7/15.  They found 3 lumps in his brain.  There was no treatment.  He was then diagnosed Goblet Cell Adenocarcinoma.   He was then transferred on 7/15 at 3am.   He had open skull surgery on 7/28, and there 7 tumors in his brain, 1 in his right eye, and numerous in his body.  No treatment.  He passed away on 8/19."
	"1697379-1"	"1697379-1"	"NECK MASS"	"10049146"	"60-64 years"	"60-64"	"On 5/19, there were two lumps grew on his left neck.   He visited his family doctor on 6/2, and some exams were done.  He got the exam report on 6/3.  It showed that his hemoglobin dropped to around 12, and he is severely dehydrated.    Second Covid shot on 6/6/2021,  2 weeks later, he couldn't walk any more due to weakness and pain, around 6/21/2021.   He went to the family doctor on 7/7, and did more test.  His hemoglobin dropped to around 11 as the result showed on 7/8.  He was sent to the emergency room at  Hospital on 7/14.  He found 1 lump in his brain and he was admitted to the hospital immediately.   He was diagnosed lymphoma. There was no treatment.  He was transferred on 7/15.  They found 3 lumps in his brain.  There was no treatment.  He was then diagnosed Goblet Cell Adenocarcinoma.   He was then transferred on 7/15 at 3am.   He had open skull surgery on 7/28, and there 7 tumors in his brain, 1 in his right eye, and numerous in his body.  No treatment.  He passed away on 8/19."
	"1697379-1"	"1697379-1"	"NEOPLASM"	"10028980"	"60-64 years"	"60-64"	"On 5/19, there were two lumps grew on his left neck.   He visited his family doctor on 6/2, and some exams were done.  He got the exam report on 6/3.  It showed that his hemoglobin dropped to around 12, and he is severely dehydrated.    Second Covid shot on 6/6/2021,  2 weeks later, he couldn't walk any more due to weakness and pain, around 6/21/2021.   He went to the family doctor on 7/7, and did more test.  His hemoglobin dropped to around 11 as the result showed on 7/8.  He was sent to the emergency room at  Hospital on 7/14.  He found 1 lump in his brain and he was admitted to the hospital immediately.   He was diagnosed lymphoma. There was no treatment.  He was transferred on 7/15.  They found 3 lumps in his brain.  There was no treatment.  He was then diagnosed Goblet Cell Adenocarcinoma.   He was then transferred on 7/15 at 3am.   He had open skull surgery on 7/28, and there 7 tumors in his brain, 1 in his right eye, and numerous in his body.  No treatment.  He passed away on 8/19."
	"1697379-1"	"1697379-1"	"OCULAR NEOPLASM"	"10052448"	"60-64 years"	"60-64"	"On 5/19, there were two lumps grew on his left neck.   He visited his family doctor on 6/2, and some exams were done.  He got the exam report on 6/3.  It showed that his hemoglobin dropped to around 12, and he is severely dehydrated.    Second Covid shot on 6/6/2021,  2 weeks later, he couldn't walk any more due to weakness and pain, around 6/21/2021.   He went to the family doctor on 7/7, and did more test.  His hemoglobin dropped to around 11 as the result showed on 7/8.  He was sent to the emergency room at  Hospital on 7/14.  He found 1 lump in his brain and he was admitted to the hospital immediately.   He was diagnosed lymphoma. There was no treatment.  He was transferred on 7/15.  They found 3 lumps in his brain.  There was no treatment.  He was then diagnosed Goblet Cell Adenocarcinoma.   He was then transferred on 7/15 at 3am.   He had open skull surgery on 7/28, and there 7 tumors in his brain, 1 in his right eye, and numerous in his body.  No treatment.  He passed away on 8/19."
	"1697379-1"	"1697379-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"On 5/19, there were two lumps grew on his left neck.   He visited his family doctor on 6/2, and some exams were done.  He got the exam report on 6/3.  It showed that his hemoglobin dropped to around 12, and he is severely dehydrated.    Second Covid shot on 6/6/2021,  2 weeks later, he couldn't walk any more due to weakness and pain, around 6/21/2021.   He went to the family doctor on 7/7, and did more test.  His hemoglobin dropped to around 11 as the result showed on 7/8.  He was sent to the emergency room at  Hospital on 7/14.  He found 1 lump in his brain and he was admitted to the hospital immediately.   He was diagnosed lymphoma. There was no treatment.  He was transferred on 7/15.  They found 3 lumps in his brain.  There was no treatment.  He was then diagnosed Goblet Cell Adenocarcinoma.   He was then transferred on 7/15 at 3am.   He had open skull surgery on 7/28, and there 7 tumors in his brain, 1 in his right eye, and numerous in his body.  No treatment.  He passed away on 8/19."
	"1700557-1"	"1700557-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient Died"
	"1700856-1"	"1700856-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 5/22/2021. Patient was diagnosed with COVID-19 on 8/25/2021 with symptoms of nausea, vomiting, diarrhea starting on 8/24/2021. Per patient reoprt, she was admitted to a different facility for COVID-19 Pneumonia for two days. Patient did not require oxygen at that time. On 9/4/2021 patient presented to ED via EMS with complaints of shortness of breath. When EMS arrived patient was 55-70% on room air, was placed on a non-rebreather and came up to 88%, and was then placed on CPAP en route. Patient was admitted and started on dexamethasone and empiric ceftriaxone. On 9/10/2021, respiratory status"
	"1700856-1"	"1700856-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 5/22/2021. Patient was diagnosed with COVID-19 on 8/25/2021 with symptoms of nausea, vomiting, diarrhea starting on 8/24/2021. Per patient reoprt, she was admitted to a different facility for COVID-19 Pneumonia for two days. Patient did not require oxygen at that time. On 9/4/2021 patient presented to ED via EMS with complaints of shortness of breath. When EMS arrived patient was 55-70% on room air, was placed on a non-rebreather and came up to 88%, and was then placed on CPAP en route. Patient was admitted and started on dexamethasone and empiric ceftriaxone. On 9/10/2021, respiratory status"
	"1700856-1"	"1700856-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 5/22/2021. Patient was diagnosed with COVID-19 on 8/25/2021 with symptoms of nausea, vomiting, diarrhea starting on 8/24/2021. Per patient reoprt, she was admitted to a different facility for COVID-19 Pneumonia for two days. Patient did not require oxygen at that time. On 9/4/2021 patient presented to ED via EMS with complaints of shortness of breath. When EMS arrived patient was 55-70% on room air, was placed on a non-rebreather and came up to 88%, and was then placed on CPAP en route. Patient was admitted and started on dexamethasone and empiric ceftriaxone. On 9/10/2021, respiratory status"
	"1700856-1"	"1700856-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 5/22/2021. Patient was diagnosed with COVID-19 on 8/25/2021 with symptoms of nausea, vomiting, diarrhea starting on 8/24/2021. Per patient reoprt, she was admitted to a different facility for COVID-19 Pneumonia for two days. Patient did not require oxygen at that time. On 9/4/2021 patient presented to ED via EMS with complaints of shortness of breath. When EMS arrived patient was 55-70% on room air, was placed on a non-rebreather and came up to 88%, and was then placed on CPAP en route. Patient was admitted and started on dexamethasone and empiric ceftriaxone. On 9/10/2021, respiratory status"
	"1700856-1"	"1700856-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 5/22/2021. Patient was diagnosed with COVID-19 on 8/25/2021 with symptoms of nausea, vomiting, diarrhea starting on 8/24/2021. Per patient reoprt, she was admitted to a different facility for COVID-19 Pneumonia for two days. Patient did not require oxygen at that time. On 9/4/2021 patient presented to ED via EMS with complaints of shortness of breath. When EMS arrived patient was 55-70% on room air, was placed on a non-rebreather and came up to 88%, and was then placed on CPAP en route. Patient was admitted and started on dexamethasone and empiric ceftriaxone. On 9/10/2021, respiratory status"
	"1700856-1"	"1700856-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 5/22/2021. Patient was diagnosed with COVID-19 on 8/25/2021 with symptoms of nausea, vomiting, diarrhea starting on 8/24/2021. Per patient reoprt, she was admitted to a different facility for COVID-19 Pneumonia for two days. Patient did not require oxygen at that time. On 9/4/2021 patient presented to ED via EMS with complaints of shortness of breath. When EMS arrived patient was 55-70% on room air, was placed on a non-rebreather and came up to 88%, and was then placed on CPAP en route. Patient was admitted and started on dexamethasone and empiric ceftriaxone. On 9/10/2021, respiratory status"
	"1700856-1"	"1700856-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 5/22/2021. Patient was diagnosed with COVID-19 on 8/25/2021 with symptoms of nausea, vomiting, diarrhea starting on 8/24/2021. Per patient reoprt, she was admitted to a different facility for COVID-19 Pneumonia for two days. Patient did not require oxygen at that time. On 9/4/2021 patient presented to ED via EMS with complaints of shortness of breath. When EMS arrived patient was 55-70% on room air, was placed on a non-rebreather and came up to 88%, and was then placed on CPAP en route. Patient was admitted and started on dexamethasone and empiric ceftriaxone. On 9/10/2021, respiratory status"
	"1700856-1"	"1700856-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 5/22/2021. Patient was diagnosed with COVID-19 on 8/25/2021 with symptoms of nausea, vomiting, diarrhea starting on 8/24/2021. Per patient reoprt, she was admitted to a different facility for COVID-19 Pneumonia for two days. Patient did not require oxygen at that time. On 9/4/2021 patient presented to ED via EMS with complaints of shortness of breath. When EMS arrived patient was 55-70% on room air, was placed on a non-rebreather and came up to 88%, and was then placed on CPAP en route. Patient was admitted and started on dexamethasone and empiric ceftriaxone. On 9/10/2021, respiratory status"
	"1700856-1"	"1700856-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 5/22/2021. Patient was diagnosed with COVID-19 on 8/25/2021 with symptoms of nausea, vomiting, diarrhea starting on 8/24/2021. Per patient reoprt, she was admitted to a different facility for COVID-19 Pneumonia for two days. Patient did not require oxygen at that time. On 9/4/2021 patient presented to ED via EMS with complaints of shortness of breath. When EMS arrived patient was 55-70% on room air, was placed on a non-rebreather and came up to 88%, and was then placed on CPAP en route. Patient was admitted and started on dexamethasone and empiric ceftriaxone. On 9/10/2021, respiratory status"
	"1700856-1"	"1700856-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 5/22/2021. Patient was diagnosed with COVID-19 on 8/25/2021 with symptoms of nausea, vomiting, diarrhea starting on 8/24/2021. Per patient reoprt, she was admitted to a different facility for COVID-19 Pneumonia for two days. Patient did not require oxygen at that time. On 9/4/2021 patient presented to ED via EMS with complaints of shortness of breath. When EMS arrived patient was 55-70% on room air, was placed on a non-rebreather and came up to 88%, and was then placed on CPAP en route. Patient was admitted and started on dexamethasone and empiric ceftriaxone. On 9/10/2021, respiratory status"
	"1700856-1"	"1700856-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 5/22/2021. Patient was diagnosed with COVID-19 on 8/25/2021 with symptoms of nausea, vomiting, diarrhea starting on 8/24/2021. Per patient reoprt, she was admitted to a different facility for COVID-19 Pneumonia for two days. Patient did not require oxygen at that time. On 9/4/2021 patient presented to ED via EMS with complaints of shortness of breath. When EMS arrived patient was 55-70% on room air, was placed on a non-rebreather and came up to 88%, and was then placed on CPAP en route. Patient was admitted and started on dexamethasone and empiric ceftriaxone. On 9/10/2021, respiratory status"
	"1700856-1"	"1700856-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 5/22/2021. Patient was diagnosed with COVID-19 on 8/25/2021 with symptoms of nausea, vomiting, diarrhea starting on 8/24/2021. Per patient reoprt, she was admitted to a different facility for COVID-19 Pneumonia for two days. Patient did not require oxygen at that time. On 9/4/2021 patient presented to ED via EMS with complaints of shortness of breath. When EMS arrived patient was 55-70% on room air, was placed on a non-rebreather and came up to 88%, and was then placed on CPAP en route. Patient was admitted and started on dexamethasone and empiric ceftriaxone. On 9/10/2021, respiratory status"
	"1700856-1"	"1700856-1"	"WITHDRAWAL OF LIFE SUPPORT"	"10067595"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 5/22/2021. Patient was diagnosed with COVID-19 on 8/25/2021 with symptoms of nausea, vomiting, diarrhea starting on 8/24/2021. Per patient reoprt, she was admitted to a different facility for COVID-19 Pneumonia for two days. Patient did not require oxygen at that time. On 9/4/2021 patient presented to ED via EMS with complaints of shortness of breath. When EMS arrived patient was 55-70% on room air, was placed on a non-rebreather and came up to 88%, and was then placed on CPAP en route. Patient was admitted and started on dexamethasone and empiric ceftriaxone. On 9/10/2021, respiratory status"
	"1704342-1"	"1704342-1"	"ILLNESS"	"10080284"	"60-64 years"	"60-64"	"Just sick as per family."
	"1704478-1"	"1704478-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"presented with weakness; COVID positive; acute hypoxemia respiratory failure"
	"1704478-1"	"1704478-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"presented with weakness; COVID positive; acute hypoxemia respiratory failure"
	"1704478-1"	"1704478-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"presented with weakness; COVID positive; acute hypoxemia respiratory failure"
	"1704478-1"	"1704478-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"presented with weakness; COVID positive; acute hypoxemia respiratory failure"
	"1704478-1"	"1704478-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"presented with weakness; COVID positive; acute hypoxemia respiratory failure"
	"1705032-1"	"1705032-1"	"ABDOMINAL PAIN"	"10000081"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"ABDOMINAL X-RAY"	"10061612"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"ARTERIOSCLEROSIS"	"10003210"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"BLOOD GLUCOSE DECREASED"	"10005555"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"BLOOD PH DECREASED"	"10005706"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"CHEST X-RAY NORMAL"	"10008500"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"COELIAC ARTERY STENOSIS"	"10067325"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"EXPLORATIVE LAPAROTOMY"	"10053361"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"GASTROINTESTINAL DISORDER"	"10017944"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"GASTROINTESTINAL TUBE INSERTION"	"10053050"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"GRIMACING"	"10061991"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"HAEMOGLOBIN DECREASED"	"10018884"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"HYPOGLYCAEMIA"	"10020993"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"HYPOTENSION"	"10021097"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"ILEUS"	"10021328"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"IMAGING PROCEDURE ABNORMAL"	"10077446"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"INTESTINAL ISCHAEMIA"	"10022680"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"MESENTERIC ARTERIAL OCCLUSION"	"10027394"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"MYDRIASIS"	"10028521"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"PROCEDURAL FAILURE"	"10081594"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1705032-1"	"1705032-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Wayde Olmsted is a 62 y.o. male was admitted on 8/31/2021 for abdominal pain. On imaging he was found to have The superior mesenteric artery origin is chronically occluded with dense calcifications.  There is a very high-grade stenosis of the proximal celiac artery. General surgery was consulted. Vascular surgery was consulted. IR was consulted.  Initially on clinical monitoring it was suspected that his symptoms are from chronic atherosclerosis of the arteries of gut supply. An attempt was made to stent with no success patient tolerated the procedure and plan was to try the next with different approach to stent. Next morning patient found to be unresponsive, hypotensive, hypoglycemic, RRT was called, upon evaluation patient was only minimally responsive to verbal commands, reponded to painful stimuli with grimacing, pupils were uneven and dilated, breathing was even, abdomen was tender, blood sugar 20-30, bp 70/30, Hb 6.8, Ph 7.2 Patient received if fluid bolus, dextrose, attempts to resuscitate made. Patient transferred to ICU. Intubated in ICU. Discuss with General surgery for possible worsening and Acute abdomen, Discuss with Vascular surgery for revascularization option. Patient went to OR open EX Lap done, Ischemic bowel deemed not salvageable. Patient returned to ICU. Called brother and Sister. Shared thought on treatment at this point would be medically futile and discussed Goals of care. They are on the way to hospital to see him and would express choices for goals of care. Patient coded before family could reach to the hospital. Code went on for more than 10 minutes. Patient was positive for covid. Family reached to the hospital and decided for comfort care measures only. Patient passed away on 9/2/2021."
	"1708500-1"	"1708500-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"pt presented with excessive sleepiness and SOB; positive COVID test; pneumonia due to COVID; hx of emphysema/COPD, CKD, HTN; pt's condition deteriorated and died in the hospital"
	"1708500-1"	"1708500-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"pt presented with excessive sleepiness and SOB; positive COVID test; pneumonia due to COVID; hx of emphysema/COPD, CKD, HTN; pt's condition deteriorated and died in the hospital"
	"1708500-1"	"1708500-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"pt presented with excessive sleepiness and SOB; positive COVID test; pneumonia due to COVID; hx of emphysema/COPD, CKD, HTN; pt's condition deteriorated and died in the hospital"
	"1708500-1"	"1708500-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"pt presented with excessive sleepiness and SOB; positive COVID test; pneumonia due to COVID; hx of emphysema/COPD, CKD, HTN; pt's condition deteriorated and died in the hospital"
	"1708500-1"	"1708500-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"60-64 years"	"60-64"	"pt presented with excessive sleepiness and SOB; positive COVID test; pneumonia due to COVID; hx of emphysema/COPD, CKD, HTN; pt's condition deteriorated and died in the hospital"
	"1708500-1"	"1708500-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"pt presented with excessive sleepiness and SOB; positive COVID test; pneumonia due to COVID; hx of emphysema/COPD, CKD, HTN; pt's condition deteriorated and died in the hospital"
	"1708500-1"	"1708500-1"	"SOMNOLENCE"	"10041349"	"60-64 years"	"60-64"	"pt presented with excessive sleepiness and SOB; positive COVID test; pneumonia due to COVID; hx of emphysema/COPD, CKD, HTN; pt's condition deteriorated and died in the hospital"
	"1712704-1"	"1712704-1"	"ACIDOSIS"	"10000486"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"ATRIAL FIBRILLATION"	"10003658"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"BACTERIAL INFECTION"	"10060945"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"BLOOD CULTURE NEGATIVE"	"10005486"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"ECHOCARDIOGRAM"	"10014113"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"ECHOCARDIOGRAM NORMAL"	"10014115"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"EJECTION FRACTION"	"10050527"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"ELECTROCARDIOGRAM NORMAL"	"10014373"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"LUNG INFILTRATION"	"10025102"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"PRONE POSITION"	"10074744"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"PULSE ABSENT"	"10037469"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"SEPSIS"	"10040047"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"ULTRASOUND DOPPLER NORMAL"	"10045414"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"ULTRASOUND SCAN NORMAL"	"10061607"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1712704-1"	"1712704-1"	"WHITE BLOOD CELL COUNT"	"10047939"	"60-64 years"	"60-64"	"Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 08/11/21. Patient was hospitalized from 08/19/21 - 09/12/21. Below is copied from discharge (death) summary:    Patient is a 62 y.o. male with PMH significant for HLD, morbid obesity, DMII, schizophrenia, and anxiety/depression who presents for shortness of breath 2/2 to COVID. Initially admitted on 8/19/21. Patient had increasing O2 requirements with multiples desaturations on HFNC, and subsequently admitted on 8/31 for acute hypoxic respiratory failure/worsening O2 requirements 2/2 COVID PNA. Pt intubated on 8/31. Episodes of Paroxysmal A-fib, lopressor started and amiodarone started on 9/1. HDS during episodes. Bedside echo demonstrated reduced EF. Formal echo on 9/1 was normal LVEF 65%. Fever spiked  8/31 empiric abx (Vanc and Cefepime and flagyl) started. Blood, urine, and respiratory cultures ordered.  Initiated prone ventilation with improving oxygenation. Continue solumedrol, floloan, and statin. DVT ppx. No Toci given duration of illness. Afib with RVR but his cardiac function is wnl so this likely driven by his sepsis and hypoxia. Continue Amio. Strep/Staph bacteremia, however, may be contamination and unable to speciate staph so given his clinical picture, will treat and continue Cefepime. D/c Vanc. D/c Cefepime. Switched to Ancef given MSSA pneumonia. Repeat blood cultures negative. Strep viridans 1/2 blood cultures. Weaning Solumdrol. Tolerating prone ventilation. Procal remains negative but up trending WBC so will send fungal cultures. US lower extremity negative for DVT. US UE negative. Diuresing with Lasix 60 mg IV x2. Robitussin-codeine started for cough. Fevers persistent and WBC slowly downtrending.  D/c Diamox given mild worsening of acidosis. NPH 25 bid with SSI. CXR concerning for progression to fibrotic covid.  S/p Ancef for MSSA pneumonia. Progressive  Hemodynamic instability 9/11 requiring pressors with levophed and vasopressin. Repeat blood cultures 9/10, 1/2 with gram positive rods. Started on vanc/zosyn/caspofungin for broad coverage on 9/11. Called at 10:00PM for lost pulses. Pulse check without pulse. ACLS inititated as patient was full code at the time. Patient received 2x Epi/Bicarb, IVF bolus, and 3 rounds of CPR with PEA. At 3rd pulse check, patient with ROSC. Epi gtt initiated alongside Levo/Vaso/IVF. Pulse Ox with persisent desaturation depsite max FiO2/PEEP. Bedside US without signs of PNX or RV enlargement/strain. ECG without RV strain. CXR without signs of PNX; persistent b/l infiltrates consistent with active COVID. Called significant other, pt made DNR. Bicarb and epi gtt added. Pt's pulse lost again. Time of death 10:17."
	"1713249-1"	"1713249-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Feeling very sick then had trouble walking. Died of a deep vein thrombosis and pulmonary embolism."
	"1713249-1"	"1713249-1"	"DEEP VEIN THROMBOSIS"	"10051055"	"60-64 years"	"60-64"	"Feeling very sick then had trouble walking. Died of a deep vein thrombosis and pulmonary embolism."
	"1713249-1"	"1713249-1"	"GAIT DISTURBANCE"	"10017577"	"60-64 years"	"60-64"	"Feeling very sick then had trouble walking. Died of a deep vein thrombosis and pulmonary embolism."
	"1713249-1"	"1713249-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"Feeling very sick then had trouble walking. Died of a deep vein thrombosis and pulmonary embolism."
	"1713249-1"	"1713249-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"Feeling very sick then had trouble walking. Died of a deep vein thrombosis and pulmonary embolism."
	"1713660-1"	"1713660-1"	"ABDOMINAL PAIN UPPER"	"10000087"	"60-64 years"	"60-64"	"After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect.  This doctor was in the ICU at hospital."
	"1713660-1"	"1713660-1"	"BLOOD TEST"	"10061726"	"60-64 years"	"60-64"	"After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect.  This doctor was in the ICU at hospital."
	"1713660-1"	"1713660-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"60-64 years"	"60-64"	"After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect.  This doctor was in the ICU at hospital."
	"1713660-1"	"1713660-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"60-64 years"	"60-64"	"After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect.  This doctor was in the ICU at hospital."
	"1713660-1"	"1713660-1"	"COMPUTERISED TOMOGRAM"	"10010234"	"60-64 years"	"60-64"	"After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect.  This doctor was in the ICU at hospital."
	"1713660-1"	"1713660-1"	"DELIRIUM"	"10012218"	"60-64 years"	"60-64"	"After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect.  This doctor was in the ICU at hospital."
	"1713660-1"	"1713660-1"	"EPISTAXIS"	"10015090"	"60-64 years"	"60-64"	"After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect.  This doctor was in the ICU at hospital."
	"1713660-1"	"1713660-1"	"FAECAL VOMITING"	"10064670"	"60-64 years"	"60-64"	"After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect.  This doctor was in the ICU at hospital."
	"1713660-1"	"1713660-1"	"HAEMATEMESIS"	"10018830"	"60-64 years"	"60-64"	"After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect.  This doctor was in the ICU at hospital."
	"1713660-1"	"1713660-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect.  This doctor was in the ICU at hospital."
	"1713660-1"	"1713660-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect.  This doctor was in the ICU at hospital."
	"1713660-1"	"1713660-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect.  This doctor was in the ICU at hospital."
	"1713660-1"	"1713660-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect.  This doctor was in the ICU at hospital."
	"1713660-1"	"1713660-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect.  This doctor was in the ICU at hospital."
	"1713660-1"	"1713660-1"	"PLATELET COUNT DECREASED"	"10035528"	"60-64 years"	"60-64"	"After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect.  This doctor was in the ICU at hospital."
	"1713660-1"	"1713660-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	"After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect.  This doctor was in the ICU at hospital."
	"1713660-1"	"1713660-1"	"THROMBOTIC THROMBOCYTOPENIC PURPURA"	"10043648"	"60-64 years"	"60-64"	"After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect.  This doctor was in the ICU at hospital."
	"1713660-1"	"1713660-1"	"URINARY TRACT INFECTION"	"10046571"	"60-64 years"	"60-64"	"After receiving his second vaccine, he complained that he was having a headache, a stomach ache, and ?not feeling good?. Went to the hospital on 03/20/2021 complaining of worsening pain and the hospital only treated him for a UTI with antibiotic, altough his platelet count was low (was unaddressed). After being released two days later, he became delirious and then starting throwing up blood, having a nose bleed, and throwing up his feces. They put him on the vent, tested him for Covid 3-6 times (all negative), and then diagnosed him with a brain hemorrhage that later led to a massive stroke. They diagnosed him (tentatively) with TTP due to low platelet count, however upon informing the doctor of him recently being vaccinated, she stated it could have been ITP, however she did not report this adverse effect.  This doctor was in the ICU at hospital."
	"1715538-1"	"1715538-1"	"AGEUSIA"	"10001480"	"60-64 years"	"60-64"	"Patient had diabetes, breast cancer and hypertension. Presented to the ED with a fever of 104, productive cough, shortness of breath, loss of taste, fatigue, and low oxygen saturations. She was diagnosed with COVID one week ago.  Patient was admitted with COVID PNA and was placed on a ventilator on 8/22/2021. Patient developed significant bradycardia due to COVID myocarditis. She had only received her first dose of Moderna 8/3/2021. She continued to deteriorate and family chose to terminally extubate her and she expired on 9/4/2021."
	"1715538-1"	"1715538-1"	"BRADYCARDIA"	"10006093"	"60-64 years"	"60-64"	"Patient had diabetes, breast cancer and hypertension. Presented to the ED with a fever of 104, productive cough, shortness of breath, loss of taste, fatigue, and low oxygen saturations. She was diagnosed with COVID one week ago.  Patient was admitted with COVID PNA and was placed on a ventilator on 8/22/2021. Patient developed significant bradycardia due to COVID myocarditis. She had only received her first dose of Moderna 8/3/2021. She continued to deteriorate and family chose to terminally extubate her and she expired on 9/4/2021."
	"1715538-1"	"1715538-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Patient had diabetes, breast cancer and hypertension. Presented to the ED with a fever of 104, productive cough, shortness of breath, loss of taste, fatigue, and low oxygen saturations. She was diagnosed with COVID one week ago.  Patient was admitted with COVID PNA and was placed on a ventilator on 8/22/2021. Patient developed significant bradycardia due to COVID myocarditis. She had only received her first dose of Moderna 8/3/2021. She continued to deteriorate and family chose to terminally extubate her and she expired on 9/4/2021."
	"1715538-1"	"1715538-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient had diabetes, breast cancer and hypertension. Presented to the ED with a fever of 104, productive cough, shortness of breath, loss of taste, fatigue, and low oxygen saturations. She was diagnosed with COVID one week ago.  Patient was admitted with COVID PNA and was placed on a ventilator on 8/22/2021. Patient developed significant bradycardia due to COVID myocarditis. She had only received her first dose of Moderna 8/3/2021. She continued to deteriorate and family chose to terminally extubate her and she expired on 9/4/2021."
	"1715538-1"	"1715538-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Patient had diabetes, breast cancer and hypertension. Presented to the ED with a fever of 104, productive cough, shortness of breath, loss of taste, fatigue, and low oxygen saturations. She was diagnosed with COVID one week ago.  Patient was admitted with COVID PNA and was placed on a ventilator on 8/22/2021. Patient developed significant bradycardia due to COVID myocarditis. She had only received her first dose of Moderna 8/3/2021. She continued to deteriorate and family chose to terminally extubate her and she expired on 9/4/2021."
	"1715538-1"	"1715538-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Patient had diabetes, breast cancer and hypertension. Presented to the ED with a fever of 104, productive cough, shortness of breath, loss of taste, fatigue, and low oxygen saturations. She was diagnosed with COVID one week ago.  Patient was admitted with COVID PNA and was placed on a ventilator on 8/22/2021. Patient developed significant bradycardia due to COVID myocarditis. She had only received her first dose of Moderna 8/3/2021. She continued to deteriorate and family chose to terminally extubate her and she expired on 9/4/2021."
	"1715538-1"	"1715538-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"60-64 years"	"60-64"	"Patient had diabetes, breast cancer and hypertension. Presented to the ED with a fever of 104, productive cough, shortness of breath, loss of taste, fatigue, and low oxygen saturations. She was diagnosed with COVID one week ago.  Patient was admitted with COVID PNA and was placed on a ventilator on 8/22/2021. Patient developed significant bradycardia due to COVID myocarditis. She had only received her first dose of Moderna 8/3/2021. She continued to deteriorate and family chose to terminally extubate her and she expired on 9/4/2021."
	"1715538-1"	"1715538-1"	"HOSPITALISATION"	"10054112"	"60-64 years"	"60-64"	"Patient had diabetes, breast cancer and hypertension. Presented to the ED with a fever of 104, productive cough, shortness of breath, loss of taste, fatigue, and low oxygen saturations. She was diagnosed with COVID one week ago.  Patient was admitted with COVID PNA and was placed on a ventilator on 8/22/2021. Patient developed significant bradycardia due to COVID myocarditis. She had only received her first dose of Moderna 8/3/2021. She continued to deteriorate and family chose to terminally extubate her and she expired on 9/4/2021."
	"1715538-1"	"1715538-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Patient had diabetes, breast cancer and hypertension. Presented to the ED with a fever of 104, productive cough, shortness of breath, loss of taste, fatigue, and low oxygen saturations. She was diagnosed with COVID one week ago.  Patient was admitted with COVID PNA and was placed on a ventilator on 8/22/2021. Patient developed significant bradycardia due to COVID myocarditis. She had only received her first dose of Moderna 8/3/2021. She continued to deteriorate and family chose to terminally extubate her and she expired on 9/4/2021."
	"1715538-1"	"1715538-1"	"MYOCARDITIS"	"10028606"	"60-64 years"	"60-64"	"Patient had diabetes, breast cancer and hypertension. Presented to the ED with a fever of 104, productive cough, shortness of breath, loss of taste, fatigue, and low oxygen saturations. She was diagnosed with COVID one week ago.  Patient was admitted with COVID PNA and was placed on a ventilator on 8/22/2021. Patient developed significant bradycardia due to COVID myocarditis. She had only received her first dose of Moderna 8/3/2021. She continued to deteriorate and family chose to terminally extubate her and she expired on 9/4/2021."
	"1715538-1"	"1715538-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"Patient had diabetes, breast cancer and hypertension. Presented to the ED with a fever of 104, productive cough, shortness of breath, loss of taste, fatigue, and low oxygen saturations. She was diagnosed with COVID one week ago.  Patient was admitted with COVID PNA and was placed on a ventilator on 8/22/2021. Patient developed significant bradycardia due to COVID myocarditis. She had only received her first dose of Moderna 8/3/2021. She continued to deteriorate and family chose to terminally extubate her and she expired on 9/4/2021."
	"1715538-1"	"1715538-1"	"PO2 DECREASED"	"10035768"	"60-64 years"	"60-64"	"Patient had diabetes, breast cancer and hypertension. Presented to the ED with a fever of 104, productive cough, shortness of breath, loss of taste, fatigue, and low oxygen saturations. She was diagnosed with COVID one week ago.  Patient was admitted with COVID PNA and was placed on a ventilator on 8/22/2021. Patient developed significant bradycardia due to COVID myocarditis. She had only received her first dose of Moderna 8/3/2021. She continued to deteriorate and family chose to terminally extubate her and she expired on 9/4/2021."
	"1715538-1"	"1715538-1"	"PRODUCTIVE COUGH"	"10036790"	"60-64 years"	"60-64"	"Patient had diabetes, breast cancer and hypertension. Presented to the ED with a fever of 104, productive cough, shortness of breath, loss of taste, fatigue, and low oxygen saturations. She was diagnosed with COVID one week ago.  Patient was admitted with COVID PNA and was placed on a ventilator on 8/22/2021. Patient developed significant bradycardia due to COVID myocarditis. She had only received her first dose of Moderna 8/3/2021. She continued to deteriorate and family chose to terminally extubate her and she expired on 9/4/2021."
	"1715538-1"	"1715538-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Patient had diabetes, breast cancer and hypertension. Presented to the ED with a fever of 104, productive cough, shortness of breath, loss of taste, fatigue, and low oxygen saturations. She was diagnosed with COVID one week ago.  Patient was admitted with COVID PNA and was placed on a ventilator on 8/22/2021. Patient developed significant bradycardia due to COVID myocarditis. She had only received her first dose of Moderna 8/3/2021. She continued to deteriorate and family chose to terminally extubate her and she expired on 9/4/2021."
	"1715718-1"	"1715718-1"	"ABDOMINAL PAIN"	"10000081"	"60-64 years"	"60-64"	"The patient reported that she experienced a: Fever, Sore Throat, Headache, Muscle Aches, Chills, Runny nose, Shortness of Breath Abdominal Pains, Cough, Nausea, Vomiting, Diarrhea, and Fatigue. Symptoms started on 7/30. The patient stated that she lives with her husband who tested positive. Reported Chronic Kidney Disease, Hypertension, PROBABLE MYOCARDIAL INFARCTION> DEATH ON 8/28/2021"
	"1715718-1"	"1715718-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"The patient reported that she experienced a: Fever, Sore Throat, Headache, Muscle Aches, Chills, Runny nose, Shortness of Breath Abdominal Pains, Cough, Nausea, Vomiting, Diarrhea, and Fatigue. Symptoms started on 7/30. The patient stated that she lives with her husband who tested positive. Reported Chronic Kidney Disease, Hypertension, PROBABLE MYOCARDIAL INFARCTION> DEATH ON 8/28/2021"
	"1715718-1"	"1715718-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"The patient reported that she experienced a: Fever, Sore Throat, Headache, Muscle Aches, Chills, Runny nose, Shortness of Breath Abdominal Pains, Cough, Nausea, Vomiting, Diarrhea, and Fatigue. Symptoms started on 7/30. The patient stated that she lives with her husband who tested positive. Reported Chronic Kidney Disease, Hypertension, PROBABLE MYOCARDIAL INFARCTION> DEATH ON 8/28/2021"
	"1715718-1"	"1715718-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"The patient reported that she experienced a: Fever, Sore Throat, Headache, Muscle Aches, Chills, Runny nose, Shortness of Breath Abdominal Pains, Cough, Nausea, Vomiting, Diarrhea, and Fatigue. Symptoms started on 7/30. The patient stated that she lives with her husband who tested positive. Reported Chronic Kidney Disease, Hypertension, PROBABLE MYOCARDIAL INFARCTION> DEATH ON 8/28/2021"
	"1715718-1"	"1715718-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"The patient reported that she experienced a: Fever, Sore Throat, Headache, Muscle Aches, Chills, Runny nose, Shortness of Breath Abdominal Pains, Cough, Nausea, Vomiting, Diarrhea, and Fatigue. Symptoms started on 7/30. The patient stated that she lives with her husband who tested positive. Reported Chronic Kidney Disease, Hypertension, PROBABLE MYOCARDIAL INFARCTION> DEATH ON 8/28/2021"
	"1715718-1"	"1715718-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"The patient reported that she experienced a: Fever, Sore Throat, Headache, Muscle Aches, Chills, Runny nose, Shortness of Breath Abdominal Pains, Cough, Nausea, Vomiting, Diarrhea, and Fatigue. Symptoms started on 7/30. The patient stated that she lives with her husband who tested positive. Reported Chronic Kidney Disease, Hypertension, PROBABLE MYOCARDIAL INFARCTION> DEATH ON 8/28/2021"
	"1715718-1"	"1715718-1"	"EXPOSURE TO SARS-COV-2"	"10084456"	"60-64 years"	"60-64"	"The patient reported that she experienced a: Fever, Sore Throat, Headache, Muscle Aches, Chills, Runny nose, Shortness of Breath Abdominal Pains, Cough, Nausea, Vomiting, Diarrhea, and Fatigue. Symptoms started on 7/30. The patient stated that she lives with her husband who tested positive. Reported Chronic Kidney Disease, Hypertension, PROBABLE MYOCARDIAL INFARCTION> DEATH ON 8/28/2021"
	"1715718-1"	"1715718-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"The patient reported that she experienced a: Fever, Sore Throat, Headache, Muscle Aches, Chills, Runny nose, Shortness of Breath Abdominal Pains, Cough, Nausea, Vomiting, Diarrhea, and Fatigue. Symptoms started on 7/30. The patient stated that she lives with her husband who tested positive. Reported Chronic Kidney Disease, Hypertension, PROBABLE MYOCARDIAL INFARCTION> DEATH ON 8/28/2021"
	"1715718-1"	"1715718-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"The patient reported that she experienced a: Fever, Sore Throat, Headache, Muscle Aches, Chills, Runny nose, Shortness of Breath Abdominal Pains, Cough, Nausea, Vomiting, Diarrhea, and Fatigue. Symptoms started on 7/30. The patient stated that she lives with her husband who tested positive. Reported Chronic Kidney Disease, Hypertension, PROBABLE MYOCARDIAL INFARCTION> DEATH ON 8/28/2021"
	"1715718-1"	"1715718-1"	"MYALGIA"	"10028411"	"60-64 years"	"60-64"	"The patient reported that she experienced a: Fever, Sore Throat, Headache, Muscle Aches, Chills, Runny nose, Shortness of Breath Abdominal Pains, Cough, Nausea, Vomiting, Diarrhea, and Fatigue. Symptoms started on 7/30. The patient stated that she lives with her husband who tested positive. Reported Chronic Kidney Disease, Hypertension, PROBABLE MYOCARDIAL INFARCTION> DEATH ON 8/28/2021"
	"1715718-1"	"1715718-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"The patient reported that she experienced a: Fever, Sore Throat, Headache, Muscle Aches, Chills, Runny nose, Shortness of Breath Abdominal Pains, Cough, Nausea, Vomiting, Diarrhea, and Fatigue. Symptoms started on 7/30. The patient stated that she lives with her husband who tested positive. Reported Chronic Kidney Disease, Hypertension, PROBABLE MYOCARDIAL INFARCTION> DEATH ON 8/28/2021"
	"1715718-1"	"1715718-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"The patient reported that she experienced a: Fever, Sore Throat, Headache, Muscle Aches, Chills, Runny nose, Shortness of Breath Abdominal Pains, Cough, Nausea, Vomiting, Diarrhea, and Fatigue. Symptoms started on 7/30. The patient stated that she lives with her husband who tested positive. Reported Chronic Kidney Disease, Hypertension, PROBABLE MYOCARDIAL INFARCTION> DEATH ON 8/28/2021"
	"1715718-1"	"1715718-1"	"OROPHARYNGEAL PAIN"	"10068319"	"60-64 years"	"60-64"	"The patient reported that she experienced a: Fever, Sore Throat, Headache, Muscle Aches, Chills, Runny nose, Shortness of Breath Abdominal Pains, Cough, Nausea, Vomiting, Diarrhea, and Fatigue. Symptoms started on 7/30. The patient stated that she lives with her husband who tested positive. Reported Chronic Kidney Disease, Hypertension, PROBABLE MYOCARDIAL INFARCTION> DEATH ON 8/28/2021"
	"1715718-1"	"1715718-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"The patient reported that she experienced a: Fever, Sore Throat, Headache, Muscle Aches, Chills, Runny nose, Shortness of Breath Abdominal Pains, Cough, Nausea, Vomiting, Diarrhea, and Fatigue. Symptoms started on 7/30. The patient stated that she lives with her husband who tested positive. Reported Chronic Kidney Disease, Hypertension, PROBABLE MYOCARDIAL INFARCTION> DEATH ON 8/28/2021"
	"1715718-1"	"1715718-1"	"RHINORRHOEA"	"10039101"	"60-64 years"	"60-64"	"The patient reported that she experienced a: Fever, Sore Throat, Headache, Muscle Aches, Chills, Runny nose, Shortness of Breath Abdominal Pains, Cough, Nausea, Vomiting, Diarrhea, and Fatigue. Symptoms started on 7/30. The patient stated that she lives with her husband who tested positive. Reported Chronic Kidney Disease, Hypertension, PROBABLE MYOCARDIAL INFARCTION> DEATH ON 8/28/2021"
	"1715718-1"	"1715718-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"The patient reported that she experienced a: Fever, Sore Throat, Headache, Muscle Aches, Chills, Runny nose, Shortness of Breath Abdominal Pains, Cough, Nausea, Vomiting, Diarrhea, and Fatigue. Symptoms started on 7/30. The patient stated that she lives with her husband who tested positive. Reported Chronic Kidney Disease, Hypertension, PROBABLE MYOCARDIAL INFARCTION> DEATH ON 8/28/2021"
	"1718168-1"	"1718168-1"	"BODY TEMPERATURE"	"10005906"	"60-64 years"	"60-64"	"Patient passed away February 9, 2021 at 2:12am.; At around 11:30pm-11:45pm  difficulty of breathing was noted.; fever,Fever progressed to 103F; Very tired/feeling of very tired; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (Patient passed away February 9, 2021 at 2:12am.) in a 62-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 028L-20A and 039K20-2A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concomitant products included RIVAROXABAN (XARELTO) for an unknown indication.   On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 08-Feb-2021, the patient experienced DYSPNOEA (At around 11:30pm-11:45pm  difficulty of breathing was noted.), PYREXIA (fever,Fever progressed to 103F) and FATIGUE (Very tired/feeling of very tired). The patient was treated with PARACETAMOL (TYLENOL) on 08-Feb-2021 for Fever, at a dose of 1 dosage form. On 09-Feb-2021, DYSPNOEA (At around 11:30pm-11:45pm  difficulty of breathing was noted.), PYREXIA (fever,Fever progressed to 103F) and FATIGUE (Very tired/feeling of very tired) outcome was unknown. The patient died on 09-Feb-2021. The cause of death was not reported. It is unknown if an autopsy was performed.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 08-Feb-2021, Body temperature: 103 (Inconclusive) Fever progressed to 103F. On 08-Feb-2021, Oxygen saturation: decreased (Inconclusive) At 10pm his oxygen level dropped.   For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.   Concomitant medication also included medication for blood pressure.  On 08 Feb 2021 patient had the 2nd dose of Moderna Covid19 vaccine in the morning. Patient was fine until 5pm when patient complained of fever and feeling of very tired. Fever progressed to 103F. Patient took Tylenol. At 10pm his oxygen level dropped; patient laid down in bed. At around 11:30pm-11:45pm difficulty of breathing was noted. They immediately called 911. 911 came at around 12:50am but the patient arrested in the driveway. At the Emergency Room, they tried to revive the patient but unsuccessful. Patient passed away on 09 Feb 2021 at 2:12am.  This case concerns a 62 year old male experienced serious adverse event of death one day after receiving the second dose of the vaccine and in addition with non-serious adverse events of dyspnea, fever and fatigue. Dechallenge was unknown and rechallenge was not applicable. Limited information provided. The benefit-risk relationship is not affected by this report.; Sender's Comments: This case concerns a 62 year old male experienced serious adverse event of death one day after receiving the second dose of the vaccine and in addition with non-serious adverse events of dyspnea, fever and fatigue. Dechallenge was unknown and rechallenge was not applicable. Limited information provided. The benefit-risk relationship is not affected by this report.; Reported Cause(s) of Death: Unknown Cause of death"
	"1718168-1"	"1718168-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient passed away February 9, 2021 at 2:12am.; At around 11:30pm-11:45pm  difficulty of breathing was noted.; fever,Fever progressed to 103F; Very tired/feeling of very tired; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (Patient passed away February 9, 2021 at 2:12am.) in a 62-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 028L-20A and 039K20-2A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concomitant products included RIVAROXABAN (XARELTO) for an unknown indication.   On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 08-Feb-2021, the patient experienced DYSPNOEA (At around 11:30pm-11:45pm  difficulty of breathing was noted.), PYREXIA (fever,Fever progressed to 103F) and FATIGUE (Very tired/feeling of very tired). The patient was treated with PARACETAMOL (TYLENOL) on 08-Feb-2021 for Fever, at a dose of 1 dosage form. On 09-Feb-2021, DYSPNOEA (At around 11:30pm-11:45pm  difficulty of breathing was noted.), PYREXIA (fever,Fever progressed to 103F) and FATIGUE (Very tired/feeling of very tired) outcome was unknown. The patient died on 09-Feb-2021. The cause of death was not reported. It is unknown if an autopsy was performed.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 08-Feb-2021, Body temperature: 103 (Inconclusive) Fever progressed to 103F. On 08-Feb-2021, Oxygen saturation: decreased (Inconclusive) At 10pm his oxygen level dropped.   For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.   Concomitant medication also included medication for blood pressure.  On 08 Feb 2021 patient had the 2nd dose of Moderna Covid19 vaccine in the morning. Patient was fine until 5pm when patient complained of fever and feeling of very tired. Fever progressed to 103F. Patient took Tylenol. At 10pm his oxygen level dropped; patient laid down in bed. At around 11:30pm-11:45pm difficulty of breathing was noted. They immediately called 911. 911 came at around 12:50am but the patient arrested in the driveway. At the Emergency Room, they tried to revive the patient but unsuccessful. Patient passed away on 09 Feb 2021 at 2:12am.  This case concerns a 62 year old male experienced serious adverse event of death one day after receiving the second dose of the vaccine and in addition with non-serious adverse events of dyspnea, fever and fatigue. Dechallenge was unknown and rechallenge was not applicable. Limited information provided. The benefit-risk relationship is not affected by this report.; Sender's Comments: This case concerns a 62 year old male experienced serious adverse event of death one day after receiving the second dose of the vaccine and in addition with non-serious adverse events of dyspnea, fever and fatigue. Dechallenge was unknown and rechallenge was not applicable. Limited information provided. The benefit-risk relationship is not affected by this report.; Reported Cause(s) of Death: Unknown Cause of death"
	"1718168-1"	"1718168-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Patient passed away February 9, 2021 at 2:12am.; At around 11:30pm-11:45pm  difficulty of breathing was noted.; fever,Fever progressed to 103F; Very tired/feeling of very tired; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (Patient passed away February 9, 2021 at 2:12am.) in a 62-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 028L-20A and 039K20-2A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concomitant products included RIVAROXABAN (XARELTO) for an unknown indication.   On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 08-Feb-2021, the patient experienced DYSPNOEA (At around 11:30pm-11:45pm  difficulty of breathing was noted.), PYREXIA (fever,Fever progressed to 103F) and FATIGUE (Very tired/feeling of very tired). The patient was treated with PARACETAMOL (TYLENOL) on 08-Feb-2021 for Fever, at a dose of 1 dosage form. On 09-Feb-2021, DYSPNOEA (At around 11:30pm-11:45pm  difficulty of breathing was noted.), PYREXIA (fever,Fever progressed to 103F) and FATIGUE (Very tired/feeling of very tired) outcome was unknown. The patient died on 09-Feb-2021. The cause of death was not reported. It is unknown if an autopsy was performed.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 08-Feb-2021, Body temperature: 103 (Inconclusive) Fever progressed to 103F. On 08-Feb-2021, Oxygen saturation: decreased (Inconclusive) At 10pm his oxygen level dropped.   For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.   Concomitant medication also included medication for blood pressure.  On 08 Feb 2021 patient had the 2nd dose of Moderna Covid19 vaccine in the morning. Patient was fine until 5pm when patient complained of fever and feeling of very tired. Fever progressed to 103F. Patient took Tylenol. At 10pm his oxygen level dropped; patient laid down in bed. At around 11:30pm-11:45pm difficulty of breathing was noted. They immediately called 911. 911 came at around 12:50am but the patient arrested in the driveway. At the Emergency Room, they tried to revive the patient but unsuccessful. Patient passed away on 09 Feb 2021 at 2:12am.  This case concerns a 62 year old male experienced serious adverse event of death one day after receiving the second dose of the vaccine and in addition with non-serious adverse events of dyspnea, fever and fatigue. Dechallenge was unknown and rechallenge was not applicable. Limited information provided. The benefit-risk relationship is not affected by this report.; Sender's Comments: This case concerns a 62 year old male experienced serious adverse event of death one day after receiving the second dose of the vaccine and in addition with non-serious adverse events of dyspnea, fever and fatigue. Dechallenge was unknown and rechallenge was not applicable. Limited information provided. The benefit-risk relationship is not affected by this report.; Reported Cause(s) of Death: Unknown Cause of death"
	"1718168-1"	"1718168-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Patient passed away February 9, 2021 at 2:12am.; At around 11:30pm-11:45pm  difficulty of breathing was noted.; fever,Fever progressed to 103F; Very tired/feeling of very tired; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (Patient passed away February 9, 2021 at 2:12am.) in a 62-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 028L-20A and 039K20-2A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concomitant products included RIVAROXABAN (XARELTO) for an unknown indication.   On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 08-Feb-2021, the patient experienced DYSPNOEA (At around 11:30pm-11:45pm  difficulty of breathing was noted.), PYREXIA (fever,Fever progressed to 103F) and FATIGUE (Very tired/feeling of very tired). The patient was treated with PARACETAMOL (TYLENOL) on 08-Feb-2021 for Fever, at a dose of 1 dosage form. On 09-Feb-2021, DYSPNOEA (At around 11:30pm-11:45pm  difficulty of breathing was noted.), PYREXIA (fever,Fever progressed to 103F) and FATIGUE (Very tired/feeling of very tired) outcome was unknown. The patient died on 09-Feb-2021. The cause of death was not reported. It is unknown if an autopsy was performed.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 08-Feb-2021, Body temperature: 103 (Inconclusive) Fever progressed to 103F. On 08-Feb-2021, Oxygen saturation: decreased (Inconclusive) At 10pm his oxygen level dropped.   For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.   Concomitant medication also included medication for blood pressure.  On 08 Feb 2021 patient had the 2nd dose of Moderna Covid19 vaccine in the morning. Patient was fine until 5pm when patient complained of fever and feeling of very tired. Fever progressed to 103F. Patient took Tylenol. At 10pm his oxygen level dropped; patient laid down in bed. At around 11:30pm-11:45pm difficulty of breathing was noted. They immediately called 911. 911 came at around 12:50am but the patient arrested in the driveway. At the Emergency Room, they tried to revive the patient but unsuccessful. Patient passed away on 09 Feb 2021 at 2:12am.  This case concerns a 62 year old male experienced serious adverse event of death one day after receiving the second dose of the vaccine and in addition with non-serious adverse events of dyspnea, fever and fatigue. Dechallenge was unknown and rechallenge was not applicable. Limited information provided. The benefit-risk relationship is not affected by this report.; Sender's Comments: This case concerns a 62 year old male experienced serious adverse event of death one day after receiving the second dose of the vaccine and in addition with non-serious adverse events of dyspnea, fever and fatigue. Dechallenge was unknown and rechallenge was not applicable. Limited information provided. The benefit-risk relationship is not affected by this report.; Reported Cause(s) of Death: Unknown Cause of death"
	"1718168-1"	"1718168-1"	"OXYGEN SATURATION"	"10033316"	"60-64 years"	"60-64"	"Patient passed away February 9, 2021 at 2:12am.; At around 11:30pm-11:45pm  difficulty of breathing was noted.; fever,Fever progressed to 103F; Very tired/feeling of very tired; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (Patient passed away February 9, 2021 at 2:12am.) in a 62-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 028L-20A and 039K20-2A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concomitant products included RIVAROXABAN (XARELTO) for an unknown indication.   On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 08-Feb-2021, the patient experienced DYSPNOEA (At around 11:30pm-11:45pm  difficulty of breathing was noted.), PYREXIA (fever,Fever progressed to 103F) and FATIGUE (Very tired/feeling of very tired). The patient was treated with PARACETAMOL (TYLENOL) on 08-Feb-2021 for Fever, at a dose of 1 dosage form. On 09-Feb-2021, DYSPNOEA (At around 11:30pm-11:45pm  difficulty of breathing was noted.), PYREXIA (fever,Fever progressed to 103F) and FATIGUE (Very tired/feeling of very tired) outcome was unknown. The patient died on 09-Feb-2021. The cause of death was not reported. It is unknown if an autopsy was performed.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 08-Feb-2021, Body temperature: 103 (Inconclusive) Fever progressed to 103F. On 08-Feb-2021, Oxygen saturation: decreased (Inconclusive) At 10pm his oxygen level dropped.   For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.   Concomitant medication also included medication for blood pressure.  On 08 Feb 2021 patient had the 2nd dose of Moderna Covid19 vaccine in the morning. Patient was fine until 5pm when patient complained of fever and feeling of very tired. Fever progressed to 103F. Patient took Tylenol. At 10pm his oxygen level dropped; patient laid down in bed. At around 11:30pm-11:45pm difficulty of breathing was noted. They immediately called 911. 911 came at around 12:50am but the patient arrested in the driveway. At the Emergency Room, they tried to revive the patient but unsuccessful. Patient passed away on 09 Feb 2021 at 2:12am.  This case concerns a 62 year old male experienced serious adverse event of death one day after receiving the second dose of the vaccine and in addition with non-serious adverse events of dyspnea, fever and fatigue. Dechallenge was unknown and rechallenge was not applicable. Limited information provided. The benefit-risk relationship is not affected by this report.; Sender's Comments: This case concerns a 62 year old male experienced serious adverse event of death one day after receiving the second dose of the vaccine and in addition with non-serious adverse events of dyspnea, fever and fatigue. Dechallenge was unknown and rechallenge was not applicable. Limited information provided. The benefit-risk relationship is not affected by this report.; Reported Cause(s) of Death: Unknown Cause of death"
	"1718168-1"	"1718168-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Patient passed away February 9, 2021 at 2:12am.; At around 11:30pm-11:45pm  difficulty of breathing was noted.; fever,Fever progressed to 103F; Very tired/feeling of very tired; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (Patient passed away February 9, 2021 at 2:12am.) in a 62-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 028L-20A and 039K20-2A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     Concomitant products included RIVAROXABAN (XARELTO) for an unknown indication.   On 13-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 08-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 08-Feb-2021, the patient experienced DYSPNOEA (At around 11:30pm-11:45pm  difficulty of breathing was noted.), PYREXIA (fever,Fever progressed to 103F) and FATIGUE (Very tired/feeling of very tired). The patient was treated with PARACETAMOL (TYLENOL) on 08-Feb-2021 for Fever, at a dose of 1 dosage form. On 09-Feb-2021, DYSPNOEA (At around 11:30pm-11:45pm  difficulty of breathing was noted.), PYREXIA (fever,Fever progressed to 103F) and FATIGUE (Very tired/feeling of very tired) outcome was unknown. The patient died on 09-Feb-2021. The cause of death was not reported. It is unknown if an autopsy was performed.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 08-Feb-2021, Body temperature: 103 (Inconclusive) Fever progressed to 103F. On 08-Feb-2021, Oxygen saturation: decreased (Inconclusive) At 10pm his oxygen level dropped.   For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.   Concomitant medication also included medication for blood pressure.  On 08 Feb 2021 patient had the 2nd dose of Moderna Covid19 vaccine in the morning. Patient was fine until 5pm when patient complained of fever and feeling of very tired. Fever progressed to 103F. Patient took Tylenol. At 10pm his oxygen level dropped; patient laid down in bed. At around 11:30pm-11:45pm difficulty of breathing was noted. They immediately called 911. 911 came at around 12:50am but the patient arrested in the driveway. At the Emergency Room, they tried to revive the patient but unsuccessful. Patient passed away on 09 Feb 2021 at 2:12am.  This case concerns a 62 year old male experienced serious adverse event of death one day after receiving the second dose of the vaccine and in addition with non-serious adverse events of dyspnea, fever and fatigue. Dechallenge was unknown and rechallenge was not applicable. Limited information provided. The benefit-risk relationship is not affected by this report.; Sender's Comments: This case concerns a 62 year old male experienced serious adverse event of death one day after receiving the second dose of the vaccine and in addition with non-serious adverse events of dyspnea, fever and fatigue. Dechallenge was unknown and rechallenge was not applicable. Limited information provided. The benefit-risk relationship is not affected by this report.; Reported Cause(s) of Death: Unknown Cause of death"
	"1718715-1"	"1718715-1"	"CEREBRAL AMYLOID ANGIOPATHY"	"10068044"	"60-64 years"	"60-64"	"Pt. had a sever hemmoragic stroke the week after her 2nd vaccine dose. We did not know it at the time but she was later diagnosed with Cerebral Amyloid Angiopathy."
	"1718715-1"	"1718715-1"	"COMPUTERISED TOMOGRAM"	"10010234"	"60-64 years"	"60-64"	"Pt. had a sever hemmoragic stroke the week after her 2nd vaccine dose. We did not know it at the time but she was later diagnosed with Cerebral Amyloid Angiopathy."
	"1718715-1"	"1718715-1"	"HAEMORRHAGIC STROKE"	"10019016"	"60-64 years"	"60-64"	"Pt. had a sever hemmoragic stroke the week after her 2nd vaccine dose. We did not know it at the time but she was later diagnosed with Cerebral Amyloid Angiopathy."
	"1718715-1"	"1718715-1"	"MAGNETIC RESONANCE IMAGING"	"10078223"	"60-64 years"	"60-64"	"Pt. had a sever hemmoragic stroke the week after her 2nd vaccine dose. We did not know it at the time but she was later diagnosed with Cerebral Amyloid Angiopathy."
	"1718910-1"	"1718910-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"SOB/RESP DISTRESS, ACUTE RESP FAILURE, ACUTE RENAL FAILURE, DEATH"
	"1718910-1"	"1718910-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"SOB/RESP DISTRESS, ACUTE RESP FAILURE, ACUTE RENAL FAILURE, DEATH"
	"1718910-1"	"1718910-1"	"BLOOD CREATININE INCREASED"	"10005483"	"60-64 years"	"60-64"	"SOB/RESP DISTRESS, ACUTE RESP FAILURE, ACUTE RENAL FAILURE, DEATH"
	"1718910-1"	"1718910-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"SOB/RESP DISTRESS, ACUTE RESP FAILURE, ACUTE RENAL FAILURE, DEATH"
	"1718910-1"	"1718910-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"SOB/RESP DISTRESS, ACUTE RESP FAILURE, ACUTE RENAL FAILURE, DEATH"
	"1718910-1"	"1718910-1"	"RESPIRATORY DISTRESS"	"10038687"	"60-64 years"	"60-64"	"SOB/RESP DISTRESS, ACUTE RESP FAILURE, ACUTE RENAL FAILURE, DEATH"
	"1718980-1"	"1718980-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Renal transplant recipient Jan 2019, on immunosuppressives, became SOB, cough"
	"1718980-1"	"1718980-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Renal transplant recipient Jan 2019, on immunosuppressives, became SOB, cough"
	"1719155-1"	"1719155-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"My Father received his second COVID19 shot on May 19th, 2021. He felt fine the day of his vaccine and the day after. He experienced minor side effects. On May 22nd, 2021 my Father suddenly died while driving to work."
	"1719155-1"	"1719155-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"My Father received his second COVID19 shot on May 19th, 2021. He felt fine the day of his vaccine and the day after. He experienced minor side effects. On May 22nd, 2021 my Father suddenly died while driving to work."
	"1719155-1"	"1719155-1"	"SUDDEN DEATH"	"10042434"	"60-64 years"	"60-64"	"My Father received his second COVID19 shot on May 19th, 2021. He felt fine the day of his vaccine and the day after. He experienced minor side effects. On May 22nd, 2021 my Father suddenly died while driving to work."
	"1719456-1"	"1719456-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"nausea, vomiting"
	"1719456-1"	"1719456-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"nausea, vomiting"
	"1719456-1"	"1719456-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"nausea, vomiting"
	"1719460-1"	"1719460-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"60-64 years"	"60-64"	"presented to hospital with complaints of increased weakness, dyspnea, and weight loss; immunosuppressed due to heart transplant; intubated, condition worsened and patient passed away in the hospital; COVID pneumonia ARDS"
	"1719460-1"	"1719460-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"presented to hospital with complaints of increased weakness, dyspnea, and weight loss; immunosuppressed due to heart transplant; intubated, condition worsened and patient passed away in the hospital; COVID pneumonia ARDS"
	"1719460-1"	"1719460-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"presented to hospital with complaints of increased weakness, dyspnea, and weight loss; immunosuppressed due to heart transplant; intubated, condition worsened and patient passed away in the hospital; COVID pneumonia ARDS"
	"1719460-1"	"1719460-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"presented to hospital with complaints of increased weakness, dyspnea, and weight loss; immunosuppressed due to heart transplant; intubated, condition worsened and patient passed away in the hospital; COVID pneumonia ARDS"
	"1719460-1"	"1719460-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"presented to hospital with complaints of increased weakness, dyspnea, and weight loss; immunosuppressed due to heart transplant; intubated, condition worsened and patient passed away in the hospital; COVID pneumonia ARDS"
	"1719460-1"	"1719460-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"presented to hospital with complaints of increased weakness, dyspnea, and weight loss; immunosuppressed due to heart transplant; intubated, condition worsened and patient passed away in the hospital; COVID pneumonia ARDS"
	"1719460-1"	"1719460-1"	"WEIGHT DECREASED"	"10047895"	"60-64 years"	"60-64"	"presented to hospital with complaints of increased weakness, dyspnea, and weight loss; immunosuppressed due to heart transplant; intubated, condition worsened and patient passed away in the hospital; COVID pneumonia ARDS"
	"1719650-1"	"1719650-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"My brother was admitted to the hospital 2 weeks after his last vaccine. There was NOTHING wrong with him prior to the shot. He went in for respiratory problems. He's was having a hard time breathing. He recovered from that, and then died from organ failure, again, never having other problems before.  I know from visiting that other spinal cord patients were in the hospital at the same time with the same issues. I knew that two of them not including my brother also died. These vaccines are NOT safe for everyone!!"
	"1719650-1"	"1719650-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"My brother was admitted to the hospital 2 weeks after his last vaccine. There was NOTHING wrong with him prior to the shot. He went in for respiratory problems. He's was having a hard time breathing. He recovered from that, and then died from organ failure, again, never having other problems before.  I know from visiting that other spinal cord patients were in the hospital at the same time with the same issues. I knew that two of them not including my brother also died. These vaccines are NOT safe for everyone!!"
	"1719650-1"	"1719650-1"	"ORGAN FAILURE"	"10053159"	"60-64 years"	"60-64"	"My brother was admitted to the hospital 2 weeks after his last vaccine. There was NOTHING wrong with him prior to the shot. He went in for respiratory problems. He's was having a hard time breathing. He recovered from that, and then died from organ failure, again, never having other problems before.  I know from visiting that other spinal cord patients were in the hospital at the same time with the same issues. I knew that two of them not including my brother also died. These vaccines are NOT safe for everyone!!"
	"1719650-1"	"1719650-1"	"RESPIRATORY SYMPTOM"	"10075535"	"60-64 years"	"60-64"	"My brother was admitted to the hospital 2 weeks after his last vaccine. There was NOTHING wrong with him prior to the shot. He went in for respiratory problems. He's was having a hard time breathing. He recovered from that, and then died from organ failure, again, never having other problems before.  I know from visiting that other spinal cord patients were in the hospital at the same time with the same issues. I knew that two of them not including my brother also died. These vaccines are NOT safe for everyone!!"
	"1722846-1"	"1722846-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 8/26/2021. Hospitalized 8/26/2021 for unknown duration. Death 9/9/2021"
	"1722846-1"	"1722846-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 8/26/2021. Hospitalized 8/26/2021 for unknown duration. Death 9/9/2021"
	"1722846-1"	"1722846-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 8/26/2021. Hospitalized 8/26/2021 for unknown duration. Death 9/9/2021"
	"1722846-1"	"1722846-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 8/26/2021. Hospitalized 8/26/2021 for unknown duration. Death 9/9/2021"
	"1723155-1"	"1723155-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Case fully vaccinated with Pfizer vaccine. Tested positive for COVID on 9/15/2021. Admitted to hospital on 8/24/2021. Tested positive for COVID while hospitalized and expired on 9/21/2021."
	"1723155-1"	"1723155-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Case fully vaccinated with Pfizer vaccine. Tested positive for COVID on 9/15/2021. Admitted to hospital on 8/24/2021. Tested positive for COVID while hospitalized and expired on 9/21/2021."
	"1723155-1"	"1723155-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Case fully vaccinated with Pfizer vaccine. Tested positive for COVID on 9/15/2021. Admitted to hospital on 8/24/2021. Tested positive for COVID while hospitalized and expired on 9/21/2021."
	"1723574-1"	"1723574-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"death N17.9 - Acute kidney failure, unspecified WEAKNESS - GENERALIZED RAPID HEART RATE"
	"1723574-1"	"1723574-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"death N17.9 - Acute kidney failure, unspecified WEAKNESS - GENERALIZED RAPID HEART RATE"
	"1723574-1"	"1723574-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death N17.9 - Acute kidney failure, unspecified WEAKNESS - GENERALIZED RAPID HEART RATE"
	"1723574-1"	"1723574-1"	"HEART RATE INCREASED"	"10019303"	"60-64 years"	"60-64"	"death N17.9 - Acute kidney failure, unspecified WEAKNESS - GENERALIZED RAPID HEART RATE"
	"1731635-1"	"1731635-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 7/24/2021: weakness, cough, body aches, nausea, cough, congestion, anorexia, shortness of breath. Hospitalized 7/31/2021 for unknown duration.  Death 8/27/2021. COD reported by ICP Acute respiratory failure with hypoxia, COVID-19 pneumonia,  pulmonary edema, Acute kidney failure"
	"1731635-1"	"1731635-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 7/24/2021: weakness, cough, body aches, nausea, cough, congestion, anorexia, shortness of breath. Hospitalized 7/31/2021 for unknown duration.  Death 8/27/2021. COD reported by ICP Acute respiratory failure with hypoxia, COVID-19 pneumonia,  pulmonary edema, Acute kidney failure"
	"1731635-1"	"1731635-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 7/24/2021: weakness, cough, body aches, nausea, cough, congestion, anorexia, shortness of breath. Hospitalized 7/31/2021 for unknown duration.  Death 8/27/2021. COD reported by ICP Acute respiratory failure with hypoxia, COVID-19 pneumonia,  pulmonary edema, Acute kidney failure"
	"1731635-1"	"1731635-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 7/24/2021: weakness, cough, body aches, nausea, cough, congestion, anorexia, shortness of breath. Hospitalized 7/31/2021 for unknown duration.  Death 8/27/2021. COD reported by ICP Acute respiratory failure with hypoxia, COVID-19 pneumonia,  pulmonary edema, Acute kidney failure"
	"1731635-1"	"1731635-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 7/24/2021: weakness, cough, body aches, nausea, cough, congestion, anorexia, shortness of breath. Hospitalized 7/31/2021 for unknown duration.  Death 8/27/2021. COD reported by ICP Acute respiratory failure with hypoxia, COVID-19 pneumonia,  pulmonary edema, Acute kidney failure"
	"1731635-1"	"1731635-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 7/24/2021: weakness, cough, body aches, nausea, cough, congestion, anorexia, shortness of breath. Hospitalized 7/31/2021 for unknown duration.  Death 8/27/2021. COD reported by ICP Acute respiratory failure with hypoxia, COVID-19 pneumonia,  pulmonary edema, Acute kidney failure"
	"1731635-1"	"1731635-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 7/24/2021: weakness, cough, body aches, nausea, cough, congestion, anorexia, shortness of breath. Hospitalized 7/31/2021 for unknown duration.  Death 8/27/2021. COD reported by ICP Acute respiratory failure with hypoxia, COVID-19 pneumonia,  pulmonary edema, Acute kidney failure"
	"1731635-1"	"1731635-1"	"DECREASED APPETITE"	"10061428"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 7/24/2021: weakness, cough, body aches, nausea, cough, congestion, anorexia, shortness of breath. Hospitalized 7/31/2021 for unknown duration.  Death 8/27/2021. COD reported by ICP Acute respiratory failure with hypoxia, COVID-19 pneumonia,  pulmonary edema, Acute kidney failure"
	"1731635-1"	"1731635-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 7/24/2021: weakness, cough, body aches, nausea, cough, congestion, anorexia, shortness of breath. Hospitalized 7/31/2021 for unknown duration.  Death 8/27/2021. COD reported by ICP Acute respiratory failure with hypoxia, COVID-19 pneumonia,  pulmonary edema, Acute kidney failure"
	"1731635-1"	"1731635-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 7/24/2021: weakness, cough, body aches, nausea, cough, congestion, anorexia, shortness of breath. Hospitalized 7/31/2021 for unknown duration.  Death 8/27/2021. COD reported by ICP Acute respiratory failure with hypoxia, COVID-19 pneumonia,  pulmonary edema, Acute kidney failure"
	"1731635-1"	"1731635-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 7/24/2021: weakness, cough, body aches, nausea, cough, congestion, anorexia, shortness of breath. Hospitalized 7/31/2021 for unknown duration.  Death 8/27/2021. COD reported by ICP Acute respiratory failure with hypoxia, COVID-19 pneumonia,  pulmonary edema, Acute kidney failure"
	"1731635-1"	"1731635-1"	"PULMONARY OEDEMA"	"10037423"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 7/24/2021: weakness, cough, body aches, nausea, cough, congestion, anorexia, shortness of breath. Hospitalized 7/31/2021 for unknown duration.  Death 8/27/2021. COD reported by ICP Acute respiratory failure with hypoxia, COVID-19 pneumonia,  pulmonary edema, Acute kidney failure"
	"1731635-1"	"1731635-1"	"RESPIRATORY TRACT CONGESTION"	"10052251"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 7/24/2021: weakness, cough, body aches, nausea, cough, congestion, anorexia, shortness of breath. Hospitalized 7/31/2021 for unknown duration.  Death 8/27/2021. COD reported by ICP Acute respiratory failure with hypoxia, COVID-19 pneumonia,  pulmonary edema, Acute kidney failure"
	"1731635-1"	"1731635-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 7/24/2021: weakness, cough, body aches, nausea, cough, congestion, anorexia, shortness of breath. Hospitalized 7/31/2021 for unknown duration.  Death 8/27/2021. COD reported by ICP Acute respiratory failure with hypoxia, COVID-19 pneumonia,  pulmonary edema, Acute kidney failure"
	"1731635-1"	"1731635-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"60-64 years"	"60-64"	"Breakthrough COVID-19 case with symptom onset 7/24/2021: weakness, cough, body aches, nausea, cough, congestion, anorexia, shortness of breath. Hospitalized 7/31/2021 for unknown duration.  Death 8/27/2021. COD reported by ICP Acute respiratory failure with hypoxia, COVID-19 pneumonia,  pulmonary edema, Acute kidney failure"
	"1731647-1"	"1731647-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Client was discharged from hospital on 09/20/2021 and was found deceased on 09/21/2021"
	"1732399-1"	"1732399-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"No adverse effect during the 15 minutes after administration of vaccine   patient expired on 9/23/21 reported by facility"
	"1732810-1"	"1732810-1"	"ARTHRALGIA"	"10003239"	"60-64 years"	"60-64"	"breathing, chest pain, and severe pain within joints."
	"1732810-1"	"1732810-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"breathing, chest pain, and severe pain within joints."
	"1732810-1"	"1732810-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"breathing, chest pain, and severe pain within joints."
	"1734587-1"	"1734587-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Heart attack, death"
	"1734587-1"	"1734587-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"Heart attack, death"
	"1735298-1"	"1735298-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death for no apparent reason"
	"1738061-1"	"1738061-1"	"ARTHRALGIA"	"10003239"	"60-64 years"	"60-64"	"Developed COVID Symptoms within <24 hours of receiving vaccine (Sore throat, mild fever, headache the morning after the vaccine). Patient had minimal to no contact with any other people prior to vaccination, and had not been around any individuals exposed to COVID in the past 2 weeks. Symptoms included fever, headache, nausea, joint & muscle pain, difficulty breathing, low oxygen stats, and vomiting.    Patient was taken to medical facility on September 6th, was admitted to the hospital, and later transferred to the MICU. Patient pronounced dead September 18, 2021."
	"1738061-1"	"1738061-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Developed COVID Symptoms within <24 hours of receiving vaccine (Sore throat, mild fever, headache the morning after the vaccine). Patient had minimal to no contact with any other people prior to vaccination, and had not been around any individuals exposed to COVID in the past 2 weeks. Symptoms included fever, headache, nausea, joint & muscle pain, difficulty breathing, low oxygen stats, and vomiting.    Patient was taken to medical facility on September 6th, was admitted to the hospital, and later transferred to the MICU. Patient pronounced dead September 18, 2021."
	"1738061-1"	"1738061-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Developed COVID Symptoms within <24 hours of receiving vaccine (Sore throat, mild fever, headache the morning after the vaccine). Patient had minimal to no contact with any other people prior to vaccination, and had not been around any individuals exposed to COVID in the past 2 weeks. Symptoms included fever, headache, nausea, joint & muscle pain, difficulty breathing, low oxygen stats, and vomiting.    Patient was taken to medical facility on September 6th, was admitted to the hospital, and later transferred to the MICU. Patient pronounced dead September 18, 2021."
	"1738061-1"	"1738061-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"Developed COVID Symptoms within <24 hours of receiving vaccine (Sore throat, mild fever, headache the morning after the vaccine). Patient had minimal to no contact with any other people prior to vaccination, and had not been around any individuals exposed to COVID in the past 2 weeks. Symptoms included fever, headache, nausea, joint & muscle pain, difficulty breathing, low oxygen stats, and vomiting.    Patient was taken to medical facility on September 6th, was admitted to the hospital, and later transferred to the MICU. Patient pronounced dead September 18, 2021."
	"1738061-1"	"1738061-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Developed COVID Symptoms within <24 hours of receiving vaccine (Sore throat, mild fever, headache the morning after the vaccine). Patient had minimal to no contact with any other people prior to vaccination, and had not been around any individuals exposed to COVID in the past 2 weeks. Symptoms included fever, headache, nausea, joint & muscle pain, difficulty breathing, low oxygen stats, and vomiting.    Patient was taken to medical facility on September 6th, was admitted to the hospital, and later transferred to the MICU. Patient pronounced dead September 18, 2021."
	"1738061-1"	"1738061-1"	"LABORATORY TEST"	"10059938"	"60-64 years"	"60-64"	"Developed COVID Symptoms within <24 hours of receiving vaccine (Sore throat, mild fever, headache the morning after the vaccine). Patient had minimal to no contact with any other people prior to vaccination, and had not been around any individuals exposed to COVID in the past 2 weeks. Symptoms included fever, headache, nausea, joint & muscle pain, difficulty breathing, low oxygen stats, and vomiting.    Patient was taken to medical facility on September 6th, was admitted to the hospital, and later transferred to the MICU. Patient pronounced dead September 18, 2021."
	"1738061-1"	"1738061-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"Developed COVID Symptoms within <24 hours of receiving vaccine (Sore throat, mild fever, headache the morning after the vaccine). Patient had minimal to no contact with any other people prior to vaccination, and had not been around any individuals exposed to COVID in the past 2 weeks. Symptoms included fever, headache, nausea, joint & muscle pain, difficulty breathing, low oxygen stats, and vomiting.    Patient was taken to medical facility on September 6th, was admitted to the hospital, and later transferred to the MICU. Patient pronounced dead September 18, 2021."
	"1738061-1"	"1738061-1"	"MYALGIA"	"10028411"	"60-64 years"	"60-64"	"Developed COVID Symptoms within <24 hours of receiving vaccine (Sore throat, mild fever, headache the morning after the vaccine). Patient had minimal to no contact with any other people prior to vaccination, and had not been around any individuals exposed to COVID in the past 2 weeks. Symptoms included fever, headache, nausea, joint & muscle pain, difficulty breathing, low oxygen stats, and vomiting.    Patient was taken to medical facility on September 6th, was admitted to the hospital, and later transferred to the MICU. Patient pronounced dead September 18, 2021."
	"1738061-1"	"1738061-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Developed COVID Symptoms within <24 hours of receiving vaccine (Sore throat, mild fever, headache the morning after the vaccine). Patient had minimal to no contact with any other people prior to vaccination, and had not been around any individuals exposed to COVID in the past 2 weeks. Symptoms included fever, headache, nausea, joint & muscle pain, difficulty breathing, low oxygen stats, and vomiting.    Patient was taken to medical facility on September 6th, was admitted to the hospital, and later transferred to the MICU. Patient pronounced dead September 18, 2021."
	"1738061-1"	"1738061-1"	"OROPHARYNGEAL PAIN"	"10068319"	"60-64 years"	"60-64"	"Developed COVID Symptoms within <24 hours of receiving vaccine (Sore throat, mild fever, headache the morning after the vaccine). Patient had minimal to no contact with any other people prior to vaccination, and had not been around any individuals exposed to COVID in the past 2 weeks. Symptoms included fever, headache, nausea, joint & muscle pain, difficulty breathing, low oxygen stats, and vomiting.    Patient was taken to medical facility on September 6th, was admitted to the hospital, and later transferred to the MICU. Patient pronounced dead September 18, 2021."
	"1738061-1"	"1738061-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"Developed COVID Symptoms within <24 hours of receiving vaccine (Sore throat, mild fever, headache the morning after the vaccine). Patient had minimal to no contact with any other people prior to vaccination, and had not been around any individuals exposed to COVID in the past 2 weeks. Symptoms included fever, headache, nausea, joint & muscle pain, difficulty breathing, low oxygen stats, and vomiting.    Patient was taken to medical facility on September 6th, was admitted to the hospital, and later transferred to the MICU. Patient pronounced dead September 18, 2021."
	"1738061-1"	"1738061-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Developed COVID Symptoms within <24 hours of receiving vaccine (Sore throat, mild fever, headache the morning after the vaccine). Patient had minimal to no contact with any other people prior to vaccination, and had not been around any individuals exposed to COVID in the past 2 weeks. Symptoms included fever, headache, nausea, joint & muscle pain, difficulty breathing, low oxygen stats, and vomiting.    Patient was taken to medical facility on September 6th, was admitted to the hospital, and later transferred to the MICU. Patient pronounced dead September 18, 2021."
	"1738061-1"	"1738061-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"Developed COVID Symptoms within <24 hours of receiving vaccine (Sore throat, mild fever, headache the morning after the vaccine). Patient had minimal to no contact with any other people prior to vaccination, and had not been around any individuals exposed to COVID in the past 2 weeks. Symptoms included fever, headache, nausea, joint & muscle pain, difficulty breathing, low oxygen stats, and vomiting.    Patient was taken to medical facility on September 6th, was admitted to the hospital, and later transferred to the MICU. Patient pronounced dead September 18, 2021."
	"1745214-1"	"1745214-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient admitted to hospital via ED 9/7/21. COVID test positive 9/7/21. Deceased 9/15/21"
	"1745214-1"	"1745214-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient admitted to hospital via ED 9/7/21. COVID test positive 9/7/21. Deceased 9/15/21"
	"1745214-1"	"1745214-1"	"LABORATORY TEST"	"10059938"	"60-64 years"	"60-64"	"Patient admitted to hospital via ED 9/7/21. COVID test positive 9/7/21. Deceased 9/15/21"
	"1745214-1"	"1745214-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Patient admitted to hospital via ED 9/7/21. COVID test positive 9/7/21. Deceased 9/15/21"
	"1753479-1"	"1753479-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient fully vaccinated and hospitalized then later died due to Covid related causes."
	"1753479-1"	"1753479-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient fully vaccinated and hospitalized then later died due to Covid related causes."
	"1753480-1"	"1753480-1"	"EXTRA DOSE ADMINISTERED"	"10064366"	"60-64 years"	"60-64"	"9/29/21- to ER for treatment."
	"1754209-1"	"1754209-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"60-64 years"	"60-64"	"Admitted to Memorial Hospital on 8/19/2021 with cough, SOB, weakness, hypoxia. Admitted to Hospital and Clinics on 8/27/2021 with dx: COVID-19 Pneumonia-ARDS with severe hypoxemic/hypercarbic respiratory failure. She died on 9/4/2021 of ACUTE HYPOXIC RESPIRATORY FAILURE 16 DAYS BACTERIAL PNEUMONIA SUPERINFECTION 16 DAYS COVID PNEUMONIA Submitter does not have access to full hospitalization records. If further follow up information on hospital course or treatment is needed, please contact:  HOSPITAL AND CLINICS  MEMORIAL HOSPITAL"
	"1754209-1"	"1754209-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"Admitted to Memorial Hospital on 8/19/2021 with cough, SOB, weakness, hypoxia. Admitted to Hospital and Clinics on 8/27/2021 with dx: COVID-19 Pneumonia-ARDS with severe hypoxemic/hypercarbic respiratory failure. She died on 9/4/2021 of ACUTE HYPOXIC RESPIRATORY FAILURE 16 DAYS BACTERIAL PNEUMONIA SUPERINFECTION 16 DAYS COVID PNEUMONIA Submitter does not have access to full hospitalization records. If further follow up information on hospital course or treatment is needed, please contact:  HOSPITAL AND CLINICS  MEMORIAL HOSPITAL"
	"1754209-1"	"1754209-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"Admitted to Memorial Hospital on 8/19/2021 with cough, SOB, weakness, hypoxia. Admitted to Hospital and Clinics on 8/27/2021 with dx: COVID-19 Pneumonia-ARDS with severe hypoxemic/hypercarbic respiratory failure. She died on 9/4/2021 of ACUTE HYPOXIC RESPIRATORY FAILURE 16 DAYS BACTERIAL PNEUMONIA SUPERINFECTION 16 DAYS COVID PNEUMONIA Submitter does not have access to full hospitalization records. If further follow up information on hospital course or treatment is needed, please contact:  HOSPITAL AND CLINICS  MEMORIAL HOSPITAL"
	"1754209-1"	"1754209-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"Admitted to Memorial Hospital on 8/19/2021 with cough, SOB, weakness, hypoxia. Admitted to Hospital and Clinics on 8/27/2021 with dx: COVID-19 Pneumonia-ARDS with severe hypoxemic/hypercarbic respiratory failure. She died on 9/4/2021 of ACUTE HYPOXIC RESPIRATORY FAILURE 16 DAYS BACTERIAL PNEUMONIA SUPERINFECTION 16 DAYS COVID PNEUMONIA Submitter does not have access to full hospitalization records. If further follow up information on hospital course or treatment is needed, please contact:  HOSPITAL AND CLINICS  MEMORIAL HOSPITAL"
	"1754209-1"	"1754209-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Admitted to Memorial Hospital on 8/19/2021 with cough, SOB, weakness, hypoxia. Admitted to Hospital and Clinics on 8/27/2021 with dx: COVID-19 Pneumonia-ARDS with severe hypoxemic/hypercarbic respiratory failure. She died on 9/4/2021 of ACUTE HYPOXIC RESPIRATORY FAILURE 16 DAYS BACTERIAL PNEUMONIA SUPERINFECTION 16 DAYS COVID PNEUMONIA Submitter does not have access to full hospitalization records. If further follow up information on hospital course or treatment is needed, please contact:  HOSPITAL AND CLINICS  MEMORIAL HOSPITAL"
	"1754209-1"	"1754209-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Admitted to Memorial Hospital on 8/19/2021 with cough, SOB, weakness, hypoxia. Admitted to Hospital and Clinics on 8/27/2021 with dx: COVID-19 Pneumonia-ARDS with severe hypoxemic/hypercarbic respiratory failure. She died on 9/4/2021 of ACUTE HYPOXIC RESPIRATORY FAILURE 16 DAYS BACTERIAL PNEUMONIA SUPERINFECTION 16 DAYS COVID PNEUMONIA Submitter does not have access to full hospitalization records. If further follow up information on hospital course or treatment is needed, please contact:  HOSPITAL AND CLINICS  MEMORIAL HOSPITAL"
	"1754209-1"	"1754209-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Admitted to Memorial Hospital on 8/19/2021 with cough, SOB, weakness, hypoxia. Admitted to Hospital and Clinics on 8/27/2021 with dx: COVID-19 Pneumonia-ARDS with severe hypoxemic/hypercarbic respiratory failure. She died on 9/4/2021 of ACUTE HYPOXIC RESPIRATORY FAILURE 16 DAYS BACTERIAL PNEUMONIA SUPERINFECTION 16 DAYS COVID PNEUMONIA Submitter does not have access to full hospitalization records. If further follow up information on hospital course or treatment is needed, please contact:  HOSPITAL AND CLINICS  MEMORIAL HOSPITAL"
	"1754209-1"	"1754209-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Admitted to Memorial Hospital on 8/19/2021 with cough, SOB, weakness, hypoxia. Admitted to Hospital and Clinics on 8/27/2021 with dx: COVID-19 Pneumonia-ARDS with severe hypoxemic/hypercarbic respiratory failure. She died on 9/4/2021 of ACUTE HYPOXIC RESPIRATORY FAILURE 16 DAYS BACTERIAL PNEUMONIA SUPERINFECTION 16 DAYS COVID PNEUMONIA Submitter does not have access to full hospitalization records. If further follow up information on hospital course or treatment is needed, please contact:  HOSPITAL AND CLINICS  MEMORIAL HOSPITAL"
	"1754209-1"	"1754209-1"	"HYPERCAPNIA"	"10020591"	"60-64 years"	"60-64"	"Admitted to Memorial Hospital on 8/19/2021 with cough, SOB, weakness, hypoxia. Admitted to Hospital and Clinics on 8/27/2021 with dx: COVID-19 Pneumonia-ARDS with severe hypoxemic/hypercarbic respiratory failure. She died on 9/4/2021 of ACUTE HYPOXIC RESPIRATORY FAILURE 16 DAYS BACTERIAL PNEUMONIA SUPERINFECTION 16 DAYS COVID PNEUMONIA Submitter does not have access to full hospitalization records. If further follow up information on hospital course or treatment is needed, please contact:  HOSPITAL AND CLINICS  MEMORIAL HOSPITAL"
	"1754209-1"	"1754209-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"Admitted to Memorial Hospital on 8/19/2021 with cough, SOB, weakness, hypoxia. Admitted to Hospital and Clinics on 8/27/2021 with dx: COVID-19 Pneumonia-ARDS with severe hypoxemic/hypercarbic respiratory failure. She died on 9/4/2021 of ACUTE HYPOXIC RESPIRATORY FAILURE 16 DAYS BACTERIAL PNEUMONIA SUPERINFECTION 16 DAYS COVID PNEUMONIA Submitter does not have access to full hospitalization records. If further follow up information on hospital course or treatment is needed, please contact:  HOSPITAL AND CLINICS  MEMORIAL HOSPITAL"
	"1754209-1"	"1754209-1"	"LUNG INFILTRATION"	"10025102"	"60-64 years"	"60-64"	"Admitted to Memorial Hospital on 8/19/2021 with cough, SOB, weakness, hypoxia. Admitted to Hospital and Clinics on 8/27/2021 with dx: COVID-19 Pneumonia-ARDS with severe hypoxemic/hypercarbic respiratory failure. She died on 9/4/2021 of ACUTE HYPOXIC RESPIRATORY FAILURE 16 DAYS BACTERIAL PNEUMONIA SUPERINFECTION 16 DAYS COVID PNEUMONIA Submitter does not have access to full hospitalization records. If further follow up information on hospital course or treatment is needed, please contact:  HOSPITAL AND CLINICS  MEMORIAL HOSPITAL"
	"1754209-1"	"1754209-1"	"PNEUMONIA BACTERIAL"	"10060946"	"60-64 years"	"60-64"	"Admitted to Memorial Hospital on 8/19/2021 with cough, SOB, weakness, hypoxia. Admitted to Hospital and Clinics on 8/27/2021 with dx: COVID-19 Pneumonia-ARDS with severe hypoxemic/hypercarbic respiratory failure. She died on 9/4/2021 of ACUTE HYPOXIC RESPIRATORY FAILURE 16 DAYS BACTERIAL PNEUMONIA SUPERINFECTION 16 DAYS COVID PNEUMONIA Submitter does not have access to full hospitalization records. If further follow up information on hospital course or treatment is needed, please contact:  HOSPITAL AND CLINICS  MEMORIAL HOSPITAL"
	"1754209-1"	"1754209-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Admitted to Memorial Hospital on 8/19/2021 with cough, SOB, weakness, hypoxia. Admitted to Hospital and Clinics on 8/27/2021 with dx: COVID-19 Pneumonia-ARDS with severe hypoxemic/hypercarbic respiratory failure. She died on 9/4/2021 of ACUTE HYPOXIC RESPIRATORY FAILURE 16 DAYS BACTERIAL PNEUMONIA SUPERINFECTION 16 DAYS COVID PNEUMONIA Submitter does not have access to full hospitalization records. If further follow up information on hospital course or treatment is needed, please contact:  HOSPITAL AND CLINICS  MEMORIAL HOSPITAL"
	"1759181-1"	"1759181-1"	"ABDOMINAL WALL HAEMATOMA"	"10067383"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"ANGIOGRAM PULMONARY ABNORMAL"	"10002441"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"ANTICOAGULANT THERAPY"	"10053468"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"ANURIA"	"10002847"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"BIOPSY CARTILAGE"	"10004750"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"BLOOD CULTURE POSITIVE"	"10005488"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"BLOOD LOSS ANAEMIA"	"10082297"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"CHEST DISCOMFORT"	"10008469"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"CULTURE POSITIVE"	"10061449"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"ENTEROBACTER INFECTION"	"10051910"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"HEPATIC FAILURE"	"10019663"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"HERPES SIMPLEX"	"10019948"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"METABOLIC ACIDOSIS"	"10027417"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"MULTIPLE ORGAN DYSFUNCTION SYNDROME"	"10077361"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"NASAL ULCER"	"10028780"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"PACKED RED BLOOD CELL TRANSFUSION"	"10033359"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"PNEUMONIA ASPIRATION"	"10035669"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"RESPIRATORY ACIDOSIS"	"10038661"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"SERRATIA INFECTION"	"10061512"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"SHOCK"	"10040560"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1759181-1"	"1759181-1"	"SKIN CULTURE POSITIVE"	"10078402"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID.  Provider discharge summary below:  ""Presented with 8/30 with worsening shortness of breath and chest discomfort following testing positive for COVID-19 on 8/25. He was vaccinated against COVID-19 with the Pfizer series on 5/3 and 5/28. He was admitted and started on oxygen and completed 5 days of remdesivir and a steroid course. Bilateral PE were found on CTA pulm on 9/5/21 and heparin was started. He continued to worsen despite HiFlo and NIPPV. He required intubation and transfer to CCU on 9/13, and started on pressors for support. CCU course was complicated by ARDS, shock, AKI and anuria requiring CRRT (managed by nephology), metabolic acidosis, liver failure, as well as acute blood loss anemia from a rectus sheath bleed causing an abdominal wall hematoma that required 1U pRBC and an abdominal binder. He was found with Serratia odorifera, Enterobacter cloacae on respiratory cultures suggesting aspiration pneumonia. HSV was detected on skin culture. Staph simulans that grew on one blood culture was deemed a contaminant. He received vancomycin, Zosyn, meropenem, metronidazole, acyclovir with antibiotic management guided by Infectious disease. ENT performed a biopsy of an ulcer of his left nare on 9/25, but pathology was pending at time of discharge. Patient did not improve despite treatment and had persistent respiratory acidosis and required maximum vasopressin and norephinephrine support. Palliative care was consulted and the grim prognosis of the patient communicated to family given his multiple organ failure. Patient was switched to comfort care status per family on 10/3/21. Patient died at 3:45 PM on October, 3, 2021.""""
	"1760669-1"	"1760669-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Per niece a couple hours after getting the vaccine started to have issues with arm and his wife took him to the hospital to get checked out.  It was took late by the time getting to the hospital and patient passed away around 1 pm.   Per the coroner the preliminary cause of death is a blood clot.  This information was provided to the pharmacy by the patients niece around 3 pm."
	"1760669-1"	"1760669-1"	"PAIN IN EXTREMITY"	"10033425"	"60-64 years"	"60-64"	"Per niece a couple hours after getting the vaccine started to have issues with arm and his wife took him to the hospital to get checked out.  It was took late by the time getting to the hospital and patient passed away around 1 pm.   Per the coroner the preliminary cause of death is a blood clot.  This information was provided to the pharmacy by the patients niece around 3 pm."
	"1760669-1"	"1760669-1"	"THROMBOSIS"	"10043607"	"60-64 years"	"60-64"	"Per niece a couple hours after getting the vaccine started to have issues with arm and his wife took him to the hospital to get checked out.  It was took late by the time getting to the hospital and patient passed away around 1 pm.   Per the coroner the preliminary cause of death is a blood clot.  This information was provided to the pharmacy by the patients niece around 3 pm."
	"1761478-1"	"1761478-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient came in with respiratory failure"
	"1761478-1"	"1761478-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	"Patient came in with respiratory failure"
	"1761478-1"	"1761478-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Patient came in with respiratory failure"
	"1761528-1"	"1761528-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID pneumonia.  Provider discharge note:  ""Admitted to the hospital on September 20, 2021 for hypoxia.  She was fully vaccinated against COVID-19.  At that time she is requiring high-flow nasal cannula oxygenation.  On 09/20 for a CT scan was done which showed a possible nonocclusive emboli in the left lower lung.  She was started on heparin. She was transferred to the intensive care unit on the morning of 09/30/2021.  She developed bilateral pneumothoracies that time.  She was intubated and chest tubes were placed.  Over the next 5 days she developed worsening ARDS with multiorgan system failure.  This presented initially with AFib with RVR and progressed to kidney failure.  On the morning of 10/04/2021 the patient's family decided that they did not want to pursue additional care.  Her respiratory cardiac function decreased until 9:45AM on 10/5/2021 when she passed away.""""
	"1761528-1"	"1761528-1"	"ANTICOAGULANT THERAPY"	"10053468"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID pneumonia.  Provider discharge note:  ""Admitted to the hospital on September 20, 2021 for hypoxia.  She was fully vaccinated against COVID-19.  At that time she is requiring high-flow nasal cannula oxygenation.  On 09/20 for a CT scan was done which showed a possible nonocclusive emboli in the left lower lung.  She was started on heparin. She was transferred to the intensive care unit on the morning of 09/30/2021.  She developed bilateral pneumothoracies that time.  She was intubated and chest tubes were placed.  Over the next 5 days she developed worsening ARDS with multiorgan system failure.  This presented initially with AFib with RVR and progressed to kidney failure.  On the morning of 10/04/2021 the patient's family decided that they did not want to pursue additional care.  Her respiratory cardiac function decreased until 9:45AM on 10/5/2021 when she passed away.""""
	"1761528-1"	"1761528-1"	"ATRIAL FIBRILLATION"	"10003658"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID pneumonia.  Provider discharge note:  ""Admitted to the hospital on September 20, 2021 for hypoxia.  She was fully vaccinated against COVID-19.  At that time she is requiring high-flow nasal cannula oxygenation.  On 09/20 for a CT scan was done which showed a possible nonocclusive emboli in the left lower lung.  She was started on heparin. She was transferred to the intensive care unit on the morning of 09/30/2021.  She developed bilateral pneumothoracies that time.  She was intubated and chest tubes were placed.  Over the next 5 days she developed worsening ARDS with multiorgan system failure.  This presented initially with AFib with RVR and progressed to kidney failure.  On the morning of 10/04/2021 the patient's family decided that they did not want to pursue additional care.  Her respiratory cardiac function decreased until 9:45AM on 10/5/2021 when she passed away.""""
	"1761528-1"	"1761528-1"	"CARDIAC FAILURE"	"10007554"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID pneumonia.  Provider discharge note:  ""Admitted to the hospital on September 20, 2021 for hypoxia.  She was fully vaccinated against COVID-19.  At that time she is requiring high-flow nasal cannula oxygenation.  On 09/20 for a CT scan was done which showed a possible nonocclusive emboli in the left lower lung.  She was started on heparin. She was transferred to the intensive care unit on the morning of 09/30/2021.  She developed bilateral pneumothoracies that time.  She was intubated and chest tubes were placed.  Over the next 5 days she developed worsening ARDS with multiorgan system failure.  This presented initially with AFib with RVR and progressed to kidney failure.  On the morning of 10/04/2021 the patient's family decided that they did not want to pursue additional care.  Her respiratory cardiac function decreased until 9:45AM on 10/5/2021 when she passed away.""""
	"1761528-1"	"1761528-1"	"CHEST TUBE INSERTION"	"10050522"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID pneumonia.  Provider discharge note:  ""Admitted to the hospital on September 20, 2021 for hypoxia.  She was fully vaccinated against COVID-19.  At that time she is requiring high-flow nasal cannula oxygenation.  On 09/20 for a CT scan was done which showed a possible nonocclusive emboli in the left lower lung.  She was started on heparin. She was transferred to the intensive care unit on the morning of 09/30/2021.  She developed bilateral pneumothoracies that time.  She was intubated and chest tubes were placed.  Over the next 5 days she developed worsening ARDS with multiorgan system failure.  This presented initially with AFib with RVR and progressed to kidney failure.  On the morning of 10/04/2021 the patient's family decided that they did not want to pursue additional care.  Her respiratory cardiac function decreased until 9:45AM on 10/5/2021 when she passed away.""""
	"1761528-1"	"1761528-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID pneumonia.  Provider discharge note:  ""Admitted to the hospital on September 20, 2021 for hypoxia.  She was fully vaccinated against COVID-19.  At that time she is requiring high-flow nasal cannula oxygenation.  On 09/20 for a CT scan was done which showed a possible nonocclusive emboli in the left lower lung.  She was started on heparin. She was transferred to the intensive care unit on the morning of 09/30/2021.  She developed bilateral pneumothoracies that time.  She was intubated and chest tubes were placed.  Over the next 5 days she developed worsening ARDS with multiorgan system failure.  This presented initially with AFib with RVR and progressed to kidney failure.  On the morning of 10/04/2021 the patient's family decided that they did not want to pursue additional care.  Her respiratory cardiac function decreased until 9:45AM on 10/5/2021 when she passed away.""""
	"1761528-1"	"1761528-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID pneumonia.  Provider discharge note:  ""Admitted to the hospital on September 20, 2021 for hypoxia.  She was fully vaccinated against COVID-19.  At that time she is requiring high-flow nasal cannula oxygenation.  On 09/20 for a CT scan was done which showed a possible nonocclusive emboli in the left lower lung.  She was started on heparin. She was transferred to the intensive care unit on the morning of 09/30/2021.  She developed bilateral pneumothoracies that time.  She was intubated and chest tubes were placed.  Over the next 5 days she developed worsening ARDS with multiorgan system failure.  This presented initially with AFib with RVR and progressed to kidney failure.  On the morning of 10/04/2021 the patient's family decided that they did not want to pursue additional care.  Her respiratory cardiac function decreased until 9:45AM on 10/5/2021 when she passed away.""""
	"1761528-1"	"1761528-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID pneumonia.  Provider discharge note:  ""Admitted to the hospital on September 20, 2021 for hypoxia.  She was fully vaccinated against COVID-19.  At that time she is requiring high-flow nasal cannula oxygenation.  On 09/20 for a CT scan was done which showed a possible nonocclusive emboli in the left lower lung.  She was started on heparin. She was transferred to the intensive care unit on the morning of 09/30/2021.  She developed bilateral pneumothoracies that time.  She was intubated and chest tubes were placed.  Over the next 5 days she developed worsening ARDS with multiorgan system failure.  This presented initially with AFib with RVR and progressed to kidney failure.  On the morning of 10/04/2021 the patient's family decided that they did not want to pursue additional care.  Her respiratory cardiac function decreased until 9:45AM on 10/5/2021 when she passed away.""""
	"1761528-1"	"1761528-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID pneumonia.  Provider discharge note:  ""Admitted to the hospital on September 20, 2021 for hypoxia.  She was fully vaccinated against COVID-19.  At that time she is requiring high-flow nasal cannula oxygenation.  On 09/20 for a CT scan was done which showed a possible nonocclusive emboli in the left lower lung.  She was started on heparin. She was transferred to the intensive care unit on the morning of 09/30/2021.  She developed bilateral pneumothoracies that time.  She was intubated and chest tubes were placed.  Over the next 5 days she developed worsening ARDS with multiorgan system failure.  This presented initially with AFib with RVR and progressed to kidney failure.  On the morning of 10/04/2021 the patient's family decided that they did not want to pursue additional care.  Her respiratory cardiac function decreased until 9:45AM on 10/5/2021 when she passed away.""""
	"1761528-1"	"1761528-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID pneumonia.  Provider discharge note:  ""Admitted to the hospital on September 20, 2021 for hypoxia.  She was fully vaccinated against COVID-19.  At that time she is requiring high-flow nasal cannula oxygenation.  On 09/20 for a CT scan was done which showed a possible nonocclusive emboli in the left lower lung.  She was started on heparin. She was transferred to the intensive care unit on the morning of 09/30/2021.  She developed bilateral pneumothoracies that time.  She was intubated and chest tubes were placed.  Over the next 5 days she developed worsening ARDS with multiorgan system failure.  This presented initially with AFib with RVR and progressed to kidney failure.  On the morning of 10/04/2021 the patient's family decided that they did not want to pursue additional care.  Her respiratory cardiac function decreased until 9:45AM on 10/5/2021 when she passed away.""""
	"1761528-1"	"1761528-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID pneumonia.  Provider discharge note:  ""Admitted to the hospital on September 20, 2021 for hypoxia.  She was fully vaccinated against COVID-19.  At that time she is requiring high-flow nasal cannula oxygenation.  On 09/20 for a CT scan was done which showed a possible nonocclusive emboli in the left lower lung.  She was started on heparin. She was transferred to the intensive care unit on the morning of 09/30/2021.  She developed bilateral pneumothoracies that time.  She was intubated and chest tubes were placed.  Over the next 5 days she developed worsening ARDS with multiorgan system failure.  This presented initially with AFib with RVR and progressed to kidney failure.  On the morning of 10/04/2021 the patient's family decided that they did not want to pursue additional care.  Her respiratory cardiac function decreased until 9:45AM on 10/5/2021 when she passed away.""""
	"1761528-1"	"1761528-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID pneumonia.  Provider discharge note:  ""Admitted to the hospital on September 20, 2021 for hypoxia.  She was fully vaccinated against COVID-19.  At that time she is requiring high-flow nasal cannula oxygenation.  On 09/20 for a CT scan was done which showed a possible nonocclusive emboli in the left lower lung.  She was started on heparin. She was transferred to the intensive care unit on the morning of 09/30/2021.  She developed bilateral pneumothoracies that time.  She was intubated and chest tubes were placed.  Over the next 5 days she developed worsening ARDS with multiorgan system failure.  This presented initially with AFib with RVR and progressed to kidney failure.  On the morning of 10/04/2021 the patient's family decided that they did not want to pursue additional care.  Her respiratory cardiac function decreased until 9:45AM on 10/5/2021 when she passed away.""""
	"1761528-1"	"1761528-1"	"MULTIPLE ORGAN DYSFUNCTION SYNDROME"	"10077361"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID pneumonia.  Provider discharge note:  ""Admitted to the hospital on September 20, 2021 for hypoxia.  She was fully vaccinated against COVID-19.  At that time she is requiring high-flow nasal cannula oxygenation.  On 09/20 for a CT scan was done which showed a possible nonocclusive emboli in the left lower lung.  She was started on heparin. She was transferred to the intensive care unit on the morning of 09/30/2021.  She developed bilateral pneumothoracies that time.  She was intubated and chest tubes were placed.  Over the next 5 days she developed worsening ARDS with multiorgan system failure.  This presented initially with AFib with RVR and progressed to kidney failure.  On the morning of 10/04/2021 the patient's family decided that they did not want to pursue additional care.  Her respiratory cardiac function decreased until 9:45AM on 10/5/2021 when she passed away.""""
	"1761528-1"	"1761528-1"	"PNEUMOTHORAX"	"10035759"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID pneumonia.  Provider discharge note:  ""Admitted to the hospital on September 20, 2021 for hypoxia.  She was fully vaccinated against COVID-19.  At that time she is requiring high-flow nasal cannula oxygenation.  On 09/20 for a CT scan was done which showed a possible nonocclusive emboli in the left lower lung.  She was started on heparin. She was transferred to the intensive care unit on the morning of 09/30/2021.  She developed bilateral pneumothoracies that time.  She was intubated and chest tubes were placed.  Over the next 5 days she developed worsening ARDS with multiorgan system failure.  This presented initially with AFib with RVR and progressed to kidney failure.  On the morning of 10/04/2021 the patient's family decided that they did not want to pursue additional care.  Her respiratory cardiac function decreased until 9:45AM on 10/5/2021 when she passed away.""""
	"1761528-1"	"1761528-1"	"RENAL FAILURE"	"10038435"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID pneumonia.  Provider discharge note:  ""Admitted to the hospital on September 20, 2021 for hypoxia.  She was fully vaccinated against COVID-19.  At that time she is requiring high-flow nasal cannula oxygenation.  On 09/20 for a CT scan was done which showed a possible nonocclusive emboli in the left lower lung.  She was started on heparin. She was transferred to the intensive care unit on the morning of 09/30/2021.  She developed bilateral pneumothoracies that time.  She was intubated and chest tubes were placed.  Over the next 5 days she developed worsening ARDS with multiorgan system failure.  This presented initially with AFib with RVR and progressed to kidney failure.  On the morning of 10/04/2021 the patient's family decided that they did not want to pursue additional care.  Her respiratory cardiac function decreased until 9:45AM on 10/5/2021 when she passed away.""""
	"1761528-1"	"1761528-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	""Fully vaccinated patient admitted for COVID pneumonia.  Provider discharge note:  ""Admitted to the hospital on September 20, 2021 for hypoxia.  She was fully vaccinated against COVID-19.  At that time she is requiring high-flow nasal cannula oxygenation.  On 09/20 for a CT scan was done which showed a possible nonocclusive emboli in the left lower lung.  She was started on heparin. She was transferred to the intensive care unit on the morning of 09/30/2021.  She developed bilateral pneumothoracies that time.  She was intubated and chest tubes were placed.  Over the next 5 days she developed worsening ARDS with multiorgan system failure.  This presented initially with AFib with RVR and progressed to kidney failure.  On the morning of 10/04/2021 the patient's family decided that they did not want to pursue additional care.  Her respiratory cardiac function decreased until 9:45AM on 10/5/2021 when she passed away.""""
	"1761576-1"	"1761576-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient fully vaccinated and later hospitalized then died due to Covid related causes."
	"1761576-1"	"1761576-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient fully vaccinated and later hospitalized then died due to Covid related causes."
	"1761895-1"	"1761895-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient passed away on 08/25/2021."
	"1761982-1"	"1761982-1"	"ABDOMINAL DISTENSION"	"10000060"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"ABDOMINAL WALL OEDEMA"	"10082609"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"ACIDOSIS"	"10000486"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"AMMONIA INCREASED"	"10001946"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"ANTIBODY TEST NEGATIVE"	"10061426"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"ANTICOAGULANT THERAPY"	"10053468"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"BLOOD CREATININE DECREASED"	"10005482"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"BRAIN INJURY"	"10067967"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"BRONCHIAL SECRETION RETENTION"	"10066820"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"BRONCHOSCOPY ABNORMAL"	"10006480"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"CARDIAC DISORDER"	"10061024"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"CHEST DISCOMFORT"	"10008469"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"CHEST TUBE INSERTION"	"10050522"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"COGNITIVE DISORDER"	"10057668"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"COMPUTERISED TOMOGRAM ABDOMEN ABNORMAL"	"10057798"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"COMPUTERISED TOMOGRAM HEAD NORMAL"	"10072167"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"COMPUTERISED TOMOGRAM THORAX ABNORMAL"	"10057799"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"COR PULMONALE ACUTE"	"10010969"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"CULTURE NEGATIVE"	"10061448"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"DECREASED BRONCHIAL SECRETION"	"10054764"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"DISSEMINATED INTRAVASCULAR COAGULATION"	"10013442"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"ECHOCARDIOGRAM ABNORMAL"	"10061593"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"EJECTION FRACTION DECREASED"	"10050528"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"ELECTROCARDIOGRAM ST SEGMENT DEPRESSION"	"10014391"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"ELECTROENCEPHALOGRAM ABNORMAL"	"10014408"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"EPILEPSY"	"10015037"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"FRACTURE"	"10017076"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"GENERALISED OEDEMA"	"10018092"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"HAEMATOLOGY TEST"	"10053076"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"HAEMOGLOBIN DECREASED"	"10018884"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"HAEMOPERITONEUM"	"10018935"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"HAEMOTHORAX"	"10019027"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"HEPARIN-INDUCED THROMBOCYTOPENIA TEST"	"10050829"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"HYPERNATRAEMIA"	"10020679"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"HYPERVOLAEMIA"	"10020919"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"HYPOPERFUSION"	"10058558"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"IMMUNE THROMBOCYTOPENIA"	"10083842"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"INFUSION"	"10060345"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"ISCHAEMIC HEPATITIS"	"10023025"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"LABORATORY TEST ABNORMAL"	"10023547"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"LACTIC ACIDOSIS"	"10023676"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"LIVER FUNCTION TEST DECREASED"	"10077677"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"LUNG CONSOLIDATION"	"10025080"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"MAGNETIC RESONANCE IMAGING ABNORMAL"	"10078224"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"MENTAL STATUS CHANGES"	"10048294"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"MESENTERIC HAEMORRHAGE"	"10060717"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"METABOLIC ACIDOSIS"	"10027417"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"MUSCLE STRAIN"	"10050031"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"MYOCARDIAL NECROSIS MARKER INCREASED"	"10075211"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"NORMOCYTIC ANAEMIA"	"10029784"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"OBSTRUCTIVE SHOCK"	"10073708"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"PLATELET COUNT DECREASED"	"10035528"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"PLEURAL EFFUSION"	"10035598"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"PULSELESS ELECTRICAL ACTIVITY"	"10058151"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"RENAL IMPAIRMENT"	"10062237"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"RENAL INFARCT"	"10038470"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"RENAL TUBULAR NECROSIS"	"10038540"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"RIGHT VENTRICULAR DILATATION"	"10074222"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"RIGHT VENTRICULAR DYSFUNCTION"	"10058597"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"SEIZURE"	"10039906"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"SHOCK"	"10040560"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"STATUS EPILEPTICUS"	"10041962"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"SYNCOPE"	"10042772"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"THROMBOCYTOPENIA"	"10043554"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"THROMBOLYSIS"	"10043568"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"TRANSAMINASES INCREASED"	"10054889"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"TRANSFUSION"	"10066152"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"TRAUMATIC HAEMOTHORAX"	"10074487"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1761982-1"	"1761982-1"	"ULTRASOUND DOPPLER"	"10045412"	"60-64 years"	"60-64"	"Deceased (10.1.21);  Hospitalized (9.17.21 - Acute massive, bilateral PE; cardiac arrest);   Fully Vaccinated (8.18 & 9.8.21)  Discharge Provider: Doctor Primary Care Physician at Discharge: Doctor  Admission Date: 9/17/2021 Date of Death: 10/1/21 Time of Death:  7:10 AM Preliminary Cause of Death: Acidosis Discharge Disposition: Deceased PRESENTING PROBLEM: Cardiac arrest Shock Acute pulmonary embolism with acute cor pulmonale, unspecified pulmonary embolism type HOSPITAL COURSE: Patient is a 61-year-old male with past medical history significant for glaucoma, hypertension, hyperlipidemia who presented to the emergency department with syncope on 9/17.  Had PEA cardiac arrest x4 secondary to bilateral massive PE with right heart strain.  Received systemic thrombolysis 9/17.  Initially in shock, likely obstcutive, and requiring pressors, though this did improve after a few days and patient came off pressors.  Also initially with metabolic/lactic acidosis, likely secondary to PEA arrest hypoperfusion.  Labs monitored with resolution.  Post arrest echo with mildly reduced EF and dilated RV.  No DVT on lower extremity Dopplers.  PE possibly provoked secondary to recent COVID-19 vaccination, though hematology felt to be unprovoked.    There was initially some concern for vaccine induced immune thrombotic thrombocytopenia secondary to patient's recent receipt of the COVID vaccine as well as thrombocytopenia.  Pf4 antibodies and serotonin release assay sent per hematology recommendation, and patient was started on argatroban for anticoagulation.  Pf4 and SRA negative with improved platelet count, so patient was transitioned to heparin infusion and remained on this throughout the course of his hospitalization.  Patient also initially with DIC, received cryoprecipitate, and labs were monitored with resolution.  He was not cooled given concerns for increased risk of bleeding secondary to DIC, thrombocytopenia, receipt of tPA.   The patient continued to require intubation and mechanical ventilation.  Initially secondary to massive PE/PEA arrest.  Continued predominantly secondary poor mental status secondary to anoxic brain injury and extremely high doses of sedating medication to control seizures.  The patient developed severely refractory seizures secondary to anoxic brain injury.  Initial EEG demonstrated status epilepticus.  He eventually required multiple antiepileptic medications as well as very deep sedation to achieve suppression. Critical Care were consulted and followed patient's course, providing recommendation.  Patient was also kept continuous EEG.  Patient was taken for MRI on 09/20 after he was sufficiently stabilized, notable for anoxic brain injury.  CT head obtained 9/27 stable, no acute abnormalities.  Ammonia level mildly elevated, not enough to explain cognitive deficit.  Per neuro recommendation, LP was not felt to be necessary given the predominantly etiology of anoxic brain injury.  Patient also developed primary lung findings of hemopneumothorax, bilateral lower lobe consolidations and pleural effusions.  Bronchoscopy performed 9/22 with removal of large amount of thick mucus, cultures negative.  Bronchoscopy again performed 9/26 with thin secretions, cultures negative.  Patient covered with Zosyn.  Chest tube placed 9/24 for hemothorax, with decrease in the amount of hemothorax confirmed on imaging.  Chest tube remained in place throughout remainder of admission. The patient was additionally found to have bilateral renal infarctions on CT as well as AKI.  Initial AKI most likely secondary to ATN in the setting of cardiac arrest.  He did not require dialysis.  Creatinine plateaued, then improved, though eventually did again worsen, unclear etiology.  Continued to make urine, though was very challenging to fully diurese, particularly given large intake from IV drips as well as hypernatremia.  Patient eventually did again develope a metabolic acidosis, likely secondary to worsened renal function.  Fluid overload caused a large amount of anasarca, particularly abdominal distension/abdominal wall edema.  Abdominal distension was initially thought to be secondary to obstruction, though imaging demonstrated no signs of obstruction and patient had bowel movements.  Patient additionally with a normocytic anemia, predominantly secondary to hemothorax.  Down trended slowly during admission.  Did require transfusion with one unit with appropriate response.  Further issues addressed during patient's hospitalization include hemoperitoneum and lower abdominal mesentery hemorrhage demonstrated on CT 9/17, improved on repeat imaging.  Chest wall fractures additionally noted on CT 9/17, though these did not require management.  The patient also had shock liver with transaminitis, though LFTs trended downward appropriately. Family was kept appraised of patient's condition and poor prognosis, particularly given severe brain injury.  Caregiving assisted, and patient's family made the decision to refrain from escalating care on 9/30.  Planned to withdraw care likely the following day once further family had had time to come and see the patient.  Patient had a worsening acidosis as well as FiO2 requirement overnight 9/30 to 10/1.  Bicarb drip was held as decision had been made for no escalation of care.  Patient expired on 10/1 at 0700."
	"1763122-1"	"1763122-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death within 7 days of vaccination"
	"1765070-1"	"1765070-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Onset of severe shortness of breath and death within several minutes."
	"1765070-1"	"1765070-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Onset of severe shortness of breath and death within several minutes."
	"1765357-1"	"1765357-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765357-1"	"1765357-1"	"ANGIOGRAM PULMONARY ABNORMAL"	"10002441"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765357-1"	"1765357-1"	"CARDIOVERSION"	"10007661"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765357-1"	"1765357-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765357-1"	"1765357-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765357-1"	"1765357-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765357-1"	"1765357-1"	"ELECTROCARDIOGRAM ABNORMAL"	"10014363"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765357-1"	"1765357-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765357-1"	"1765357-1"	"EXTUBATION"	"10015894"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765357-1"	"1765357-1"	"HYPOTENSION"	"10021097"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765357-1"	"1765357-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765357-1"	"1765357-1"	"LABORATORY TEST NORMAL"	"10054052"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765357-1"	"1765357-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765357-1"	"1765357-1"	"MENTAL STATUS CHANGES"	"10048294"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765357-1"	"1765357-1"	"PRONE POSITION"	"10074744"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765357-1"	"1765357-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765357-1"	"1765357-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765357-1"	"1765357-1"	"VASOPRESSIVE THERAPY"	"10064148"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765357-1"	"1765357-1"	"VENTRICULAR TACHYCARDIA"	"10047302"	"60-64 years"	"60-64"	"Patient is a 64 y.o. female with a past medical history of hyperlipidemia, IDDM2, OSA, anxiety/depression, and chronic back pain who presented from Clinic on 9/4/2021 with acute respiratory failure due to COVID-19 infection. Required intubation secondary to refractory hypoxemia with worsening mental status and increased work of breathing on 9/6. Was initially on paralytics and intermittently in prone position following intubation. Hospital course complicated by persistent fevers up to 103.9, multiple infectious workups negative.    On 9/16/2021, Patient had acute decompensation with hypotension, hypoxia and ventricular tachycardia requiring defibrillation. CTPA revealed pulmonary embolism. EKG with anterior leads concerning for ischemia, on-call cardiologist notified, stat echo ordered. See code documentation from 9/16 for further information. She continued to decompensate despite maximal support from vasopressors and mechanical ventilation.    Family present at beside, pt husband expressed wishes to transition to Home Care. Code status changed to DNRCC, pt compassionately extubated with time of death at 2051 on 9/16/2021."
	"1765490-1"	"1765490-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient contracted COVID, was hospitalized, and died"
	"1765490-1"	"1765490-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient contracted COVID, was hospitalized, and died"
	"1765490-1"	"1765490-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Patient contracted COVID, was hospitalized, and died"
	"1765598-1"	"1765598-1"	"CHEST DISCOMFORT"	"10008469"	"60-64 years"	"60-64"	"Nearly immediately patient didn't feel well with general malaise. He took that afternoon off work and the following Tuesday off as well (May 10 and 11). He went back to work Wednesday (May 12) and complained of being tired and having a hard time breathing. He took Thursday off and only worked a  couple of hours on Friday (May 13 and 14 respectively). He described a heaviness on his chest. On Saturday, May 15 he experienced chest pains while mowing the lawn. He told people he was in a lot of pain and thought he was having a heart attack especially at night when he would lie down to sleep. He was drinking lots of water and was checked by a men's health clinic with a handheld ECG on Monday, May 17. They reported his heart was healthy but he continued to experience shortness of breath and tightness in his chest. He worked a few hours each day Monday through Thursday, May 17-21, but continued to indicate he didn't feel well."
	"1765598-1"	"1765598-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"Nearly immediately patient didn't feel well with general malaise. He took that afternoon off work and the following Tuesday off as well (May 10 and 11). He went back to work Wednesday (May 12) and complained of being tired and having a hard time breathing. He took Thursday off and only worked a  couple of hours on Friday (May 13 and 14 respectively). He described a heaviness on his chest. On Saturday, May 15 he experienced chest pains while mowing the lawn. He told people he was in a lot of pain and thought he was having a heart attack especially at night when he would lie down to sleep. He was drinking lots of water and was checked by a men's health clinic with a handheld ECG on Monday, May 17. They reported his heart was healthy but he continued to experience shortness of breath and tightness in his chest. He worked a few hours each day Monday through Thursday, May 17-21, but continued to indicate he didn't feel well."
	"1765598-1"	"1765598-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Nearly immediately patient didn't feel well with general malaise. He took that afternoon off work and the following Tuesday off as well (May 10 and 11). He went back to work Wednesday (May 12) and complained of being tired and having a hard time breathing. He took Thursday off and only worked a  couple of hours on Friday (May 13 and 14 respectively). He described a heaviness on his chest. On Saturday, May 15 he experienced chest pains while mowing the lawn. He told people he was in a lot of pain and thought he was having a heart attack especially at night when he would lie down to sleep. He was drinking lots of water and was checked by a men's health clinic with a handheld ECG on Monday, May 17. They reported his heart was healthy but he continued to experience shortness of breath and tightness in his chest. He worked a few hours each day Monday through Thursday, May 17-21, but continued to indicate he didn't feel well."
	"1765598-1"	"1765598-1"	"ELECTROCARDIOGRAM NORMAL"	"10014373"	"60-64 years"	"60-64"	"Nearly immediately patient didn't feel well with general malaise. He took that afternoon off work and the following Tuesday off as well (May 10 and 11). He went back to work Wednesday (May 12) and complained of being tired and having a hard time breathing. He took Thursday off and only worked a  couple of hours on Friday (May 13 and 14 respectively). He described a heaviness on his chest. On Saturday, May 15 he experienced chest pains while mowing the lawn. He told people he was in a lot of pain and thought he was having a heart attack especially at night when he would lie down to sleep. He was drinking lots of water and was checked by a men's health clinic with a handheld ECG on Monday, May 17. They reported his heart was healthy but he continued to experience shortness of breath and tightness in his chest. He worked a few hours each day Monday through Thursday, May 17-21, but continued to indicate he didn't feel well."
	"1765598-1"	"1765598-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Nearly immediately patient didn't feel well with general malaise. He took that afternoon off work and the following Tuesday off as well (May 10 and 11). He went back to work Wednesday (May 12) and complained of being tired and having a hard time breathing. He took Thursday off and only worked a  couple of hours on Friday (May 13 and 14 respectively). He described a heaviness on his chest. On Saturday, May 15 he experienced chest pains while mowing the lawn. He told people he was in a lot of pain and thought he was having a heart attack especially at night when he would lie down to sleep. He was drinking lots of water and was checked by a men's health clinic with a handheld ECG on Monday, May 17. They reported his heart was healthy but he continued to experience shortness of breath and tightness in his chest. He worked a few hours each day Monday through Thursday, May 17-21, but continued to indicate he didn't feel well."
	"1765598-1"	"1765598-1"	"IMPAIRED WORK ABILITY"	"10052302"	"60-64 years"	"60-64"	"Nearly immediately patient didn't feel well with general malaise. He took that afternoon off work and the following Tuesday off as well (May 10 and 11). He went back to work Wednesday (May 12) and complained of being tired and having a hard time breathing. He took Thursday off and only worked a  couple of hours on Friday (May 13 and 14 respectively). He described a heaviness on his chest. On Saturday, May 15 he experienced chest pains while mowing the lawn. He told people he was in a lot of pain and thought he was having a heart attack especially at night when he would lie down to sleep. He was drinking lots of water and was checked by a men's health clinic with a handheld ECG on Monday, May 17. They reported his heart was healthy but he continued to experience shortness of breath and tightness in his chest. He worked a few hours each day Monday through Thursday, May 17-21, but continued to indicate he didn't feel well."
	"1765598-1"	"1765598-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"Nearly immediately patient didn't feel well with general malaise. He took that afternoon off work and the following Tuesday off as well (May 10 and 11). He went back to work Wednesday (May 12) and complained of being tired and having a hard time breathing. He took Thursday off and only worked a  couple of hours on Friday (May 13 and 14 respectively). He described a heaviness on his chest. On Saturday, May 15 he experienced chest pains while mowing the lawn. He told people he was in a lot of pain and thought he was having a heart attack especially at night when he would lie down to sleep. He was drinking lots of water and was checked by a men's health clinic with a handheld ECG on Monday, May 17. They reported his heart was healthy but he continued to experience shortness of breath and tightness in his chest. He worked a few hours each day Monday through Thursday, May 17-21, but continued to indicate he didn't feel well."
	"1765598-1"	"1765598-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"Nearly immediately patient didn't feel well with general malaise. He took that afternoon off work and the following Tuesday off as well (May 10 and 11). He went back to work Wednesday (May 12) and complained of being tired and having a hard time breathing. He took Thursday off and only worked a  couple of hours on Friday (May 13 and 14 respectively). He described a heaviness on his chest. On Saturday, May 15 he experienced chest pains while mowing the lawn. He told people he was in a lot of pain and thought he was having a heart attack especially at night when he would lie down to sleep. He was drinking lots of water and was checked by a men's health clinic with a handheld ECG on Monday, May 17. They reported his heart was healthy but he continued to experience shortness of breath and tightness in his chest. He worked a few hours each day Monday through Thursday, May 17-21, but continued to indicate he didn't feel well."
	"1767137-1"	"1767137-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient fully vaccinated and died due to Covid related causes"
	"1767137-1"	"1767137-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient fully vaccinated and died due to Covid related causes"
	"1768407-1"	"1768407-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768407-1"	"1768407-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768407-1"	"1768407-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768407-1"	"1768407-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768407-1"	"1768407-1"	"DYSPNOEA EXERTIONAL"	"10013971"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768407-1"	"1768407-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768407-1"	"1768407-1"	"ENTEROCOCCAL INFECTION"	"10061124"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768407-1"	"1768407-1"	"EXPOSURE TO SARS-COV-2"	"10084456"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768407-1"	"1768407-1"	"FUNGAL DISEASE CARRIER"	"10080548"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768407-1"	"1768407-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768407-1"	"1768407-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768407-1"	"1768407-1"	"LUNG ASSIST DEVICE THERAPY"	"10082527"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768407-1"	"1768407-1"	"LUNG TRANSPLANT REJECTION"	"10051604"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768407-1"	"1768407-1"	"PNEUMONIA PNEUMOCOCCAL"	"10035728"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768407-1"	"1768407-1"	"RESPIRATORY DEPRESSION"	"10038678"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768407-1"	"1768407-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768407-1"	"1768407-1"	"SEPSIS"	"10040047"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768407-1"	"1768407-1"	"TRAUMATIC LUNG INJURY"	"10069363"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768407-1"	"1768407-1"	"URINARY TRACT INFECTION"	"10046571"	"60-64 years"	"60-64"	"63 y.o. female patient with PMHx of COPD s/p bilateral lung transplant (CMV D+/R+, EBV D+/R+, Toxo D-/R-) from an increased risk donor on 6/14/18 who was HCV NAT+/Ab+ as well as HBcAb+ and history of acute transplant rejection who presented to ED for dyspnea on exertion for two days. She was found to have had exposure to close contact with Covid 19 infection. She was previously vaccinated for COVID; admitted 8/1/2021 with confirmed COVID-19. Respiratory status has been worsening, requiring higher oxygen suppor, thus she was transferred to the MICU. At a local hospital, she was started on HFNC and then intubated for increasing/worsening hypoxia. ICU course complicated by need for ECMO cannulation with ARDS, sepsis from E.faecalis UTI and strep pneumoniae PNA ISO aspergillus colonization, and acute bilateral lung transplant rejection. Overall burden of lung injury felt to be not survivable, so her family made the decision for CMO on 9/12/21. VV ECMO support discontinued at 12:35 PM on 9/12/2021 and time of death was 1:05 PM on 9/12/2021."
	"1768627-1"	"1768627-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"death  - Pneumonia, unspecified organism - Acute kidney failure, unspecified  - Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type"
	"1768627-1"	"1768627-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death  - Pneumonia, unspecified organism - Acute kidney failure, unspecified  - Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type"
	"1768627-1"	"1768627-1"	"GASTROINTESTINAL HAEMORRHAGE"	"10017955"	"60-64 years"	"60-64"	"death  - Pneumonia, unspecified organism - Acute kidney failure, unspecified  - Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type"
	"1768627-1"	"1768627-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"death  - Pneumonia, unspecified organism - Acute kidney failure, unspecified  - Gastrointestinal hemorrhage, unspecified gastrointestinal hemorrhage type"
	"1768639-1"	"1768639-1"	"AGEUSIA"	"10001480"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Presented to ED on 10/1/2021 with reports of loss of taste, dyspnea on exertion, and diarrhea consists of watery stools 3 times a days for the past 2-3 days. Patient reports drinking 5 of 8oz water bottles every day but is having very minimal urine production.  He reports associated lightheadedness, chills, non-productive cough, and decreased appetite. He was treated with Remdesivir, Tocilizumab, Decadron and supportive care. On 10/3/21 patient had a syncopal episode and became bradycardic. He went into cardiac arrest. CPR was initiated. Patient eventually expired."
	"1768639-1"	"1768639-1"	"BRADYCARDIA"	"10006093"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Presented to ED on 10/1/2021 with reports of loss of taste, dyspnea on exertion, and diarrhea consists of watery stools 3 times a days for the past 2-3 days. Patient reports drinking 5 of 8oz water bottles every day but is having very minimal urine production.  He reports associated lightheadedness, chills, non-productive cough, and decreased appetite. He was treated with Remdesivir, Tocilizumab, Decadron and supportive care. On 10/3/21 patient had a syncopal episode and became bradycardic. He went into cardiac arrest. CPR was initiated. Patient eventually expired."
	"1768639-1"	"1768639-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Presented to ED on 10/1/2021 with reports of loss of taste, dyspnea on exertion, and diarrhea consists of watery stools 3 times a days for the past 2-3 days. Patient reports drinking 5 of 8oz water bottles every day but is having very minimal urine production.  He reports associated lightheadedness, chills, non-productive cough, and decreased appetite. He was treated with Remdesivir, Tocilizumab, Decadron and supportive care. On 10/3/21 patient had a syncopal episode and became bradycardic. He went into cardiac arrest. CPR was initiated. Patient eventually expired."
	"1768639-1"	"1768639-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Presented to ED on 10/1/2021 with reports of loss of taste, dyspnea on exertion, and diarrhea consists of watery stools 3 times a days for the past 2-3 days. Patient reports drinking 5 of 8oz water bottles every day but is having very minimal urine production.  He reports associated lightheadedness, chills, non-productive cough, and decreased appetite. He was treated with Remdesivir, Tocilizumab, Decadron and supportive care. On 10/3/21 patient had a syncopal episode and became bradycardic. He went into cardiac arrest. CPR was initiated. Patient eventually expired."
	"1768639-1"	"1768639-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Presented to ED on 10/1/2021 with reports of loss of taste, dyspnea on exertion, and diarrhea consists of watery stools 3 times a days for the past 2-3 days. Patient reports drinking 5 of 8oz water bottles every day but is having very minimal urine production.  He reports associated lightheadedness, chills, non-productive cough, and decreased appetite. He was treated with Remdesivir, Tocilizumab, Decadron and supportive care. On 10/3/21 patient had a syncopal episode and became bradycardic. He went into cardiac arrest. CPR was initiated. Patient eventually expired."
	"1768639-1"	"1768639-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Presented to ED on 10/1/2021 with reports of loss of taste, dyspnea on exertion, and diarrhea consists of watery stools 3 times a days for the past 2-3 days. Patient reports drinking 5 of 8oz water bottles every day but is having very minimal urine production.  He reports associated lightheadedness, chills, non-productive cough, and decreased appetite. He was treated with Remdesivir, Tocilizumab, Decadron and supportive care. On 10/3/21 patient had a syncopal episode and became bradycardic. He went into cardiac arrest. CPR was initiated. Patient eventually expired."
	"1768639-1"	"1768639-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Presented to ED on 10/1/2021 with reports of loss of taste, dyspnea on exertion, and diarrhea consists of watery stools 3 times a days for the past 2-3 days. Patient reports drinking 5 of 8oz water bottles every day but is having very minimal urine production.  He reports associated lightheadedness, chills, non-productive cough, and decreased appetite. He was treated with Remdesivir, Tocilizumab, Decadron and supportive care. On 10/3/21 patient had a syncopal episode and became bradycardic. He went into cardiac arrest. CPR was initiated. Patient eventually expired."
	"1768639-1"	"1768639-1"	"DECREASED APPETITE"	"10061428"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Presented to ED on 10/1/2021 with reports of loss of taste, dyspnea on exertion, and diarrhea consists of watery stools 3 times a days for the past 2-3 days. Patient reports drinking 5 of 8oz water bottles every day but is having very minimal urine production.  He reports associated lightheadedness, chills, non-productive cough, and decreased appetite. He was treated with Remdesivir, Tocilizumab, Decadron and supportive care. On 10/3/21 patient had a syncopal episode and became bradycardic. He went into cardiac arrest. CPR was initiated. Patient eventually expired."
	"1768639-1"	"1768639-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Presented to ED on 10/1/2021 with reports of loss of taste, dyspnea on exertion, and diarrhea consists of watery stools 3 times a days for the past 2-3 days. Patient reports drinking 5 of 8oz water bottles every day but is having very minimal urine production.  He reports associated lightheadedness, chills, non-productive cough, and decreased appetite. He was treated with Remdesivir, Tocilizumab, Decadron and supportive care. On 10/3/21 patient had a syncopal episode and became bradycardic. He went into cardiac arrest. CPR was initiated. Patient eventually expired."
	"1768639-1"	"1768639-1"	"DIZZINESS"	"10013573"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Presented to ED on 10/1/2021 with reports of loss of taste, dyspnea on exertion, and diarrhea consists of watery stools 3 times a days for the past 2-3 days. Patient reports drinking 5 of 8oz water bottles every day but is having very minimal urine production.  He reports associated lightheadedness, chills, non-productive cough, and decreased appetite. He was treated with Remdesivir, Tocilizumab, Decadron and supportive care. On 10/3/21 patient had a syncopal episode and became bradycardic. He went into cardiac arrest. CPR was initiated. Patient eventually expired."
	"1768639-1"	"1768639-1"	"DYSPNOEA EXERTIONAL"	"10013971"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Presented to ED on 10/1/2021 with reports of loss of taste, dyspnea on exertion, and diarrhea consists of watery stools 3 times a days for the past 2-3 days. Patient reports drinking 5 of 8oz water bottles every day but is having very minimal urine production.  He reports associated lightheadedness, chills, non-productive cough, and decreased appetite. He was treated with Remdesivir, Tocilizumab, Decadron and supportive care. On 10/3/21 patient had a syncopal episode and became bradycardic. He went into cardiac arrest. CPR was initiated. Patient eventually expired."
	"1768639-1"	"1768639-1"	"OLIGURIA"	"10030302"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Presented to ED on 10/1/2021 with reports of loss of taste, dyspnea on exertion, and diarrhea consists of watery stools 3 times a days for the past 2-3 days. Patient reports drinking 5 of 8oz water bottles every day but is having very minimal urine production.  He reports associated lightheadedness, chills, non-productive cough, and decreased appetite. He was treated with Remdesivir, Tocilizumab, Decadron and supportive care. On 10/3/21 patient had a syncopal episode and became bradycardic. He went into cardiac arrest. CPR was initiated. Patient eventually expired."
	"1768639-1"	"1768639-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Presented to ED on 10/1/2021 with reports of loss of taste, dyspnea on exertion, and diarrhea consists of watery stools 3 times a days for the past 2-3 days. Patient reports drinking 5 of 8oz water bottles every day but is having very minimal urine production.  He reports associated lightheadedness, chills, non-productive cough, and decreased appetite. He was treated with Remdesivir, Tocilizumab, Decadron and supportive care. On 10/3/21 patient had a syncopal episode and became bradycardic. He went into cardiac arrest. CPR was initiated. Patient eventually expired."
	"1768639-1"	"1768639-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Presented to ED on 10/1/2021 with reports of loss of taste, dyspnea on exertion, and diarrhea consists of watery stools 3 times a days for the past 2-3 days. Patient reports drinking 5 of 8oz water bottles every day but is having very minimal urine production.  He reports associated lightheadedness, chills, non-productive cough, and decreased appetite. He was treated with Remdesivir, Tocilizumab, Decadron and supportive care. On 10/3/21 patient had a syncopal episode and became bradycardic. He went into cardiac arrest. CPR was initiated. Patient eventually expired."
	"1768639-1"	"1768639-1"	"SYNCOPE"	"10042772"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 4/14/2021 and 5/5/2021. Presented to ED on 10/1/2021 with reports of loss of taste, dyspnea on exertion, and diarrhea consists of watery stools 3 times a days for the past 2-3 days. Patient reports drinking 5 of 8oz water bottles every day but is having very minimal urine production.  He reports associated lightheadedness, chills, non-productive cough, and decreased appetite. He was treated with Remdesivir, Tocilizumab, Decadron and supportive care. On 10/3/21 patient had a syncopal episode and became bradycardic. He went into cardiac arrest. CPR was initiated. Patient eventually expired."
	"1775170-1"	"1775170-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"60-64 years"	"60-64"	"Chest pain, shortness of breath, Acute Myocardial Infarction"
	"1775170-1"	"1775170-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"Chest pain, shortness of breath, Acute Myocardial Infarction"
	"1775170-1"	"1775170-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Chest pain, shortness of breath, Acute Myocardial Infarction"
	"1776387-1"	"1776387-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"Found unresponsive after coworker heard a thud.  Code Blue called.  CPR initiated, AED applied and no shockable  rhythm x3.  Code continued for 45 minutes with paramedics on scene and drugs administered. Time of death called by  ER physician on phone."
	"1776387-1"	"1776387-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Found unresponsive after coworker heard a thud.  Code Blue called.  CPR initiated, AED applied and no shockable  rhythm x3.  Code continued for 45 minutes with paramedics on scene and drugs administered. Time of death called by  ER physician on phone."
	"1776387-1"	"1776387-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Found unresponsive after coworker heard a thud.  Code Blue called.  CPR initiated, AED applied and no shockable  rhythm x3.  Code continued for 45 minutes with paramedics on scene and drugs administered. Time of death called by  ER physician on phone."
	"1776387-1"	"1776387-1"	"SARS-COV-2 TEST NEGATIVE"	"10084273"	"60-64 years"	"60-64"	"Found unresponsive after coworker heard a thud.  Code Blue called.  CPR initiated, AED applied and no shockable  rhythm x3.  Code continued for 45 minutes with paramedics on scene and drugs administered. Time of death called by  ER physician on phone."
	"1776387-1"	"1776387-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Found unresponsive after coworker heard a thud.  Code Blue called.  CPR initiated, AED applied and no shockable  rhythm x3.  Code continued for 45 minutes with paramedics on scene and drugs administered. Time of death called by  ER physician on phone."
	"1776605-1"	"1776605-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death approximately 18 hours following vaccination. Asymptomatic. Died in sleep."
	"1777335-1"	"1777335-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"My husband died of a massive pulmonary embolism four moths after receiving the vaccine on 06/24/2021 ( never had any symptoms or injuries prior to receiving the vaccine). I found my husband dead in our home upon arriving from work. An autopsy was performed and that's how I learned that he died of a massive pulmonary embolism.."
	"1777335-1"	"1777335-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"My husband died of a massive pulmonary embolism four moths after receiving the vaccine on 06/24/2021 ( never had any symptoms or injuries prior to receiving the vaccine). I found my husband dead in our home upon arriving from work. An autopsy was performed and that's how I learned that he died of a massive pulmonary embolism.."
	"1777335-1"	"1777335-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"My husband died of a massive pulmonary embolism four moths after receiving the vaccine on 06/24/2021 ( never had any symptoms or injuries prior to receiving the vaccine). I found my husband dead in our home upon arriving from work. An autopsy was performed and that's how I learned that he died of a massive pulmonary embolism.."
	"1778922-1"	"1778922-1"	"ACIDOSIS"	"10000486"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"ARTERIAL CATHETERISATION"	"10003148"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"AUSCULTATION"	"10076270"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"BREATH SOUNDS ABNORMAL"	"10064780"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"CENTRAL VENOUS CATHETERISATION"	"10053377"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"COMPUTERISED TOMOGRAM THORAX ABNORMAL"	"10057799"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"HYPERKALAEMIA"	"10020646"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"INTESTINAL ISCHAEMIA"	"10022680"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"LUNG INFILTRATION"	"10025102"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"LUNG OPACITY"	"10081792"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"MULTIPLE ORGAN DYSFUNCTION SYNDROME"	"10077361"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"PALLOR"	"10033546"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"PH BODY FLUID"	"10061346"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"RALES"	"10037833"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"RENAL FAILURE"	"10038435"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"RESPIRATORY FATIGUE"	"10068733"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"SEPTIC SHOCK"	"10040070"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"TACHYCARDIA"	"10043071"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"TACHYPNOEA"	"10043089"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1778922-1"	"1778922-1"	"WHEEZING"	"10047924"	"60-64 years"	"60-64"	"9/24 PMHx of COPD, pneumonia, pulm HTN, Anxiety who presents for SOB w/ wheezing x 3 days. Diag. w/ Pneumonia upon assessment. 9/25 CT  suspicious for small pulmonary emboli. Examination of the lungs reveals numerous groundglass airspace opacities throughout the upper lobes and lower lobes bilaterally.  9/28  Lungs reduced  to auscultation bilaterally. Right lower lobe crackles. On CT There is interval worsening in aeration with development of bilateral infiltrates diffusely throughout both lungs. The pleural spaces remain clear.  10/4 patient currently requiring warmed high flow oxygen at 45L. Overnihgt desaturations into 10/5  10/6  pt desat to 62%, pt pale, tachypenic, tachycardic. Rapid response called to aid 10/6 Again RRT was called due to hypoxia Osat was in mid 80s%, pt was on high flow 10/6 She has been transferred to the ICU due to worsening respiratory status. Discussed plan for EGD tomorrow with patient and her daughter at the bedside.  10/6 Called to ICU patient showing signs of respiratory fatigue, requested to intubate patient. Patient oxygenated with ambu bag and mask with FiO2 100%. Intubation followed. 10/7 Central Line Placement - Right Internal Jugular 10/7 COIVD+ Result 10/7 Discussed with family poor prognosis, and clinical deterioration, will remain full code 10/8 CRITICAL CARE PROCEDURE NOTE - ARTERIAL CATHETER INSERTION 10/8 Septic shock with multiple organ failure, suspect ischemic bowel 10/8 Code blue called at 05:31 pm. On arrival to room, patient had achieved ROSC. Per nursing staff patient has been severely acidotic throughout the day with pH<7. Patient is on multiple pressors. Renal failure with hyperkalemia. There was suspicion for possible ischemic bowel however CT of abdomen could not be obtained as patient is too unstable. Patient had coded again while I was at rapid response. Per nurse staff ED doctor present for the code and pronounced patient"
	"1779214-1"	"1779214-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Notified by medical examiner that patient was found deceased at home 10/08/2021, no report of symptoms in interim"
	"1782382-1"	"1782382-1"	"ARTHRITIS BACTERIAL"	"10053555"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Vaccine on 4/6/2021. Patient admitted for septic arthritis 9/9/2021. Patient began to experience respiratory symptoms on 9/11/2021. Patient received: ascorbic acid, broad spectrum antibiotics, dexamethasone, remdesivir, tocilizumab, and zinc. On 9/272021, patient was emergently intubated, shortly after went into cardiac arrest and CPR initiated.  Patient expired 9/27/2021 at 1447."
	"1782382-1"	"1782382-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Vaccine on 4/6/2021. Patient admitted for septic arthritis 9/9/2021. Patient began to experience respiratory symptoms on 9/11/2021. Patient received: ascorbic acid, broad spectrum antibiotics, dexamethasone, remdesivir, tocilizumab, and zinc. On 9/272021, patient was emergently intubated, shortly after went into cardiac arrest and CPR initiated.  Patient expired 9/27/2021 at 1447."
	"1782382-1"	"1782382-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Vaccine on 4/6/2021. Patient admitted for septic arthritis 9/9/2021. Patient began to experience respiratory symptoms on 9/11/2021. Patient received: ascorbic acid, broad spectrum antibiotics, dexamethasone, remdesivir, tocilizumab, and zinc. On 9/272021, patient was emergently intubated, shortly after went into cardiac arrest and CPR initiated.  Patient expired 9/27/2021 at 1447."
	"1782382-1"	"1782382-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Vaccine on 4/6/2021. Patient admitted for septic arthritis 9/9/2021. Patient began to experience respiratory symptoms on 9/11/2021. Patient received: ascorbic acid, broad spectrum antibiotics, dexamethasone, remdesivir, tocilizumab, and zinc. On 9/272021, patient was emergently intubated, shortly after went into cardiac arrest and CPR initiated.  Patient expired 9/27/2021 at 1447."
	"1782382-1"	"1782382-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Vaccine on 4/6/2021. Patient admitted for septic arthritis 9/9/2021. Patient began to experience respiratory symptoms on 9/11/2021. Patient received: ascorbic acid, broad spectrum antibiotics, dexamethasone, remdesivir, tocilizumab, and zinc. On 9/272021, patient was emergently intubated, shortly after went into cardiac arrest and CPR initiated.  Patient expired 9/27/2021 at 1447."
	"1782382-1"	"1782382-1"	"IMAGING PROCEDURE ABNORMAL"	"10077446"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Vaccine on 4/6/2021. Patient admitted for septic arthritis 9/9/2021. Patient began to experience respiratory symptoms on 9/11/2021. Patient received: ascorbic acid, broad spectrum antibiotics, dexamethasone, remdesivir, tocilizumab, and zinc. On 9/272021, patient was emergently intubated, shortly after went into cardiac arrest and CPR initiated.  Patient expired 9/27/2021 at 1447."
	"1782382-1"	"1782382-1"	"LUNG INFILTRATION"	"10025102"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Vaccine on 4/6/2021. Patient admitted for septic arthritis 9/9/2021. Patient began to experience respiratory symptoms on 9/11/2021. Patient received: ascorbic acid, broad spectrum antibiotics, dexamethasone, remdesivir, tocilizumab, and zinc. On 9/272021, patient was emergently intubated, shortly after went into cardiac arrest and CPR initiated.  Patient expired 9/27/2021 at 1447."
	"1782382-1"	"1782382-1"	"RESPIRATORY SYMPTOM"	"10075535"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Vaccine on 4/6/2021. Patient admitted for septic arthritis 9/9/2021. Patient began to experience respiratory symptoms on 9/11/2021. Patient received: ascorbic acid, broad spectrum antibiotics, dexamethasone, remdesivir, tocilizumab, and zinc. On 9/272021, patient was emergently intubated, shortly after went into cardiac arrest and CPR initiated.  Patient expired 9/27/2021 at 1447."
	"1782382-1"	"1782382-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Vaccine on 4/6/2021. Patient admitted for septic arthritis 9/9/2021. Patient began to experience respiratory symptoms on 9/11/2021. Patient received: ascorbic acid, broad spectrum antibiotics, dexamethasone, remdesivir, tocilizumab, and zinc. On 9/272021, patient was emergently intubated, shortly after went into cardiac arrest and CPR initiated.  Patient expired 9/27/2021 at 1447."
	"1782382-1"	"1782382-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Vaccine on 4/6/2021. Patient admitted for septic arthritis 9/9/2021. Patient began to experience respiratory symptoms on 9/11/2021. Patient received: ascorbic acid, broad spectrum antibiotics, dexamethasone, remdesivir, tocilizumab, and zinc. On 9/272021, patient was emergently intubated, shortly after went into cardiac arrest and CPR initiated.  Patient expired 9/27/2021 at 1447."
	"1782382-1"	"1782382-1"	"STAPHYLOCOCCUS TEST POSITIVE"	"10070052"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Vaccine on 4/6/2021. Patient admitted for septic arthritis 9/9/2021. Patient began to experience respiratory symptoms on 9/11/2021. Patient received: ascorbic acid, broad spectrum antibiotics, dexamethasone, remdesivir, tocilizumab, and zinc. On 9/272021, patient was emergently intubated, shortly after went into cardiac arrest and CPR initiated.  Patient expired 9/27/2021 at 1447."
	"1782423-1"	"1782423-1"	"AGEUSIA"	"10001480"	"60-64 years"	"60-64"	"Hospitalized and death; symptoms include fever, rhinorrhea, sore throat, cough, shortness of breath, chest pain, headache, fatigue, diarrhea, congestion, and loss of taste/smell."
	"1782423-1"	"1782423-1"	"ANOSMIA"	"10002653"	"60-64 years"	"60-64"	"Hospitalized and death; symptoms include fever, rhinorrhea, sore throat, cough, shortness of breath, chest pain, headache, fatigue, diarrhea, congestion, and loss of taste/smell."
	"1782423-1"	"1782423-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"Hospitalized and death; symptoms include fever, rhinorrhea, sore throat, cough, shortness of breath, chest pain, headache, fatigue, diarrhea, congestion, and loss of taste/smell."
	"1782423-1"	"1782423-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Hospitalized and death; symptoms include fever, rhinorrhea, sore throat, cough, shortness of breath, chest pain, headache, fatigue, diarrhea, congestion, and loss of taste/smell."
	"1782423-1"	"1782423-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Hospitalized and death; symptoms include fever, rhinorrhea, sore throat, cough, shortness of breath, chest pain, headache, fatigue, diarrhea, congestion, and loss of taste/smell."
	"1782423-1"	"1782423-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"Hospitalized and death; symptoms include fever, rhinorrhea, sore throat, cough, shortness of breath, chest pain, headache, fatigue, diarrhea, congestion, and loss of taste/smell."
	"1782423-1"	"1782423-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Hospitalized and death; symptoms include fever, rhinorrhea, sore throat, cough, shortness of breath, chest pain, headache, fatigue, diarrhea, congestion, and loss of taste/smell."
	"1782423-1"	"1782423-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Hospitalized and death; symptoms include fever, rhinorrhea, sore throat, cough, shortness of breath, chest pain, headache, fatigue, diarrhea, congestion, and loss of taste/smell."
	"1782423-1"	"1782423-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"Hospitalized and death; symptoms include fever, rhinorrhea, sore throat, cough, shortness of breath, chest pain, headache, fatigue, diarrhea, congestion, and loss of taste/smell."
	"1782423-1"	"1782423-1"	"OROPHARYNGEAL PAIN"	"10068319"	"60-64 years"	"60-64"	"Hospitalized and death; symptoms include fever, rhinorrhea, sore throat, cough, shortness of breath, chest pain, headache, fatigue, diarrhea, congestion, and loss of taste/smell."
	"1782423-1"	"1782423-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Hospitalized and death; symptoms include fever, rhinorrhea, sore throat, cough, shortness of breath, chest pain, headache, fatigue, diarrhea, congestion, and loss of taste/smell."
	"1782423-1"	"1782423-1"	"RESPIRATORY TRACT CONGESTION"	"10052251"	"60-64 years"	"60-64"	"Hospitalized and death; symptoms include fever, rhinorrhea, sore throat, cough, shortness of breath, chest pain, headache, fatigue, diarrhea, congestion, and loss of taste/smell."
	"1782423-1"	"1782423-1"	"RHINORRHOEA"	"10039101"	"60-64 years"	"60-64"	"Hospitalized and death; symptoms include fever, rhinorrhea, sore throat, cough, shortness of breath, chest pain, headache, fatigue, diarrhea, congestion, and loss of taste/smell."
	"1782423-1"	"1782423-1"	"SARS-COV-2 TEST"	"10084354"	"60-64 years"	"60-64"	"Hospitalized and death; symptoms include fever, rhinorrhea, sore throat, cough, shortness of breath, chest pain, headache, fatigue, diarrhea, congestion, and loss of taste/smell."
	"1783039-1"	"1783039-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"PATIENT DIED OF ACUTE HYPOXEMIC RESPIRATORY FAILURE SECONDARY TO COVID 19 PNEUMONIA AFTER BEING FULLY VACCINATED FOR COVID 19"
	"1783039-1"	"1783039-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"PATIENT DIED OF ACUTE HYPOXEMIC RESPIRATORY FAILURE SECONDARY TO COVID 19 PNEUMONIA AFTER BEING FULLY VACCINATED FOR COVID 19"
	"1783039-1"	"1783039-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"PATIENT DIED OF ACUTE HYPOXEMIC RESPIRATORY FAILURE SECONDARY TO COVID 19 PNEUMONIA AFTER BEING FULLY VACCINATED FOR COVID 19"
	"1784958-1"	"1784958-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient fully vaccinated and died due to Covid related causes"
	"1784958-1"	"1784958-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient fully vaccinated and died due to Covid related causes"
	"1785281-1"	"1785281-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"60-64 years"	"60-64"	"Admitted with adult respiratory distress syndrome, septic shock, pneumonia, COPD . Family chose comfort care instead of aggressive treatments and patient died. Vapotherm, BiPap, intubated, pressors"
	"1785281-1"	"1785281-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"Admitted with adult respiratory distress syndrome, septic shock, pneumonia, COPD . Family chose comfort care instead of aggressive treatments and patient died. Vapotherm, BiPap, intubated, pressors"
	"1785281-1"	"1785281-1"	"CHRONIC OBSTRUCTIVE PULMONARY DISEASE"	"10009033"	"60-64 years"	"60-64"	"Admitted with adult respiratory distress syndrome, septic shock, pneumonia, COPD . Family chose comfort care instead of aggressive treatments and patient died. Vapotherm, BiPap, intubated, pressors"
	"1785281-1"	"1785281-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"Admitted with adult respiratory distress syndrome, septic shock, pneumonia, COPD . Family chose comfort care instead of aggressive treatments and patient died. Vapotherm, BiPap, intubated, pressors"
	"1785281-1"	"1785281-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Admitted with adult respiratory distress syndrome, septic shock, pneumonia, COPD . Family chose comfort care instead of aggressive treatments and patient died. Vapotherm, BiPap, intubated, pressors"
	"1785281-1"	"1785281-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Admitted with adult respiratory distress syndrome, septic shock, pneumonia, COPD . Family chose comfort care instead of aggressive treatments and patient died. Vapotherm, BiPap, intubated, pressors"
	"1785281-1"	"1785281-1"	"LUNG OPACITY"	"10081792"	"60-64 years"	"60-64"	"Admitted with adult respiratory distress syndrome, septic shock, pneumonia, COPD . Family chose comfort care instead of aggressive treatments and patient died. Vapotherm, BiPap, intubated, pressors"
	"1785281-1"	"1785281-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"Admitted with adult respiratory distress syndrome, septic shock, pneumonia, COPD . Family chose comfort care instead of aggressive treatments and patient died. Vapotherm, BiPap, intubated, pressors"
	"1785281-1"	"1785281-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"60-64 years"	"60-64"	"Admitted with adult respiratory distress syndrome, septic shock, pneumonia, COPD . Family chose comfort care instead of aggressive treatments and patient died. Vapotherm, BiPap, intubated, pressors"
	"1785281-1"	"1785281-1"	"PULMONARY FIBROSIS"	"10037383"	"60-64 years"	"60-64"	"Admitted with adult respiratory distress syndrome, septic shock, pneumonia, COPD . Family chose comfort care instead of aggressive treatments and patient died. Vapotherm, BiPap, intubated, pressors"
	"1785281-1"	"1785281-1"	"SEPTIC SHOCK"	"10040070"	"60-64 years"	"60-64"	"Admitted with adult respiratory distress syndrome, septic shock, pneumonia, COPD . Family chose comfort care instead of aggressive treatments and patient died. Vapotherm, BiPap, intubated, pressors"
	"1785320-1"	"1785320-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"10/8/21 PATIENT ADMITTED TO MEDICAL CENTER aCUTE ON CHRONIC lv SYSTOLIC HEART FAILURE. PATIENT REPORTING SOB , CARDIAC CATH SHOWED NORMAL, ACUTE RENAL FAILURE NOTED .imPELLA DEVICE PLACED.  COVID + ACUTE RESP FAILURE.  10/9/21 PATIENT HAD CARDIOPULMONARY ARREST.  PATIENT INTUBATED . PATINET  PROGRESSIVELY MORE HYPOTENSION AND BRADYCARDIC. ON 10/9/21 PATIETN DIED."
	"1785320-1"	"1785320-1"	"ACUTE LEFT VENTRICULAR FAILURE"	"10063081"	"60-64 years"	"60-64"	"10/8/21 PATIENT ADMITTED TO MEDICAL CENTER aCUTE ON CHRONIC lv SYSTOLIC HEART FAILURE. PATIENT REPORTING SOB , CARDIAC CATH SHOWED NORMAL, ACUTE RENAL FAILURE NOTED .imPELLA DEVICE PLACED.  COVID + ACUTE RESP FAILURE.  10/9/21 PATIENT HAD CARDIOPULMONARY ARREST.  PATIENT INTUBATED . PATINET  PROGRESSIVELY MORE HYPOTENSION AND BRADYCARDIC. ON 10/9/21 PATIETN DIED."
	"1785320-1"	"1785320-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"10/8/21 PATIENT ADMITTED TO MEDICAL CENTER aCUTE ON CHRONIC lv SYSTOLIC HEART FAILURE. PATIENT REPORTING SOB , CARDIAC CATH SHOWED NORMAL, ACUTE RENAL FAILURE NOTED .imPELLA DEVICE PLACED.  COVID + ACUTE RESP FAILURE.  10/9/21 PATIENT HAD CARDIOPULMONARY ARREST.  PATIENT INTUBATED . PATINET  PROGRESSIVELY MORE HYPOTENSION AND BRADYCARDIC. ON 10/9/21 PATIETN DIED."
	"1785320-1"	"1785320-1"	"BRADYCARDIA"	"10006093"	"60-64 years"	"60-64"	"10/8/21 PATIENT ADMITTED TO MEDICAL CENTER aCUTE ON CHRONIC lv SYSTOLIC HEART FAILURE. PATIENT REPORTING SOB , CARDIAC CATH SHOWED NORMAL, ACUTE RENAL FAILURE NOTED .imPELLA DEVICE PLACED.  COVID + ACUTE RESP FAILURE.  10/9/21 PATIENT HAD CARDIOPULMONARY ARREST.  PATIENT INTUBATED . PATINET  PROGRESSIVELY MORE HYPOTENSION AND BRADYCARDIC. ON 10/9/21 PATIETN DIED."
	"1785320-1"	"1785320-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"10/8/21 PATIENT ADMITTED TO MEDICAL CENTER aCUTE ON CHRONIC lv SYSTOLIC HEART FAILURE. PATIENT REPORTING SOB , CARDIAC CATH SHOWED NORMAL, ACUTE RENAL FAILURE NOTED .imPELLA DEVICE PLACED.  COVID + ACUTE RESP FAILURE.  10/9/21 PATIENT HAD CARDIOPULMONARY ARREST.  PATIENT INTUBATED . PATINET  PROGRESSIVELY MORE HYPOTENSION AND BRADYCARDIC. ON 10/9/21 PATIETN DIED."
	"1785320-1"	"1785320-1"	"CATHETERISATION CARDIAC"	"10007815"	"60-64 years"	"60-64"	"10/8/21 PATIENT ADMITTED TO MEDICAL CENTER aCUTE ON CHRONIC lv SYSTOLIC HEART FAILURE. PATIENT REPORTING SOB , CARDIAC CATH SHOWED NORMAL, ACUTE RENAL FAILURE NOTED .imPELLA DEVICE PLACED.  COVID + ACUTE RESP FAILURE.  10/9/21 PATIENT HAD CARDIOPULMONARY ARREST.  PATIENT INTUBATED . PATINET  PROGRESSIVELY MORE HYPOTENSION AND BRADYCARDIC. ON 10/9/21 PATIETN DIED."
	"1785320-1"	"1785320-1"	"CHRONIC LEFT VENTRICULAR FAILURE"	"10063083"	"60-64 years"	"60-64"	"10/8/21 PATIENT ADMITTED TO MEDICAL CENTER aCUTE ON CHRONIC lv SYSTOLIC HEART FAILURE. PATIENT REPORTING SOB , CARDIAC CATH SHOWED NORMAL, ACUTE RENAL FAILURE NOTED .imPELLA DEVICE PLACED.  COVID + ACUTE RESP FAILURE.  10/9/21 PATIENT HAD CARDIOPULMONARY ARREST.  PATIENT INTUBATED . PATINET  PROGRESSIVELY MORE HYPOTENSION AND BRADYCARDIC. ON 10/9/21 PATIETN DIED."
	"1785320-1"	"1785320-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"10/8/21 PATIENT ADMITTED TO MEDICAL CENTER aCUTE ON CHRONIC lv SYSTOLIC HEART FAILURE. PATIENT REPORTING SOB , CARDIAC CATH SHOWED NORMAL, ACUTE RENAL FAILURE NOTED .imPELLA DEVICE PLACED.  COVID + ACUTE RESP FAILURE.  10/9/21 PATIENT HAD CARDIOPULMONARY ARREST.  PATIENT INTUBATED . PATINET  PROGRESSIVELY MORE HYPOTENSION AND BRADYCARDIC. ON 10/9/21 PATIETN DIED."
	"1785320-1"	"1785320-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"10/8/21 PATIENT ADMITTED TO MEDICAL CENTER aCUTE ON CHRONIC lv SYSTOLIC HEART FAILURE. PATIENT REPORTING SOB , CARDIAC CATH SHOWED NORMAL, ACUTE RENAL FAILURE NOTED .imPELLA DEVICE PLACED.  COVID + ACUTE RESP FAILURE.  10/9/21 PATIENT HAD CARDIOPULMONARY ARREST.  PATIENT INTUBATED . PATINET  PROGRESSIVELY MORE HYPOTENSION AND BRADYCARDIC. ON 10/9/21 PATIETN DIED."
	"1785320-1"	"1785320-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"10/8/21 PATIENT ADMITTED TO MEDICAL CENTER aCUTE ON CHRONIC lv SYSTOLIC HEART FAILURE. PATIENT REPORTING SOB , CARDIAC CATH SHOWED NORMAL, ACUTE RENAL FAILURE NOTED .imPELLA DEVICE PLACED.  COVID + ACUTE RESP FAILURE.  10/9/21 PATIENT HAD CARDIOPULMONARY ARREST.  PATIENT INTUBATED . PATINET  PROGRESSIVELY MORE HYPOTENSION AND BRADYCARDIC. ON 10/9/21 PATIETN DIED."
	"1785320-1"	"1785320-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"10/8/21 PATIENT ADMITTED TO MEDICAL CENTER aCUTE ON CHRONIC lv SYSTOLIC HEART FAILURE. PATIENT REPORTING SOB , CARDIAC CATH SHOWED NORMAL, ACUTE RENAL FAILURE NOTED .imPELLA DEVICE PLACED.  COVID + ACUTE RESP FAILURE.  10/9/21 PATIENT HAD CARDIOPULMONARY ARREST.  PATIENT INTUBATED . PATINET  PROGRESSIVELY MORE HYPOTENSION AND BRADYCARDIC. ON 10/9/21 PATIETN DIED."
	"1785320-1"	"1785320-1"	"HYPOTENSION"	"10021097"	"60-64 years"	"60-64"	"10/8/21 PATIENT ADMITTED TO MEDICAL CENTER aCUTE ON CHRONIC lv SYSTOLIC HEART FAILURE. PATIENT REPORTING SOB , CARDIAC CATH SHOWED NORMAL, ACUTE RENAL FAILURE NOTED .imPELLA DEVICE PLACED.  COVID + ACUTE RESP FAILURE.  10/9/21 PATIENT HAD CARDIOPULMONARY ARREST.  PATIENT INTUBATED . PATINET  PROGRESSIVELY MORE HYPOTENSION AND BRADYCARDIC. ON 10/9/21 PATIETN DIED."
	"1785320-1"	"1785320-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"10/8/21 PATIENT ADMITTED TO MEDICAL CENTER aCUTE ON CHRONIC lv SYSTOLIC HEART FAILURE. PATIENT REPORTING SOB , CARDIAC CATH SHOWED NORMAL, ACUTE RENAL FAILURE NOTED .imPELLA DEVICE PLACED.  COVID + ACUTE RESP FAILURE.  10/9/21 PATIENT HAD CARDIOPULMONARY ARREST.  PATIENT INTUBATED . PATINET  PROGRESSIVELY MORE HYPOTENSION AND BRADYCARDIC. ON 10/9/21 PATIETN DIED."
	"1785320-1"	"1785320-1"	"VENTRICULAR ASSIST DEVICE INSERTION"	"10052371"	"60-64 years"	"60-64"	"10/8/21 PATIENT ADMITTED TO MEDICAL CENTER aCUTE ON CHRONIC lv SYSTOLIC HEART FAILURE. PATIENT REPORTING SOB , CARDIAC CATH SHOWED NORMAL, ACUTE RENAL FAILURE NOTED .imPELLA DEVICE PLACED.  COVID + ACUTE RESP FAILURE.  10/9/21 PATIENT HAD CARDIOPULMONARY ARREST.  PATIENT INTUBATED . PATINET  PROGRESSIVELY MORE HYPOTENSION AND BRADYCARDIC. ON 10/9/21 PATIETN DIED."
	"1785592-1"	"1785592-1"	"CONFUSIONAL STATE"	"10010305"	"60-64 years"	"60-64"	"She stated the PUI started to have symptoms on 09/10/2021 with cough, fatigue and brain confusions. She stated as of today the PUI is not doing so well. PUI is hospitalized at Hospital since 09/11/2021. She said she think the only reason why he still in the hospital is due to his brain cancer and since having COVID it has made things worse. Patient is fully vaccinated."
	"1785592-1"	"1785592-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"She stated the PUI started to have symptoms on 09/10/2021 with cough, fatigue and brain confusions. She stated as of today the PUI is not doing so well. PUI is hospitalized at Hospital since 09/11/2021. She said she think the only reason why he still in the hospital is due to his brain cancer and since having COVID it has made things worse. Patient is fully vaccinated."
	"1785592-1"	"1785592-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"She stated the PUI started to have symptoms on 09/10/2021 with cough, fatigue and brain confusions. She stated as of today the PUI is not doing so well. PUI is hospitalized at Hospital since 09/11/2021. She said she think the only reason why he still in the hospital is due to his brain cancer and since having COVID it has made things worse. Patient is fully vaccinated."
	"1785592-1"	"1785592-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"She stated the PUI started to have symptoms on 09/10/2021 with cough, fatigue and brain confusions. She stated as of today the PUI is not doing so well. PUI is hospitalized at Hospital since 09/11/2021. She said she think the only reason why he still in the hospital is due to his brain cancer and since having COVID it has made things worse. Patient is fully vaccinated."
	"1785592-1"	"1785592-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"She stated the PUI started to have symptoms on 09/10/2021 with cough, fatigue and brain confusions. She stated as of today the PUI is not doing so well. PUI is hospitalized at Hospital since 09/11/2021. She said she think the only reason why he still in the hospital is due to his brain cancer and since having COVID it has made things worse. Patient is fully vaccinated."
	"1788244-1"	"1788244-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	""Fully vaccinated patient admitting through ED for COVID who subsequently died from COVID.  Provider discharge note ""65 YO male with AML requiring BMT and subsequent GVHD admitted with hypoxia due to covid pneumonia.  Patient developed respiratory failure with hypoxia requiring HFNC and BiPAP support.  Eventually transitioned to comfort care with progression of disease despite aggressive treatment.  Patient passed today comfortably with family at bedside at 856AM.""""
	"1788244-1"	"1788244-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	""Fully vaccinated patient admitting through ED for COVID who subsequently died from COVID.  Provider discharge note ""65 YO male with AML requiring BMT and subsequent GVHD admitted with hypoxia due to covid pneumonia.  Patient developed respiratory failure with hypoxia requiring HFNC and BiPAP support.  Eventually transitioned to comfort care with progression of disease despite aggressive treatment.  Patient passed today comfortably with family at bedside at 856AM.""""
	"1788244-1"	"1788244-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""Fully vaccinated patient admitting through ED for COVID who subsequently died from COVID.  Provider discharge note ""65 YO male with AML requiring BMT and subsequent GVHD admitted with hypoxia due to covid pneumonia.  Patient developed respiratory failure with hypoxia requiring HFNC and BiPAP support.  Eventually transitioned to comfort care with progression of disease despite aggressive treatment.  Patient passed today comfortably with family at bedside at 856AM.""""
	"1788244-1"	"1788244-1"	"DISEASE PROGRESSION"	"10061818"	"60-64 years"	"60-64"	""Fully vaccinated patient admitting through ED for COVID who subsequently died from COVID.  Provider discharge note ""65 YO male with AML requiring BMT and subsequent GVHD admitted with hypoxia due to covid pneumonia.  Patient developed respiratory failure with hypoxia requiring HFNC and BiPAP support.  Eventually transitioned to comfort care with progression of disease despite aggressive treatment.  Patient passed today comfortably with family at bedside at 856AM.""""
	"1788244-1"	"1788244-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	""Fully vaccinated patient admitting through ED for COVID who subsequently died from COVID.  Provider discharge note ""65 YO male with AML requiring BMT and subsequent GVHD admitted with hypoxia due to covid pneumonia.  Patient developed respiratory failure with hypoxia requiring HFNC and BiPAP support.  Eventually transitioned to comfort care with progression of disease despite aggressive treatment.  Patient passed today comfortably with family at bedside at 856AM.""""
	"1788244-1"	"1788244-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"60-64 years"	"60-64"	""Fully vaccinated patient admitting through ED for COVID who subsequently died from COVID.  Provider discharge note ""65 YO male with AML requiring BMT and subsequent GVHD admitted with hypoxia due to covid pneumonia.  Patient developed respiratory failure with hypoxia requiring HFNC and BiPAP support.  Eventually transitioned to comfort care with progression of disease despite aggressive treatment.  Patient passed today comfortably with family at bedside at 856AM.""""
	"1788244-1"	"1788244-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	""Fully vaccinated patient admitting through ED for COVID who subsequently died from COVID.  Provider discharge note ""65 YO male with AML requiring BMT and subsequent GVHD admitted with hypoxia due to covid pneumonia.  Patient developed respiratory failure with hypoxia requiring HFNC and BiPAP support.  Eventually transitioned to comfort care with progression of disease despite aggressive treatment.  Patient passed today comfortably with family at bedside at 856AM.""""
	"1788244-1"	"1788244-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	""Fully vaccinated patient admitting through ED for COVID who subsequently died from COVID.  Provider discharge note ""65 YO male with AML requiring BMT and subsequent GVHD admitted with hypoxia due to covid pneumonia.  Patient developed respiratory failure with hypoxia requiring HFNC and BiPAP support.  Eventually transitioned to comfort care with progression of disease despite aggressive treatment.  Patient passed today comfortably with family at bedside at 856AM.""""
	"1788586-1"	"1788586-1"	"ALTERED STATE OF CONSCIOUSNESS"	"10001854"	"60-64 years"	"60-64"	"Patient found down at home 10/3 due to large brainstem intracerebral hemorrhage. Likely due to cocaine use as she was found with drug paraphernalia- but report being submitted to rule out vaccine contribution"
	"1788586-1"	"1788586-1"	"BASAL GANGLIA HAEMORRHAGE"	"10067057"	"60-64 years"	"60-64"	"Patient found down at home 10/3 due to large brainstem intracerebral hemorrhage. Likely due to cocaine use as she was found with drug paraphernalia- but report being submitted to rule out vaccine contribution"
	"1788586-1"	"1788586-1"	"BLOOD CREATININE INCREASED"	"10005483"	"60-64 years"	"60-64"	"Patient found down at home 10/3 due to large brainstem intracerebral hemorrhage. Likely due to cocaine use as she was found with drug paraphernalia- but report being submitted to rule out vaccine contribution"
	"1788586-1"	"1788586-1"	"BRAIN STEM HAEMORRHAGE"	"10006145"	"60-64 years"	"60-64"	"Patient found down at home 10/3 due to large brainstem intracerebral hemorrhage. Likely due to cocaine use as she was found with drug paraphernalia- but report being submitted to rule out vaccine contribution"
	"1788586-1"	"1788586-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"60-64 years"	"60-64"	"Patient found down at home 10/3 due to large brainstem intracerebral hemorrhage. Likely due to cocaine use as she was found with drug paraphernalia- but report being submitted to rule out vaccine contribution"
	"1788586-1"	"1788586-1"	"CEREBRAL VENTRICLE DILATATION"	"10048824"	"60-64 years"	"60-64"	"Patient found down at home 10/3 due to large brainstem intracerebral hemorrhage. Likely due to cocaine use as she was found with drug paraphernalia- but report being submitted to rule out vaccine contribution"
	"1788586-1"	"1788586-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"60-64 years"	"60-64"	"Patient found down at home 10/3 due to large brainstem intracerebral hemorrhage. Likely due to cocaine use as she was found with drug paraphernalia- but report being submitted to rule out vaccine contribution"
	"1788586-1"	"1788586-1"	"DRUG ABUSE"	"10013654"	"60-64 years"	"60-64"	"Patient found down at home 10/3 due to large brainstem intracerebral hemorrhage. Likely due to cocaine use as she was found with drug paraphernalia- but report being submitted to rule out vaccine contribution"
	"1788586-1"	"1788586-1"	"SUBARACHNOID HAEMORRHAGE"	"10042316"	"60-64 years"	"60-64"	"Patient found down at home 10/3 due to large brainstem intracerebral hemorrhage. Likely due to cocaine use as she was found with drug paraphernalia- but report being submitted to rule out vaccine contribution"
	"1791260-1"	"1791260-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""death/died; Couldn''t even urinate, collapsed with kicking by Mess, like to trauma unit.; swelling from the waist down; collapsed with kicking by Mess, like to trauma unit; This is a spontaneous report from a non-contactable consumer. A 62-year-old male patient (Uncle) received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration on 23Jun2021 (at the age of 62 years old) (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient's medical history included hospitalization. Patient had had multiple hospitalization. No Other Medical Conditions, not even cold, no diabetes, no cancer. The patient's concomitant medications were not reported. The patient declared death and died on 24Jun2021 from the Pfizer vaccine. He died because he was forced to get the shot to keep his job and died within 24 hour and that was in the report. He died in the trauma unit of the hospital. It was unknown if an autopsy was performed. He experienced swelling from the waist down immediately after his 2nd shot and by that evening, couldn't even urinate, collapsed with kicking by Mess, like to trauma unit and died next morning and doctor declared, It's a vaccine injury. For Height and Weight, Reporter Stated, ""Probably 6 foot may be 175 (not clarify, hence not captured in tab). For Other Medications, Reporter Stated, ""Not that I am aware of. They are not take any medications"". The patient was hospitalized on the 23rd, that evening he admitted, 23rd June (23Jun2021). Seriousness for He died in the trauma unit of the hospital was Hospitalization, Death. The patient underwent lab tests and procedures which included lab test with unknown results on an unspecified date. The outcome of the event death/died was fatal, of the other events was unknown.   No follow-up attempts are possible; information about lot/batch cannot be obtained. No further information is expected.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101335055 same reporter/drug, different patient/event.;US-PFIZER INC-202101335048 same reporter/drug, different patient/event.; Reported Cause(s) of Death: death/died""
	"1791260-1"	"1791260-1"	"LABORATORY TEST"	"10059938"	"60-64 years"	"60-64"	""death/died; Couldn''t even urinate, collapsed with kicking by Mess, like to trauma unit.; swelling from the waist down; collapsed with kicking by Mess, like to trauma unit; This is a spontaneous report from a non-contactable consumer. A 62-year-old male patient (Uncle) received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration on 23Jun2021 (at the age of 62 years old) (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient's medical history included hospitalization. Patient had had multiple hospitalization. No Other Medical Conditions, not even cold, no diabetes, no cancer. The patient's concomitant medications were not reported. The patient declared death and died on 24Jun2021 from the Pfizer vaccine. He died because he was forced to get the shot to keep his job and died within 24 hour and that was in the report. He died in the trauma unit of the hospital. It was unknown if an autopsy was performed. He experienced swelling from the waist down immediately after his 2nd shot and by that evening, couldn't even urinate, collapsed with kicking by Mess, like to trauma unit and died next morning and doctor declared, It's a vaccine injury. For Height and Weight, Reporter Stated, ""Probably 6 foot may be 175 (not clarify, hence not captured in tab). For Other Medications, Reporter Stated, ""Not that I am aware of. They are not take any medications"". The patient was hospitalized on the 23rd, that evening he admitted, 23rd June (23Jun2021). Seriousness for He died in the trauma unit of the hospital was Hospitalization, Death. The patient underwent lab tests and procedures which included lab test with unknown results on an unspecified date. The outcome of the event death/died was fatal, of the other events was unknown.   No follow-up attempts are possible; information about lot/batch cannot be obtained. No further information is expected.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101335055 same reporter/drug, different patient/event.;US-PFIZER INC-202101335048 same reporter/drug, different patient/event.; Reported Cause(s) of Death: death/died""
	"1791260-1"	"1791260-1"	"SWELLING"	"10042674"	"60-64 years"	"60-64"	""death/died; Couldn''t even urinate, collapsed with kicking by Mess, like to trauma unit.; swelling from the waist down; collapsed with kicking by Mess, like to trauma unit; This is a spontaneous report from a non-contactable consumer. A 62-year-old male patient (Uncle) received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration on 23Jun2021 (at the age of 62 years old) (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient's medical history included hospitalization. Patient had had multiple hospitalization. No Other Medical Conditions, not even cold, no diabetes, no cancer. The patient's concomitant medications were not reported. The patient declared death and died on 24Jun2021 from the Pfizer vaccine. He died because he was forced to get the shot to keep his job and died within 24 hour and that was in the report. He died in the trauma unit of the hospital. It was unknown if an autopsy was performed. He experienced swelling from the waist down immediately after his 2nd shot and by that evening, couldn't even urinate, collapsed with kicking by Mess, like to trauma unit and died next morning and doctor declared, It's a vaccine injury. For Height and Weight, Reporter Stated, ""Probably 6 foot may be 175 (not clarify, hence not captured in tab). For Other Medications, Reporter Stated, ""Not that I am aware of. They are not take any medications"". The patient was hospitalized on the 23rd, that evening he admitted, 23rd June (23Jun2021). Seriousness for He died in the trauma unit of the hospital was Hospitalization, Death. The patient underwent lab tests and procedures which included lab test with unknown results on an unspecified date. The outcome of the event death/died was fatal, of the other events was unknown.   No follow-up attempts are possible; information about lot/batch cannot be obtained. No further information is expected.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101335055 same reporter/drug, different patient/event.;US-PFIZER INC-202101335048 same reporter/drug, different patient/event.; Reported Cause(s) of Death: death/died""
	"1791260-1"	"1791260-1"	"SYNCOPE"	"10042772"	"60-64 years"	"60-64"	""death/died; Couldn''t even urinate, collapsed with kicking by Mess, like to trauma unit.; swelling from the waist down; collapsed with kicking by Mess, like to trauma unit; This is a spontaneous report from a non-contactable consumer. A 62-year-old male patient (Uncle) received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration on 23Jun2021 (at the age of 62 years old) (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient's medical history included hospitalization. Patient had had multiple hospitalization. No Other Medical Conditions, not even cold, no diabetes, no cancer. The patient's concomitant medications were not reported. The patient declared death and died on 24Jun2021 from the Pfizer vaccine. He died because he was forced to get the shot to keep his job and died within 24 hour and that was in the report. He died in the trauma unit of the hospital. It was unknown if an autopsy was performed. He experienced swelling from the waist down immediately after his 2nd shot and by that evening, couldn't even urinate, collapsed with kicking by Mess, like to trauma unit and died next morning and doctor declared, It's a vaccine injury. For Height and Weight, Reporter Stated, ""Probably 6 foot may be 175 (not clarify, hence not captured in tab). For Other Medications, Reporter Stated, ""Not that I am aware of. They are not take any medications"". The patient was hospitalized on the 23rd, that evening he admitted, 23rd June (23Jun2021). Seriousness for He died in the trauma unit of the hospital was Hospitalization, Death. The patient underwent lab tests and procedures which included lab test with unknown results on an unspecified date. The outcome of the event death/died was fatal, of the other events was unknown.   No follow-up attempts are possible; information about lot/batch cannot be obtained. No further information is expected.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101335055 same reporter/drug, different patient/event.;US-PFIZER INC-202101335048 same reporter/drug, different patient/event.; Reported Cause(s) of Death: death/died""
	"1791260-1"	"1791260-1"	"URINARY RETENTION"	"10046555"	"60-64 years"	"60-64"	""death/died; Couldn''t even urinate, collapsed with kicking by Mess, like to trauma unit.; swelling from the waist down; collapsed with kicking by Mess, like to trauma unit; This is a spontaneous report from a non-contactable consumer. A 62-year-old male patient (Uncle) received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration on 23Jun2021 (at the age of 62 years old) (Batch/Lot number was not reported) as single dose for covid-19 immunisation. The patient's medical history included hospitalization. Patient had had multiple hospitalization. No Other Medical Conditions, not even cold, no diabetes, no cancer. The patient's concomitant medications were not reported. The patient declared death and died on 24Jun2021 from the Pfizer vaccine. He died because he was forced to get the shot to keep his job and died within 24 hour and that was in the report. He died in the trauma unit of the hospital. It was unknown if an autopsy was performed. He experienced swelling from the waist down immediately after his 2nd shot and by that evening, couldn't even urinate, collapsed with kicking by Mess, like to trauma unit and died next morning and doctor declared, It's a vaccine injury. For Height and Weight, Reporter Stated, ""Probably 6 foot may be 175 (not clarify, hence not captured in tab). For Other Medications, Reporter Stated, ""Not that I am aware of. They are not take any medications"". The patient was hospitalized on the 23rd, that evening he admitted, 23rd June (23Jun2021). Seriousness for He died in the trauma unit of the hospital was Hospitalization, Death. The patient underwent lab tests and procedures which included lab test with unknown results on an unspecified date. The outcome of the event death/died was fatal, of the other events was unknown.   No follow-up attempts are possible; information about lot/batch cannot be obtained. No further information is expected.; Sender's Comments: Linked Report(s) : US-PFIZER INC-202101335055 same reporter/drug, different patient/event.;US-PFIZER INC-202101335048 same reporter/drug, different patient/event.; Reported Cause(s) of Death: death/died""
	"1794355-1"	"1794355-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"My mom received the first Pfizer dose and unexpectedly went into sudden cardiac arrest and died  one week and a half later. She had no known prior Comorbidities. Her death came as a total shock to us all"
	"1794355-1"	"1794355-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"My mom received the first Pfizer dose and unexpectedly went into sudden cardiac arrest and died  one week and a half later. She had no known prior Comorbidities. Her death came as a total shock to us all"
	"1795403-1"	"1795403-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"PATIENT EXPIRED ON 09/13/2021"
	"1796350-1"	"1796350-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Eye bulging out of socket Swelling on right side of face Next day DEATH 08/19/2021"
	"1796350-1"	"1796350-1"	"EXOPHTHALMOS"	"10015683"	"60-64 years"	"60-64"	"Eye bulging out of socket Swelling on right side of face Next day DEATH 08/19/2021"
	"1796350-1"	"1796350-1"	"SWELLING FACE"	"10042682"	"60-64 years"	"60-64"	"Eye bulging out of socket Swelling on right side of face Next day DEATH 08/19/2021"
	"1798477-1"	"1798477-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Death   Less than Two weeks after vaccine Pfizer booster. Autopsy report stated cardiomyopathy with CHF  . Died suddenly  was previously healthy."
	"1798477-1"	"1798477-1"	"CARDIAC FAILURE CONGESTIVE"	"10007559"	"60-64 years"	"60-64"	"Death   Less than Two weeks after vaccine Pfizer booster. Autopsy report stated cardiomyopathy with CHF  . Died suddenly  was previously healthy."
	"1798477-1"	"1798477-1"	"CARDIOMYOPATHY"	"10007636"	"60-64 years"	"60-64"	"Death   Less than Two weeks after vaccine Pfizer booster. Autopsy report stated cardiomyopathy with CHF  . Died suddenly  was previously healthy."
	"1798477-1"	"1798477-1"	"SUDDEN DEATH"	"10042434"	"60-64 years"	"60-64"	"Death   Less than Two weeks after vaccine Pfizer booster. Autopsy report stated cardiomyopathy with CHF  . Died suddenly  was previously healthy."
	"1800582-1"	"1800582-1"	"ANTIFUNGAL TREATMENT"	"10068723"	"60-64 years"	"60-64"	"Presented to hospital on 9/28 with worsening shortness of breath. Diagnosed with COVID-19 pneumonia. Received dexamethasone and remdesivir with Vapotherm support.  Saturations continued to decrease and was intubated. Also received PICC line and vascular catheter for renal replacement therapy. Developed candid fungemia and given antifungal therapy. Develope renal failure requiring CRRT. Had cardiac arrest on 10/16 with 3 rounds of CPR and received calcium and epinephrine with continued asystole. After discussion with patient sister the code was called."
	"1800582-1"	"1800582-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Presented to hospital on 9/28 with worsening shortness of breath. Diagnosed with COVID-19 pneumonia. Received dexamethasone and remdesivir with Vapotherm support.  Saturations continued to decrease and was intubated. Also received PICC line and vascular catheter for renal replacement therapy. Developed candid fungemia and given antifungal therapy. Develope renal failure requiring CRRT. Had cardiac arrest on 10/16 with 3 rounds of CPR and received calcium and epinephrine with continued asystole. After discussion with patient sister the code was called."
	"1800582-1"	"1800582-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"Presented to hospital on 9/28 with worsening shortness of breath. Diagnosed with COVID-19 pneumonia. Received dexamethasone and remdesivir with Vapotherm support.  Saturations continued to decrease and was intubated. Also received PICC line and vascular catheter for renal replacement therapy. Developed candid fungemia and given antifungal therapy. Develope renal failure requiring CRRT. Had cardiac arrest on 10/16 with 3 rounds of CPR and received calcium and epinephrine with continued asystole. After discussion with patient sister the code was called."
	"1800582-1"	"1800582-1"	"CENTRAL VENOUS CATHETERISATION"	"10053377"	"60-64 years"	"60-64"	"Presented to hospital on 9/28 with worsening shortness of breath. Diagnosed with COVID-19 pneumonia. Received dexamethasone and remdesivir with Vapotherm support.  Saturations continued to decrease and was intubated. Also received PICC line and vascular catheter for renal replacement therapy. Developed candid fungemia and given antifungal therapy. Develope renal failure requiring CRRT. Had cardiac arrest on 10/16 with 3 rounds of CPR and received calcium and epinephrine with continued asystole. After discussion with patient sister the code was called."
	"1800582-1"	"1800582-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Presented to hospital on 9/28 with worsening shortness of breath. Diagnosed with COVID-19 pneumonia. Received dexamethasone and remdesivir with Vapotherm support.  Saturations continued to decrease and was intubated. Also received PICC line and vascular catheter for renal replacement therapy. Developed candid fungemia and given antifungal therapy. Develope renal failure requiring CRRT. Had cardiac arrest on 10/16 with 3 rounds of CPR and received calcium and epinephrine with continued asystole. After discussion with patient sister the code was called."
	"1800582-1"	"1800582-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Presented to hospital on 9/28 with worsening shortness of breath. Diagnosed with COVID-19 pneumonia. Received dexamethasone and remdesivir with Vapotherm support.  Saturations continued to decrease and was intubated. Also received PICC line and vascular catheter for renal replacement therapy. Developed candid fungemia and given antifungal therapy. Develope renal failure requiring CRRT. Had cardiac arrest on 10/16 with 3 rounds of CPR and received calcium and epinephrine with continued asystole. After discussion with patient sister the code was called."
	"1800582-1"	"1800582-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Presented to hospital on 9/28 with worsening shortness of breath. Diagnosed with COVID-19 pneumonia. Received dexamethasone and remdesivir with Vapotherm support.  Saturations continued to decrease and was intubated. Also received PICC line and vascular catheter for renal replacement therapy. Developed candid fungemia and given antifungal therapy. Develope renal failure requiring CRRT. Had cardiac arrest on 10/16 with 3 rounds of CPR and received calcium and epinephrine with continued asystole. After discussion with patient sister the code was called."
	"1800582-1"	"1800582-1"	"FUNGAEMIA"	"10017523"	"60-64 years"	"60-64"	"Presented to hospital on 9/28 with worsening shortness of breath. Diagnosed with COVID-19 pneumonia. Received dexamethasone and remdesivir with Vapotherm support.  Saturations continued to decrease and was intubated. Also received PICC line and vascular catheter for renal replacement therapy. Developed candid fungemia and given antifungal therapy. Develope renal failure requiring CRRT. Had cardiac arrest on 10/16 with 3 rounds of CPR and received calcium and epinephrine with continued asystole. After discussion with patient sister the code was called."
	"1800582-1"	"1800582-1"	"HAEMOFILTRATION"	"10053090"	"60-64 years"	"60-64"	"Presented to hospital on 9/28 with worsening shortness of breath. Diagnosed with COVID-19 pneumonia. Received dexamethasone and remdesivir with Vapotherm support.  Saturations continued to decrease and was intubated. Also received PICC line and vascular catheter for renal replacement therapy. Developed candid fungemia and given antifungal therapy. Develope renal failure requiring CRRT. Had cardiac arrest on 10/16 with 3 rounds of CPR and received calcium and epinephrine with continued asystole. After discussion with patient sister the code was called."
	"1800582-1"	"1800582-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"Presented to hospital on 9/28 with worsening shortness of breath. Diagnosed with COVID-19 pneumonia. Received dexamethasone and remdesivir with Vapotherm support.  Saturations continued to decrease and was intubated. Also received PICC line and vascular catheter for renal replacement therapy. Developed candid fungemia and given antifungal therapy. Develope renal failure requiring CRRT. Had cardiac arrest on 10/16 with 3 rounds of CPR and received calcium and epinephrine with continued asystole. After discussion with patient sister the code was called."
	"1800582-1"	"1800582-1"	"RENAL FAILURE"	"10038435"	"60-64 years"	"60-64"	"Presented to hospital on 9/28 with worsening shortness of breath. Diagnosed with COVID-19 pneumonia. Received dexamethasone and remdesivir with Vapotherm support.  Saturations continued to decrease and was intubated. Also received PICC line and vascular catheter for renal replacement therapy. Developed candid fungemia and given antifungal therapy. Develope renal failure requiring CRRT. Had cardiac arrest on 10/16 with 3 rounds of CPR and received calcium and epinephrine with continued asystole. After discussion with patient sister the code was called."
	"1800582-1"	"1800582-1"	"RENAL REPLACEMENT THERAPY"	"10074746"	"60-64 years"	"60-64"	"Presented to hospital on 9/28 with worsening shortness of breath. Diagnosed with COVID-19 pneumonia. Received dexamethasone and remdesivir with Vapotherm support.  Saturations continued to decrease and was intubated. Also received PICC line and vascular catheter for renal replacement therapy. Developed candid fungemia and given antifungal therapy. Develope renal failure requiring CRRT. Had cardiac arrest on 10/16 with 3 rounds of CPR and received calcium and epinephrine with continued asystole. After discussion with patient sister the code was called."
	"1800582-1"	"1800582-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Presented to hospital on 9/28 with worsening shortness of breath. Diagnosed with COVID-19 pneumonia. Received dexamethasone and remdesivir with Vapotherm support.  Saturations continued to decrease and was intubated. Also received PICC line and vascular catheter for renal replacement therapy. Developed candid fungemia and given antifungal therapy. Develope renal failure requiring CRRT. Had cardiac arrest on 10/16 with 3 rounds of CPR and received calcium and epinephrine with continued asystole. After discussion with patient sister the code was called."
	"1800582-1"	"1800582-1"	"VASCULAR CATHETERISATION"	"10074169"	"60-64 years"	"60-64"	"Presented to hospital on 9/28 with worsening shortness of breath. Diagnosed with COVID-19 pneumonia. Received dexamethasone and remdesivir with Vapotherm support.  Saturations continued to decrease and was intubated. Also received PICC line and vascular catheter for renal replacement therapy. Developed candid fungemia and given antifungal therapy. Develope renal failure requiring CRRT. Had cardiac arrest on 10/16 with 3 rounds of CPR and received calcium and epinephrine with continued asystole. After discussion with patient sister the code was called."
	"1800987-1"	"1800987-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"This patient was initially seen in Emergency Department in October with a complaint of shortness of breath, cough malaise fatigue and rhinorrhea. Patient's husband did test positive for COVID-19, this patient did as well test positive during emergency department evaluation. This patient did receive COVID-19 vaccination Jansen single dose.   Patient was admitted to the hospital service started on dexamethasone 10 mg q. 12 hours and 5 day course of Remdesivir.  Patient also started on therapeutic Lovenox and IV antibiotic directed at acute acquired pneumonia ceftriaxone and azithromycin.   7 October pulmonary was consulted, with recommendations to continue the course of dexamethasone and Remdesivir. 10 October Pt transferred to the ICU started on noninvasive ventilation. 13 October respiratory failure with pending respiratory arrest patient was intubated placed on full mechanical ventilation. Pt then underwent proning protocol with some benefit early on. However, patient continued to be hypoxic while supine. Prone protocol was DC due to skin breakdown with persistent hypoxia as supine. Patient later developed septic shock placed on broad-spectrum antibiotics. Patient requiring pressor support to maintain map pressure above 60.  Discussing patient's care with daughter, given its poor diagnosis, decision was to make patient DNR and to redirect care to comfort."
	"1800987-1"	"1800987-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"This patient was initially seen in Emergency Department in October with a complaint of shortness of breath, cough malaise fatigue and rhinorrhea. Patient's husband did test positive for COVID-19, this patient did as well test positive during emergency department evaluation. This patient did receive COVID-19 vaccination Jansen single dose.   Patient was admitted to the hospital service started on dexamethasone 10 mg q. 12 hours and 5 day course of Remdesivir.  Patient also started on therapeutic Lovenox and IV antibiotic directed at acute acquired pneumonia ceftriaxone and azithromycin.   7 October pulmonary was consulted, with recommendations to continue the course of dexamethasone and Remdesivir. 10 October Pt transferred to the ICU started on noninvasive ventilation. 13 October respiratory failure with pending respiratory arrest patient was intubated placed on full mechanical ventilation. Pt then underwent proning protocol with some benefit early on. However, patient continued to be hypoxic while supine. Prone protocol was DC due to skin breakdown with persistent hypoxia as supine. Patient later developed septic shock placed on broad-spectrum antibiotics. Patient requiring pressor support to maintain map pressure above 60.  Discussing patient's care with daughter, given its poor diagnosis, decision was to make patient DNR and to redirect care to comfort."
	"1800987-1"	"1800987-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"This patient was initially seen in Emergency Department in October with a complaint of shortness of breath, cough malaise fatigue and rhinorrhea. Patient's husband did test positive for COVID-19, this patient did as well test positive during emergency department evaluation. This patient did receive COVID-19 vaccination Jansen single dose.   Patient was admitted to the hospital service started on dexamethasone 10 mg q. 12 hours and 5 day course of Remdesivir.  Patient also started on therapeutic Lovenox and IV antibiotic directed at acute acquired pneumonia ceftriaxone and azithromycin.   7 October pulmonary was consulted, with recommendations to continue the course of dexamethasone and Remdesivir. 10 October Pt transferred to the ICU started on noninvasive ventilation. 13 October respiratory failure with pending respiratory arrest patient was intubated placed on full mechanical ventilation. Pt then underwent proning protocol with some benefit early on. However, patient continued to be hypoxic while supine. Prone protocol was DC due to skin breakdown with persistent hypoxia as supine. Patient later developed septic shock placed on broad-spectrum antibiotics. Patient requiring pressor support to maintain map pressure above 60.  Discussing patient's care with daughter, given its poor diagnosis, decision was to make patient DNR and to redirect care to comfort."
	"1800987-1"	"1800987-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"This patient was initially seen in Emergency Department in October with a complaint of shortness of breath, cough malaise fatigue and rhinorrhea. Patient's husband did test positive for COVID-19, this patient did as well test positive during emergency department evaluation. This patient did receive COVID-19 vaccination Jansen single dose.   Patient was admitted to the hospital service started on dexamethasone 10 mg q. 12 hours and 5 day course of Remdesivir.  Patient also started on therapeutic Lovenox and IV antibiotic directed at acute acquired pneumonia ceftriaxone and azithromycin.   7 October pulmonary was consulted, with recommendations to continue the course of dexamethasone and Remdesivir. 10 October Pt transferred to the ICU started on noninvasive ventilation. 13 October respiratory failure with pending respiratory arrest patient was intubated placed on full mechanical ventilation. Pt then underwent proning protocol with some benefit early on. However, patient continued to be hypoxic while supine. Prone protocol was DC due to skin breakdown with persistent hypoxia as supine. Patient later developed septic shock placed on broad-spectrum antibiotics. Patient requiring pressor support to maintain map pressure above 60.  Discussing patient's care with daughter, given its poor diagnosis, decision was to make patient DNR and to redirect care to comfort."
	"1800987-1"	"1800987-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"This patient was initially seen in Emergency Department in October with a complaint of shortness of breath, cough malaise fatigue and rhinorrhea. Patient's husband did test positive for COVID-19, this patient did as well test positive during emergency department evaluation. This patient did receive COVID-19 vaccination Jansen single dose.   Patient was admitted to the hospital service started on dexamethasone 10 mg q. 12 hours and 5 day course of Remdesivir.  Patient also started on therapeutic Lovenox and IV antibiotic directed at acute acquired pneumonia ceftriaxone and azithromycin.   7 October pulmonary was consulted, with recommendations to continue the course of dexamethasone and Remdesivir. 10 October Pt transferred to the ICU started on noninvasive ventilation. 13 October respiratory failure with pending respiratory arrest patient was intubated placed on full mechanical ventilation. Pt then underwent proning protocol with some benefit early on. However, patient continued to be hypoxic while supine. Prone protocol was DC due to skin breakdown with persistent hypoxia as supine. Patient later developed septic shock placed on broad-spectrum antibiotics. Patient requiring pressor support to maintain map pressure above 60.  Discussing patient's care with daughter, given its poor diagnosis, decision was to make patient DNR and to redirect care to comfort."
	"1800987-1"	"1800987-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"This patient was initially seen in Emergency Department in October with a complaint of shortness of breath, cough malaise fatigue and rhinorrhea. Patient's husband did test positive for COVID-19, this patient did as well test positive during emergency department evaluation. This patient did receive COVID-19 vaccination Jansen single dose.   Patient was admitted to the hospital service started on dexamethasone 10 mg q. 12 hours and 5 day course of Remdesivir.  Patient also started on therapeutic Lovenox and IV antibiotic directed at acute acquired pneumonia ceftriaxone and azithromycin.   7 October pulmonary was consulted, with recommendations to continue the course of dexamethasone and Remdesivir. 10 October Pt transferred to the ICU started on noninvasive ventilation. 13 October respiratory failure with pending respiratory arrest patient was intubated placed on full mechanical ventilation. Pt then underwent proning protocol with some benefit early on. However, patient continued to be hypoxic while supine. Prone protocol was DC due to skin breakdown with persistent hypoxia as supine. Patient later developed septic shock placed on broad-spectrum antibiotics. Patient requiring pressor support to maintain map pressure above 60.  Discussing patient's care with daughter, given its poor diagnosis, decision was to make patient DNR and to redirect care to comfort."
	"1800987-1"	"1800987-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"This patient was initially seen in Emergency Department in October with a complaint of shortness of breath, cough malaise fatigue and rhinorrhea. Patient's husband did test positive for COVID-19, this patient did as well test positive during emergency department evaluation. This patient did receive COVID-19 vaccination Jansen single dose.   Patient was admitted to the hospital service started on dexamethasone 10 mg q. 12 hours and 5 day course of Remdesivir.  Patient also started on therapeutic Lovenox and IV antibiotic directed at acute acquired pneumonia ceftriaxone and azithromycin.   7 October pulmonary was consulted, with recommendations to continue the course of dexamethasone and Remdesivir. 10 October Pt transferred to the ICU started on noninvasive ventilation. 13 October respiratory failure with pending respiratory arrest patient was intubated placed on full mechanical ventilation. Pt then underwent proning protocol with some benefit early on. However, patient continued to be hypoxic while supine. Prone protocol was DC due to skin breakdown with persistent hypoxia as supine. Patient later developed septic shock placed on broad-spectrum antibiotics. Patient requiring pressor support to maintain map pressure above 60.  Discussing patient's care with daughter, given its poor diagnosis, decision was to make patient DNR and to redirect care to comfort."
	"1800987-1"	"1800987-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"This patient was initially seen in Emergency Department in October with a complaint of shortness of breath, cough malaise fatigue and rhinorrhea. Patient's husband did test positive for COVID-19, this patient did as well test positive during emergency department evaluation. This patient did receive COVID-19 vaccination Jansen single dose.   Patient was admitted to the hospital service started on dexamethasone 10 mg q. 12 hours and 5 day course of Remdesivir.  Patient also started on therapeutic Lovenox and IV antibiotic directed at acute acquired pneumonia ceftriaxone and azithromycin.   7 October pulmonary was consulted, with recommendations to continue the course of dexamethasone and Remdesivir. 10 October Pt transferred to the ICU started on noninvasive ventilation. 13 October respiratory failure with pending respiratory arrest patient was intubated placed on full mechanical ventilation. Pt then underwent proning protocol with some benefit early on. However, patient continued to be hypoxic while supine. Prone protocol was DC due to skin breakdown with persistent hypoxia as supine. Patient later developed septic shock placed on broad-spectrum antibiotics. Patient requiring pressor support to maintain map pressure above 60.  Discussing patient's care with daughter, given its poor diagnosis, decision was to make patient DNR and to redirect care to comfort."
	"1800987-1"	"1800987-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"This patient was initially seen in Emergency Department in October with a complaint of shortness of breath, cough malaise fatigue and rhinorrhea. Patient's husband did test positive for COVID-19, this patient did as well test positive during emergency department evaluation. This patient did receive COVID-19 vaccination Jansen single dose.   Patient was admitted to the hospital service started on dexamethasone 10 mg q. 12 hours and 5 day course of Remdesivir.  Patient also started on therapeutic Lovenox and IV antibiotic directed at acute acquired pneumonia ceftriaxone and azithromycin.   7 October pulmonary was consulted, with recommendations to continue the course of dexamethasone and Remdesivir. 10 October Pt transferred to the ICU started on noninvasive ventilation. 13 October respiratory failure with pending respiratory arrest patient was intubated placed on full mechanical ventilation. Pt then underwent proning protocol with some benefit early on. However, patient continued to be hypoxic while supine. Prone protocol was DC due to skin breakdown with persistent hypoxia as supine. Patient later developed septic shock placed on broad-spectrum antibiotics. Patient requiring pressor support to maintain map pressure above 60.  Discussing patient's care with daughter, given its poor diagnosis, decision was to make patient DNR and to redirect care to comfort."
	"1800987-1"	"1800987-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"This patient was initially seen in Emergency Department in October with a complaint of shortness of breath, cough malaise fatigue and rhinorrhea. Patient's husband did test positive for COVID-19, this patient did as well test positive during emergency department evaluation. This patient did receive COVID-19 vaccination Jansen single dose.   Patient was admitted to the hospital service started on dexamethasone 10 mg q. 12 hours and 5 day course of Remdesivir.  Patient also started on therapeutic Lovenox and IV antibiotic directed at acute acquired pneumonia ceftriaxone and azithromycin.   7 October pulmonary was consulted, with recommendations to continue the course of dexamethasone and Remdesivir. 10 October Pt transferred to the ICU started on noninvasive ventilation. 13 October respiratory failure with pending respiratory arrest patient was intubated placed on full mechanical ventilation. Pt then underwent proning protocol with some benefit early on. However, patient continued to be hypoxic while supine. Prone protocol was DC due to skin breakdown with persistent hypoxia as supine. Patient later developed septic shock placed on broad-spectrum antibiotics. Patient requiring pressor support to maintain map pressure above 60.  Discussing patient's care with daughter, given its poor diagnosis, decision was to make patient DNR and to redirect care to comfort."
	"1800987-1"	"1800987-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	"This patient was initially seen in Emergency Department in October with a complaint of shortness of breath, cough malaise fatigue and rhinorrhea. Patient's husband did test positive for COVID-19, this patient did as well test positive during emergency department evaluation. This patient did receive COVID-19 vaccination Jansen single dose.   Patient was admitted to the hospital service started on dexamethasone 10 mg q. 12 hours and 5 day course of Remdesivir.  Patient also started on therapeutic Lovenox and IV antibiotic directed at acute acquired pneumonia ceftriaxone and azithromycin.   7 October pulmonary was consulted, with recommendations to continue the course of dexamethasone and Remdesivir. 10 October Pt transferred to the ICU started on noninvasive ventilation. 13 October respiratory failure with pending respiratory arrest patient was intubated placed on full mechanical ventilation. Pt then underwent proning protocol with some benefit early on. However, patient continued to be hypoxic while supine. Prone protocol was DC due to skin breakdown with persistent hypoxia as supine. Patient later developed septic shock placed on broad-spectrum antibiotics. Patient requiring pressor support to maintain map pressure above 60.  Discussing patient's care with daughter, given its poor diagnosis, decision was to make patient DNR and to redirect care to comfort."
	"1800987-1"	"1800987-1"	"RHINORRHOEA"	"10039101"	"60-64 years"	"60-64"	"This patient was initially seen in Emergency Department in October with a complaint of shortness of breath, cough malaise fatigue and rhinorrhea. Patient's husband did test positive for COVID-19, this patient did as well test positive during emergency department evaluation. This patient did receive COVID-19 vaccination Jansen single dose.   Patient was admitted to the hospital service started on dexamethasone 10 mg q. 12 hours and 5 day course of Remdesivir.  Patient also started on therapeutic Lovenox and IV antibiotic directed at acute acquired pneumonia ceftriaxone and azithromycin.   7 October pulmonary was consulted, with recommendations to continue the course of dexamethasone and Remdesivir. 10 October Pt transferred to the ICU started on noninvasive ventilation. 13 October respiratory failure with pending respiratory arrest patient was intubated placed on full mechanical ventilation. Pt then underwent proning protocol with some benefit early on. However, patient continued to be hypoxic while supine. Prone protocol was DC due to skin breakdown with persistent hypoxia as supine. Patient later developed septic shock placed on broad-spectrum antibiotics. Patient requiring pressor support to maintain map pressure above 60.  Discussing patient's care with daughter, given its poor diagnosis, decision was to make patient DNR and to redirect care to comfort."
	"1800987-1"	"1800987-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"This patient was initially seen in Emergency Department in October with a complaint of shortness of breath, cough malaise fatigue and rhinorrhea. Patient's husband did test positive for COVID-19, this patient did as well test positive during emergency department evaluation. This patient did receive COVID-19 vaccination Jansen single dose.   Patient was admitted to the hospital service started on dexamethasone 10 mg q. 12 hours and 5 day course of Remdesivir.  Patient also started on therapeutic Lovenox and IV antibiotic directed at acute acquired pneumonia ceftriaxone and azithromycin.   7 October pulmonary was consulted, with recommendations to continue the course of dexamethasone and Remdesivir. 10 October Pt transferred to the ICU started on noninvasive ventilation. 13 October respiratory failure with pending respiratory arrest patient was intubated placed on full mechanical ventilation. Pt then underwent proning protocol with some benefit early on. However, patient continued to be hypoxic while supine. Prone protocol was DC due to skin breakdown with persistent hypoxia as supine. Patient later developed septic shock placed on broad-spectrum antibiotics. Patient requiring pressor support to maintain map pressure above 60.  Discussing patient's care with daughter, given its poor diagnosis, decision was to make patient DNR and to redirect care to comfort."
	"1800987-1"	"1800987-1"	"SEPTIC SHOCK"	"10040070"	"60-64 years"	"60-64"	"This patient was initially seen in Emergency Department in October with a complaint of shortness of breath, cough malaise fatigue and rhinorrhea. Patient's husband did test positive for COVID-19, this patient did as well test positive during emergency department evaluation. This patient did receive COVID-19 vaccination Jansen single dose.   Patient was admitted to the hospital service started on dexamethasone 10 mg q. 12 hours and 5 day course of Remdesivir.  Patient also started on therapeutic Lovenox and IV antibiotic directed at acute acquired pneumonia ceftriaxone and azithromycin.   7 October pulmonary was consulted, with recommendations to continue the course of dexamethasone and Remdesivir. 10 October Pt transferred to the ICU started on noninvasive ventilation. 13 October respiratory failure with pending respiratory arrest patient was intubated placed on full mechanical ventilation. Pt then underwent proning protocol with some benefit early on. However, patient continued to be hypoxic while supine. Prone protocol was DC due to skin breakdown with persistent hypoxia as supine. Patient later developed septic shock placed on broad-spectrum antibiotics. Patient requiring pressor support to maintain map pressure above 60.  Discussing patient's care with daughter, given its poor diagnosis, decision was to make patient DNR and to redirect care to comfort."
	"1800987-1"	"1800987-1"	"SKIN DISORDER"	"10040831"	"60-64 years"	"60-64"	"This patient was initially seen in Emergency Department in October with a complaint of shortness of breath, cough malaise fatigue and rhinorrhea. Patient's husband did test positive for COVID-19, this patient did as well test positive during emergency department evaluation. This patient did receive COVID-19 vaccination Jansen single dose.   Patient was admitted to the hospital service started on dexamethasone 10 mg q. 12 hours and 5 day course of Remdesivir.  Patient also started on therapeutic Lovenox and IV antibiotic directed at acute acquired pneumonia ceftriaxone and azithromycin.   7 October pulmonary was consulted, with recommendations to continue the course of dexamethasone and Remdesivir. 10 October Pt transferred to the ICU started on noninvasive ventilation. 13 October respiratory failure with pending respiratory arrest patient was intubated placed on full mechanical ventilation. Pt then underwent proning protocol with some benefit early on. However, patient continued to be hypoxic while supine. Prone protocol was DC due to skin breakdown with persistent hypoxia as supine. Patient later developed septic shock placed on broad-spectrum antibiotics. Patient requiring pressor support to maintain map pressure above 60.  Discussing patient's care with daughter, given its poor diagnosis, decision was to make patient DNR and to redirect care to comfort."
	"1801596-1"	"1801596-1"	"ARTERIOSCLEROSIS"	"10003210"	"60-64 years"	"60-64"	"Patient died within 72 hours of second dose. Extensive medical history including HTN, ESRD on dialysis and DM. Autopsy revealed cause of death to be Hypertensive and atherosclerotic cardiovascular disease with DM in part two. Vaccine didn't contribute to death."
	"1801596-1"	"1801596-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Patient died within 72 hours of second dose. Extensive medical history including HTN, ESRD on dialysis and DM. Autopsy revealed cause of death to be Hypertensive and atherosclerotic cardiovascular disease with DM in part two. Vaccine didn't contribute to death."
	"1801596-1"	"1801596-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"Patient died within 72 hours of second dose. Extensive medical history including HTN, ESRD on dialysis and DM. Autopsy revealed cause of death to be Hypertensive and atherosclerotic cardiovascular disease with DM in part two. Vaccine didn't contribute to death."
	"1801596-1"	"1801596-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient died within 72 hours of second dose. Extensive medical history including HTN, ESRD on dialysis and DM. Autopsy revealed cause of death to be Hypertensive and atherosclerotic cardiovascular disease with DM in part two. Vaccine didn't contribute to death."
	"1801596-1"	"1801596-1"	"DIABETES MELLITUS"	"10012601"	"60-64 years"	"60-64"	"Patient died within 72 hours of second dose. Extensive medical history including HTN, ESRD on dialysis and DM. Autopsy revealed cause of death to be Hypertensive and atherosclerotic cardiovascular disease with DM in part two. Vaccine didn't contribute to death."
	"1801596-1"	"1801596-1"	"HYPERTENSION"	"10020772"	"60-64 years"	"60-64"	"Patient died within 72 hours of second dose. Extensive medical history including HTN, ESRD on dialysis and DM. Autopsy revealed cause of death to be Hypertensive and atherosclerotic cardiovascular disease with DM in part two. Vaccine didn't contribute to death."
	"1804274-1"	"1804274-1"	"ANGIOGRAM CEREBRAL"	"10052905"	"60-64 years"	"60-64"	"Patient developed PEA arrest from massive PE 6/19/21. Patient died 6/21/21"
	"1804274-1"	"1804274-1"	"ARTERIOGRAM CAROTID"	"10003194"	"60-64 years"	"60-64"	"Patient developed PEA arrest from massive PE 6/19/21. Patient died 6/21/21"
	"1804274-1"	"1804274-1"	"COMPUTERISED TOMOGRAM ABDOMEN"	"10053876"	"60-64 years"	"60-64"	"Patient developed PEA arrest from massive PE 6/19/21. Patient died 6/21/21"
	"1804274-1"	"1804274-1"	"COMPUTERISED TOMOGRAM HEAD"	"10054003"	"60-64 years"	"60-64"	"Patient developed PEA arrest from massive PE 6/19/21. Patient died 6/21/21"
	"1804274-1"	"1804274-1"	"COMPUTERISED TOMOGRAM THORAX"	"10053875"	"60-64 years"	"60-64"	"Patient developed PEA arrest from massive PE 6/19/21. Patient died 6/21/21"
	"1804274-1"	"1804274-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient developed PEA arrest from massive PE 6/19/21. Patient died 6/21/21"
	"1804274-1"	"1804274-1"	"ECHOCARDIOGRAM"	"10014113"	"60-64 years"	"60-64"	"Patient developed PEA arrest from massive PE 6/19/21. Patient died 6/21/21"
	"1804274-1"	"1804274-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"Patient developed PEA arrest from massive PE 6/19/21. Patient died 6/21/21"
	"1804274-1"	"1804274-1"	"PULSELESS ELECTRICAL ACTIVITY"	"10058151"	"60-64 years"	"60-64"	"Patient developed PEA arrest from massive PE 6/19/21. Patient died 6/21/21"
	"1804620-1"	"1804620-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"death U07.1, J12.82 - Pneumonia due to COVID-19 virus J96.01 - Acute respiratory failure with hypoxia"
	"1804620-1"	"1804620-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"death U07.1, J12.82 - Pneumonia due to COVID-19 virus J96.01 - Acute respiratory failure with hypoxia"
	"1804620-1"	"1804620-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death U07.1, J12.82 - Pneumonia due to COVID-19 virus J96.01 - Acute respiratory failure with hypoxia"
	"1804666-1"	"1804666-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death Hyponatremia Carcinoma brain mass"
	"1804666-1"	"1804666-1"	"HYPONATRAEMIA"	"10021036"	"60-64 years"	"60-64"	"death Hyponatremia Carcinoma brain mass"
	"1804666-1"	"1804666-1"	"INTRACRANIAL MASS"	"10077667"	"60-64 years"	"60-64"	"death Hyponatremia Carcinoma brain mass"
	"1804666-1"	"1804666-1"	"NEOPLASM MALIGNANT"	"10028997"	"60-64 years"	"60-64"	"death Hyponatremia Carcinoma brain mass"
	"1804695-1"	"1804695-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Had breakthrough infection and deceased."
	"1804695-1"	"1804695-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Had breakthrough infection and deceased."
	"1804695-1"	"1804695-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Had breakthrough infection and deceased."
	"1804695-1"	"1804695-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"60-64 years"	"60-64"	"Had breakthrough infection and deceased."
	"1804826-1"	"1804826-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"60-64 years"	"60-64"	"This is an instance of breakthrough disease that resulted in death.   Death Certificate details are as follows:  Part I Cause of Death A: Acute Respiratory Failure B: Adult Respiratory Distress Syndrome C: COVID 19 Pneumonia Part II Other Significant Conditions: Acute Kidney Failure, Sepsis, Encephalopathy, Atrial Fibrillation, Coronary Artery Disease  The patient was admitted to the hospital on 09/08/2021. It is unknown if they were having symptoms, but the patient did receive  diagnoses of both pneumonia and ARDS so it seems that respiratory symptoms were likely."
	"1804826-1"	"1804826-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"This is an instance of breakthrough disease that resulted in death.   Death Certificate details are as follows:  Part I Cause of Death A: Acute Respiratory Failure B: Adult Respiratory Distress Syndrome C: COVID 19 Pneumonia Part II Other Significant Conditions: Acute Kidney Failure, Sepsis, Encephalopathy, Atrial Fibrillation, Coronary Artery Disease  The patient was admitted to the hospital on 09/08/2021. It is unknown if they were having symptoms, but the patient did receive  diagnoses of both pneumonia and ARDS so it seems that respiratory symptoms were likely."
	"1804826-1"	"1804826-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"This is an instance of breakthrough disease that resulted in death.   Death Certificate details are as follows:  Part I Cause of Death A: Acute Respiratory Failure B: Adult Respiratory Distress Syndrome C: COVID 19 Pneumonia Part II Other Significant Conditions: Acute Kidney Failure, Sepsis, Encephalopathy, Atrial Fibrillation, Coronary Artery Disease  The patient was admitted to the hospital on 09/08/2021. It is unknown if they were having symptoms, but the patient did receive  diagnoses of both pneumonia and ARDS so it seems that respiratory symptoms were likely."
	"1804826-1"	"1804826-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"This is an instance of breakthrough disease that resulted in death.   Death Certificate details are as follows:  Part I Cause of Death A: Acute Respiratory Failure B: Adult Respiratory Distress Syndrome C: COVID 19 Pneumonia Part II Other Significant Conditions: Acute Kidney Failure, Sepsis, Encephalopathy, Atrial Fibrillation, Coronary Artery Disease  The patient was admitted to the hospital on 09/08/2021. It is unknown if they were having symptoms, but the patient did receive  diagnoses of both pneumonia and ARDS so it seems that respiratory symptoms were likely."
	"1804826-1"	"1804826-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"This is an instance of breakthrough disease that resulted in death.   Death Certificate details are as follows:  Part I Cause of Death A: Acute Respiratory Failure B: Adult Respiratory Distress Syndrome C: COVID 19 Pneumonia Part II Other Significant Conditions: Acute Kidney Failure, Sepsis, Encephalopathy, Atrial Fibrillation, Coronary Artery Disease  The patient was admitted to the hospital on 09/08/2021. It is unknown if they were having symptoms, but the patient did receive  diagnoses of both pneumonia and ARDS so it seems that respiratory symptoms were likely."
	"1804826-1"	"1804826-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"60-64 years"	"60-64"	"This is an instance of breakthrough disease that resulted in death.   Death Certificate details are as follows:  Part I Cause of Death A: Acute Respiratory Failure B: Adult Respiratory Distress Syndrome C: COVID 19 Pneumonia Part II Other Significant Conditions: Acute Kidney Failure, Sepsis, Encephalopathy, Atrial Fibrillation, Coronary Artery Disease  The patient was admitted to the hospital on 09/08/2021. It is unknown if they were having symptoms, but the patient did receive  diagnoses of both pneumonia and ARDS so it seems that respiratory symptoms were likely."
	"1807889-1"	"1807889-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Cardiac Arrest- died 24 hour after vaccination"
	"1807889-1"	"1807889-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Cardiac Arrest- died 24 hour after vaccination"
	"1807889-1"	"1807889-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Cardiac Arrest- died 24 hour after vaccination"
	"1807889-1"	"1807889-1"	"HAEMORRHAGE"	"10055798"	"60-64 years"	"60-64"	"Cardiac Arrest- died 24 hour after vaccination"
	"1807889-1"	"1807889-1"	"HYPOTENSION"	"10021097"	"60-64 years"	"60-64"	"Cardiac Arrest- died 24 hour after vaccination"
	"1807889-1"	"1807889-1"	"LUMBAR PUNCTURE NORMAL"	"10025002"	"60-64 years"	"60-64"	"Cardiac Arrest- died 24 hour after vaccination"
	"1807889-1"	"1807889-1"	"MAGNETIC RESONANCE IMAGING NORMAL"	"10078225"	"60-64 years"	"60-64"	"Cardiac Arrest- died 24 hour after vaccination"
	"1807889-1"	"1807889-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Cardiac Arrest- died 24 hour after vaccination"
	"1807889-1"	"1807889-1"	"MOUTH HAEMORRHAGE"	"10028024"	"60-64 years"	"60-64"	"Cardiac Arrest- died 24 hour after vaccination"
	"1807889-1"	"1807889-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Cardiac Arrest- died 24 hour after vaccination"
	"1807889-1"	"1807889-1"	"SYNCOPE"	"10042772"	"60-64 years"	"60-64"	"Cardiac Arrest- died 24 hour after vaccination"
	"1807889-1"	"1807889-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Cardiac Arrest- died 24 hour after vaccination"
	"1807989-1"	"1807989-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pt was admitte dto the hospital with small bowel obstruction, sepsis, died 3 days later. Not a Covid related death"
	"1807989-1"	"1807989-1"	"SEPSIS"	"10040047"	"60-64 years"	"60-64"	"Pt was admitte dto the hospital with small bowel obstruction, sepsis, died 3 days later. Not a Covid related death"
	"1807989-1"	"1807989-1"	"SMALL INTESTINAL OBSTRUCTION"	"10041101"	"60-64 years"	"60-64"	"Pt was admitte dto the hospital with small bowel obstruction, sepsis, died 3 days later. Not a Covid related death"
	"1808242-1"	"1808242-1"	"ABDOMINAL PAIN"	"10000081"	"60-64 years"	"60-64"	"Hospital Course:  61F with ovarian cancer, metastatic to LN and omentum, most recently Carboplatin (4/2021), pelvic XRT (6/2021), with comorbidities of bipolar affective disorder, chronic BLE lymphedema/anasarca, recurrent cellulitis, pAfib, right THA (2019) c/b PJI (9/2020) and sepsis (5/2021), admitted 8/10 with abdominal pain and symptoms from worsening lymphedema/anasarca. Admit complicated by AMS, ongoing pain, and intermittent hypotension (responsive to IVF). Given clinical decline, transition to CMO. Now COVID positive; plan to remain in-house for EOL. We were unable to transfer to an hospice at end of life because of covid infection.    Patient passed peacefully at 7:17 AM on 9/26. She was kept comfortable with a morphine drip and PRN thorazine. Her husband and her outpatient providers were notified. See below for problem based hospital course."
	"1808242-1"	"1808242-1"	"ATRIAL FIBRILLATION"	"10003658"	"60-64 years"	"60-64"	"Hospital Course:  61F with ovarian cancer, metastatic to LN and omentum, most recently Carboplatin (4/2021), pelvic XRT (6/2021), with comorbidities of bipolar affective disorder, chronic BLE lymphedema/anasarca, recurrent cellulitis, pAfib, right THA (2019) c/b PJI (9/2020) and sepsis (5/2021), admitted 8/10 with abdominal pain and symptoms from worsening lymphedema/anasarca. Admit complicated by AMS, ongoing pain, and intermittent hypotension (responsive to IVF). Given clinical decline, transition to CMO. Now COVID positive; plan to remain in-house for EOL. We were unable to transfer to an hospice at end of life because of covid infection.    Patient passed peacefully at 7:17 AM on 9/26. She was kept comfortable with a morphine drip and PRN thorazine. Her husband and her outpatient providers were notified. See below for problem based hospital course."
	"1808242-1"	"1808242-1"	"BIPOLAR DISORDER"	"10057667"	"60-64 years"	"60-64"	"Hospital Course:  61F with ovarian cancer, metastatic to LN and omentum, most recently Carboplatin (4/2021), pelvic XRT (6/2021), with comorbidities of bipolar affective disorder, chronic BLE lymphedema/anasarca, recurrent cellulitis, pAfib, right THA (2019) c/b PJI (9/2020) and sepsis (5/2021), admitted 8/10 with abdominal pain and symptoms from worsening lymphedema/anasarca. Admit complicated by AMS, ongoing pain, and intermittent hypotension (responsive to IVF). Given clinical decline, transition to CMO. Now COVID positive; plan to remain in-house for EOL. We were unable to transfer to an hospice at end of life because of covid infection.    Patient passed peacefully at 7:17 AM on 9/26. She was kept comfortable with a morphine drip and PRN thorazine. Her husband and her outpatient providers were notified. See below for problem based hospital course."
	"1808242-1"	"1808242-1"	"CELLULITIS"	"10007882"	"60-64 years"	"60-64"	"Hospital Course:  61F with ovarian cancer, metastatic to LN and omentum, most recently Carboplatin (4/2021), pelvic XRT (6/2021), with comorbidities of bipolar affective disorder, chronic BLE lymphedema/anasarca, recurrent cellulitis, pAfib, right THA (2019) c/b PJI (9/2020) and sepsis (5/2021), admitted 8/10 with abdominal pain and symptoms from worsening lymphedema/anasarca. Admit complicated by AMS, ongoing pain, and intermittent hypotension (responsive to IVF). Given clinical decline, transition to CMO. Now COVID positive; plan to remain in-house for EOL. We were unable to transfer to an hospice at end of life because of covid infection.    Patient passed peacefully at 7:17 AM on 9/26. She was kept comfortable with a morphine drip and PRN thorazine. Her husband and her outpatient providers were notified. See below for problem based hospital course."
	"1808242-1"	"1808242-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"Hospital Course:  61F with ovarian cancer, metastatic to LN and omentum, most recently Carboplatin (4/2021), pelvic XRT (6/2021), with comorbidities of bipolar affective disorder, chronic BLE lymphedema/anasarca, recurrent cellulitis, pAfib, right THA (2019) c/b PJI (9/2020) and sepsis (5/2021), admitted 8/10 with abdominal pain and symptoms from worsening lymphedema/anasarca. Admit complicated by AMS, ongoing pain, and intermittent hypotension (responsive to IVF). Given clinical decline, transition to CMO. Now COVID positive; plan to remain in-house for EOL. We were unable to transfer to an hospice at end of life because of covid infection.    Patient passed peacefully at 7:17 AM on 9/26. She was kept comfortable with a morphine drip and PRN thorazine. Her husband and her outpatient providers were notified. See below for problem based hospital course."
	"1808242-1"	"1808242-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Hospital Course:  61F with ovarian cancer, metastatic to LN and omentum, most recently Carboplatin (4/2021), pelvic XRT (6/2021), with comorbidities of bipolar affective disorder, chronic BLE lymphedema/anasarca, recurrent cellulitis, pAfib, right THA (2019) c/b PJI (9/2020) and sepsis (5/2021), admitted 8/10 with abdominal pain and symptoms from worsening lymphedema/anasarca. Admit complicated by AMS, ongoing pain, and intermittent hypotension (responsive to IVF). Given clinical decline, transition to CMO. Now COVID positive; plan to remain in-house for EOL. We were unable to transfer to an hospice at end of life because of covid infection.    Patient passed peacefully at 7:17 AM on 9/26. She was kept comfortable with a morphine drip and PRN thorazine. Her husband and her outpatient providers were notified. See below for problem based hospital course."
	"1808242-1"	"1808242-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Hospital Course:  61F with ovarian cancer, metastatic to LN and omentum, most recently Carboplatin (4/2021), pelvic XRT (6/2021), with comorbidities of bipolar affective disorder, chronic BLE lymphedema/anasarca, recurrent cellulitis, pAfib, right THA (2019) c/b PJI (9/2020) and sepsis (5/2021), admitted 8/10 with abdominal pain and symptoms from worsening lymphedema/anasarca. Admit complicated by AMS, ongoing pain, and intermittent hypotension (responsive to IVF). Given clinical decline, transition to CMO. Now COVID positive; plan to remain in-house for EOL. We were unable to transfer to an hospice at end of life because of covid infection.    Patient passed peacefully at 7:17 AM on 9/26. She was kept comfortable with a morphine drip and PRN thorazine. Her husband and her outpatient providers were notified. See below for problem based hospital course."
	"1808242-1"	"1808242-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"60-64 years"	"60-64"	"Hospital Course:  61F with ovarian cancer, metastatic to LN and omentum, most recently Carboplatin (4/2021), pelvic XRT (6/2021), with comorbidities of bipolar affective disorder, chronic BLE lymphedema/anasarca, recurrent cellulitis, pAfib, right THA (2019) c/b PJI (9/2020) and sepsis (5/2021), admitted 8/10 with abdominal pain and symptoms from worsening lymphedema/anasarca. Admit complicated by AMS, ongoing pain, and intermittent hypotension (responsive to IVF). Given clinical decline, transition to CMO. Now COVID positive; plan to remain in-house for EOL. We were unable to transfer to an hospice at end of life because of covid infection.    Patient passed peacefully at 7:17 AM on 9/26. She was kept comfortable with a morphine drip and PRN thorazine. Her husband and her outpatient providers were notified. See below for problem based hospital course."
	"1808242-1"	"1808242-1"	"GENERALISED OEDEMA"	"10018092"	"60-64 years"	"60-64"	"Hospital Course:  61F with ovarian cancer, metastatic to LN and omentum, most recently Carboplatin (4/2021), pelvic XRT (6/2021), with comorbidities of bipolar affective disorder, chronic BLE lymphedema/anasarca, recurrent cellulitis, pAfib, right THA (2019) c/b PJI (9/2020) and sepsis (5/2021), admitted 8/10 with abdominal pain and symptoms from worsening lymphedema/anasarca. Admit complicated by AMS, ongoing pain, and intermittent hypotension (responsive to IVF). Given clinical decline, transition to CMO. Now COVID positive; plan to remain in-house for EOL. We were unable to transfer to an hospice at end of life because of covid infection.    Patient passed peacefully at 7:17 AM on 9/26. She was kept comfortable with a morphine drip and PRN thorazine. Her husband and her outpatient providers were notified. See below for problem based hospital course."
	"1808242-1"	"1808242-1"	"HYPOTENSION"	"10021097"	"60-64 years"	"60-64"	"Hospital Course:  61F with ovarian cancer, metastatic to LN and omentum, most recently Carboplatin (4/2021), pelvic XRT (6/2021), with comorbidities of bipolar affective disorder, chronic BLE lymphedema/anasarca, recurrent cellulitis, pAfib, right THA (2019) c/b PJI (9/2020) and sepsis (5/2021), admitted 8/10 with abdominal pain and symptoms from worsening lymphedema/anasarca. Admit complicated by AMS, ongoing pain, and intermittent hypotension (responsive to IVF). Given clinical decline, transition to CMO. Now COVID positive; plan to remain in-house for EOL. We were unable to transfer to an hospice at end of life because of covid infection.    Patient passed peacefully at 7:17 AM on 9/26. She was kept comfortable with a morphine drip and PRN thorazine. Her husband and her outpatient providers were notified. See below for problem based hospital course."
	"1808242-1"	"1808242-1"	"LYMPHOEDEMA"	"10025282"	"60-64 years"	"60-64"	"Hospital Course:  61F with ovarian cancer, metastatic to LN and omentum, most recently Carboplatin (4/2021), pelvic XRT (6/2021), with comorbidities of bipolar affective disorder, chronic BLE lymphedema/anasarca, recurrent cellulitis, pAfib, right THA (2019) c/b PJI (9/2020) and sepsis (5/2021), admitted 8/10 with abdominal pain and symptoms from worsening lymphedema/anasarca. Admit complicated by AMS, ongoing pain, and intermittent hypotension (responsive to IVF). Given clinical decline, transition to CMO. Now COVID positive; plan to remain in-house for EOL. We were unable to transfer to an hospice at end of life because of covid infection.    Patient passed peacefully at 7:17 AM on 9/26. She was kept comfortable with a morphine drip and PRN thorazine. Her husband and her outpatient providers were notified. See below for problem based hospital course."
	"1808242-1"	"1808242-1"	"MENTAL STATUS CHANGES"	"10048294"	"60-64 years"	"60-64"	"Hospital Course:  61F with ovarian cancer, metastatic to LN and omentum, most recently Carboplatin (4/2021), pelvic XRT (6/2021), with comorbidities of bipolar affective disorder, chronic BLE lymphedema/anasarca, recurrent cellulitis, pAfib, right THA (2019) c/b PJI (9/2020) and sepsis (5/2021), admitted 8/10 with abdominal pain and symptoms from worsening lymphedema/anasarca. Admit complicated by AMS, ongoing pain, and intermittent hypotension (responsive to IVF). Given clinical decline, transition to CMO. Now COVID positive; plan to remain in-house for EOL. We were unable to transfer to an hospice at end of life because of covid infection.    Patient passed peacefully at 7:17 AM on 9/26. She was kept comfortable with a morphine drip and PRN thorazine. Her husband and her outpatient providers were notified. See below for problem based hospital course."
	"1808242-1"	"1808242-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"Hospital Course:  61F with ovarian cancer, metastatic to LN and omentum, most recently Carboplatin (4/2021), pelvic XRT (6/2021), with comorbidities of bipolar affective disorder, chronic BLE lymphedema/anasarca, recurrent cellulitis, pAfib, right THA (2019) c/b PJI (9/2020) and sepsis (5/2021), admitted 8/10 with abdominal pain and symptoms from worsening lymphedema/anasarca. Admit complicated by AMS, ongoing pain, and intermittent hypotension (responsive to IVF). Given clinical decline, transition to CMO. Now COVID positive; plan to remain in-house for EOL. We were unable to transfer to an hospice at end of life because of covid infection.    Patient passed peacefully at 7:17 AM on 9/26. She was kept comfortable with a morphine drip and PRN thorazine. Her husband and her outpatient providers were notified. See below for problem based hospital course."
	"1808242-1"	"1808242-1"	"RADIOTHERAPY"	"10037794"	"60-64 years"	"60-64"	"Hospital Course:  61F with ovarian cancer, metastatic to LN and omentum, most recently Carboplatin (4/2021), pelvic XRT (6/2021), with comorbidities of bipolar affective disorder, chronic BLE lymphedema/anasarca, recurrent cellulitis, pAfib, right THA (2019) c/b PJI (9/2020) and sepsis (5/2021), admitted 8/10 with abdominal pain and symptoms from worsening lymphedema/anasarca. Admit complicated by AMS, ongoing pain, and intermittent hypotension (responsive to IVF). Given clinical decline, transition to CMO. Now COVID positive; plan to remain in-house for EOL. We were unable to transfer to an hospice at end of life because of covid infection.    Patient passed peacefully at 7:17 AM on 9/26. She was kept comfortable with a morphine drip and PRN thorazine. Her husband and her outpatient providers were notified. See below for problem based hospital course."
	"1808242-1"	"1808242-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Hospital Course:  61F with ovarian cancer, metastatic to LN and omentum, most recently Carboplatin (4/2021), pelvic XRT (6/2021), with comorbidities of bipolar affective disorder, chronic BLE lymphedema/anasarca, recurrent cellulitis, pAfib, right THA (2019) c/b PJI (9/2020) and sepsis (5/2021), admitted 8/10 with abdominal pain and symptoms from worsening lymphedema/anasarca. Admit complicated by AMS, ongoing pain, and intermittent hypotension (responsive to IVF). Given clinical decline, transition to CMO. Now COVID positive; plan to remain in-house for EOL. We were unable to transfer to an hospice at end of life because of covid infection.    Patient passed peacefully at 7:17 AM on 9/26. She was kept comfortable with a morphine drip and PRN thorazine. Her husband and her outpatient providers were notified. See below for problem based hospital course."
	"1808577-1"	"1808577-1"	"ASPHYXIA"	"10003497"	"60-64 years"	"60-64"	"My husband became weak thought he had MS, was not able to ride his bike or go for 3 mile walks starting the end of March. He thought he might have pleurisy so he went to the Cardiologist. Dr ran test said he was retaining fluid and put him on diuretics. He starting to lose his grip strength and could not work. He found it difficult to breath and stumbles and dropped things. He woke up with numbness in his feet and it quickly spread to his hands, then his legs and arms he went to the ER they thought he had Dengi Fever could not help, we drove to ER they diagnosed him with  Guillan Barre syndrome intimated him and med evacuated him. While we were I was told they still didn't know what was wrong with him and that he would not die if he had Guillan Barre, they started IV IG therapy. He died in ICU on 16 May 2021. I have some of the same symptoms we had the same vaccine we went together on the same day and times. I have body reactive extreme anxiety. I feel as though I will not make it. My feet are becoming numb my arms are weaker. I notice a twitch in my limbs every now an then. I have heart palpatations and increased blood pressure it used to be consistently low. I have a dryness in the back of my mouth. I have balance issue from time to time. I have trouble thinking while I am at work. I am a dental hygienist. My husband was a prosthetist orthotist."
	"1808577-1"	"1808577-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"My husband became weak thought he had MS, was not able to ride his bike or go for 3 mile walks starting the end of March. He thought he might have pleurisy so he went to the Cardiologist. Dr ran test said he was retaining fluid and put him on diuretics. He starting to lose his grip strength and could not work. He found it difficult to breath and stumbles and dropped things. He woke up with numbness in his feet and it quickly spread to his hands, then his legs and arms he went to the ER they thought he had Dengi Fever could not help, we drove to ER they diagnosed him with  Guillan Barre syndrome intimated him and med evacuated him. While we were I was told they still didn't know what was wrong with him and that he would not die if he had Guillan Barre, they started IV IG therapy. He died in ICU on 16 May 2021. I have some of the same symptoms we had the same vaccine we went together on the same day and times. I have body reactive extreme anxiety. I feel as though I will not make it. My feet are becoming numb my arms are weaker. I notice a twitch in my limbs every now an then. I have heart palpatations and increased blood pressure it used to be consistently low. I have a dryness in the back of my mouth. I have balance issue from time to time. I have trouble thinking while I am at work. I am a dental hygienist. My husband was a prosthetist orthotist."
	"1808577-1"	"1808577-1"	"CLUMSINESS"	"10009696"	"60-64 years"	"60-64"	"My husband became weak thought he had MS, was not able to ride his bike or go for 3 mile walks starting the end of March. He thought he might have pleurisy so he went to the Cardiologist. Dr ran test said he was retaining fluid and put him on diuretics. He starting to lose his grip strength and could not work. He found it difficult to breath and stumbles and dropped things. He woke up with numbness in his feet and it quickly spread to his hands, then his legs and arms he went to the ER they thought he had Dengi Fever could not help, we drove to ER they diagnosed him with  Guillan Barre syndrome intimated him and med evacuated him. While we were I was told they still didn't know what was wrong with him and that he would not die if he had Guillan Barre, they started IV IG therapy. He died in ICU on 16 May 2021. I have some of the same symptoms we had the same vaccine we went together on the same day and times. I have body reactive extreme anxiety. I feel as though I will not make it. My feet are becoming numb my arms are weaker. I notice a twitch in my limbs every now an then. I have heart palpatations and increased blood pressure it used to be consistently low. I have a dryness in the back of my mouth. I have balance issue from time to time. I have trouble thinking while I am at work. I am a dental hygienist. My husband was a prosthetist orthotist."
	"1808577-1"	"1808577-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"My husband became weak thought he had MS, was not able to ride his bike or go for 3 mile walks starting the end of March. He thought he might have pleurisy so he went to the Cardiologist. Dr ran test said he was retaining fluid and put him on diuretics. He starting to lose his grip strength and could not work. He found it difficult to breath and stumbles and dropped things. He woke up with numbness in his feet and it quickly spread to his hands, then his legs and arms he went to the ER they thought he had Dengi Fever could not help, we drove to ER they diagnosed him with  Guillan Barre syndrome intimated him and med evacuated him. While we were I was told they still didn't know what was wrong with him and that he would not die if he had Guillan Barre, they started IV IG therapy. He died in ICU on 16 May 2021. I have some of the same symptoms we had the same vaccine we went together on the same day and times. I have body reactive extreme anxiety. I feel as though I will not make it. My feet are becoming numb my arms are weaker. I notice a twitch in my limbs every now an then. I have heart palpatations and increased blood pressure it used to be consistently low. I have a dryness in the back of my mouth. I have balance issue from time to time. I have trouble thinking while I am at work. I am a dental hygienist. My husband was a prosthetist orthotist."
	"1808577-1"	"1808577-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"My husband became weak thought he had MS, was not able to ride his bike or go for 3 mile walks starting the end of March. He thought he might have pleurisy so he went to the Cardiologist. Dr ran test said he was retaining fluid and put him on diuretics. He starting to lose his grip strength and could not work. He found it difficult to breath and stumbles and dropped things. He woke up with numbness in his feet and it quickly spread to his hands, then his legs and arms he went to the ER they thought he had Dengi Fever could not help, we drove to ER they diagnosed him with  Guillan Barre syndrome intimated him and med evacuated him. While we were I was told they still didn't know what was wrong with him and that he would not die if he had Guillan Barre, they started IV IG therapy. He died in ICU on 16 May 2021. I have some of the same symptoms we had the same vaccine we went together on the same day and times. I have body reactive extreme anxiety. I feel as though I will not make it. My feet are becoming numb my arms are weaker. I notice a twitch in my limbs every now an then. I have heart palpatations and increased blood pressure it used to be consistently low. I have a dryness in the back of my mouth. I have balance issue from time to time. I have trouble thinking while I am at work. I am a dental hygienist. My husband was a prosthetist orthotist."
	"1808577-1"	"1808577-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"My husband became weak thought he had MS, was not able to ride his bike or go for 3 mile walks starting the end of March. He thought he might have pleurisy so he went to the Cardiologist. Dr ran test said he was retaining fluid and put him on diuretics. He starting to lose his grip strength and could not work. He found it difficult to breath and stumbles and dropped things. He woke up with numbness in his feet and it quickly spread to his hands, then his legs and arms he went to the ER they thought he had Dengi Fever could not help, we drove to ER they diagnosed him with  Guillan Barre syndrome intimated him and med evacuated him. While we were I was told they still didn't know what was wrong with him and that he would not die if he had Guillan Barre, they started IV IG therapy. He died in ICU on 16 May 2021. I have some of the same symptoms we had the same vaccine we went together on the same day and times. I have body reactive extreme anxiety. I feel as though I will not make it. My feet are becoming numb my arms are weaker. I notice a twitch in my limbs every now an then. I have heart palpatations and increased blood pressure it used to be consistently low. I have a dryness in the back of my mouth. I have balance issue from time to time. I have trouble thinking while I am at work. I am a dental hygienist. My husband was a prosthetist orthotist."
	"1808577-1"	"1808577-1"	"FLUID RETENTION"	"10016807"	"60-64 years"	"60-64"	"My husband became weak thought he had MS, was not able to ride his bike or go for 3 mile walks starting the end of March. He thought he might have pleurisy so he went to the Cardiologist. Dr ran test said he was retaining fluid and put him on diuretics. He starting to lose his grip strength and could not work. He found it difficult to breath and stumbles and dropped things. He woke up with numbness in his feet and it quickly spread to his hands, then his legs and arms he went to the ER they thought he had Dengi Fever could not help, we drove to ER they diagnosed him with  Guillan Barre syndrome intimated him and med evacuated him. While we were I was told they still didn't know what was wrong with him and that he would not die if he had Guillan Barre, they started IV IG therapy. He died in ICU on 16 May 2021. I have some of the same symptoms we had the same vaccine we went together on the same day and times. I have body reactive extreme anxiety. I feel as though I will not make it. My feet are becoming numb my arms are weaker. I notice a twitch in my limbs every now an then. I have heart palpatations and increased blood pressure it used to be consistently low. I have a dryness in the back of my mouth. I have balance issue from time to time. I have trouble thinking while I am at work. I am a dental hygienist. My husband was a prosthetist orthotist."
	"1808577-1"	"1808577-1"	"GAIT DISTURBANCE"	"10017577"	"60-64 years"	"60-64"	"My husband became weak thought he had MS, was not able to ride his bike or go for 3 mile walks starting the end of March. He thought he might have pleurisy so he went to the Cardiologist. Dr ran test said he was retaining fluid and put him on diuretics. He starting to lose his grip strength and could not work. He found it difficult to breath and stumbles and dropped things. He woke up with numbness in his feet and it quickly spread to his hands, then his legs and arms he went to the ER they thought he had Dengi Fever could not help, we drove to ER they diagnosed him with  Guillan Barre syndrome intimated him and med evacuated him. While we were I was told they still didn't know what was wrong with him and that he would not die if he had Guillan Barre, they started IV IG therapy. He died in ICU on 16 May 2021. I have some of the same symptoms we had the same vaccine we went together on the same day and times. I have body reactive extreme anxiety. I feel as though I will not make it. My feet are becoming numb my arms are weaker. I notice a twitch in my limbs every now an then. I have heart palpatations and increased blood pressure it used to be consistently low. I have a dryness in the back of my mouth. I have balance issue from time to time. I have trouble thinking while I am at work. I am a dental hygienist. My husband was a prosthetist orthotist."
	"1808577-1"	"1808577-1"	"GRIP STRENGTH DECREASED"	"10062556"	"60-64 years"	"60-64"	"My husband became weak thought he had MS, was not able to ride his bike or go for 3 mile walks starting the end of March. He thought he might have pleurisy so he went to the Cardiologist. Dr ran test said he was retaining fluid and put him on diuretics. He starting to lose his grip strength and could not work. He found it difficult to breath and stumbles and dropped things. He woke up with numbness in his feet and it quickly spread to his hands, then his legs and arms he went to the ER they thought he had Dengi Fever could not help, we drove to ER they diagnosed him with  Guillan Barre syndrome intimated him and med evacuated him. While we were I was told they still didn't know what was wrong with him and that he would not die if he had Guillan Barre, they started IV IG therapy. He died in ICU on 16 May 2021. I have some of the same symptoms we had the same vaccine we went together on the same day and times. I have body reactive extreme anxiety. I feel as though I will not make it. My feet are becoming numb my arms are weaker. I notice a twitch in my limbs every now an then. I have heart palpatations and increased blood pressure it used to be consistently low. I have a dryness in the back of my mouth. I have balance issue from time to time. I have trouble thinking while I am at work. I am a dental hygienist. My husband was a prosthetist orthotist."
	"1808577-1"	"1808577-1"	"GUILLAIN-BARRE SYNDROME"	"10018767"	"60-64 years"	"60-64"	"My husband became weak thought he had MS, was not able to ride his bike or go for 3 mile walks starting the end of March. He thought he might have pleurisy so he went to the Cardiologist. Dr ran test said he was retaining fluid and put him on diuretics. He starting to lose his grip strength and could not work. He found it difficult to breath and stumbles and dropped things. He woke up with numbness in his feet and it quickly spread to his hands, then his legs and arms he went to the ER they thought he had Dengi Fever could not help, we drove to ER they diagnosed him with  Guillan Barre syndrome intimated him and med evacuated him. While we were I was told they still didn't know what was wrong with him and that he would not die if he had Guillan Barre, they started IV IG therapy. He died in ICU on 16 May 2021. I have some of the same symptoms we had the same vaccine we went together on the same day and times. I have body reactive extreme anxiety. I feel as though I will not make it. My feet are becoming numb my arms are weaker. I notice a twitch in my limbs every now an then. I have heart palpatations and increased blood pressure it used to be consistently low. I have a dryness in the back of my mouth. I have balance issue from time to time. I have trouble thinking while I am at work. I am a dental hygienist. My husband was a prosthetist orthotist."
	"1808577-1"	"1808577-1"	"HYPOAESTHESIA"	"10020937"	"60-64 years"	"60-64"	"My husband became weak thought he had MS, was not able to ride his bike or go for 3 mile walks starting the end of March. He thought he might have pleurisy so he went to the Cardiologist. Dr ran test said he was retaining fluid and put him on diuretics. He starting to lose his grip strength and could not work. He found it difficult to breath and stumbles and dropped things. He woke up with numbness in his feet and it quickly spread to his hands, then his legs and arms he went to the ER they thought he had Dengi Fever could not help, we drove to ER they diagnosed him with  Guillan Barre syndrome intimated him and med evacuated him. While we were I was told they still didn't know what was wrong with him and that he would not die if he had Guillan Barre, they started IV IG therapy. He died in ICU on 16 May 2021. I have some of the same symptoms we had the same vaccine we went together on the same day and times. I have body reactive extreme anxiety. I feel as though I will not make it. My feet are becoming numb my arms are weaker. I notice a twitch in my limbs every now an then. I have heart palpatations and increased blood pressure it used to be consistently low. I have a dryness in the back of my mouth. I have balance issue from time to time. I have trouble thinking while I am at work. I am a dental hygienist. My husband was a prosthetist orthotist."
	"1808577-1"	"1808577-1"	"IMMUNOGLOBULIN THERAPY"	"10069534"	"60-64 years"	"60-64"	"My husband became weak thought he had MS, was not able to ride his bike or go for 3 mile walks starting the end of March. He thought he might have pleurisy so he went to the Cardiologist. Dr ran test said he was retaining fluid and put him on diuretics. He starting to lose his grip strength and could not work. He found it difficult to breath and stumbles and dropped things. He woke up with numbness in his feet and it quickly spread to his hands, then his legs and arms he went to the ER they thought he had Dengi Fever could not help, we drove to ER they diagnosed him with  Guillan Barre syndrome intimated him and med evacuated him. While we were I was told they still didn't know what was wrong with him and that he would not die if he had Guillan Barre, they started IV IG therapy. He died in ICU on 16 May 2021. I have some of the same symptoms we had the same vaccine we went together on the same day and times. I have body reactive extreme anxiety. I feel as though I will not make it. My feet are becoming numb my arms are weaker. I notice a twitch in my limbs every now an then. I have heart palpatations and increased blood pressure it used to be consistently low. I have a dryness in the back of my mouth. I have balance issue from time to time. I have trouble thinking while I am at work. I am a dental hygienist. My husband was a prosthetist orthotist."
	"1808577-1"	"1808577-1"	"IMPAIRED WORK ABILITY"	"10052302"	"60-64 years"	"60-64"	"My husband became weak thought he had MS, was not able to ride his bike or go for 3 mile walks starting the end of March. He thought he might have pleurisy so he went to the Cardiologist. Dr ran test said he was retaining fluid and put him on diuretics. He starting to lose his grip strength and could not work. He found it difficult to breath and stumbles and dropped things. He woke up with numbness in his feet and it quickly spread to his hands, then his legs and arms he went to the ER they thought he had Dengi Fever could not help, we drove to ER they diagnosed him with  Guillan Barre syndrome intimated him and med evacuated him. While we were I was told they still didn't know what was wrong with him and that he would not die if he had Guillan Barre, they started IV IG therapy. He died in ICU on 16 May 2021. I have some of the same symptoms we had the same vaccine we went together on the same day and times. I have body reactive extreme anxiety. I feel as though I will not make it. My feet are becoming numb my arms are weaker. I notice a twitch in my limbs every now an then. I have heart palpatations and increased blood pressure it used to be consistently low. I have a dryness in the back of my mouth. I have balance issue from time to time. I have trouble thinking while I am at work. I am a dental hygienist. My husband was a prosthetist orthotist."
	"1808577-1"	"1808577-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"My husband became weak thought he had MS, was not able to ride his bike or go for 3 mile walks starting the end of March. He thought he might have pleurisy so he went to the Cardiologist. Dr ran test said he was retaining fluid and put him on diuretics. He starting to lose his grip strength and could not work. He found it difficult to breath and stumbles and dropped things. He woke up with numbness in his feet and it quickly spread to his hands, then his legs and arms he went to the ER they thought he had Dengi Fever could not help, we drove to ER they diagnosed him with  Guillan Barre syndrome intimated him and med evacuated him. While we were I was told they still didn't know what was wrong with him and that he would not die if he had Guillan Barre, they started IV IG therapy. He died in ICU on 16 May 2021. I have some of the same symptoms we had the same vaccine we went together on the same day and times. I have body reactive extreme anxiety. I feel as though I will not make it. My feet are becoming numb my arms are weaker. I notice a twitch in my limbs every now an then. I have heart palpatations and increased blood pressure it used to be consistently low. I have a dryness in the back of my mouth. I have balance issue from time to time. I have trouble thinking while I am at work. I am a dental hygienist. My husband was a prosthetist orthotist."
	"1813526-1"	"1813526-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"PATIENT BEGAN FEELING PAIN IN HIS CHEST CAVITY APPROX. JUNE 15, 2021"
	"1813898-1"	"1813898-1"	"CARDIOVASCULAR DISORDER"	"10007649"	"60-64 years"	"60-64"	"Patient stopped any shopping and phone activity as of May 19, 2021.  We found him on June 1, 2021 which the coroner was required to list as the day of his death.  He had been dead for quite a while. Coroner decided he had cardiovascular disease."
	"1813898-1"	"1813898-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient stopped any shopping and phone activity as of May 19, 2021.  We found him on June 1, 2021 which the coroner was required to list as the day of his death.  He had been dead for quite a while. Coroner decided he had cardiovascular disease."
	"1814845-1"	"1814845-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"FEVER, CHILLS, NAUSEA"
	"1814845-1"	"1814845-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"FEVER, CHILLS, NAUSEA"
	"1814845-1"	"1814845-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"FEVER, CHILLS, NAUSEA"
	"1818141-1"	"1818141-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Diagnosed with COVID-19 on 8/23/2021 and experienced shortness of breath, pneumonia."
	"1818141-1"	"1818141-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Diagnosed with COVID-19 on 8/23/2021 and experienced shortness of breath, pneumonia."
	"1818141-1"	"1818141-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"Diagnosed with COVID-19 on 8/23/2021 and experienced shortness of breath, pneumonia."
	"1818141-1"	"1818141-1"	"SARS-COV-2 RNA"	"10085493"	"60-64 years"	"60-64"	"Diagnosed with COVID-19 on 8/23/2021 and experienced shortness of breath, pneumonia."
	"1818141-1"	"1818141-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Diagnosed with COVID-19 on 8/23/2021 and experienced shortness of breath, pneumonia."
	"1818204-1"	"1818204-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Symptomatic on 09/18/2021: headache and myalgia"
	"1818204-1"	"1818204-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"Symptomatic on 09/18/2021: headache and myalgia"
	"1818204-1"	"1818204-1"	"MYALGIA"	"10028411"	"60-64 years"	"60-64"	"Symptomatic on 09/18/2021: headache and myalgia"
	"1818204-1"	"1818204-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Symptomatic on 09/18/2021: headache and myalgia"
	"1818312-1"	"1818312-1"	"ALCOHOL USE"	"10048921"	"60-64 years"	"60-64"	"Fall down stairs, +EtOH, catastrophic brain injury, death. Though her death seems to be clearly caused by direct head trauma, the cause of her fall may be multifactorial including weakness from recent vaccination in combination with EtOH."
	"1818312-1"	"1818312-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"Fall down stairs, +EtOH, catastrophic brain injury, death. Though her death seems to be clearly caused by direct head trauma, the cause of her fall may be multifactorial including weakness from recent vaccination in combination with EtOH."
	"1818312-1"	"1818312-1"	"BLOOD ALCOHOL INCREASED"	"10060013"	"60-64 years"	"60-64"	"Fall down stairs, +EtOH, catastrophic brain injury, death. Though her death seems to be clearly caused by direct head trauma, the cause of her fall may be multifactorial including weakness from recent vaccination in combination with EtOH."
	"1818312-1"	"1818312-1"	"BRAIN HERNIATION"	"10006126"	"60-64 years"	"60-64"	"Fall down stairs, +EtOH, catastrophic brain injury, death. Though her death seems to be clearly caused by direct head trauma, the cause of her fall may be multifactorial including weakness from recent vaccination in combination with EtOH."
	"1818312-1"	"1818312-1"	"BRAIN INJURY"	"10067967"	"60-64 years"	"60-64"	"Fall down stairs, +EtOH, catastrophic brain injury, death. Though her death seems to be clearly caused by direct head trauma, the cause of her fall may be multifactorial including weakness from recent vaccination in combination with EtOH."
	"1818312-1"	"1818312-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"60-64 years"	"60-64"	"Fall down stairs, +EtOH, catastrophic brain injury, death. Though her death seems to be clearly caused by direct head trauma, the cause of her fall may be multifactorial including weakness from recent vaccination in combination with EtOH."
	"1818312-1"	"1818312-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Fall down stairs, +EtOH, catastrophic brain injury, death. Though her death seems to be clearly caused by direct head trauma, the cause of her fall may be multifactorial including weakness from recent vaccination in combination with EtOH."
	"1818312-1"	"1818312-1"	"FALL"	"10016173"	"60-64 years"	"60-64"	"Fall down stairs, +EtOH, catastrophic brain injury, death. Though her death seems to be clearly caused by direct head trauma, the cause of her fall may be multifactorial including weakness from recent vaccination in combination with EtOH."
	"1818312-1"	"1818312-1"	"INJURY"	"10022116"	"60-64 years"	"60-64"	"Fall down stairs, +EtOH, catastrophic brain injury, death. Though her death seems to be clearly caused by direct head trauma, the cause of her fall may be multifactorial including weakness from recent vaccination in combination with EtOH."
	"1818312-1"	"1818312-1"	"INTERNATIONAL NORMALISED RATIO NORMAL"	"10022596"	"60-64 years"	"60-64"	"Fall down stairs, +EtOH, catastrophic brain injury, death. Though her death seems to be clearly caused by direct head trauma, the cause of her fall may be multifactorial including weakness from recent vaccination in combination with EtOH."
	"1818312-1"	"1818312-1"	"PNEUMOCEPHALUS"	"10048736"	"60-64 years"	"60-64"	"Fall down stairs, +EtOH, catastrophic brain injury, death. Though her death seems to be clearly caused by direct head trauma, the cause of her fall may be multifactorial including weakness from recent vaccination in combination with EtOH."
	"1818312-1"	"1818312-1"	"PROTHROMBIN TIME NORMAL"	"10037062"	"60-64 years"	"60-64"	"Fall down stairs, +EtOH, catastrophic brain injury, death. Though her death seems to be clearly caused by direct head trauma, the cause of her fall may be multifactorial including weakness from recent vaccination in combination with EtOH."
	"1818312-1"	"1818312-1"	"SKULL FRACTURE"	"10061365"	"60-64 years"	"60-64"	"Fall down stairs, +EtOH, catastrophic brain injury, death. Though her death seems to be clearly caused by direct head trauma, the cause of her fall may be multifactorial including weakness from recent vaccination in combination with EtOH."
	"1818312-1"	"1818312-1"	"SUBDURAL HAEMATOMA"	"10042361"	"60-64 years"	"60-64"	"Fall down stairs, +EtOH, catastrophic brain injury, death. Though her death seems to be clearly caused by direct head trauma, the cause of her fall may be multifactorial including weakness from recent vaccination in combination with EtOH."
	"1818543-1"	"1818543-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"BROUGHT TO HOSPITAL FOR FACIAL DROOP AND DECREASED ALERTNESS"
	"1818543-1"	"1818543-1"	"DEPRESSED LEVEL OF CONSCIOUSNESS"	"10012373"	"60-64 years"	"60-64"	"BROUGHT TO HOSPITAL FOR FACIAL DROOP AND DECREASED ALERTNESS"
	"1818543-1"	"1818543-1"	"FACIAL PARALYSIS"	"10016062"	"60-64 years"	"60-64"	"BROUGHT TO HOSPITAL FOR FACIAL DROOP AND DECREASED ALERTNESS"
	"1818543-1"	"1818543-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"BROUGHT TO HOSPITAL FOR FACIAL DROOP AND DECREASED ALERTNESS"
	"1818596-1"	"1818596-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"SOB O2 54% ON RA"
	"1818596-1"	"1818596-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"SOB O2 54% ON RA"
	"1818596-1"	"1818596-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"SOB O2 54% ON RA"
	"1821085-1"	"1821085-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient diagnosed and hospitalized with COVID-19 while fully vaccinated."
	"1821164-1"	"1821164-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Pt.'s Sister states that after receiving the 1st dose of Phizer 09/10/2021, started experiencing symptoms 10/19/2021 pt. found unconscious on the floor, Emergency Room visit *transported suffered 3 Heart Attacks, Cardiac Arrest resulting in Death 10/20/2021."
	"1821164-1"	"1821164-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pt.'s Sister states that after receiving the 1st dose of Phizer 09/10/2021, started experiencing symptoms 10/19/2021 pt. found unconscious on the floor, Emergency Room visit *transported suffered 3 Heart Attacks, Cardiac Arrest resulting in Death 10/20/2021."
	"1821164-1"	"1821164-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"60-64 years"	"60-64"	"Pt.'s Sister states that after receiving the 1st dose of Phizer 09/10/2021, started experiencing symptoms 10/19/2021 pt. found unconscious on the floor, Emergency Room visit *transported suffered 3 Heart Attacks, Cardiac Arrest resulting in Death 10/20/2021."
	"1821164-1"	"1821164-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"Pt.'s Sister states that after receiving the 1st dose of Phizer 09/10/2021, started experiencing symptoms 10/19/2021 pt. found unconscious on the floor, Emergency Room visit *transported suffered 3 Heart Attacks, Cardiac Arrest resulting in Death 10/20/2021."
	"1821241-1"	"1821241-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Pt died after being diagnosed with COVID concurrently with a devastating left thalamic IPH with extensive IPH and ventricular blood."
	"1821241-1"	"1821241-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pt died after being diagnosed with COVID concurrently with a devastating left thalamic IPH with extensive IPH and ventricular blood."
	"1821241-1"	"1821241-1"	"PULMONARY HAEMOSIDEROSIS"	"10037396"	"60-64 years"	"60-64"	"Pt died after being diagnosed with COVID concurrently with a devastating left thalamic IPH with extensive IPH and ventricular blood."
	"1821341-1"	"1821341-1"	"CHILLS"	"10008531"	"60-64 years"	"60-64"	"pt diagnosed and hospitalized x 2days with positive COVID test prior to this hosp admission; pt presented to ED with fever, chills, fatigue and increasing SOB, placed on Airvo; hx of DM and RA; eventually placed on BiPAP; alternated with BiPAP and Airvo; pt was tiring and requested intubation; placed in prone position most of the time; family requested no CPR; developed Shock, renal failure related to COVID sepsis; pt's condition worsened and he expired in the hospital"
	"1821341-1"	"1821341-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"pt diagnosed and hospitalized x 2days with positive COVID test prior to this hosp admission; pt presented to ED with fever, chills, fatigue and increasing SOB, placed on Airvo; hx of DM and RA; eventually placed on BiPAP; alternated with BiPAP and Airvo; pt was tiring and requested intubation; placed in prone position most of the time; family requested no CPR; developed Shock, renal failure related to COVID sepsis; pt's condition worsened and he expired in the hospital"
	"1821341-1"	"1821341-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"pt diagnosed and hospitalized x 2days with positive COVID test prior to this hosp admission; pt presented to ED with fever, chills, fatigue and increasing SOB, placed on Airvo; hx of DM and RA; eventually placed on BiPAP; alternated with BiPAP and Airvo; pt was tiring and requested intubation; placed in prone position most of the time; family requested no CPR; developed Shock, renal failure related to COVID sepsis; pt's condition worsened and he expired in the hospital"
	"1821341-1"	"1821341-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"pt diagnosed and hospitalized x 2days with positive COVID test prior to this hosp admission; pt presented to ED with fever, chills, fatigue and increasing SOB, placed on Airvo; hx of DM and RA; eventually placed on BiPAP; alternated with BiPAP and Airvo; pt was tiring and requested intubation; placed in prone position most of the time; family requested no CPR; developed Shock, renal failure related to COVID sepsis; pt's condition worsened and he expired in the hospital"
	"1821341-1"	"1821341-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"pt diagnosed and hospitalized x 2days with positive COVID test prior to this hosp admission; pt presented to ED with fever, chills, fatigue and increasing SOB, placed on Airvo; hx of DM and RA; eventually placed on BiPAP; alternated with BiPAP and Airvo; pt was tiring and requested intubation; placed in prone position most of the time; family requested no CPR; developed Shock, renal failure related to COVID sepsis; pt's condition worsened and he expired in the hospital"
	"1821341-1"	"1821341-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"60-64 years"	"60-64"	"pt diagnosed and hospitalized x 2days with positive COVID test prior to this hosp admission; pt presented to ED with fever, chills, fatigue and increasing SOB, placed on Airvo; hx of DM and RA; eventually placed on BiPAP; alternated with BiPAP and Airvo; pt was tiring and requested intubation; placed in prone position most of the time; family requested no CPR; developed Shock, renal failure related to COVID sepsis; pt's condition worsened and he expired in the hospital"
	"1821341-1"	"1821341-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"60-64 years"	"60-64"	"pt diagnosed and hospitalized x 2days with positive COVID test prior to this hosp admission; pt presented to ED with fever, chills, fatigue and increasing SOB, placed on Airvo; hx of DM and RA; eventually placed on BiPAP; alternated with BiPAP and Airvo; pt was tiring and requested intubation; placed in prone position most of the time; family requested no CPR; developed Shock, renal failure related to COVID sepsis; pt's condition worsened and he expired in the hospital"
	"1821341-1"	"1821341-1"	"PRONE POSITION"	"10074744"	"60-64 years"	"60-64"	"pt diagnosed and hospitalized x 2days with positive COVID test prior to this hosp admission; pt presented to ED with fever, chills, fatigue and increasing SOB, placed on Airvo; hx of DM and RA; eventually placed on BiPAP; alternated with BiPAP and Airvo; pt was tiring and requested intubation; placed in prone position most of the time; family requested no CPR; developed Shock, renal failure related to COVID sepsis; pt's condition worsened and he expired in the hospital"
	"1821341-1"	"1821341-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"pt diagnosed and hospitalized x 2days with positive COVID test prior to this hosp admission; pt presented to ED with fever, chills, fatigue and increasing SOB, placed on Airvo; hx of DM and RA; eventually placed on BiPAP; alternated with BiPAP and Airvo; pt was tiring and requested intubation; placed in prone position most of the time; family requested no CPR; developed Shock, renal failure related to COVID sepsis; pt's condition worsened and he expired in the hospital"
	"1821341-1"	"1821341-1"	"RENAL FAILURE"	"10038435"	"60-64 years"	"60-64"	"pt diagnosed and hospitalized x 2days with positive COVID test prior to this hosp admission; pt presented to ED with fever, chills, fatigue and increasing SOB, placed on Airvo; hx of DM and RA; eventually placed on BiPAP; alternated with BiPAP and Airvo; pt was tiring and requested intubation; placed in prone position most of the time; family requested no CPR; developed Shock, renal failure related to COVID sepsis; pt's condition worsened and he expired in the hospital"
	"1821341-1"	"1821341-1"	"SARS-COV-2 SEPSIS"	"10084639"	"60-64 years"	"60-64"	"pt diagnosed and hospitalized x 2days with positive COVID test prior to this hosp admission; pt presented to ED with fever, chills, fatigue and increasing SOB, placed on Airvo; hx of DM and RA; eventually placed on BiPAP; alternated with BiPAP and Airvo; pt was tiring and requested intubation; placed in prone position most of the time; family requested no CPR; developed Shock, renal failure related to COVID sepsis; pt's condition worsened and he expired in the hospital"
	"1821341-1"	"1821341-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"pt diagnosed and hospitalized x 2days with positive COVID test prior to this hosp admission; pt presented to ED with fever, chills, fatigue and increasing SOB, placed on Airvo; hx of DM and RA; eventually placed on BiPAP; alternated with BiPAP and Airvo; pt was tiring and requested intubation; placed in prone position most of the time; family requested no CPR; developed Shock, renal failure related to COVID sepsis; pt's condition worsened and he expired in the hospital"
	"1821341-1"	"1821341-1"	"SHOCK"	"10040560"	"60-64 years"	"60-64"	"pt diagnosed and hospitalized x 2days with positive COVID test prior to this hosp admission; pt presented to ED with fever, chills, fatigue and increasing SOB, placed on Airvo; hx of DM and RA; eventually placed on BiPAP; alternated with BiPAP and Airvo; pt was tiring and requested intubation; placed in prone position most of the time; family requested no CPR; developed Shock, renal failure related to COVID sepsis; pt's condition worsened and he expired in the hospital"
	"1821662-1"	"1821662-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"death N17.9 - AKI (acute kidney injury) (CMS/HCC)"
	"1821662-1"	"1821662-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death N17.9 - AKI (acute kidney injury) (CMS/HCC)"
	"1825340-1"	"1825340-1"	"BLOOD CREATININE INCREASED"	"10005483"	"60-64 years"	"60-64"	"Case of a 65 years old female with past medical history of high blood pressure, HFrEF, COPD, CAD with CABG x 5 and hyperlipidemia presents to the ED due to complaints of shortness of breath,  On EMS arrival patient was found in the 70s O2 room air, given breathing treatments during route to the ED, she is vaccinated against covid. She has been exposed to family members at home. Denies any hx of diarrheas, abdominal pain, headache, fever or other associated symptoms.  Urine and bowel pattern within normal limits, patient is also aware that she has a mass in her lung and she has been unable to have a CT, since she has been denies twice by her insurance. Patient is independent ADLs and instrumental ADLs. Denies any toxic habits/ former smoker    On admission:   ProBNP is 29783.   Her creatinine is noted to be 5.2.  Previous creatinine from September of 2021 was 2.4.  EKG shows sinus rhythm at 73 beats per minute with incomplete right bundle-branch block.     XR Chest 1V 1. Focal masslike opacity in the left midlung. This may reflect a well-defined focus of consolidation or pneumonia however a mass is not ruled out. Further characterization with CT chest recommended.  2. Left basilar infiltrates and adjacent mild left-sided effusion.  3. Background of COPD and scattered fine reticular opacities suspected chronic. Tested + COVID 10/10/2021 1256"
	"1825340-1"	"1825340-1"	"BUNDLE BRANCH BLOCK RIGHT"	"10006582"	"60-64 years"	"60-64"	"Case of a 65 years old female with past medical history of high blood pressure, HFrEF, COPD, CAD with CABG x 5 and hyperlipidemia presents to the ED due to complaints of shortness of breath,  On EMS arrival patient was found in the 70s O2 room air, given breathing treatments during route to the ED, she is vaccinated against covid. She has been exposed to family members at home. Denies any hx of diarrheas, abdominal pain, headache, fever or other associated symptoms.  Urine and bowel pattern within normal limits, patient is also aware that she has a mass in her lung and she has been unable to have a CT, since she has been denies twice by her insurance. Patient is independent ADLs and instrumental ADLs. Denies any toxic habits/ former smoker    On admission:   ProBNP is 29783.   Her creatinine is noted to be 5.2.  Previous creatinine from September of 2021 was 2.4.  EKG shows sinus rhythm at 73 beats per minute with incomplete right bundle-branch block.     XR Chest 1V 1. Focal masslike opacity in the left midlung. This may reflect a well-defined focus of consolidation or pneumonia however a mass is not ruled out. Further characterization with CT chest recommended.  2. Left basilar infiltrates and adjacent mild left-sided effusion.  3. Background of COPD and scattered fine reticular opacities suspected chronic. Tested + COVID 10/10/2021 1256"
	"1825340-1"	"1825340-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"Case of a 65 years old female with past medical history of high blood pressure, HFrEF, COPD, CAD with CABG x 5 and hyperlipidemia presents to the ED due to complaints of shortness of breath,  On EMS arrival patient was found in the 70s O2 room air, given breathing treatments during route to the ED, she is vaccinated against covid. She has been exposed to family members at home. Denies any hx of diarrheas, abdominal pain, headache, fever or other associated symptoms.  Urine and bowel pattern within normal limits, patient is also aware that she has a mass in her lung and she has been unable to have a CT, since she has been denies twice by her insurance. Patient is independent ADLs and instrumental ADLs. Denies any toxic habits/ former smoker    On admission:   ProBNP is 29783.   Her creatinine is noted to be 5.2.  Previous creatinine from September of 2021 was 2.4.  EKG shows sinus rhythm at 73 beats per minute with incomplete right bundle-branch block.     XR Chest 1V 1. Focal masslike opacity in the left midlung. This may reflect a well-defined focus of consolidation or pneumonia however a mass is not ruled out. Further characterization with CT chest recommended.  2. Left basilar infiltrates and adjacent mild left-sided effusion.  3. Background of COPD and scattered fine reticular opacities suspected chronic. Tested + COVID 10/10/2021 1256"
	"1825340-1"	"1825340-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Case of a 65 years old female with past medical history of high blood pressure, HFrEF, COPD, CAD with CABG x 5 and hyperlipidemia presents to the ED due to complaints of shortness of breath,  On EMS arrival patient was found in the 70s O2 room air, given breathing treatments during route to the ED, she is vaccinated against covid. She has been exposed to family members at home. Denies any hx of diarrheas, abdominal pain, headache, fever or other associated symptoms.  Urine and bowel pattern within normal limits, patient is also aware that she has a mass in her lung and she has been unable to have a CT, since she has been denies twice by her insurance. Patient is independent ADLs and instrumental ADLs. Denies any toxic habits/ former smoker    On admission:   ProBNP is 29783.   Her creatinine is noted to be 5.2.  Previous creatinine from September of 2021 was 2.4.  EKG shows sinus rhythm at 73 beats per minute with incomplete right bundle-branch block.     XR Chest 1V 1. Focal masslike opacity in the left midlung. This may reflect a well-defined focus of consolidation or pneumonia however a mass is not ruled out. Further characterization with CT chest recommended.  2. Left basilar infiltrates and adjacent mild left-sided effusion.  3. Background of COPD and scattered fine reticular opacities suspected chronic. Tested + COVID 10/10/2021 1256"
	"1825340-1"	"1825340-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Case of a 65 years old female with past medical history of high blood pressure, HFrEF, COPD, CAD with CABG x 5 and hyperlipidemia presents to the ED due to complaints of shortness of breath,  On EMS arrival patient was found in the 70s O2 room air, given breathing treatments during route to the ED, she is vaccinated against covid. She has been exposed to family members at home. Denies any hx of diarrheas, abdominal pain, headache, fever or other associated symptoms.  Urine and bowel pattern within normal limits, patient is also aware that she has a mass in her lung and she has been unable to have a CT, since she has been denies twice by her insurance. Patient is independent ADLs and instrumental ADLs. Denies any toxic habits/ former smoker    On admission:   ProBNP is 29783.   Her creatinine is noted to be 5.2.  Previous creatinine from September of 2021 was 2.4.  EKG shows sinus rhythm at 73 beats per minute with incomplete right bundle-branch block.     XR Chest 1V 1. Focal masslike opacity in the left midlung. This may reflect a well-defined focus of consolidation or pneumonia however a mass is not ruled out. Further characterization with CT chest recommended.  2. Left basilar infiltrates and adjacent mild left-sided effusion.  3. Background of COPD and scattered fine reticular opacities suspected chronic. Tested + COVID 10/10/2021 1256"
	"1825340-1"	"1825340-1"	"ELECTROCARDIOGRAM ABNORMAL"	"10014363"	"60-64 years"	"60-64"	"Case of a 65 years old female with past medical history of high blood pressure, HFrEF, COPD, CAD with CABG x 5 and hyperlipidemia presents to the ED due to complaints of shortness of breath,  On EMS arrival patient was found in the 70s O2 room air, given breathing treatments during route to the ED, she is vaccinated against covid. She has been exposed to family members at home. Denies any hx of diarrheas, abdominal pain, headache, fever or other associated symptoms.  Urine and bowel pattern within normal limits, patient is also aware that she has a mass in her lung and she has been unable to have a CT, since she has been denies twice by her insurance. Patient is independent ADLs and instrumental ADLs. Denies any toxic habits/ former smoker    On admission:   ProBNP is 29783.   Her creatinine is noted to be 5.2.  Previous creatinine from September of 2021 was 2.4.  EKG shows sinus rhythm at 73 beats per minute with incomplete right bundle-branch block.     XR Chest 1V 1. Focal masslike opacity in the left midlung. This may reflect a well-defined focus of consolidation or pneumonia however a mass is not ruled out. Further characterization with CT chest recommended.  2. Left basilar infiltrates and adjacent mild left-sided effusion.  3. Background of COPD and scattered fine reticular opacities suspected chronic. Tested + COVID 10/10/2021 1256"
	"1825340-1"	"1825340-1"	"EXPOSURE TO SARS-COV-2"	"10084456"	"60-64 years"	"60-64"	"Case of a 65 years old female with past medical history of high blood pressure, HFrEF, COPD, CAD with CABG x 5 and hyperlipidemia presents to the ED due to complaints of shortness of breath,  On EMS arrival patient was found in the 70s O2 room air, given breathing treatments during route to the ED, she is vaccinated against covid. She has been exposed to family members at home. Denies any hx of diarrheas, abdominal pain, headache, fever or other associated symptoms.  Urine and bowel pattern within normal limits, patient is also aware that she has a mass in her lung and she has been unable to have a CT, since she has been denies twice by her insurance. Patient is independent ADLs and instrumental ADLs. Denies any toxic habits/ former smoker    On admission:   ProBNP is 29783.   Her creatinine is noted to be 5.2.  Previous creatinine from September of 2021 was 2.4.  EKG shows sinus rhythm at 73 beats per minute with incomplete right bundle-branch block.     XR Chest 1V 1. Focal masslike opacity in the left midlung. This may reflect a well-defined focus of consolidation or pneumonia however a mass is not ruled out. Further characterization with CT chest recommended.  2. Left basilar infiltrates and adjacent mild left-sided effusion.  3. Background of COPD and scattered fine reticular opacities suspected chronic. Tested + COVID 10/10/2021 1256"
	"1825340-1"	"1825340-1"	"LUNG INFILTRATION"	"10025102"	"60-64 years"	"60-64"	"Case of a 65 years old female with past medical history of high blood pressure, HFrEF, COPD, CAD with CABG x 5 and hyperlipidemia presents to the ED due to complaints of shortness of breath,  On EMS arrival patient was found in the 70s O2 room air, given breathing treatments during route to the ED, she is vaccinated against covid. She has been exposed to family members at home. Denies any hx of diarrheas, abdominal pain, headache, fever or other associated symptoms.  Urine and bowel pattern within normal limits, patient is also aware that she has a mass in her lung and she has been unable to have a CT, since she has been denies twice by her insurance. Patient is independent ADLs and instrumental ADLs. Denies any toxic habits/ former smoker    On admission:   ProBNP is 29783.   Her creatinine is noted to be 5.2.  Previous creatinine from September of 2021 was 2.4.  EKG shows sinus rhythm at 73 beats per minute with incomplete right bundle-branch block.     XR Chest 1V 1. Focal masslike opacity in the left midlung. This may reflect a well-defined focus of consolidation or pneumonia however a mass is not ruled out. Further characterization with CT chest recommended.  2. Left basilar infiltrates and adjacent mild left-sided effusion.  3. Background of COPD and scattered fine reticular opacities suspected chronic. Tested + COVID 10/10/2021 1256"
	"1825340-1"	"1825340-1"	"LUNG OPACITY"	"10081792"	"60-64 years"	"60-64"	"Case of a 65 years old female with past medical history of high blood pressure, HFrEF, COPD, CAD with CABG x 5 and hyperlipidemia presents to the ED due to complaints of shortness of breath,  On EMS arrival patient was found in the 70s O2 room air, given breathing treatments during route to the ED, she is vaccinated against covid. She has been exposed to family members at home. Denies any hx of diarrheas, abdominal pain, headache, fever or other associated symptoms.  Urine and bowel pattern within normal limits, patient is also aware that she has a mass in her lung and she has been unable to have a CT, since she has been denies twice by her insurance. Patient is independent ADLs and instrumental ADLs. Denies any toxic habits/ former smoker    On admission:   ProBNP is 29783.   Her creatinine is noted to be 5.2.  Previous creatinine from September of 2021 was 2.4.  EKG shows sinus rhythm at 73 beats per minute with incomplete right bundle-branch block.     XR Chest 1V 1. Focal masslike opacity in the left midlung. This may reflect a well-defined focus of consolidation or pneumonia however a mass is not ruled out. Further characterization with CT chest recommended.  2. Left basilar infiltrates and adjacent mild left-sided effusion.  3. Background of COPD and scattered fine reticular opacities suspected chronic. Tested + COVID 10/10/2021 1256"
	"1825340-1"	"1825340-1"	"PLEURAL EFFUSION"	"10035598"	"60-64 years"	"60-64"	"Case of a 65 years old female with past medical history of high blood pressure, HFrEF, COPD, CAD with CABG x 5 and hyperlipidemia presents to the ED due to complaints of shortness of breath,  On EMS arrival patient was found in the 70s O2 room air, given breathing treatments during route to the ED, she is vaccinated against covid. She has been exposed to family members at home. Denies any hx of diarrheas, abdominal pain, headache, fever or other associated symptoms.  Urine and bowel pattern within normal limits, patient is also aware that she has a mass in her lung and she has been unable to have a CT, since she has been denies twice by her insurance. Patient is independent ADLs and instrumental ADLs. Denies any toxic habits/ former smoker    On admission:   ProBNP is 29783.   Her creatinine is noted to be 5.2.  Previous creatinine from September of 2021 was 2.4.  EKG shows sinus rhythm at 73 beats per minute with incomplete right bundle-branch block.     XR Chest 1V 1. Focal masslike opacity in the left midlung. This may reflect a well-defined focus of consolidation or pneumonia however a mass is not ruled out. Further characterization with CT chest recommended.  2. Left basilar infiltrates and adjacent mild left-sided effusion.  3. Background of COPD and scattered fine reticular opacities suspected chronic. Tested + COVID 10/10/2021 1256"
	"1825340-1"	"1825340-1"	"PROHORMONE BRAIN NATRIURETIC PEPTIDE INCREASED"	"10077781"	"60-64 years"	"60-64"	"Case of a 65 years old female with past medical history of high blood pressure, HFrEF, COPD, CAD with CABG x 5 and hyperlipidemia presents to the ED due to complaints of shortness of breath,  On EMS arrival patient was found in the 70s O2 room air, given breathing treatments during route to the ED, she is vaccinated against covid. She has been exposed to family members at home. Denies any hx of diarrheas, abdominal pain, headache, fever or other associated symptoms.  Urine and bowel pattern within normal limits, patient is also aware that she has a mass in her lung and she has been unable to have a CT, since she has been denies twice by her insurance. Patient is independent ADLs and instrumental ADLs. Denies any toxic habits/ former smoker    On admission:   ProBNP is 29783.   Her creatinine is noted to be 5.2.  Previous creatinine from September of 2021 was 2.4.  EKG shows sinus rhythm at 73 beats per minute with incomplete right bundle-branch block.     XR Chest 1V 1. Focal masslike opacity in the left midlung. This may reflect a well-defined focus of consolidation or pneumonia however a mass is not ruled out. Further characterization with CT chest recommended.  2. Left basilar infiltrates and adjacent mild left-sided effusion.  3. Background of COPD and scattered fine reticular opacities suspected chronic. Tested + COVID 10/10/2021 1256"
	"1825340-1"	"1825340-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Case of a 65 years old female with past medical history of high blood pressure, HFrEF, COPD, CAD with CABG x 5 and hyperlipidemia presents to the ED due to complaints of shortness of breath,  On EMS arrival patient was found in the 70s O2 room air, given breathing treatments during route to the ED, she is vaccinated against covid. She has been exposed to family members at home. Denies any hx of diarrheas, abdominal pain, headache, fever or other associated symptoms.  Urine and bowel pattern within normal limits, patient is also aware that she has a mass in her lung and she has been unable to have a CT, since she has been denies twice by her insurance. Patient is independent ADLs and instrumental ADLs. Denies any toxic habits/ former smoker    On admission:   ProBNP is 29783.   Her creatinine is noted to be 5.2.  Previous creatinine from September of 2021 was 2.4.  EKG shows sinus rhythm at 73 beats per minute with incomplete right bundle-branch block.     XR Chest 1V 1. Focal masslike opacity in the left midlung. This may reflect a well-defined focus of consolidation or pneumonia however a mass is not ruled out. Further characterization with CT chest recommended.  2. Left basilar infiltrates and adjacent mild left-sided effusion.  3. Background of COPD and scattered fine reticular opacities suspected chronic. Tested + COVID 10/10/2021 1256"
	"1825631-1"	"1825631-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Death"
	"1825680-1"	"1825680-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient had breakthrough infection and deceased."
	"1825680-1"	"1825680-1"	"SARS-COV-2 TEST"	"10084354"	"60-64 years"	"60-64"	"Patient had breakthrough infection and deceased."
	"1825680-1"	"1825680-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"60-64 years"	"60-64"	"Patient had breakthrough infection and deceased."
	"1828685-1"	"1828685-1"	"ANAEMIA"	"10002034"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"APHASIA"	"10002948"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"ATRIAL FIBRILLATION"	"10003658"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"CHRONIC OBSTRUCTIVE PULMONARY DISEASE"	"10009033"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"CULTURE POSITIVE"	"10061449"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"DYSPNOEA EXERTIONAL"	"10013971"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"DYSPNOEA PAROXYSMAL NOCTURNAL"	"10013974"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"HAEMOPTYSIS"	"10018964"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"HYPOTENSION"	"10021097"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"ORTHOPNOEA"	"10031123"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"PACKED RED BLOOD CELL TRANSFUSION"	"10033359"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"PLATELET TRANSFUSION"	"10035543"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"RENAL FAILURE"	"10038435"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"RESPIRATORY VIRAL PANEL"	"10075165"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"THROMBOCYTOPENIA"	"10043554"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"VENTILATION/PERFUSION SCAN NORMAL"	"10047266"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1828685-1"	"1828685-1"	"WHEEZING"	"10047924"	"60-64 years"	"60-64"	"Janssen COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Janssen Vaccine on 8/26/2021. Patient presented to ED on 10/2/2021 for shortness of breath, coughing and wheezing. Patient has a week of feeling unwell, saying she has had worsening dyspnea on exertion, PND and orthopnea. She also mentions stopping all of her medications for two days when that happened because she was feeling too unwell. 4 days ago, her shortness of breath acutely worsened. She had been dusting and the dust made her wheezing and coughing worse. Shortness of breath became severe enough that she needed to come to the ED. The patient was admitted on 10/3 for COPD exacerbation and COVID pneumonia. She developed worsening hypoxemic respiratory failure with increasing HFNC requirements and was subsequently transferred to the ICU on 10/11. Her renal failure worsened so a femoral quinton was placed but the patient became very hypotensive and hypoxic with every attempt at HD or CRRT. The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Code status was changed to DNAR-COT. Since dialysis made the patient too hypoxic while already on HFNC, the decision was made to not pursue further dialysis and the quinton was removed. Then, the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold. She was started on cefepime and cresemba. Her oxygen requirements decreased and she was transferred back to the floor on 10/19. However, on 10/20 she was brought back to the ICU once again for worsening hypoxia requiring 60L/90% on HFNC. She also developed hemoptysis, anemia, and thrombocytopenia requiring transfusion of platelets and pRBCs. V/Q scan was negative for PE. On 10/23, the patient developed acute word finding difficulty while speaking with family member in the setting of a brief run of afib and ongoing thrombocytopenia. CT brain was ordered to assess for stroke/bleed. However, after discussion with the patient and her daughter, the decision was made to withdraw all support. She was made DNAR-AND and was started on comfort care.  On 10/24/2021, patient was pronounced deceased."
	"1829151-1"	"1829151-1"	"ARTHROPATHY"	"10003285"	"60-64 years"	"60-64"	"First shot was February 8, 2021. A day later he started to lose control of his nerves. He was constantly shaking. He couldn't hold a glass with water without it flying out of his hand accidentally. He needed someone behind him to walk anywhere because he would faint.  The second shot was March 8, 2021. The symptoms got worse. He was not able to walk without a walker, which quickly led him to a wheelchair. There was one day he felt to confident and tried to sit at the counter barstool. His legs gave out, or he fainted, we're not sure, but he landed on the ground and hit his head so hard he was unconscious and he brought him to the hospital. A week later he was on his way out from discharge and he fell again.  He did not leave the hospital again.  His kidneys failed, then his liver, and then his heart. He died on May 14, 2021."
	"1829151-1"	"1829151-1"	"CARDIAC FAILURE"	"10007554"	"60-64 years"	"60-64"	"First shot was February 8, 2021. A day later he started to lose control of his nerves. He was constantly shaking. He couldn't hold a glass with water without it flying out of his hand accidentally. He needed someone behind him to walk anywhere because he would faint.  The second shot was March 8, 2021. The symptoms got worse. He was not able to walk without a walker, which quickly led him to a wheelchair. There was one day he felt to confident and tried to sit at the counter barstool. His legs gave out, or he fainted, we're not sure, but he landed on the ground and hit his head so hard he was unconscious and he brought him to the hospital. A week later he was on his way out from discharge and he fell again.  He did not leave the hospital again.  His kidneys failed, then his liver, and then his heart. He died on May 14, 2021."
	"1829151-1"	"1829151-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"First shot was February 8, 2021. A day later he started to lose control of his nerves. He was constantly shaking. He couldn't hold a glass with water without it flying out of his hand accidentally. He needed someone behind him to walk anywhere because he would faint.  The second shot was March 8, 2021. The symptoms got worse. He was not able to walk without a walker, which quickly led him to a wheelchair. There was one day he felt to confident and tried to sit at the counter barstool. His legs gave out, or he fainted, we're not sure, but he landed on the ground and hit his head so hard he was unconscious and he brought him to the hospital. A week later he was on his way out from discharge and he fell again.  He did not leave the hospital again.  His kidneys failed, then his liver, and then his heart. He died on May 14, 2021."
	"1829151-1"	"1829151-1"	"FALL"	"10016173"	"60-64 years"	"60-64"	"First shot was February 8, 2021. A day later he started to lose control of his nerves. He was constantly shaking. He couldn't hold a glass with water without it flying out of his hand accidentally. He needed someone behind him to walk anywhere because he would faint.  The second shot was March 8, 2021. The symptoms got worse. He was not able to walk without a walker, which quickly led him to a wheelchair. There was one day he felt to confident and tried to sit at the counter barstool. His legs gave out, or he fainted, we're not sure, but he landed on the ground and hit his head so hard he was unconscious and he brought him to the hospital. A week later he was on his way out from discharge and he fell again.  He did not leave the hospital again.  His kidneys failed, then his liver, and then his heart. He died on May 14, 2021."
	"1829151-1"	"1829151-1"	"GAIT DISTURBANCE"	"10017577"	"60-64 years"	"60-64"	"First shot was February 8, 2021. A day later he started to lose control of his nerves. He was constantly shaking. He couldn't hold a glass with water without it flying out of his hand accidentally. He needed someone behind him to walk anywhere because he would faint.  The second shot was March 8, 2021. The symptoms got worse. He was not able to walk without a walker, which quickly led him to a wheelchair. There was one day he felt to confident and tried to sit at the counter barstool. His legs gave out, or he fainted, we're not sure, but he landed on the ground and hit his head so hard he was unconscious and he brought him to the hospital. A week later he was on his way out from discharge and he fell again.  He did not leave the hospital again.  His kidneys failed, then his liver, and then his heart. He died on May 14, 2021."
	"1829151-1"	"1829151-1"	"HEAD INJURY"	"10019196"	"60-64 years"	"60-64"	"First shot was February 8, 2021. A day later he started to lose control of his nerves. He was constantly shaking. He couldn't hold a glass with water without it flying out of his hand accidentally. He needed someone behind him to walk anywhere because he would faint.  The second shot was March 8, 2021. The symptoms got worse. He was not able to walk without a walker, which quickly led him to a wheelchair. There was one day he felt to confident and tried to sit at the counter barstool. His legs gave out, or he fainted, we're not sure, but he landed on the ground and hit his head so hard he was unconscious and he brought him to the hospital. A week later he was on his way out from discharge and he fell again.  He did not leave the hospital again.  His kidneys failed, then his liver, and then his heart. He died on May 14, 2021."
	"1829151-1"	"1829151-1"	"HEPATIC FAILURE"	"10019663"	"60-64 years"	"60-64"	"First shot was February 8, 2021. A day later he started to lose control of his nerves. He was constantly shaking. He couldn't hold a glass with water without it flying out of his hand accidentally. He needed someone behind him to walk anywhere because he would faint.  The second shot was March 8, 2021. The symptoms got worse. He was not able to walk without a walker, which quickly led him to a wheelchair. There was one day he felt to confident and tried to sit at the counter barstool. His legs gave out, or he fainted, we're not sure, but he landed on the ground and hit his head so hard he was unconscious and he brought him to the hospital. A week later he was on his way out from discharge and he fell again.  He did not leave the hospital again.  His kidneys failed, then his liver, and then his heart. He died on May 14, 2021."
	"1829151-1"	"1829151-1"	"LOSS OF CONSCIOUSNESS"	"10024855"	"60-64 years"	"60-64"	"First shot was February 8, 2021. A day later he started to lose control of his nerves. He was constantly shaking. He couldn't hold a glass with water without it flying out of his hand accidentally. He needed someone behind him to walk anywhere because he would faint.  The second shot was March 8, 2021. The symptoms got worse. He was not able to walk without a walker, which quickly led him to a wheelchair. There was one day he felt to confident and tried to sit at the counter barstool. His legs gave out, or he fainted, we're not sure, but he landed on the ground and hit his head so hard he was unconscious and he brought him to the hospital. A week later he was on his way out from discharge and he fell again.  He did not leave the hospital again.  His kidneys failed, then his liver, and then his heart. He died on May 14, 2021."
	"1829151-1"	"1829151-1"	"RENAL FAILURE"	"10038435"	"60-64 years"	"60-64"	"First shot was February 8, 2021. A day later he started to lose control of his nerves. He was constantly shaking. He couldn't hold a glass with water without it flying out of his hand accidentally. He needed someone behind him to walk anywhere because he would faint.  The second shot was March 8, 2021. The symptoms got worse. He was not able to walk without a walker, which quickly led him to a wheelchair. There was one day he felt to confident and tried to sit at the counter barstool. His legs gave out, or he fainted, we're not sure, but he landed on the ground and hit his head so hard he was unconscious and he brought him to the hospital. A week later he was on his way out from discharge and he fell again.  He did not leave the hospital again.  His kidneys failed, then his liver, and then his heart. He died on May 14, 2021."
	"1829151-1"	"1829151-1"	"SYNCOPE"	"10042772"	"60-64 years"	"60-64"	"First shot was February 8, 2021. A day later he started to lose control of his nerves. He was constantly shaking. He couldn't hold a glass with water without it flying out of his hand accidentally. He needed someone behind him to walk anywhere because he would faint.  The second shot was March 8, 2021. The symptoms got worse. He was not able to walk without a walker, which quickly led him to a wheelchair. There was one day he felt to confident and tried to sit at the counter barstool. His legs gave out, or he fainted, we're not sure, but he landed on the ground and hit his head so hard he was unconscious and he brought him to the hospital. A week later he was on his way out from discharge and he fell again.  He did not leave the hospital again.  His kidneys failed, then his liver, and then his heart. He died on May 14, 2021."
	"1829151-1"	"1829151-1"	"WALKING AID USER"	"10050778"	"60-64 years"	"60-64"	"First shot was February 8, 2021. A day later he started to lose control of his nerves. He was constantly shaking. He couldn't hold a glass with water without it flying out of his hand accidentally. He needed someone behind him to walk anywhere because he would faint.  The second shot was March 8, 2021. The symptoms got worse. He was not able to walk without a walker, which quickly led him to a wheelchair. There was one day he felt to confident and tried to sit at the counter barstool. His legs gave out, or he fainted, we're not sure, but he landed on the ground and hit his head so hard he was unconscious and he brought him to the hospital. A week later he was on his way out from discharge and he fell again.  He did not leave the hospital again.  His kidneys failed, then his liver, and then his heart. He died on May 14, 2021."
	"1829151-1"	"1829151-1"	"WHEELCHAIR USER"	"10047920"	"60-64 years"	"60-64"	"First shot was February 8, 2021. A day later he started to lose control of his nerves. He was constantly shaking. He couldn't hold a glass with water without it flying out of his hand accidentally. He needed someone behind him to walk anywhere because he would faint.  The second shot was March 8, 2021. The symptoms got worse. He was not able to walk without a walker, which quickly led him to a wheelchair. There was one day he felt to confident and tried to sit at the counter barstool. His legs gave out, or he fainted, we're not sure, but he landed on the ground and hit his head so hard he was unconscious and he brought him to the hospital. A week later he was on his way out from discharge and he fell again.  He did not leave the hospital again.  His kidneys failed, then his liver, and then his heart. He died on May 14, 2021."
	"1836638-1"	"1836638-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"a 63 y.o. male has history of HFrEF due to ICM, mod-severe MR, CKD II-III, DMII, MI X2 with PCI and  LV thrombus on warfarin. He is currently listed for heart transplant.  Patient complaints of loss of appetite, generalized weakness, mild productive cough, and mild dyspnea since Saturday.  He denies fever, chills, sore throat, nausea, vomiting, abdominal pain, diarrhea, loss of taste or smell.  Patient denies any recent weight gain or weight loss.  He initially went to Emergency Room where he was tested positive for COVID 19.  He was given Tylenol then was transferred for higher level care.    Unknown contact information for provider who cared for the patient.   Review of Systems  Constitutional: Positive for appetite change and fatigue.  Respiratory: Positive for cough and shortness of breath.     Pt remained on warfarin, was started on remdesivir and steriods. Pt was diuresed for fluid overload and developed AKI, lasix were held. Pt had worsening oxygen requirements overnight and was re-started on diuresis. Pt coded and underwent about 1 hour of CPR and was pronounced at 11:28 am."
	"1836638-1"	"1836638-1"	"ANTICOAGULANT THERAPY"	"10053468"	"60-64 years"	"60-64"	"a 63 y.o. male has history of HFrEF due to ICM, mod-severe MR, CKD II-III, DMII, MI X2 with PCI and  LV thrombus on warfarin. He is currently listed for heart transplant.  Patient complaints of loss of appetite, generalized weakness, mild productive cough, and mild dyspnea since Saturday.  He denies fever, chills, sore throat, nausea, vomiting, abdominal pain, diarrhea, loss of taste or smell.  Patient denies any recent weight gain or weight loss.  He initially went to Emergency Room where he was tested positive for COVID 19.  He was given Tylenol then was transferred for higher level care.    Unknown contact information for provider who cared for the patient.   Review of Systems  Constitutional: Positive for appetite change and fatigue.  Respiratory: Positive for cough and shortness of breath.     Pt remained on warfarin, was started on remdesivir and steriods. Pt was diuresed for fluid overload and developed AKI, lasix were held. Pt had worsening oxygen requirements overnight and was re-started on diuresis. Pt coded and underwent about 1 hour of CPR and was pronounced at 11:28 am."
	"1836638-1"	"1836638-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"a 63 y.o. male has history of HFrEF due to ICM, mod-severe MR, CKD II-III, DMII, MI X2 with PCI and  LV thrombus on warfarin. He is currently listed for heart transplant.  Patient complaints of loss of appetite, generalized weakness, mild productive cough, and mild dyspnea since Saturday.  He denies fever, chills, sore throat, nausea, vomiting, abdominal pain, diarrhea, loss of taste or smell.  Patient denies any recent weight gain or weight loss.  He initially went to Emergency Room where he was tested positive for COVID 19.  He was given Tylenol then was transferred for higher level care.    Unknown contact information for provider who cared for the patient.   Review of Systems  Constitutional: Positive for appetite change and fatigue.  Respiratory: Positive for cough and shortness of breath.     Pt remained on warfarin, was started on remdesivir and steriods. Pt was diuresed for fluid overload and developed AKI, lasix were held. Pt had worsening oxygen requirements overnight and was re-started on diuresis. Pt coded and underwent about 1 hour of CPR and was pronounced at 11:28 am."
	"1836638-1"	"1836638-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"a 63 y.o. male has history of HFrEF due to ICM, mod-severe MR, CKD II-III, DMII, MI X2 with PCI and  LV thrombus on warfarin. He is currently listed for heart transplant.  Patient complaints of loss of appetite, generalized weakness, mild productive cough, and mild dyspnea since Saturday.  He denies fever, chills, sore throat, nausea, vomiting, abdominal pain, diarrhea, loss of taste or smell.  Patient denies any recent weight gain or weight loss.  He initially went to Emergency Room where he was tested positive for COVID 19.  He was given Tylenol then was transferred for higher level care.    Unknown contact information for provider who cared for the patient.   Review of Systems  Constitutional: Positive for appetite change and fatigue.  Respiratory: Positive for cough and shortness of breath.     Pt remained on warfarin, was started on remdesivir and steriods. Pt was diuresed for fluid overload and developed AKI, lasix were held. Pt had worsening oxygen requirements overnight and was re-started on diuresis. Pt coded and underwent about 1 hour of CPR and was pronounced at 11:28 am."
	"1836638-1"	"1836638-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"a 63 y.o. male has history of HFrEF due to ICM, mod-severe MR, CKD II-III, DMII, MI X2 with PCI and  LV thrombus on warfarin. He is currently listed for heart transplant.  Patient complaints of loss of appetite, generalized weakness, mild productive cough, and mild dyspnea since Saturday.  He denies fever, chills, sore throat, nausea, vomiting, abdominal pain, diarrhea, loss of taste or smell.  Patient denies any recent weight gain or weight loss.  He initially went to Emergency Room where he was tested positive for COVID 19.  He was given Tylenol then was transferred for higher level care.    Unknown contact information for provider who cared for the patient.   Review of Systems  Constitutional: Positive for appetite change and fatigue.  Respiratory: Positive for cough and shortness of breath.     Pt remained on warfarin, was started on remdesivir and steriods. Pt was diuresed for fluid overload and developed AKI, lasix were held. Pt had worsening oxygen requirements overnight and was re-started on diuresis. Pt coded and underwent about 1 hour of CPR and was pronounced at 11:28 am."
	"1836638-1"	"1836638-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"a 63 y.o. male has history of HFrEF due to ICM, mod-severe MR, CKD II-III, DMII, MI X2 with PCI and  LV thrombus on warfarin. He is currently listed for heart transplant.  Patient complaints of loss of appetite, generalized weakness, mild productive cough, and mild dyspnea since Saturday.  He denies fever, chills, sore throat, nausea, vomiting, abdominal pain, diarrhea, loss of taste or smell.  Patient denies any recent weight gain or weight loss.  He initially went to Emergency Room where he was tested positive for COVID 19.  He was given Tylenol then was transferred for higher level care.    Unknown contact information for provider who cared for the patient.   Review of Systems  Constitutional: Positive for appetite change and fatigue.  Respiratory: Positive for cough and shortness of breath.     Pt remained on warfarin, was started on remdesivir and steriods. Pt was diuresed for fluid overload and developed AKI, lasix were held. Pt had worsening oxygen requirements overnight and was re-started on diuresis. Pt coded and underwent about 1 hour of CPR and was pronounced at 11:28 am."
	"1836638-1"	"1836638-1"	"DECREASED APPETITE"	"10061428"	"60-64 years"	"60-64"	"a 63 y.o. male has history of HFrEF due to ICM, mod-severe MR, CKD II-III, DMII, MI X2 with PCI and  LV thrombus on warfarin. He is currently listed for heart transplant.  Patient complaints of loss of appetite, generalized weakness, mild productive cough, and mild dyspnea since Saturday.  He denies fever, chills, sore throat, nausea, vomiting, abdominal pain, diarrhea, loss of taste or smell.  Patient denies any recent weight gain or weight loss.  He initially went to Emergency Room where he was tested positive for COVID 19.  He was given Tylenol then was transferred for higher level care.    Unknown contact information for provider who cared for the patient.   Review of Systems  Constitutional: Positive for appetite change and fatigue.  Respiratory: Positive for cough and shortness of breath.     Pt remained on warfarin, was started on remdesivir and steriods. Pt was diuresed for fluid overload and developed AKI, lasix were held. Pt had worsening oxygen requirements overnight and was re-started on diuresis. Pt coded and underwent about 1 hour of CPR and was pronounced at 11:28 am."
	"1836638-1"	"1836638-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"a 63 y.o. male has history of HFrEF due to ICM, mod-severe MR, CKD II-III, DMII, MI X2 with PCI and  LV thrombus on warfarin. He is currently listed for heart transplant.  Patient complaints of loss of appetite, generalized weakness, mild productive cough, and mild dyspnea since Saturday.  He denies fever, chills, sore throat, nausea, vomiting, abdominal pain, diarrhea, loss of taste or smell.  Patient denies any recent weight gain or weight loss.  He initially went to Emergency Room where he was tested positive for COVID 19.  He was given Tylenol then was transferred for higher level care.    Unknown contact information for provider who cared for the patient.   Review of Systems  Constitutional: Positive for appetite change and fatigue.  Respiratory: Positive for cough and shortness of breath.     Pt remained on warfarin, was started on remdesivir and steriods. Pt was diuresed for fluid overload and developed AKI, lasix were held. Pt had worsening oxygen requirements overnight and was re-started on diuresis. Pt coded and underwent about 1 hour of CPR and was pronounced at 11:28 am."
	"1836638-1"	"1836638-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"a 63 y.o. male has history of HFrEF due to ICM, mod-severe MR, CKD II-III, DMII, MI X2 with PCI and  LV thrombus on warfarin. He is currently listed for heart transplant.  Patient complaints of loss of appetite, generalized weakness, mild productive cough, and mild dyspnea since Saturday.  He denies fever, chills, sore throat, nausea, vomiting, abdominal pain, diarrhea, loss of taste or smell.  Patient denies any recent weight gain or weight loss.  He initially went to Emergency Room where he was tested positive for COVID 19.  He was given Tylenol then was transferred for higher level care.    Unknown contact information for provider who cared for the patient.   Review of Systems  Constitutional: Positive for appetite change and fatigue.  Respiratory: Positive for cough and shortness of breath.     Pt remained on warfarin, was started on remdesivir and steriods. Pt was diuresed for fluid overload and developed AKI, lasix were held. Pt had worsening oxygen requirements overnight and was re-started on diuresis. Pt coded and underwent about 1 hour of CPR and was pronounced at 11:28 am."
	"1836638-1"	"1836638-1"	"HYPERVOLAEMIA"	"10020919"	"60-64 years"	"60-64"	"a 63 y.o. male has history of HFrEF due to ICM, mod-severe MR, CKD II-III, DMII, MI X2 with PCI and  LV thrombus on warfarin. He is currently listed for heart transplant.  Patient complaints of loss of appetite, generalized weakness, mild productive cough, and mild dyspnea since Saturday.  He denies fever, chills, sore throat, nausea, vomiting, abdominal pain, diarrhea, loss of taste or smell.  Patient denies any recent weight gain or weight loss.  He initially went to Emergency Room where he was tested positive for COVID 19.  He was given Tylenol then was transferred for higher level care.    Unknown contact information for provider who cared for the patient.   Review of Systems  Constitutional: Positive for appetite change and fatigue.  Respiratory: Positive for cough and shortness of breath.     Pt remained on warfarin, was started on remdesivir and steriods. Pt was diuresed for fluid overload and developed AKI, lasix were held. Pt had worsening oxygen requirements overnight and was re-started on diuresis. Pt coded and underwent about 1 hour of CPR and was pronounced at 11:28 am."
	"1836638-1"	"1836638-1"	"POLYURIA"	"10036142"	"60-64 years"	"60-64"	"a 63 y.o. male has history of HFrEF due to ICM, mod-severe MR, CKD II-III, DMII, MI X2 with PCI and  LV thrombus on warfarin. He is currently listed for heart transplant.  Patient complaints of loss of appetite, generalized weakness, mild productive cough, and mild dyspnea since Saturday.  He denies fever, chills, sore throat, nausea, vomiting, abdominal pain, diarrhea, loss of taste or smell.  Patient denies any recent weight gain or weight loss.  He initially went to Emergency Room where he was tested positive for COVID 19.  He was given Tylenol then was transferred for higher level care.    Unknown contact information for provider who cared for the patient.   Review of Systems  Constitutional: Positive for appetite change and fatigue.  Respiratory: Positive for cough and shortness of breath.     Pt remained on warfarin, was started on remdesivir and steriods. Pt was diuresed for fluid overload and developed AKI, lasix were held. Pt had worsening oxygen requirements overnight and was re-started on diuresis. Pt coded and underwent about 1 hour of CPR and was pronounced at 11:28 am."
	"1836638-1"	"1836638-1"	"PRODUCTIVE COUGH"	"10036790"	"60-64 years"	"60-64"	"a 63 y.o. male has history of HFrEF due to ICM, mod-severe MR, CKD II-III, DMII, MI X2 with PCI and  LV thrombus on warfarin. He is currently listed for heart transplant.  Patient complaints of loss of appetite, generalized weakness, mild productive cough, and mild dyspnea since Saturday.  He denies fever, chills, sore throat, nausea, vomiting, abdominal pain, diarrhea, loss of taste or smell.  Patient denies any recent weight gain or weight loss.  He initially went to Emergency Room where he was tested positive for COVID 19.  He was given Tylenol then was transferred for higher level care.    Unknown contact information for provider who cared for the patient.   Review of Systems  Constitutional: Positive for appetite change and fatigue.  Respiratory: Positive for cough and shortness of breath.     Pt remained on warfarin, was started on remdesivir and steriods. Pt was diuresed for fluid overload and developed AKI, lasix were held. Pt had worsening oxygen requirements overnight and was re-started on diuresis. Pt coded and underwent about 1 hour of CPR and was pronounced at 11:28 am."
	"1836638-1"	"1836638-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"a 63 y.o. male has history of HFrEF due to ICM, mod-severe MR, CKD II-III, DMII, MI X2 with PCI and  LV thrombus on warfarin. He is currently listed for heart transplant.  Patient complaints of loss of appetite, generalized weakness, mild productive cough, and mild dyspnea since Saturday.  He denies fever, chills, sore throat, nausea, vomiting, abdominal pain, diarrhea, loss of taste or smell.  Patient denies any recent weight gain or weight loss.  He initially went to Emergency Room where he was tested positive for COVID 19.  He was given Tylenol then was transferred for higher level care.    Unknown contact information for provider who cared for the patient.   Review of Systems  Constitutional: Positive for appetite change and fatigue.  Respiratory: Positive for cough and shortness of breath.     Pt remained on warfarin, was started on remdesivir and steriods. Pt was diuresed for fluid overload and developed AKI, lasix were held. Pt had worsening oxygen requirements overnight and was re-started on diuresis. Pt coded and underwent about 1 hour of CPR and was pronounced at 11:28 am."
	"1836638-1"	"1836638-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"a 63 y.o. male has history of HFrEF due to ICM, mod-severe MR, CKD II-III, DMII, MI X2 with PCI and  LV thrombus on warfarin. He is currently listed for heart transplant.  Patient complaints of loss of appetite, generalized weakness, mild productive cough, and mild dyspnea since Saturday.  He denies fever, chills, sore throat, nausea, vomiting, abdominal pain, diarrhea, loss of taste or smell.  Patient denies any recent weight gain or weight loss.  He initially went to Emergency Room where he was tested positive for COVID 19.  He was given Tylenol then was transferred for higher level care.    Unknown contact information for provider who cared for the patient.   Review of Systems  Constitutional: Positive for appetite change and fatigue.  Respiratory: Positive for cough and shortness of breath.     Pt remained on warfarin, was started on remdesivir and steriods. Pt was diuresed for fluid overload and developed AKI, lasix were held. Pt had worsening oxygen requirements overnight and was re-started on diuresis. Pt coded and underwent about 1 hour of CPR and was pronounced at 11:28 am."
	"1839197-1"	"1839197-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"60-64 years"	"60-64"	""a Acute MI of the LAD; pulmonary embolism that resulted in sudden death; sudden death; symptoms of fatigue; fever; congestion; This is a spontaneous report from a contactable consumer (patient's wife) reported for her husband (the patient). A 62-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), dose 2 via an unspecified route of administration, administered in Arm Left on 27Sep2021 10:00 (Lot Number: 301358A) at the age of 62-year-old as single dose for covid-19 immunization at a Pharmacy or Drug Store. Medical history included COVID prior vaccination, Asthma, Atrial fibrillation (A-fib), Hyperlipidemia, bradycardia, Obstructive Sleep Apnea, Mild mitral and tricuspid regurgitation. No known allergies. Concomitant medications included apixaban (ELIQUIS); atorvastatin calcium (LIPITOR); digoxin; flecainide; and tadalafil (CIALIS); all taken for unspecified indications, start and stop dates were not reported. No other vaccine in four weeks. Historical vaccine included bnt162b2, dose 1 on 06Sep2021 11:00 (Lot Number: 301308A) at the age of 62-year-old for covid-19 immunization. The reporter's husband had a Acute MI (myocardial infarction) of the LAD (left anterior descending) on 03Oct2021, six days after second Covid-19 and pulmonary embolism that resulted in sudden death. He experienced symptoms of fatigue, fever, congestion after both vaccines. The above mentioned events were reported as started from On 03Oct2021 17:30, and resulted in patient died. No treatment for the above mentioned events. The patient died on 03Oct2021. Also reported death causes as Acute MI and pulmonary embolism. An autopsy was performed that remarked ""Acute MI to LAD"". No COVID tested post vaccination.; Reported Cause(s) of Death: congestion; fever; sudden death; symptoms of fatigue; pulmonary embolism; a Acute MI of the LAD; Autopsy-determined Cause(s) of Death: Acute MI to LAD""
	"1839197-1"	"1839197-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	""a Acute MI of the LAD; pulmonary embolism that resulted in sudden death; sudden death; symptoms of fatigue; fever; congestion; This is a spontaneous report from a contactable consumer (patient's wife) reported for her husband (the patient). A 62-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), dose 2 via an unspecified route of administration, administered in Arm Left on 27Sep2021 10:00 (Lot Number: 301358A) at the age of 62-year-old as single dose for covid-19 immunization at a Pharmacy or Drug Store. Medical history included COVID prior vaccination, Asthma, Atrial fibrillation (A-fib), Hyperlipidemia, bradycardia, Obstructive Sleep Apnea, Mild mitral and tricuspid regurgitation. No known allergies. Concomitant medications included apixaban (ELIQUIS); atorvastatin calcium (LIPITOR); digoxin; flecainide; and tadalafil (CIALIS); all taken for unspecified indications, start and stop dates were not reported. No other vaccine in four weeks. Historical vaccine included bnt162b2, dose 1 on 06Sep2021 11:00 (Lot Number: 301308A) at the age of 62-year-old for covid-19 immunization. The reporter's husband had a Acute MI (myocardial infarction) of the LAD (left anterior descending) on 03Oct2021, six days after second Covid-19 and pulmonary embolism that resulted in sudden death. He experienced symptoms of fatigue, fever, congestion after both vaccines. The above mentioned events were reported as started from On 03Oct2021 17:30, and resulted in patient died. No treatment for the above mentioned events. The patient died on 03Oct2021. Also reported death causes as Acute MI and pulmonary embolism. An autopsy was performed that remarked ""Acute MI to LAD"". No COVID tested post vaccination.; Reported Cause(s) of Death: congestion; fever; sudden death; symptoms of fatigue; pulmonary embolism; a Acute MI of the LAD; Autopsy-determined Cause(s) of Death: Acute MI to LAD""
	"1839197-1"	"1839197-1"	"NASAL CONGESTION"	"10028735"	"60-64 years"	"60-64"	""a Acute MI of the LAD; pulmonary embolism that resulted in sudden death; sudden death; symptoms of fatigue; fever; congestion; This is a spontaneous report from a contactable consumer (patient's wife) reported for her husband (the patient). A 62-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), dose 2 via an unspecified route of administration, administered in Arm Left on 27Sep2021 10:00 (Lot Number: 301358A) at the age of 62-year-old as single dose for covid-19 immunization at a Pharmacy or Drug Store. Medical history included COVID prior vaccination, Asthma, Atrial fibrillation (A-fib), Hyperlipidemia, bradycardia, Obstructive Sleep Apnea, Mild mitral and tricuspid regurgitation. No known allergies. Concomitant medications included apixaban (ELIQUIS); atorvastatin calcium (LIPITOR); digoxin; flecainide; and tadalafil (CIALIS); all taken for unspecified indications, start and stop dates were not reported. No other vaccine in four weeks. Historical vaccine included bnt162b2, dose 1 on 06Sep2021 11:00 (Lot Number: 301308A) at the age of 62-year-old for covid-19 immunization. The reporter's husband had a Acute MI (myocardial infarction) of the LAD (left anterior descending) on 03Oct2021, six days after second Covid-19 and pulmonary embolism that resulted in sudden death. He experienced symptoms of fatigue, fever, congestion after both vaccines. The above mentioned events were reported as started from On 03Oct2021 17:30, and resulted in patient died. No treatment for the above mentioned events. The patient died on 03Oct2021. Also reported death causes as Acute MI and pulmonary embolism. An autopsy was performed that remarked ""Acute MI to LAD"". No COVID tested post vaccination.; Reported Cause(s) of Death: congestion; fever; sudden death; symptoms of fatigue; pulmonary embolism; a Acute MI of the LAD; Autopsy-determined Cause(s) of Death: Acute MI to LAD""
	"1839197-1"	"1839197-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	""a Acute MI of the LAD; pulmonary embolism that resulted in sudden death; sudden death; symptoms of fatigue; fever; congestion; This is a spontaneous report from a contactable consumer (patient's wife) reported for her husband (the patient). A 62-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), dose 2 via an unspecified route of administration, administered in Arm Left on 27Sep2021 10:00 (Lot Number: 301358A) at the age of 62-year-old as single dose for covid-19 immunization at a Pharmacy or Drug Store. Medical history included COVID prior vaccination, Asthma, Atrial fibrillation (A-fib), Hyperlipidemia, bradycardia, Obstructive Sleep Apnea, Mild mitral and tricuspid regurgitation. No known allergies. Concomitant medications included apixaban (ELIQUIS); atorvastatin calcium (LIPITOR); digoxin; flecainide; and tadalafil (CIALIS); all taken for unspecified indications, start and stop dates were not reported. No other vaccine in four weeks. Historical vaccine included bnt162b2, dose 1 on 06Sep2021 11:00 (Lot Number: 301308A) at the age of 62-year-old for covid-19 immunization. The reporter's husband had a Acute MI (myocardial infarction) of the LAD (left anterior descending) on 03Oct2021, six days after second Covid-19 and pulmonary embolism that resulted in sudden death. He experienced symptoms of fatigue, fever, congestion after both vaccines. The above mentioned events were reported as started from On 03Oct2021 17:30, and resulted in patient died. No treatment for the above mentioned events. The patient died on 03Oct2021. Also reported death causes as Acute MI and pulmonary embolism. An autopsy was performed that remarked ""Acute MI to LAD"". No COVID tested post vaccination.; Reported Cause(s) of Death: congestion; fever; sudden death; symptoms of fatigue; pulmonary embolism; a Acute MI of the LAD; Autopsy-determined Cause(s) of Death: Acute MI to LAD""
	"1839197-1"	"1839197-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	""a Acute MI of the LAD; pulmonary embolism that resulted in sudden death; sudden death; symptoms of fatigue; fever; congestion; This is a spontaneous report from a contactable consumer (patient's wife) reported for her husband (the patient). A 62-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), dose 2 via an unspecified route of administration, administered in Arm Left on 27Sep2021 10:00 (Lot Number: 301358A) at the age of 62-year-old as single dose for covid-19 immunization at a Pharmacy or Drug Store. Medical history included COVID prior vaccination, Asthma, Atrial fibrillation (A-fib), Hyperlipidemia, bradycardia, Obstructive Sleep Apnea, Mild mitral and tricuspid regurgitation. No known allergies. Concomitant medications included apixaban (ELIQUIS); atorvastatin calcium (LIPITOR); digoxin; flecainide; and tadalafil (CIALIS); all taken for unspecified indications, start and stop dates were not reported. No other vaccine in four weeks. Historical vaccine included bnt162b2, dose 1 on 06Sep2021 11:00 (Lot Number: 301308A) at the age of 62-year-old for covid-19 immunization. The reporter's husband had a Acute MI (myocardial infarction) of the LAD (left anterior descending) on 03Oct2021, six days after second Covid-19 and pulmonary embolism that resulted in sudden death. He experienced symptoms of fatigue, fever, congestion after both vaccines. The above mentioned events were reported as started from On 03Oct2021 17:30, and resulted in patient died. No treatment for the above mentioned events. The patient died on 03Oct2021. Also reported death causes as Acute MI and pulmonary embolism. An autopsy was performed that remarked ""Acute MI to LAD"". No COVID tested post vaccination.; Reported Cause(s) of Death: congestion; fever; sudden death; symptoms of fatigue; pulmonary embolism; a Acute MI of the LAD; Autopsy-determined Cause(s) of Death: Acute MI to LAD""
	"1839197-1"	"1839197-1"	"SUDDEN DEATH"	"10042434"	"60-64 years"	"60-64"	""a Acute MI of the LAD; pulmonary embolism that resulted in sudden death; sudden death; symptoms of fatigue; fever; congestion; This is a spontaneous report from a contactable consumer (patient's wife) reported for her husband (the patient). A 62-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 MRNA VACCINE), dose 2 via an unspecified route of administration, administered in Arm Left on 27Sep2021 10:00 (Lot Number: 301358A) at the age of 62-year-old as single dose for covid-19 immunization at a Pharmacy or Drug Store. Medical history included COVID prior vaccination, Asthma, Atrial fibrillation (A-fib), Hyperlipidemia, bradycardia, Obstructive Sleep Apnea, Mild mitral and tricuspid regurgitation. No known allergies. Concomitant medications included apixaban (ELIQUIS); atorvastatin calcium (LIPITOR); digoxin; flecainide; and tadalafil (CIALIS); all taken for unspecified indications, start and stop dates were not reported. No other vaccine in four weeks. Historical vaccine included bnt162b2, dose 1 on 06Sep2021 11:00 (Lot Number: 301308A) at the age of 62-year-old for covid-19 immunization. The reporter's husband had a Acute MI (myocardial infarction) of the LAD (left anterior descending) on 03Oct2021, six days after second Covid-19 and pulmonary embolism that resulted in sudden death. He experienced symptoms of fatigue, fever, congestion after both vaccines. The above mentioned events were reported as started from On 03Oct2021 17:30, and resulted in patient died. No treatment for the above mentioned events. The patient died on 03Oct2021. Also reported death causes as Acute MI and pulmonary embolism. An autopsy was performed that remarked ""Acute MI to LAD"". No COVID tested post vaccination.; Reported Cause(s) of Death: congestion; fever; sudden death; symptoms of fatigue; pulmonary embolism; a Acute MI of the LAD; Autopsy-determined Cause(s) of Death: Acute MI to LAD""
	"1840132-1"	"1840132-1"	"ACUTE RESPIRATORY FAILURE"	"10001053"	"60-64 years"	"60-64"	"pt brought to ED by EMS unresponsive; intubated for acute hypoxic respiratory failure and airway protection; positive for COVID; pt in DKA; given insulin, tocilizimab, and steroids; pt became bradycardic and hypoxic; pt went into cardiac arrest and she died in the ED"
	"1840132-1"	"1840132-1"	"BRADYCARDIA"	"10006093"	"60-64 years"	"60-64"	"pt brought to ED by EMS unresponsive; intubated for acute hypoxic respiratory failure and airway protection; positive for COVID; pt in DKA; given insulin, tocilizimab, and steroids; pt became bradycardic and hypoxic; pt went into cardiac arrest and she died in the ED"
	"1840132-1"	"1840132-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"pt brought to ED by EMS unresponsive; intubated for acute hypoxic respiratory failure and airway protection; positive for COVID; pt in DKA; given insulin, tocilizimab, and steroids; pt became bradycardic and hypoxic; pt went into cardiac arrest and she died in the ED"
	"1840132-1"	"1840132-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"pt brought to ED by EMS unresponsive; intubated for acute hypoxic respiratory failure and airway protection; positive for COVID; pt in DKA; given insulin, tocilizimab, and steroids; pt became bradycardic and hypoxic; pt went into cardiac arrest and she died in the ED"
	"1840132-1"	"1840132-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"pt brought to ED by EMS unresponsive; intubated for acute hypoxic respiratory failure and airway protection; positive for COVID; pt in DKA; given insulin, tocilizimab, and steroids; pt became bradycardic and hypoxic; pt went into cardiac arrest and she died in the ED"
	"1840132-1"	"1840132-1"	"DIABETIC KETOACIDOSIS"	"10012671"	"60-64 years"	"60-64"	"pt brought to ED by EMS unresponsive; intubated for acute hypoxic respiratory failure and airway protection; positive for COVID; pt in DKA; given insulin, tocilizimab, and steroids; pt became bradycardic and hypoxic; pt went into cardiac arrest and she died in the ED"
	"1840132-1"	"1840132-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"pt brought to ED by EMS unresponsive; intubated for acute hypoxic respiratory failure and airway protection; positive for COVID; pt in DKA; given insulin, tocilizimab, and steroids; pt became bradycardic and hypoxic; pt went into cardiac arrest and she died in the ED"
	"1840132-1"	"1840132-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"pt brought to ED by EMS unresponsive; intubated for acute hypoxic respiratory failure and airway protection; positive for COVID; pt in DKA; given insulin, tocilizimab, and steroids; pt became bradycardic and hypoxic; pt went into cardiac arrest and she died in the ED"
	"1840132-1"	"1840132-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"pt brought to ED by EMS unresponsive; intubated for acute hypoxic respiratory failure and airway protection; positive for COVID; pt in DKA; given insulin, tocilizimab, and steroids; pt became bradycardic and hypoxic; pt went into cardiac arrest and she died in the ED"
	"1840132-1"	"1840132-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"pt brought to ED by EMS unresponsive; intubated for acute hypoxic respiratory failure and airway protection; positive for COVID; pt in DKA; given insulin, tocilizimab, and steroids; pt became bradycardic and hypoxic; pt went into cardiac arrest and she died in the ED"
	"1842897-1"	"1842897-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"pt hospitalized at another hosp approx 1 wk ago, tested positive for COVID, dc'd to home on steroids and home O2 @ 3 LPM via NC; called EMS with c/o dyspnea, fever, and chest pain; presented to ED with worsening SOB, hypoxic; COVID test was positive; DNI; on NRB mask; admitted to ICU; pt's condition worsened and she was moved to comfort care measures; BiPAP mask removed and she passed away in the hospital"
	"1842897-1"	"1842897-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"pt hospitalized at another hosp approx 1 wk ago, tested positive for COVID, dc'd to home on steroids and home O2 @ 3 LPM via NC; called EMS with c/o dyspnea, fever, and chest pain; presented to ED with worsening SOB, hypoxic; COVID test was positive; DNI; on NRB mask; admitted to ICU; pt's condition worsened and she was moved to comfort care measures; BiPAP mask removed and she passed away in the hospital"
	"1842897-1"	"1842897-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"pt hospitalized at another hosp approx 1 wk ago, tested positive for COVID, dc'd to home on steroids and home O2 @ 3 LPM via NC; called EMS with c/o dyspnea, fever, and chest pain; presented to ED with worsening SOB, hypoxic; COVID test was positive; DNI; on NRB mask; admitted to ICU; pt's condition worsened and she was moved to comfort care measures; BiPAP mask removed and she passed away in the hospital"
	"1842897-1"	"1842897-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"pt hospitalized at another hosp approx 1 wk ago, tested positive for COVID, dc'd to home on steroids and home O2 @ 3 LPM via NC; called EMS with c/o dyspnea, fever, and chest pain; presented to ED with worsening SOB, hypoxic; COVID test was positive; DNI; on NRB mask; admitted to ICU; pt's condition worsened and she was moved to comfort care measures; BiPAP mask removed and she passed away in the hospital"
	"1842897-1"	"1842897-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"pt hospitalized at another hosp approx 1 wk ago, tested positive for COVID, dc'd to home on steroids and home O2 @ 3 LPM via NC; called EMS with c/o dyspnea, fever, and chest pain; presented to ED with worsening SOB, hypoxic; COVID test was positive; DNI; on NRB mask; admitted to ICU; pt's condition worsened and she was moved to comfort care measures; BiPAP mask removed and she passed away in the hospital"
	"1842897-1"	"1842897-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"pt hospitalized at another hosp approx 1 wk ago, tested positive for COVID, dc'd to home on steroids and home O2 @ 3 LPM via NC; called EMS with c/o dyspnea, fever, and chest pain; presented to ED with worsening SOB, hypoxic; COVID test was positive; DNI; on NRB mask; admitted to ICU; pt's condition worsened and she was moved to comfort care measures; BiPAP mask removed and she passed away in the hospital"
	"1842897-1"	"1842897-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"60-64 years"	"60-64"	"pt hospitalized at another hosp approx 1 wk ago, tested positive for COVID, dc'd to home on steroids and home O2 @ 3 LPM via NC; called EMS with c/o dyspnea, fever, and chest pain; presented to ED with worsening SOB, hypoxic; COVID test was positive; DNI; on NRB mask; admitted to ICU; pt's condition worsened and she was moved to comfort care measures; BiPAP mask removed and she passed away in the hospital"
	"1842897-1"	"1842897-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"pt hospitalized at another hosp approx 1 wk ago, tested positive for COVID, dc'd to home on steroids and home O2 @ 3 LPM via NC; called EMS with c/o dyspnea, fever, and chest pain; presented to ED with worsening SOB, hypoxic; COVID test was positive; DNI; on NRB mask; admitted to ICU; pt's condition worsened and she was moved to comfort care measures; BiPAP mask removed and she passed away in the hospital"
	"1842897-1"	"1842897-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"pt hospitalized at another hosp approx 1 wk ago, tested positive for COVID, dc'd to home on steroids and home O2 @ 3 LPM via NC; called EMS with c/o dyspnea, fever, and chest pain; presented to ED with worsening SOB, hypoxic; COVID test was positive; DNI; on NRB mask; admitted to ICU; pt's condition worsened and she was moved to comfort care measures; BiPAP mask removed and she passed away in the hospital"
	"1843289-1"	"1843289-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient received the vaccination one week prior to death"
	"1846613-1"	"1846613-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"They had a breakthrough infection and expired."
	"1846613-1"	"1846613-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"They had a breakthrough infection and expired."
	"1846613-1"	"1846613-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"They had a breakthrough infection and expired."
	"1846613-1"	"1846613-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"60-64 years"	"60-64"	"They had a breakthrough infection and expired."
	"1847400-1"	"1847400-1"	"PHARYNGEAL SWELLING"	"10082270"	"60-64 years"	"60-64"	"Swollen throat"
	"1848575-1"	"1848575-1"	"BRAIN INJURY"	"10067967"	"60-64 years"	"60-64"	"3 heart attacks; Cardiac arrest; kidneys started shutting down; brain damage; liver was shutting down; she slipped when she stood up; This is a spontaneous report from a contactable consumer (patient's sister). A 64-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Right on 10Sep2021 10:11 (Batch/Lot Number: FE2588) as single dose for covid-19 immunisation (age at vaccination was 64-year-old). Medical history was reported as patient was allergic to penicillin which caused her to have a stroke when she was a baby (2 years old). The penicillin caused her to be paralyzed on her left side. She was slobbered, she could not help it. She could not swallow like the typical person could. She couldn't even close her eyes, she could not blink normally. She had to wait to fall asleep when her eyes could not hold themselves open anymore and would come together on their own. She had a little allergies to things but because they live in the mountains and surrounded by trees, there was all kinds of pollen. She did sneeze, but it was nothing she took any medicine for. The caller confirmed it was something they already had prior to receiving the COVID-19 shot. She had a stroke when she was young and it took her vocal cords so her sister cannot talk. Patient was handicapped. Patient had seizure. Patient had constipation and stomach pain.  Concomitant medications included phenobarbital sodium (PHENOBARBITAL [PHENOBARBITAL SODIUM]) taken for seizure, start and stop date were not reported; phenytoin sodium (DILANTIN D.A.) taken for seizure, start and stop date were not reported. The patient previously took macrogol 3350 (MIRALAX) for constipated (prescribed macrogol to get her bowels moving. Patient was constipated for maybe about a week. The caller clarifies the constipation began prior to receiving the COVID-19 shot. When they went and saw the neurologist on 08Sep2021, the doctor wrote patient a prescription for it. Her sister was constipated already. Her sister did go to the bathroom well, but she had not went for about a week. Her stomach was hurting so the doctor thought it was better to start giving her sister the MiraLAX). Patient did not receive other vaccinations within four weeks prior to the first administration date of the suspect vaccine. The patient experienced slipped when she stood up, 3 heart attacks, cardiac arrest, kidneys started shutting down, brain damage and liver was shutting down, all on 19Sep2021 with outcome of fatal. The patient was hospitalized for the events from 19Sep2021 to 20Sep2021. The patient underwent lab test which included heart rate: no pulse on 19Sep2021. Therapeutic measures were taken as a result the events. The patient died on 20Sep2021. An autopsy was not performed. The events resulted in Emergency Room Visit.  Clinical course was reported as on 10Sep2021, patient had their first Pfizer COVID-19 shot. On 19Sep2021, patient was on the floor. The caller clarifies she would walk over to her sister's house to make sure her sister took her medications. The caller stated back in the middle of last year, she discovered her sister was not taking her meds like she was supposed to, she was going off of her schedule. At that point last year, the caller took her sister to the ER to make sure everything was okay. Apparently, they had changed her sister's phenobarbital dose from three times a day to one pill which was causing her sister to hallucinate, her sister was seeing things. They saw her sister in the ER and then the caller began to go over to her sisters three times a day, once at 08:00, then at 13:00, then at 16:00. On 19Sep2021, the caller had gotten her sister breakfast. The caller explains her sister ate and took her medication and was fine. Her sister started getting kind of tired but the caller thought it was due to her sister having a stomach problem. The caller clarified her sister was constipated and her sister said she quit drinking her coffee because it hurt her stomach. So, the caller thought her sister was tired maybe because of that. Later in the evening of 19Sep2021, around 16:00, the caller found her sister on the floor. She clarified her sister wasn't dead. She asked her sister if she had a seizure and her sister waved her hand down and explained she slipped when she stood up. The caller clarifies her sister had a stroke when she was young and it took her vocal cords so her sister cant talk. The stroke also paralyzed her sister on the left side so she is only able to sign language with one hand. The caller explains she was talking to her sister. She asked her sister if she knew who she was and her sister signed her name, Privacy, in her hand (there is a certain way her name is used in sign language for one handed people). The caller was trying to get her sister up but couldn't. The caller had to get her son to help. Her sister could not walk, so they had to carry the patient into the living room. The caller called 911, however, because of the way the trailer was set up, they could not get the gurney through to the bedroom, so her sister had to be carried into the living room where the couch was. When the ambulance showed up, they said her sister had no pulse although the caller had just talked to her. The caller explains it had been 3-4 minutes, at most 5 minutes, and when the ambulance did show up, her sisters eyes were open and everything. They were feeling for a pulse and could not find one. The ambulance used the machine for the heart to try and get her heartbeat to come back. The caller explains it took about 30 minutes to get a pulse, and they ended up going to the hospital. The caller was told they got a slight pulse at the ER doors. Her sister of course could not talk, but because of COVID, the hospital wouldnt allow the caller to go back with her sister. Apparently, there were four positive cases at the hospital. Her sister was put on a ventilator. The caller explains she sat there for a long, long time- it seemed like forever, where they would not let the caller see her sister or nothing. Then, the doctor came out and explained to the caller that because her sister did not have a pulse, her kidneys started shutting down. Her liver was shutting down. The doctor shined the light in her sister's eyes and there was no response. Her eyes were dilated, which could be an indication of brain damage. The caller clarified further she went over to her sister house on 19Sep2021 where she found her on the floor and then she had no heartbeat. But apparently, they got her heartbeat back the next day so they pronounced her dead on 20Sep2021. She received a phone call informing her that her sister passed way at 06:19 on 20Sep2021. Her sister had 3 heart attacks the night of 19Sep2021 in the ER waiting for a room. One was a code blue.  Follow-up attempts are completed. No further information is expected.; Reported Cause(s) of Death: she slipped when she stood up; kidneys started shutting down; brain damage; liver was shutting down; 3 heart attacks; Cardiac arrest"
	"1848575-1"	"1848575-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"3 heart attacks; Cardiac arrest; kidneys started shutting down; brain damage; liver was shutting down; she slipped when she stood up; This is a spontaneous report from a contactable consumer (patient's sister). A 64-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Right on 10Sep2021 10:11 (Batch/Lot Number: FE2588) as single dose for covid-19 immunisation (age at vaccination was 64-year-old). Medical history was reported as patient was allergic to penicillin which caused her to have a stroke when she was a baby (2 years old). The penicillin caused her to be paralyzed on her left side. She was slobbered, she could not help it. She could not swallow like the typical person could. She couldn't even close her eyes, she could not blink normally. She had to wait to fall asleep when her eyes could not hold themselves open anymore and would come together on their own. She had a little allergies to things but because they live in the mountains and surrounded by trees, there was all kinds of pollen. She did sneeze, but it was nothing she took any medicine for. The caller confirmed it was something they already had prior to receiving the COVID-19 shot. She had a stroke when she was young and it took her vocal cords so her sister cannot talk. Patient was handicapped. Patient had seizure. Patient had constipation and stomach pain.  Concomitant medications included phenobarbital sodium (PHENOBARBITAL [PHENOBARBITAL SODIUM]) taken for seizure, start and stop date were not reported; phenytoin sodium (DILANTIN D.A.) taken for seizure, start and stop date were not reported. The patient previously took macrogol 3350 (MIRALAX) for constipated (prescribed macrogol to get her bowels moving. Patient was constipated for maybe about a week. The caller clarifies the constipation began prior to receiving the COVID-19 shot. When they went and saw the neurologist on 08Sep2021, the doctor wrote patient a prescription for it. Her sister was constipated already. Her sister did go to the bathroom well, but she had not went for about a week. Her stomach was hurting so the doctor thought it was better to start giving her sister the MiraLAX). Patient did not receive other vaccinations within four weeks prior to the first administration date of the suspect vaccine. The patient experienced slipped when she stood up, 3 heart attacks, cardiac arrest, kidneys started shutting down, brain damage and liver was shutting down, all on 19Sep2021 with outcome of fatal. The patient was hospitalized for the events from 19Sep2021 to 20Sep2021. The patient underwent lab test which included heart rate: no pulse on 19Sep2021. Therapeutic measures were taken as a result the events. The patient died on 20Sep2021. An autopsy was not performed. The events resulted in Emergency Room Visit.  Clinical course was reported as on 10Sep2021, patient had their first Pfizer COVID-19 shot. On 19Sep2021, patient was on the floor. The caller clarifies she would walk over to her sister's house to make sure her sister took her medications. The caller stated back in the middle of last year, she discovered her sister was not taking her meds like she was supposed to, she was going off of her schedule. At that point last year, the caller took her sister to the ER to make sure everything was okay. Apparently, they had changed her sister's phenobarbital dose from three times a day to one pill which was causing her sister to hallucinate, her sister was seeing things. They saw her sister in the ER and then the caller began to go over to her sisters three times a day, once at 08:00, then at 13:00, then at 16:00. On 19Sep2021, the caller had gotten her sister breakfast. The caller explains her sister ate and took her medication and was fine. Her sister started getting kind of tired but the caller thought it was due to her sister having a stomach problem. The caller clarified her sister was constipated and her sister said she quit drinking her coffee because it hurt her stomach. So, the caller thought her sister was tired maybe because of that. Later in the evening of 19Sep2021, around 16:00, the caller found her sister on the floor. She clarified her sister wasn't dead. She asked her sister if she had a seizure and her sister waved her hand down and explained she slipped when she stood up. The caller clarifies her sister had a stroke when she was young and it took her vocal cords so her sister cant talk. The stroke also paralyzed her sister on the left side so she is only able to sign language with one hand. The caller explains she was talking to her sister. She asked her sister if she knew who she was and her sister signed her name, Privacy, in her hand (there is a certain way her name is used in sign language for one handed people). The caller was trying to get her sister up but couldn't. The caller had to get her son to help. Her sister could not walk, so they had to carry the patient into the living room. The caller called 911, however, because of the way the trailer was set up, they could not get the gurney through to the bedroom, so her sister had to be carried into the living room where the couch was. When the ambulance showed up, they said her sister had no pulse although the caller had just talked to her. The caller explains it had been 3-4 minutes, at most 5 minutes, and when the ambulance did show up, her sisters eyes were open and everything. They were feeling for a pulse and could not find one. The ambulance used the machine for the heart to try and get her heartbeat to come back. The caller explains it took about 30 minutes to get a pulse, and they ended up going to the hospital. The caller was told they got a slight pulse at the ER doors. Her sister of course could not talk, but because of COVID, the hospital wouldnt allow the caller to go back with her sister. Apparently, there were four positive cases at the hospital. Her sister was put on a ventilator. The caller explains she sat there for a long, long time- it seemed like forever, where they would not let the caller see her sister or nothing. Then, the doctor came out and explained to the caller that because her sister did not have a pulse, her kidneys started shutting down. Her liver was shutting down. The doctor shined the light in her sister's eyes and there was no response. Her eyes were dilated, which could be an indication of brain damage. The caller clarified further she went over to her sister house on 19Sep2021 where she found her on the floor and then she had no heartbeat. But apparently, they got her heartbeat back the next day so they pronounced her dead on 20Sep2021. She received a phone call informing her that her sister passed way at 06:19 on 20Sep2021. Her sister had 3 heart attacks the night of 19Sep2021 in the ER waiting for a room. One was a code blue.  Follow-up attempts are completed. No further information is expected.; Reported Cause(s) of Death: she slipped when she stood up; kidneys started shutting down; brain damage; liver was shutting down; 3 heart attacks; Cardiac arrest"
	"1848575-1"	"1848575-1"	"FALL"	"10016173"	"60-64 years"	"60-64"	"3 heart attacks; Cardiac arrest; kidneys started shutting down; brain damage; liver was shutting down; she slipped when she stood up; This is a spontaneous report from a contactable consumer (patient's sister). A 64-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Right on 10Sep2021 10:11 (Batch/Lot Number: FE2588) as single dose for covid-19 immunisation (age at vaccination was 64-year-old). Medical history was reported as patient was allergic to penicillin which caused her to have a stroke when she was a baby (2 years old). The penicillin caused her to be paralyzed on her left side. She was slobbered, she could not help it. She could not swallow like the typical person could. She couldn't even close her eyes, she could not blink normally. She had to wait to fall asleep when her eyes could not hold themselves open anymore and would come together on their own. She had a little allergies to things but because they live in the mountains and surrounded by trees, there was all kinds of pollen. She did sneeze, but it was nothing she took any medicine for. The caller confirmed it was something they already had prior to receiving the COVID-19 shot. She had a stroke when she was young and it took her vocal cords so her sister cannot talk. Patient was handicapped. Patient had seizure. Patient had constipation and stomach pain.  Concomitant medications included phenobarbital sodium (PHENOBARBITAL [PHENOBARBITAL SODIUM]) taken for seizure, start and stop date were not reported; phenytoin sodium (DILANTIN D.A.) taken for seizure, start and stop date were not reported. The patient previously took macrogol 3350 (MIRALAX) for constipated (prescribed macrogol to get her bowels moving. Patient was constipated for maybe about a week. The caller clarifies the constipation began prior to receiving the COVID-19 shot. When they went and saw the neurologist on 08Sep2021, the doctor wrote patient a prescription for it. Her sister was constipated already. Her sister did go to the bathroom well, but she had not went for about a week. Her stomach was hurting so the doctor thought it was better to start giving her sister the MiraLAX). Patient did not receive other vaccinations within four weeks prior to the first administration date of the suspect vaccine. The patient experienced slipped when she stood up, 3 heart attacks, cardiac arrest, kidneys started shutting down, brain damage and liver was shutting down, all on 19Sep2021 with outcome of fatal. The patient was hospitalized for the events from 19Sep2021 to 20Sep2021. The patient underwent lab test which included heart rate: no pulse on 19Sep2021. Therapeutic measures were taken as a result the events. The patient died on 20Sep2021. An autopsy was not performed. The events resulted in Emergency Room Visit.  Clinical course was reported as on 10Sep2021, patient had their first Pfizer COVID-19 shot. On 19Sep2021, patient was on the floor. The caller clarifies she would walk over to her sister's house to make sure her sister took her medications. The caller stated back in the middle of last year, she discovered her sister was not taking her meds like she was supposed to, she was going off of her schedule. At that point last year, the caller took her sister to the ER to make sure everything was okay. Apparently, they had changed her sister's phenobarbital dose from three times a day to one pill which was causing her sister to hallucinate, her sister was seeing things. They saw her sister in the ER and then the caller began to go over to her sisters three times a day, once at 08:00, then at 13:00, then at 16:00. On 19Sep2021, the caller had gotten her sister breakfast. The caller explains her sister ate and took her medication and was fine. Her sister started getting kind of tired but the caller thought it was due to her sister having a stomach problem. The caller clarified her sister was constipated and her sister said she quit drinking her coffee because it hurt her stomach. So, the caller thought her sister was tired maybe because of that. Later in the evening of 19Sep2021, around 16:00, the caller found her sister on the floor. She clarified her sister wasn't dead. She asked her sister if she had a seizure and her sister waved her hand down and explained she slipped when she stood up. The caller clarifies her sister had a stroke when she was young and it took her vocal cords so her sister cant talk. The stroke also paralyzed her sister on the left side so she is only able to sign language with one hand. The caller explains she was talking to her sister. She asked her sister if she knew who she was and her sister signed her name, Privacy, in her hand (there is a certain way her name is used in sign language for one handed people). The caller was trying to get her sister up but couldn't. The caller had to get her son to help. Her sister could not walk, so they had to carry the patient into the living room. The caller called 911, however, because of the way the trailer was set up, they could not get the gurney through to the bedroom, so her sister had to be carried into the living room where the couch was. When the ambulance showed up, they said her sister had no pulse although the caller had just talked to her. The caller explains it had been 3-4 minutes, at most 5 minutes, and when the ambulance did show up, her sisters eyes were open and everything. They were feeling for a pulse and could not find one. The ambulance used the machine for the heart to try and get her heartbeat to come back. The caller explains it took about 30 minutes to get a pulse, and they ended up going to the hospital. The caller was told they got a slight pulse at the ER doors. Her sister of course could not talk, but because of COVID, the hospital wouldnt allow the caller to go back with her sister. Apparently, there were four positive cases at the hospital. Her sister was put on a ventilator. The caller explains she sat there for a long, long time- it seemed like forever, where they would not let the caller see her sister or nothing. Then, the doctor came out and explained to the caller that because her sister did not have a pulse, her kidneys started shutting down. Her liver was shutting down. The doctor shined the light in her sister's eyes and there was no response. Her eyes were dilated, which could be an indication of brain damage. The caller clarified further she went over to her sister house on 19Sep2021 where she found her on the floor and then she had no heartbeat. But apparently, they got her heartbeat back the next day so they pronounced her dead on 20Sep2021. She received a phone call informing her that her sister passed way at 06:19 on 20Sep2021. Her sister had 3 heart attacks the night of 19Sep2021 in the ER waiting for a room. One was a code blue.  Follow-up attempts are completed. No further information is expected.; Reported Cause(s) of Death: she slipped when she stood up; kidneys started shutting down; brain damage; liver was shutting down; 3 heart attacks; Cardiac arrest"
	"1848575-1"	"1848575-1"	"HEART RATE"	"10019299"	"60-64 years"	"60-64"	"3 heart attacks; Cardiac arrest; kidneys started shutting down; brain damage; liver was shutting down; she slipped when she stood up; This is a spontaneous report from a contactable consumer (patient's sister). A 64-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Right on 10Sep2021 10:11 (Batch/Lot Number: FE2588) as single dose for covid-19 immunisation (age at vaccination was 64-year-old). Medical history was reported as patient was allergic to penicillin which caused her to have a stroke when she was a baby (2 years old). The penicillin caused her to be paralyzed on her left side. She was slobbered, she could not help it. She could not swallow like the typical person could. She couldn't even close her eyes, she could not blink normally. She had to wait to fall asleep when her eyes could not hold themselves open anymore and would come together on their own. She had a little allergies to things but because they live in the mountains and surrounded by trees, there was all kinds of pollen. She did sneeze, but it was nothing she took any medicine for. The caller confirmed it was something they already had prior to receiving the COVID-19 shot. She had a stroke when she was young and it took her vocal cords so her sister cannot talk. Patient was handicapped. Patient had seizure. Patient had constipation and stomach pain.  Concomitant medications included phenobarbital sodium (PHENOBARBITAL [PHENOBARBITAL SODIUM]) taken for seizure, start and stop date were not reported; phenytoin sodium (DILANTIN D.A.) taken for seizure, start and stop date were not reported. The patient previously took macrogol 3350 (MIRALAX) for constipated (prescribed macrogol to get her bowels moving. Patient was constipated for maybe about a week. The caller clarifies the constipation began prior to receiving the COVID-19 shot. When they went and saw the neurologist on 08Sep2021, the doctor wrote patient a prescription for it. Her sister was constipated already. Her sister did go to the bathroom well, but she had not went for about a week. Her stomach was hurting so the doctor thought it was better to start giving her sister the MiraLAX). Patient did not receive other vaccinations within four weeks prior to the first administration date of the suspect vaccine. The patient experienced slipped when she stood up, 3 heart attacks, cardiac arrest, kidneys started shutting down, brain damage and liver was shutting down, all on 19Sep2021 with outcome of fatal. The patient was hospitalized for the events from 19Sep2021 to 20Sep2021. The patient underwent lab test which included heart rate: no pulse on 19Sep2021. Therapeutic measures were taken as a result the events. The patient died on 20Sep2021. An autopsy was not performed. The events resulted in Emergency Room Visit.  Clinical course was reported as on 10Sep2021, patient had their first Pfizer COVID-19 shot. On 19Sep2021, patient was on the floor. The caller clarifies she would walk over to her sister's house to make sure her sister took her medications. The caller stated back in the middle of last year, she discovered her sister was not taking her meds like she was supposed to, she was going off of her schedule. At that point last year, the caller took her sister to the ER to make sure everything was okay. Apparently, they had changed her sister's phenobarbital dose from three times a day to one pill which was causing her sister to hallucinate, her sister was seeing things. They saw her sister in the ER and then the caller began to go over to her sisters three times a day, once at 08:00, then at 13:00, then at 16:00. On 19Sep2021, the caller had gotten her sister breakfast. The caller explains her sister ate and took her medication and was fine. Her sister started getting kind of tired but the caller thought it was due to her sister having a stomach problem. The caller clarified her sister was constipated and her sister said she quit drinking her coffee because it hurt her stomach. So, the caller thought her sister was tired maybe because of that. Later in the evening of 19Sep2021, around 16:00, the caller found her sister on the floor. She clarified her sister wasn't dead. She asked her sister if she had a seizure and her sister waved her hand down and explained she slipped when she stood up. The caller clarifies her sister had a stroke when she was young and it took her vocal cords so her sister cant talk. The stroke also paralyzed her sister on the left side so she is only able to sign language with one hand. The caller explains she was talking to her sister. She asked her sister if she knew who she was and her sister signed her name, Privacy, in her hand (there is a certain way her name is used in sign language for one handed people). The caller was trying to get her sister up but couldn't. The caller had to get her son to help. Her sister could not walk, so they had to carry the patient into the living room. The caller called 911, however, because of the way the trailer was set up, they could not get the gurney through to the bedroom, so her sister had to be carried into the living room where the couch was. When the ambulance showed up, they said her sister had no pulse although the caller had just talked to her. The caller explains it had been 3-4 minutes, at most 5 minutes, and when the ambulance did show up, her sisters eyes were open and everything. They were feeling for a pulse and could not find one. The ambulance used the machine for the heart to try and get her heartbeat to come back. The caller explains it took about 30 minutes to get a pulse, and they ended up going to the hospital. The caller was told they got a slight pulse at the ER doors. Her sister of course could not talk, but because of COVID, the hospital wouldnt allow the caller to go back with her sister. Apparently, there were four positive cases at the hospital. Her sister was put on a ventilator. The caller explains she sat there for a long, long time- it seemed like forever, where they would not let the caller see her sister or nothing. Then, the doctor came out and explained to the caller that because her sister did not have a pulse, her kidneys started shutting down. Her liver was shutting down. The doctor shined the light in her sister's eyes and there was no response. Her eyes were dilated, which could be an indication of brain damage. The caller clarified further she went over to her sister house on 19Sep2021 where she found her on the floor and then she had no heartbeat. But apparently, they got her heartbeat back the next day so they pronounced her dead on 20Sep2021. She received a phone call informing her that her sister passed way at 06:19 on 20Sep2021. Her sister had 3 heart attacks the night of 19Sep2021 in the ER waiting for a room. One was a code blue.  Follow-up attempts are completed. No further information is expected.; Reported Cause(s) of Death: she slipped when she stood up; kidneys started shutting down; brain damage; liver was shutting down; 3 heart attacks; Cardiac arrest"
	"1848575-1"	"1848575-1"	"LIVER DISORDER"	"10024670"	"60-64 years"	"60-64"	"3 heart attacks; Cardiac arrest; kidneys started shutting down; brain damage; liver was shutting down; she slipped when she stood up; This is a spontaneous report from a contactable consumer (patient's sister). A 64-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Right on 10Sep2021 10:11 (Batch/Lot Number: FE2588) as single dose for covid-19 immunisation (age at vaccination was 64-year-old). Medical history was reported as patient was allergic to penicillin which caused her to have a stroke when she was a baby (2 years old). The penicillin caused her to be paralyzed on her left side. She was slobbered, she could not help it. She could not swallow like the typical person could. She couldn't even close her eyes, she could not blink normally. She had to wait to fall asleep when her eyes could not hold themselves open anymore and would come together on their own. She had a little allergies to things but because they live in the mountains and surrounded by trees, there was all kinds of pollen. She did sneeze, but it was nothing she took any medicine for. The caller confirmed it was something they already had prior to receiving the COVID-19 shot. She had a stroke when she was young and it took her vocal cords so her sister cannot talk. Patient was handicapped. Patient had seizure. Patient had constipation and stomach pain.  Concomitant medications included phenobarbital sodium (PHENOBARBITAL [PHENOBARBITAL SODIUM]) taken for seizure, start and stop date were not reported; phenytoin sodium (DILANTIN D.A.) taken for seizure, start and stop date were not reported. The patient previously took macrogol 3350 (MIRALAX) for constipated (prescribed macrogol to get her bowels moving. Patient was constipated for maybe about a week. The caller clarifies the constipation began prior to receiving the COVID-19 shot. When they went and saw the neurologist on 08Sep2021, the doctor wrote patient a prescription for it. Her sister was constipated already. Her sister did go to the bathroom well, but she had not went for about a week. Her stomach was hurting so the doctor thought it was better to start giving her sister the MiraLAX). Patient did not receive other vaccinations within four weeks prior to the first administration date of the suspect vaccine. The patient experienced slipped when she stood up, 3 heart attacks, cardiac arrest, kidneys started shutting down, brain damage and liver was shutting down, all on 19Sep2021 with outcome of fatal. The patient was hospitalized for the events from 19Sep2021 to 20Sep2021. The patient underwent lab test which included heart rate: no pulse on 19Sep2021. Therapeutic measures were taken as a result the events. The patient died on 20Sep2021. An autopsy was not performed. The events resulted in Emergency Room Visit.  Clinical course was reported as on 10Sep2021, patient had their first Pfizer COVID-19 shot. On 19Sep2021, patient was on the floor. The caller clarifies she would walk over to her sister's house to make sure her sister took her medications. The caller stated back in the middle of last year, she discovered her sister was not taking her meds like she was supposed to, she was going off of her schedule. At that point last year, the caller took her sister to the ER to make sure everything was okay. Apparently, they had changed her sister's phenobarbital dose from three times a day to one pill which was causing her sister to hallucinate, her sister was seeing things. They saw her sister in the ER and then the caller began to go over to her sisters three times a day, once at 08:00, then at 13:00, then at 16:00. On 19Sep2021, the caller had gotten her sister breakfast. The caller explains her sister ate and took her medication and was fine. Her sister started getting kind of tired but the caller thought it was due to her sister having a stomach problem. The caller clarified her sister was constipated and her sister said she quit drinking her coffee because it hurt her stomach. So, the caller thought her sister was tired maybe because of that. Later in the evening of 19Sep2021, around 16:00, the caller found her sister on the floor. She clarified her sister wasn't dead. She asked her sister if she had a seizure and her sister waved her hand down and explained she slipped when she stood up. The caller clarifies her sister had a stroke when she was young and it took her vocal cords so her sister cant talk. The stroke also paralyzed her sister on the left side so she is only able to sign language with one hand. The caller explains she was talking to her sister. She asked her sister if she knew who she was and her sister signed her name, Privacy, in her hand (there is a certain way her name is used in sign language for one handed people). The caller was trying to get her sister up but couldn't. The caller had to get her son to help. Her sister could not walk, so they had to carry the patient into the living room. The caller called 911, however, because of the way the trailer was set up, they could not get the gurney through to the bedroom, so her sister had to be carried into the living room where the couch was. When the ambulance showed up, they said her sister had no pulse although the caller had just talked to her. The caller explains it had been 3-4 minutes, at most 5 minutes, and when the ambulance did show up, her sisters eyes were open and everything. They were feeling for a pulse and could not find one. The ambulance used the machine for the heart to try and get her heartbeat to come back. The caller explains it took about 30 minutes to get a pulse, and they ended up going to the hospital. The caller was told they got a slight pulse at the ER doors. Her sister of course could not talk, but because of COVID, the hospital wouldnt allow the caller to go back with her sister. Apparently, there were four positive cases at the hospital. Her sister was put on a ventilator. The caller explains she sat there for a long, long time- it seemed like forever, where they would not let the caller see her sister or nothing. Then, the doctor came out and explained to the caller that because her sister did not have a pulse, her kidneys started shutting down. Her liver was shutting down. The doctor shined the light in her sister's eyes and there was no response. Her eyes were dilated, which could be an indication of brain damage. The caller clarified further she went over to her sister house on 19Sep2021 where she found her on the floor and then she had no heartbeat. But apparently, they got her heartbeat back the next day so they pronounced her dead on 20Sep2021. She received a phone call informing her that her sister passed way at 06:19 on 20Sep2021. Her sister had 3 heart attacks the night of 19Sep2021 in the ER waiting for a room. One was a code blue.  Follow-up attempts are completed. No further information is expected.; Reported Cause(s) of Death: she slipped when she stood up; kidneys started shutting down; brain damage; liver was shutting down; 3 heart attacks; Cardiac arrest"
	"1848575-1"	"1848575-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"3 heart attacks; Cardiac arrest; kidneys started shutting down; brain damage; liver was shutting down; she slipped when she stood up; This is a spontaneous report from a contactable consumer (patient's sister). A 64-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Right on 10Sep2021 10:11 (Batch/Lot Number: FE2588) as single dose for covid-19 immunisation (age at vaccination was 64-year-old). Medical history was reported as patient was allergic to penicillin which caused her to have a stroke when she was a baby (2 years old). The penicillin caused her to be paralyzed on her left side. She was slobbered, she could not help it. She could not swallow like the typical person could. She couldn't even close her eyes, she could not blink normally. She had to wait to fall asleep when her eyes could not hold themselves open anymore and would come together on their own. She had a little allergies to things but because they live in the mountains and surrounded by trees, there was all kinds of pollen. She did sneeze, but it was nothing she took any medicine for. The caller confirmed it was something they already had prior to receiving the COVID-19 shot. She had a stroke when she was young and it took her vocal cords so her sister cannot talk. Patient was handicapped. Patient had seizure. Patient had constipation and stomach pain.  Concomitant medications included phenobarbital sodium (PHENOBARBITAL [PHENOBARBITAL SODIUM]) taken for seizure, start and stop date were not reported; phenytoin sodium (DILANTIN D.A.) taken for seizure, start and stop date were not reported. The patient previously took macrogol 3350 (MIRALAX) for constipated (prescribed macrogol to get her bowels moving. Patient was constipated for maybe about a week. The caller clarifies the constipation began prior to receiving the COVID-19 shot. When they went and saw the neurologist on 08Sep2021, the doctor wrote patient a prescription for it. Her sister was constipated already. Her sister did go to the bathroom well, but she had not went for about a week. Her stomach was hurting so the doctor thought it was better to start giving her sister the MiraLAX). Patient did not receive other vaccinations within four weeks prior to the first administration date of the suspect vaccine. The patient experienced slipped when she stood up, 3 heart attacks, cardiac arrest, kidneys started shutting down, brain damage and liver was shutting down, all on 19Sep2021 with outcome of fatal. The patient was hospitalized for the events from 19Sep2021 to 20Sep2021. The patient underwent lab test which included heart rate: no pulse on 19Sep2021. Therapeutic measures were taken as a result the events. The patient died on 20Sep2021. An autopsy was not performed. The events resulted in Emergency Room Visit.  Clinical course was reported as on 10Sep2021, patient had their first Pfizer COVID-19 shot. On 19Sep2021, patient was on the floor. The caller clarifies she would walk over to her sister's house to make sure her sister took her medications. The caller stated back in the middle of last year, she discovered her sister was not taking her meds like she was supposed to, she was going off of her schedule. At that point last year, the caller took her sister to the ER to make sure everything was okay. Apparently, they had changed her sister's phenobarbital dose from three times a day to one pill which was causing her sister to hallucinate, her sister was seeing things. They saw her sister in the ER and then the caller began to go over to her sisters three times a day, once at 08:00, then at 13:00, then at 16:00. On 19Sep2021, the caller had gotten her sister breakfast. The caller explains her sister ate and took her medication and was fine. Her sister started getting kind of tired but the caller thought it was due to her sister having a stomach problem. The caller clarified her sister was constipated and her sister said she quit drinking her coffee because it hurt her stomach. So, the caller thought her sister was tired maybe because of that. Later in the evening of 19Sep2021, around 16:00, the caller found her sister on the floor. She clarified her sister wasn't dead. She asked her sister if she had a seizure and her sister waved her hand down and explained she slipped when she stood up. The caller clarifies her sister had a stroke when she was young and it took her vocal cords so her sister cant talk. The stroke also paralyzed her sister on the left side so she is only able to sign language with one hand. The caller explains she was talking to her sister. She asked her sister if she knew who she was and her sister signed her name, Privacy, in her hand (there is a certain way her name is used in sign language for one handed people). The caller was trying to get her sister up but couldn't. The caller had to get her son to help. Her sister could not walk, so they had to carry the patient into the living room. The caller called 911, however, because of the way the trailer was set up, they could not get the gurney through to the bedroom, so her sister had to be carried into the living room where the couch was. When the ambulance showed up, they said her sister had no pulse although the caller had just talked to her. The caller explains it had been 3-4 minutes, at most 5 minutes, and when the ambulance did show up, her sisters eyes were open and everything. They were feeling for a pulse and could not find one. The ambulance used the machine for the heart to try and get her heartbeat to come back. The caller explains it took about 30 minutes to get a pulse, and they ended up going to the hospital. The caller was told they got a slight pulse at the ER doors. Her sister of course could not talk, but because of COVID, the hospital wouldnt allow the caller to go back with her sister. Apparently, there were four positive cases at the hospital. Her sister was put on a ventilator. The caller explains she sat there for a long, long time- it seemed like forever, where they would not let the caller see her sister or nothing. Then, the doctor came out and explained to the caller that because her sister did not have a pulse, her kidneys started shutting down. Her liver was shutting down. The doctor shined the light in her sister's eyes and there was no response. Her eyes were dilated, which could be an indication of brain damage. The caller clarified further she went over to her sister house on 19Sep2021 where she found her on the floor and then she had no heartbeat. But apparently, they got her heartbeat back the next day so they pronounced her dead on 20Sep2021. She received a phone call informing her that her sister passed way at 06:19 on 20Sep2021. Her sister had 3 heart attacks the night of 19Sep2021 in the ER waiting for a room. One was a code blue.  Follow-up attempts are completed. No further information is expected.; Reported Cause(s) of Death: she slipped when she stood up; kidneys started shutting down; brain damage; liver was shutting down; 3 heart attacks; Cardiac arrest"
	"1848575-1"	"1848575-1"	"RENAL IMPAIRMENT"	"10062237"	"60-64 years"	"60-64"	"3 heart attacks; Cardiac arrest; kidneys started shutting down; brain damage; liver was shutting down; she slipped when she stood up; This is a spontaneous report from a contactable consumer (patient's sister). A 64-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Right on 10Sep2021 10:11 (Batch/Lot Number: FE2588) as single dose for covid-19 immunisation (age at vaccination was 64-year-old). Medical history was reported as patient was allergic to penicillin which caused her to have a stroke when she was a baby (2 years old). The penicillin caused her to be paralyzed on her left side. She was slobbered, she could not help it. She could not swallow like the typical person could. She couldn't even close her eyes, she could not blink normally. She had to wait to fall asleep when her eyes could not hold themselves open anymore and would come together on their own. She had a little allergies to things but because they live in the mountains and surrounded by trees, there was all kinds of pollen. She did sneeze, but it was nothing she took any medicine for. The caller confirmed it was something they already had prior to receiving the COVID-19 shot. She had a stroke when she was young and it took her vocal cords so her sister cannot talk. Patient was handicapped. Patient had seizure. Patient had constipation and stomach pain.  Concomitant medications included phenobarbital sodium (PHENOBARBITAL [PHENOBARBITAL SODIUM]) taken for seizure, start and stop date were not reported; phenytoin sodium (DILANTIN D.A.) taken for seizure, start and stop date were not reported. The patient previously took macrogol 3350 (MIRALAX) for constipated (prescribed macrogol to get her bowels moving. Patient was constipated for maybe about a week. The caller clarifies the constipation began prior to receiving the COVID-19 shot. When they went and saw the neurologist on 08Sep2021, the doctor wrote patient a prescription for it. Her sister was constipated already. Her sister did go to the bathroom well, but she had not went for about a week. Her stomach was hurting so the doctor thought it was better to start giving her sister the MiraLAX). Patient did not receive other vaccinations within four weeks prior to the first administration date of the suspect vaccine. The patient experienced slipped when she stood up, 3 heart attacks, cardiac arrest, kidneys started shutting down, brain damage and liver was shutting down, all on 19Sep2021 with outcome of fatal. The patient was hospitalized for the events from 19Sep2021 to 20Sep2021. The patient underwent lab test which included heart rate: no pulse on 19Sep2021. Therapeutic measures were taken as a result the events. The patient died on 20Sep2021. An autopsy was not performed. The events resulted in Emergency Room Visit.  Clinical course was reported as on 10Sep2021, patient had their first Pfizer COVID-19 shot. On 19Sep2021, patient was on the floor. The caller clarifies she would walk over to her sister's house to make sure her sister took her medications. The caller stated back in the middle of last year, she discovered her sister was not taking her meds like she was supposed to, she was going off of her schedule. At that point last year, the caller took her sister to the ER to make sure everything was okay. Apparently, they had changed her sister's phenobarbital dose from three times a day to one pill which was causing her sister to hallucinate, her sister was seeing things. They saw her sister in the ER and then the caller began to go over to her sisters three times a day, once at 08:00, then at 13:00, then at 16:00. On 19Sep2021, the caller had gotten her sister breakfast. The caller explains her sister ate and took her medication and was fine. Her sister started getting kind of tired but the caller thought it was due to her sister having a stomach problem. The caller clarified her sister was constipated and her sister said she quit drinking her coffee because it hurt her stomach. So, the caller thought her sister was tired maybe because of that. Later in the evening of 19Sep2021, around 16:00, the caller found her sister on the floor. She clarified her sister wasn't dead. She asked her sister if she had a seizure and her sister waved her hand down and explained she slipped when she stood up. The caller clarifies her sister had a stroke when she was young and it took her vocal cords so her sister cant talk. The stroke also paralyzed her sister on the left side so she is only able to sign language with one hand. The caller explains she was talking to her sister. She asked her sister if she knew who she was and her sister signed her name, Privacy, in her hand (there is a certain way her name is used in sign language for one handed people). The caller was trying to get her sister up but couldn't. The caller had to get her son to help. Her sister could not walk, so they had to carry the patient into the living room. The caller called 911, however, because of the way the trailer was set up, they could not get the gurney through to the bedroom, so her sister had to be carried into the living room where the couch was. When the ambulance showed up, they said her sister had no pulse although the caller had just talked to her. The caller explains it had been 3-4 minutes, at most 5 minutes, and when the ambulance did show up, her sisters eyes were open and everything. They were feeling for a pulse and could not find one. The ambulance used the machine for the heart to try and get her heartbeat to come back. The caller explains it took about 30 minutes to get a pulse, and they ended up going to the hospital. The caller was told they got a slight pulse at the ER doors. Her sister of course could not talk, but because of COVID, the hospital wouldnt allow the caller to go back with her sister. Apparently, there were four positive cases at the hospital. Her sister was put on a ventilator. The caller explains she sat there for a long, long time- it seemed like forever, where they would not let the caller see her sister or nothing. Then, the doctor came out and explained to the caller that because her sister did not have a pulse, her kidneys started shutting down. Her liver was shutting down. The doctor shined the light in her sister's eyes and there was no response. Her eyes were dilated, which could be an indication of brain damage. The caller clarified further she went over to her sister house on 19Sep2021 where she found her on the floor and then she had no heartbeat. But apparently, they got her heartbeat back the next day so they pronounced her dead on 20Sep2021. She received a phone call informing her that her sister passed way at 06:19 on 20Sep2021. Her sister had 3 heart attacks the night of 19Sep2021 in the ER waiting for a room. One was a code blue.  Follow-up attempts are completed. No further information is expected.; Reported Cause(s) of Death: she slipped when she stood up; kidneys started shutting down; brain damage; liver was shutting down; 3 heart attacks; Cardiac arrest"
	"1848897-1"	"1848897-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Became nauseated, dipahoretic; was dead on arrival to ED, presumed MI"
	"1848897-1"	"1848897-1"	"HYPERHIDROSIS"	"10020642"	"60-64 years"	"60-64"	"Became nauseated, dipahoretic; was dead on arrival to ED, presumed MI"
	"1848897-1"	"1848897-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Became nauseated, dipahoretic; was dead on arrival to ED, presumed MI"
	"1850162-1"	"1850162-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Massive Heart attack. Patient is deceased"
	"1850162-1"	"1850162-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"Massive Heart attack. Patient is deceased"
	"1850335-1"	"1850335-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"60-64 years"	"60-64"	"death Nontraumatic intracranial hemorrhage, unspecified Hemorrhagic cerebrovascular accident (CVA)"
	"1850335-1"	"1850335-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death Nontraumatic intracranial hemorrhage, unspecified Hemorrhagic cerebrovascular accident (CVA)"
	"1850335-1"	"1850335-1"	"HAEMORRHAGE INTRACRANIAL"	"10018985"	"60-64 years"	"60-64"	"death Nontraumatic intracranial hemorrhage, unspecified Hemorrhagic cerebrovascular accident (CVA)"
	"1850380-1"	"1850380-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"10/24 SEEN IN ER WITH DIFFICULTY BREATHING ONSET 1 WEEK. CHEST PAIN POST FALL DX: PNEUMONIA DUE TO COVID19, RESP FAILURE. HYPOXIC REQUIREING 5-6 L OF OXYGEN SATTING AT 92%. CONDITION CONTINUED TO DECLINE REQUIRING BIPAP THERAPY. PT AND FAMILY ELECTED TO TRANSITION TO COMFORT CARE. PATIENT DIED ON 11/4/21. PATIENT REC'D PFIZER COVID 19 VACCINATIONS: 3/1/21 AT HOSPITAL PFIZER LOT NUMBER : EL9269 DOSE 1 3/22/21 AT HOSPITAL PFIZER LOT NUMBER: EN6200 DOSE 2"
	"1850380-1"	"1850380-1"	"COMPUTERISED TOMOGRAM THORAX ABNORMAL"	"10057799"	"60-64 years"	"60-64"	"10/24 SEEN IN ER WITH DIFFICULTY BREATHING ONSET 1 WEEK. CHEST PAIN POST FALL DX: PNEUMONIA DUE TO COVID19, RESP FAILURE. HYPOXIC REQUIREING 5-6 L OF OXYGEN SATTING AT 92%. CONDITION CONTINUED TO DECLINE REQUIRING BIPAP THERAPY. PT AND FAMILY ELECTED TO TRANSITION TO COMFORT CARE. PATIENT DIED ON 11/4/21. PATIENT REC'D PFIZER COVID 19 VACCINATIONS: 3/1/21 AT HOSPITAL PFIZER LOT NUMBER : EL9269 DOSE 1 3/22/21 AT HOSPITAL PFIZER LOT NUMBER: EN6200 DOSE 2"
	"1850380-1"	"1850380-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"10/24 SEEN IN ER WITH DIFFICULTY BREATHING ONSET 1 WEEK. CHEST PAIN POST FALL DX: PNEUMONIA DUE TO COVID19, RESP FAILURE. HYPOXIC REQUIREING 5-6 L OF OXYGEN SATTING AT 92%. CONDITION CONTINUED TO DECLINE REQUIRING BIPAP THERAPY. PT AND FAMILY ELECTED TO TRANSITION TO COMFORT CARE. PATIENT DIED ON 11/4/21. PATIENT REC'D PFIZER COVID 19 VACCINATIONS: 3/1/21 AT HOSPITAL PFIZER LOT NUMBER : EL9269 DOSE 1 3/22/21 AT HOSPITAL PFIZER LOT NUMBER: EN6200 DOSE 2"
	"1850380-1"	"1850380-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"10/24 SEEN IN ER WITH DIFFICULTY BREATHING ONSET 1 WEEK. CHEST PAIN POST FALL DX: PNEUMONIA DUE TO COVID19, RESP FAILURE. HYPOXIC REQUIREING 5-6 L OF OXYGEN SATTING AT 92%. CONDITION CONTINUED TO DECLINE REQUIRING BIPAP THERAPY. PT AND FAMILY ELECTED TO TRANSITION TO COMFORT CARE. PATIENT DIED ON 11/4/21. PATIENT REC'D PFIZER COVID 19 VACCINATIONS: 3/1/21 AT HOSPITAL PFIZER LOT NUMBER : EL9269 DOSE 1 3/22/21 AT HOSPITAL PFIZER LOT NUMBER: EN6200 DOSE 2"
	"1850380-1"	"1850380-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"10/24 SEEN IN ER WITH DIFFICULTY BREATHING ONSET 1 WEEK. CHEST PAIN POST FALL DX: PNEUMONIA DUE TO COVID19, RESP FAILURE. HYPOXIC REQUIREING 5-6 L OF OXYGEN SATTING AT 92%. CONDITION CONTINUED TO DECLINE REQUIRING BIPAP THERAPY. PT AND FAMILY ELECTED TO TRANSITION TO COMFORT CARE. PATIENT DIED ON 11/4/21. PATIENT REC'D PFIZER COVID 19 VACCINATIONS: 3/1/21 AT HOSPITAL PFIZER LOT NUMBER : EL9269 DOSE 1 3/22/21 AT HOSPITAL PFIZER LOT NUMBER: EN6200 DOSE 2"
	"1850380-1"	"1850380-1"	"FALL"	"10016173"	"60-64 years"	"60-64"	"10/24 SEEN IN ER WITH DIFFICULTY BREATHING ONSET 1 WEEK. CHEST PAIN POST FALL DX: PNEUMONIA DUE TO COVID19, RESP FAILURE. HYPOXIC REQUIREING 5-6 L OF OXYGEN SATTING AT 92%. CONDITION CONTINUED TO DECLINE REQUIRING BIPAP THERAPY. PT AND FAMILY ELECTED TO TRANSITION TO COMFORT CARE. PATIENT DIED ON 11/4/21. PATIENT REC'D PFIZER COVID 19 VACCINATIONS: 3/1/21 AT HOSPITAL PFIZER LOT NUMBER : EL9269 DOSE 1 3/22/21 AT HOSPITAL PFIZER LOT NUMBER: EN6200 DOSE 2"
	"1850380-1"	"1850380-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"10/24 SEEN IN ER WITH DIFFICULTY BREATHING ONSET 1 WEEK. CHEST PAIN POST FALL DX: PNEUMONIA DUE TO COVID19, RESP FAILURE. HYPOXIC REQUIREING 5-6 L OF OXYGEN SATTING AT 92%. CONDITION CONTINUED TO DECLINE REQUIRING BIPAP THERAPY. PT AND FAMILY ELECTED TO TRANSITION TO COMFORT CARE. PATIENT DIED ON 11/4/21. PATIENT REC'D PFIZER COVID 19 VACCINATIONS: 3/1/21 AT HOSPITAL PFIZER LOT NUMBER : EL9269 DOSE 1 3/22/21 AT HOSPITAL PFIZER LOT NUMBER: EN6200 DOSE 2"
	"1850380-1"	"1850380-1"	"INTERSTITIAL LUNG DISEASE"	"10022611"	"60-64 years"	"60-64"	"10/24 SEEN IN ER WITH DIFFICULTY BREATHING ONSET 1 WEEK. CHEST PAIN POST FALL DX: PNEUMONIA DUE TO COVID19, RESP FAILURE. HYPOXIC REQUIREING 5-6 L OF OXYGEN SATTING AT 92%. CONDITION CONTINUED TO DECLINE REQUIRING BIPAP THERAPY. PT AND FAMILY ELECTED TO TRANSITION TO COMFORT CARE. PATIENT DIED ON 11/4/21. PATIENT REC'D PFIZER COVID 19 VACCINATIONS: 3/1/21 AT HOSPITAL PFIZER LOT NUMBER : EL9269 DOSE 1 3/22/21 AT HOSPITAL PFIZER LOT NUMBER: EN6200 DOSE 2"
	"1850380-1"	"1850380-1"	"PLEURAL EFFUSION"	"10035598"	"60-64 years"	"60-64"	"10/24 SEEN IN ER WITH DIFFICULTY BREATHING ONSET 1 WEEK. CHEST PAIN POST FALL DX: PNEUMONIA DUE TO COVID19, RESP FAILURE. HYPOXIC REQUIREING 5-6 L OF OXYGEN SATTING AT 92%. CONDITION CONTINUED TO DECLINE REQUIRING BIPAP THERAPY. PT AND FAMILY ELECTED TO TRANSITION TO COMFORT CARE. PATIENT DIED ON 11/4/21. PATIENT REC'D PFIZER COVID 19 VACCINATIONS: 3/1/21 AT HOSPITAL PFIZER LOT NUMBER : EL9269 DOSE 1 3/22/21 AT HOSPITAL PFIZER LOT NUMBER: EN6200 DOSE 2"
	"1850380-1"	"1850380-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"60-64 years"	"60-64"	"10/24 SEEN IN ER WITH DIFFICULTY BREATHING ONSET 1 WEEK. CHEST PAIN POST FALL DX: PNEUMONIA DUE TO COVID19, RESP FAILURE. HYPOXIC REQUIREING 5-6 L OF OXYGEN SATTING AT 92%. CONDITION CONTINUED TO DECLINE REQUIRING BIPAP THERAPY. PT AND FAMILY ELECTED TO TRANSITION TO COMFORT CARE. PATIENT DIED ON 11/4/21. PATIENT REC'D PFIZER COVID 19 VACCINATIONS: 3/1/21 AT HOSPITAL PFIZER LOT NUMBER : EL9269 DOSE 1 3/22/21 AT HOSPITAL PFIZER LOT NUMBER: EN6200 DOSE 2"
	"1850380-1"	"1850380-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	"10/24 SEEN IN ER WITH DIFFICULTY BREATHING ONSET 1 WEEK. CHEST PAIN POST FALL DX: PNEUMONIA DUE TO COVID19, RESP FAILURE. HYPOXIC REQUIREING 5-6 L OF OXYGEN SATTING AT 92%. CONDITION CONTINUED TO DECLINE REQUIRING BIPAP THERAPY. PT AND FAMILY ELECTED TO TRANSITION TO COMFORT CARE. PATIENT DIED ON 11/4/21. PATIENT REC'D PFIZER COVID 19 VACCINATIONS: 3/1/21 AT HOSPITAL PFIZER LOT NUMBER : EL9269 DOSE 1 3/22/21 AT HOSPITAL PFIZER LOT NUMBER: EN6200 DOSE 2"
	"1850380-1"	"1850380-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"10/24 SEEN IN ER WITH DIFFICULTY BREATHING ONSET 1 WEEK. CHEST PAIN POST FALL DX: PNEUMONIA DUE TO COVID19, RESP FAILURE. HYPOXIC REQUIREING 5-6 L OF OXYGEN SATTING AT 92%. CONDITION CONTINUED TO DECLINE REQUIRING BIPAP THERAPY. PT AND FAMILY ELECTED TO TRANSITION TO COMFORT CARE. PATIENT DIED ON 11/4/21. PATIENT REC'D PFIZER COVID 19 VACCINATIONS: 3/1/21 AT HOSPITAL PFIZER LOT NUMBER : EL9269 DOSE 1 3/22/21 AT HOSPITAL PFIZER LOT NUMBER: EN6200 DOSE 2"
	"1850490-1"	"1850490-1"	"BREAST CANCER FEMALE"	"10057654"	"60-64 years"	"60-64"	"Dose 1 3/22/2021 007B21A Moderna  Pt died of end stage breast cancer"
	"1850490-1"	"1850490-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Dose 1 3/22/2021 007B21A Moderna  Pt died of end stage breast cancer"
	"1850490-1"	"1850490-1"	"NEOPLASM MALIGNANT"	"10028997"	"60-64 years"	"60-64"	"Dose 1 3/22/2021 007B21A Moderna  Pt died of end stage breast cancer"
	"1851232-1"	"1851232-1"	"ANTICOAGULANT THERAPY"	"10053468"	"60-64 years"	"60-64"	"pt diagnosed positive for COVID on 8/14/21 by PCP; presents to ED with c/o increasing SOB and decreased O2 sats (76% on NRB); hx of COPD, multiple myloma; treated with antibiotics, steroids, anticoagulants, remdisivir; placed on BiPAP; eventually required intubation due to worsening condition; family decided on comfort care measures; pt was extubated and died at the hosp"
	"1851232-1"	"1851232-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"pt diagnosed positive for COVID on 8/14/21 by PCP; presents to ED with c/o increasing SOB and decreased O2 sats (76% on NRB); hx of COPD, multiple myloma; treated with antibiotics, steroids, anticoagulants, remdisivir; placed on BiPAP; eventually required intubation due to worsening condition; family decided on comfort care measures; pt was extubated and died at the hosp"
	"1851232-1"	"1851232-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"pt diagnosed positive for COVID on 8/14/21 by PCP; presents to ED with c/o increasing SOB and decreased O2 sats (76% on NRB); hx of COPD, multiple myloma; treated with antibiotics, steroids, anticoagulants, remdisivir; placed on BiPAP; eventually required intubation due to worsening condition; family decided on comfort care measures; pt was extubated and died at the hosp"
	"1851232-1"	"1851232-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"pt diagnosed positive for COVID on 8/14/21 by PCP; presents to ED with c/o increasing SOB and decreased O2 sats (76% on NRB); hx of COPD, multiple myloma; treated with antibiotics, steroids, anticoagulants, remdisivir; placed on BiPAP; eventually required intubation due to worsening condition; family decided on comfort care measures; pt was extubated and died at the hosp"
	"1851232-1"	"1851232-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"pt diagnosed positive for COVID on 8/14/21 by PCP; presents to ED with c/o increasing SOB and decreased O2 sats (76% on NRB); hx of COPD, multiple myloma; treated with antibiotics, steroids, anticoagulants, remdisivir; placed on BiPAP; eventually required intubation due to worsening condition; family decided on comfort care measures; pt was extubated and died at the hosp"
	"1851232-1"	"1851232-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"pt diagnosed positive for COVID on 8/14/21 by PCP; presents to ED with c/o increasing SOB and decreased O2 sats (76% on NRB); hx of COPD, multiple myloma; treated with antibiotics, steroids, anticoagulants, remdisivir; placed on BiPAP; eventually required intubation due to worsening condition; family decided on comfort care measures; pt was extubated and died at the hosp"
	"1851232-1"	"1851232-1"	"POSITIVE AIRWAY PRESSURE THERAPY"	"10086397"	"60-64 years"	"60-64"	"pt diagnosed positive for COVID on 8/14/21 by PCP; presents to ED with c/o increasing SOB and decreased O2 sats (76% on NRB); hx of COPD, multiple myloma; treated with antibiotics, steroids, anticoagulants, remdisivir; placed on BiPAP; eventually required intubation due to worsening condition; family decided on comfort care measures; pt was extubated and died at the hosp"
	"1851232-1"	"1851232-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"pt diagnosed positive for COVID on 8/14/21 by PCP; presents to ED with c/o increasing SOB and decreased O2 sats (76% on NRB); hx of COPD, multiple myloma; treated with antibiotics, steroids, anticoagulants, remdisivir; placed on BiPAP; eventually required intubation due to worsening condition; family decided on comfort care measures; pt was extubated and died at the hosp"
	"1851808-1"	"1851808-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""I had received a text message from my father on 9/15/2021 after his first vaccine dose that said ""Yeah that shot was not fun Never had a shot that made me feel so bad so quick ""I felt bad with in a minute 4 hrs ago and breathing is still difficult it sucks"" On 10/23/2021, my father called 9-1-1 and was taken & he passed away 10/24/2021 from what is listed as Massive upper gastrointestinal hemorrhage on his death certificate. I have spoken to people that knew him and said he was feeling sick for the past few weeks, he started taking antacid and Imodium in the days leading up to his death.""
	"1851808-1"	"1851808-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	""I had received a text message from my father on 9/15/2021 after his first vaccine dose that said ""Yeah that shot was not fun Never had a shot that made me feel so bad so quick ""I felt bad with in a minute 4 hrs ago and breathing is still difficult it sucks"" On 10/23/2021, my father called 9-1-1 and was taken & he passed away 10/24/2021 from what is listed as Massive upper gastrointestinal hemorrhage on his death certificate. I have spoken to people that knew him and said he was feeling sick for the past few weeks, he started taking antacid and Imodium in the days leading up to his death.""
	"1851808-1"	"1851808-1"	"FEELING ABNORMAL"	"10016322"	"60-64 years"	"60-64"	""I had received a text message from my father on 9/15/2021 after his first vaccine dose that said ""Yeah that shot was not fun Never had a shot that made me feel so bad so quick ""I felt bad with in a minute 4 hrs ago and breathing is still difficult it sucks"" On 10/23/2021, my father called 9-1-1 and was taken & he passed away 10/24/2021 from what is listed as Massive upper gastrointestinal hemorrhage on his death certificate. I have spoken to people that knew him and said he was feeling sick for the past few weeks, he started taking antacid and Imodium in the days leading up to his death.""
	"1851808-1"	"1851808-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	""I had received a text message from my father on 9/15/2021 after his first vaccine dose that said ""Yeah that shot was not fun Never had a shot that made me feel so bad so quick ""I felt bad with in a minute 4 hrs ago and breathing is still difficult it sucks"" On 10/23/2021, my father called 9-1-1 and was taken & he passed away 10/24/2021 from what is listed as Massive upper gastrointestinal hemorrhage on his death certificate. I have spoken to people that knew him and said he was feeling sick for the past few weeks, he started taking antacid and Imodium in the days leading up to his death.""
	"1851808-1"	"1851808-1"	"UPPER GASTROINTESTINAL HAEMORRHAGE"	"10046274"	"60-64 years"	"60-64"	""I had received a text message from my father on 9/15/2021 after his first vaccine dose that said ""Yeah that shot was not fun Never had a shot that made me feel so bad so quick ""I felt bad with in a minute 4 hrs ago and breathing is still difficult it sucks"" On 10/23/2021, my father called 9-1-1 and was taken & he passed away 10/24/2021 from what is listed as Massive upper gastrointestinal hemorrhage on his death certificate. I have spoken to people that knew him and said he was feeling sick for the past few weeks, he started taking antacid and Imodium in the days leading up to his death.""
	"1853611-1"	"1853611-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"ACUTE RESPIRATORY DISTRESS SYNDROME"	"10001052"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"ATRIAL FIBRILLATION"	"10003658"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"DEBRIDEMENT"	"10067806"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"DIABETIC KETOACIDOSIS"	"10012671"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"EXTUBATION"	"10015894"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"GENERAL PHYSICAL HEALTH DETERIORATION"	"10049438"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"HYPERCAPNIA"	"10020591"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"HYPERVOLAEMIA"	"10020919"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"INFECTION"	"10021789"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"NECROTISING FASCIITIS"	"10028885"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"PARALYSIS"	"10033799"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"RASH"	"10037844"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"SEPTIC SHOCK"	"10040070"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1853611-1"	"1853611-1"	"SUPRAVENTRICULAR TACHYCARDIA"	"10042604"	"60-64 years"	"60-64"	"Hospitalized 10/26/2021; COVID-19 positive 10/27/2021, fully vaccinated  BRIEF OVERVIEW: Discharge Provider: DOCTOR Primary Care Physician at Discharge: DOCTOR Admission Date: 10/26/2021 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Septic shock   HOSPITAL COURSE: Patient is a 60 year old male with PMH of HTN, HLD, DMII, super morbid obesity who initially presented to outside hospital with a 2-3 day history of right groin rash and found to have necrotizing fascitis. Patient underwent his initial debridement at outside hospital prior to transferring to Butterworth SICU. Of note, patient was hypoxic prior to intubation and found to have COVID-19 pneumonia which was treated with steroids and Remdesivir. Patient was intubated and sedated upon transfer and had pressor requirements due to septic shock from the necrotizing fascitis. Patient underwent IV abx therapy, resuscitation with fluids and pressors, and ventilator support. Patient underwent a second debridement for source control the following day. Patient's ICU course was also complicated by Diabetic ketoacidosis for which he was on endotool with DGMS following, AKI, and SVT with RVR. During his ICU course, source control was obtained from his infection, however patient's respiratory status continued to decline with ARDS. Patient on high ventilator requirements of 90-100% Fi02 with hypercarbia due to large body habitus with chest wall restrction, COVID-19, and volume overload due to resuscitation for septic shock. Patient was paralyzed during his course to assist with ventilation however this did not improve his respiratory status. Pulmonary critical care was consulted however patient not a candidate for ECMO given his BMI. Discussion was held with family (sister) on 10/31/21 given poor prognosis even with aggressive therapy. Comfort care was ultimately decided upon per family. Paralyzation was stopped and patient was subsequently extubated and expired on 10/31/2021 at 1354"
	"1857174-1"	"1857174-1"	"ACUTE MYOCARDIAL INFARCTION"	"10000891"	"60-64 years"	"60-64"	"death- Hypoxemic Respiratory Failure; STEMI myocardial infarction"
	"1857174-1"	"1857174-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"death- Hypoxemic Respiratory Failure; STEMI myocardial infarction"
	"1857174-1"	"1857174-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	"death- Hypoxemic Respiratory Failure; STEMI myocardial infarction"
	"1857540-1"	"1857540-1"	"SUDDEN DEATH"	"10042434"	"60-64 years"	"60-64"	"Sudden Death"
	"1861168-1"	"1861168-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"cardiac arrest"
	"1861248-1"	"1861248-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient was end stage dialysis last dialysis was on Friday Nov 5th  she refused to go to dialysis on Monday Nov 8th. Patient received vaccine on  11/09/2021 and on 11/10/2021 was unresponsive at 7am sent to ER and expired."
	"1861248-1"	"1861248-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Patient was end stage dialysis last dialysis was on Friday Nov 5th  she refused to go to dialysis on Monday Nov 8th. Patient received vaccine on  11/09/2021 and on 11/10/2021 was unresponsive at 7am sent to ER and expired."
	"1861486-1"	"1861486-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient had breakthrough infection and expired"
	"1861486-1"	"1861486-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient had breakthrough infection and expired"
	"1861486-1"	"1861486-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Patient had breakthrough infection and expired"
	"1861486-1"	"1861486-1"	"VACCINE BREAKTHROUGH INFECTION"	"10067923"	"60-64 years"	"60-64"	"Patient had breakthrough infection and expired"
	"1865658-1"	"1865658-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	""pt presents to ED with productive cough, fever and SOB; states has been on 6 L O2 @ home ""all the time"" for a few days; positive for COVID; treated with steroids, breathing treatments, antibiotics; moved to ICU; COVID pneumonia; required emergent intubation; pt's condition worsened; placed on comfort care and extubated; died in the hospital""
	"1865658-1"	"1865658-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	""pt presents to ED with productive cough, fever and SOB; states has been on 6 L O2 @ home ""all the time"" for a few days; positive for COVID; treated with steroids, breathing treatments, antibiotics; moved to ICU; COVID pneumonia; required emergent intubation; pt's condition worsened; placed on comfort care and extubated; died in the hospital""
	"1865658-1"	"1865658-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""pt presents to ED with productive cough, fever and SOB; states has been on 6 L O2 @ home ""all the time"" for a few days; positive for COVID; treated with steroids, breathing treatments, antibiotics; moved to ICU; COVID pneumonia; required emergent intubation; pt's condition worsened; placed on comfort care and extubated; died in the hospital""
	"1865658-1"	"1865658-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	""pt presents to ED with productive cough, fever and SOB; states has been on 6 L O2 @ home ""all the time"" for a few days; positive for COVID; treated with steroids, breathing treatments, antibiotics; moved to ICU; COVID pneumonia; required emergent intubation; pt's condition worsened; placed on comfort care and extubated; died in the hospital""
	"1865658-1"	"1865658-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	""pt presents to ED with productive cough, fever and SOB; states has been on 6 L O2 @ home ""all the time"" for a few days; positive for COVID; treated with steroids, breathing treatments, antibiotics; moved to ICU; COVID pneumonia; required emergent intubation; pt's condition worsened; placed on comfort care and extubated; died in the hospital""
	"1865658-1"	"1865658-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	""pt presents to ED with productive cough, fever and SOB; states has been on 6 L O2 @ home ""all the time"" for a few days; positive for COVID; treated with steroids, breathing treatments, antibiotics; moved to ICU; COVID pneumonia; required emergent intubation; pt's condition worsened; placed on comfort care and extubated; died in the hospital""
	"1865658-1"	"1865658-1"	"PRODUCTIVE COUGH"	"10036790"	"60-64 years"	"60-64"	""pt presents to ED with productive cough, fever and SOB; states has been on 6 L O2 @ home ""all the time"" for a few days; positive for COVID; treated with steroids, breathing treatments, antibiotics; moved to ICU; COVID pneumonia; required emergent intubation; pt's condition worsened; placed on comfort care and extubated; died in the hospital""
	"1865658-1"	"1865658-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	""pt presents to ED with productive cough, fever and SOB; states has been on 6 L O2 @ home ""all the time"" for a few days; positive for COVID; treated with steroids, breathing treatments, antibiotics; moved to ICU; COVID pneumonia; required emergent intubation; pt's condition worsened; placed on comfort care and extubated; died in the hospital""
	"1865658-1"	"1865658-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	""pt presents to ED with productive cough, fever and SOB; states has been on 6 L O2 @ home ""all the time"" for a few days; positive for COVID; treated with steroids, breathing treatments, antibiotics; moved to ICU; COVID pneumonia; required emergent intubation; pt's condition worsened; placed on comfort care and extubated; died in the hospital""
	"1868024-1"	"1868024-1"	"ABDOMINAL PAIN"	"10000081"	"60-64 years"	"60-64"	"Starting in mid-October she experienced abdominal pain. Admitted for stroke on 11/5/2021 Superior mesenteric artery occlusion on 11/9/2021 left common femoral artery occlusion on 11/9/2021 death on 11/12/2021"
	"1868024-1"	"1868024-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"60-64 years"	"60-64"	"Starting in mid-October she experienced abdominal pain. Admitted for stroke on 11/5/2021 Superior mesenteric artery occlusion on 11/9/2021 left common femoral artery occlusion on 11/9/2021 death on 11/12/2021"
	"1868024-1"	"1868024-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Starting in mid-October she experienced abdominal pain. Admitted for stroke on 11/5/2021 Superior mesenteric artery occlusion on 11/9/2021 left common femoral artery occlusion on 11/9/2021 death on 11/12/2021"
	"1868024-1"	"1868024-1"	"MESENTERIC ARTERIAL OCCLUSION"	"10027394"	"60-64 years"	"60-64"	"Starting in mid-October she experienced abdominal pain. Admitted for stroke on 11/5/2021 Superior mesenteric artery occlusion on 11/9/2021 left common femoral artery occlusion on 11/9/2021 death on 11/12/2021"
	"1868024-1"	"1868024-1"	"PERIPHERAL ARTERY OCCLUSION"	"10057525"	"60-64 years"	"60-64"	"Starting in mid-October she experienced abdominal pain. Admitted for stroke on 11/5/2021 Superior mesenteric artery occlusion on 11/9/2021 left common femoral artery occlusion on 11/9/2021 death on 11/12/2021"
	"1868233-1"	"1868233-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Patient died after suffering a heart attack the morning after the first dose was given. Patient had history of diabetes but not heart condition."
	"1868233-1"	"1868233-1"	"CARDIAC FAILURE"	"10007554"	"60-64 years"	"60-64"	"Patient died after suffering a heart attack the morning after the first dose was given. Patient had history of diabetes but not heart condition."
	"1868233-1"	"1868233-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient died after suffering a heart attack the morning after the first dose was given. Patient had history of diabetes but not heart condition."
	"1868233-1"	"1868233-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"Patient died after suffering a heart attack the morning after the first dose was given. Patient had history of diabetes but not heart condition."
	"1869411-1"	"1869411-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Headache 8PM on 11/10/21, found dead the next morning unsure of connection."
	"1869411-1"	"1869411-1"	"HEADACHE"	"10019211"	"60-64 years"	"60-64"	"Headache 8PM on 11/10/21, found dead the next morning unsure of connection."
	"1872966-1"	"1872966-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"I am the epidemiologist reporting on behalf of 62 year-old male patient.  Patient received one dose of the Pfizer vaccine on 3/15/2021, according to immunization records.  The patient passed away on 3/17/2021 (2 days post first dose, hospital inpatient). The death certificate lists ?Cardiac Arrest? as the immediate cause of death due to or as a consequence of esophageal cancer, possible bowel ischemia and colon cancer. No additional information regarding underlying conditions that may have contributed to this death is available."
	"1872966-1"	"1872966-1"	"COLON CANCER"	"10009944"	"60-64 years"	"60-64"	"I am the epidemiologist reporting on behalf of 62 year-old male patient.  Patient received one dose of the Pfizer vaccine on 3/15/2021, according to immunization records.  The patient passed away on 3/17/2021 (2 days post first dose, hospital inpatient). The death certificate lists ?Cardiac Arrest? as the immediate cause of death due to or as a consequence of esophageal cancer, possible bowel ischemia and colon cancer. No additional information regarding underlying conditions that may have contributed to this death is available."
	"1872966-1"	"1872966-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"I am the epidemiologist reporting on behalf of 62 year-old male patient.  Patient received one dose of the Pfizer vaccine on 3/15/2021, according to immunization records.  The patient passed away on 3/17/2021 (2 days post first dose, hospital inpatient). The death certificate lists ?Cardiac Arrest? as the immediate cause of death due to or as a consequence of esophageal cancer, possible bowel ischemia and colon cancer. No additional information regarding underlying conditions that may have contributed to this death is available."
	"1872966-1"	"1872966-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"I am the epidemiologist reporting on behalf of 62 year-old male patient.  Patient received one dose of the Pfizer vaccine on 3/15/2021, according to immunization records.  The patient passed away on 3/17/2021 (2 days post first dose, hospital inpatient). The death certificate lists ?Cardiac Arrest? as the immediate cause of death due to or as a consequence of esophageal cancer, possible bowel ischemia and colon cancer. No additional information regarding underlying conditions that may have contributed to this death is available."
	"1872966-1"	"1872966-1"	"OESOPHAGEAL CARCINOMA"	"10030155"	"60-64 years"	"60-64"	"I am the epidemiologist reporting on behalf of 62 year-old male patient.  Patient received one dose of the Pfizer vaccine on 3/15/2021, according to immunization records.  The patient passed away on 3/17/2021 (2 days post first dose, hospital inpatient). The death certificate lists ?Cardiac Arrest? as the immediate cause of death due to or as a consequence of esophageal cancer, possible bowel ischemia and colon cancer. No additional information regarding underlying conditions that may have contributed to this death is available."
	"1873219-1"	"1873219-1"	"ASTHENIA"	"10003549"	"60-64 years"	"60-64"	"Presented with weakness/diarrhea/vomiting/fever/SOB; dx with Covid PNA; treated with Vit D/Vit C/Zinc/steroids/antibiotics; discharged home; No oxygen needed. pt died on 8/21/21 during subsequent admission (not covid related)"
	"1873219-1"	"1873219-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"Presented with weakness/diarrhea/vomiting/fever/SOB; dx with Covid PNA; treated with Vit D/Vit C/Zinc/steroids/antibiotics; discharged home; No oxygen needed. pt died on 8/21/21 during subsequent admission (not covid related)"
	"1873219-1"	"1873219-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Presented with weakness/diarrhea/vomiting/fever/SOB; dx with Covid PNA; treated with Vit D/Vit C/Zinc/steroids/antibiotics; discharged home; No oxygen needed. pt died on 8/21/21 during subsequent admission (not covid related)"
	"1873219-1"	"1873219-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"Presented with weakness/diarrhea/vomiting/fever/SOB; dx with Covid PNA; treated with Vit D/Vit C/Zinc/steroids/antibiotics; discharged home; No oxygen needed. pt died on 8/21/21 during subsequent admission (not covid related)"
	"1873219-1"	"1873219-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Presented with weakness/diarrhea/vomiting/fever/SOB; dx with Covid PNA; treated with Vit D/Vit C/Zinc/steroids/antibiotics; discharged home; No oxygen needed. pt died on 8/21/21 during subsequent admission (not covid related)"
	"1873219-1"	"1873219-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Presented with weakness/diarrhea/vomiting/fever/SOB; dx with Covid PNA; treated with Vit D/Vit C/Zinc/steroids/antibiotics; discharged home; No oxygen needed. pt died on 8/21/21 during subsequent admission (not covid related)"
	"1873219-1"	"1873219-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"Presented with weakness/diarrhea/vomiting/fever/SOB; dx with Covid PNA; treated with Vit D/Vit C/Zinc/steroids/antibiotics; discharged home; No oxygen needed. pt died on 8/21/21 during subsequent admission (not covid related)"
	"1873273-1"	"1873273-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Sore arm but in May started to feel vertigo like symptoms and was nauseous and couldn?t lay on one side of body. Day she died shortness of breath."
	"1873273-1"	"1873273-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"Sore arm but in May started to feel vertigo like symptoms and was nauseous and couldn?t lay on one side of body. Day she died shortness of breath."
	"1873273-1"	"1873273-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Sore arm but in May started to feel vertigo like symptoms and was nauseous and couldn?t lay on one side of body. Day she died shortness of breath."
	"1873273-1"	"1873273-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Sore arm but in May started to feel vertigo like symptoms and was nauseous and couldn?t lay on one side of body. Day she died shortness of breath."
	"1873273-1"	"1873273-1"	"INTRACARDIAC THROMBUS"	"10048620"	"60-64 years"	"60-64"	"Sore arm but in May started to feel vertigo like symptoms and was nauseous and couldn?t lay on one side of body. Day she died shortness of breath."
	"1873273-1"	"1873273-1"	"NAUSEA"	"10028813"	"60-64 years"	"60-64"	"Sore arm but in May started to feel vertigo like symptoms and was nauseous and couldn?t lay on one side of body. Day she died shortness of breath."
	"1873273-1"	"1873273-1"	"PAIN IN EXTREMITY"	"10033425"	"60-64 years"	"60-64"	"Sore arm but in May started to feel vertigo like symptoms and was nauseous and couldn?t lay on one side of body. Day she died shortness of breath."
	"1873273-1"	"1873273-1"	"PULMONARY THROMBOSIS"	"10037437"	"60-64 years"	"60-64"	"Sore arm but in May started to feel vertigo like symptoms and was nauseous and couldn?t lay on one side of body. Day she died shortness of breath."
	"1873273-1"	"1873273-1"	"VERTIGO"	"10047340"	"60-64 years"	"60-64"	"Sore arm but in May started to feel vertigo like symptoms and was nauseous and couldn?t lay on one side of body. Day she died shortness of breath."
	"1876991-1"	"1876991-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"Patient is a 61 yr/o female who presents today for  cardiac evaluation   for chest pain, abnormal EKG and prior history of coronary artery disease.  Conference for discussion of abnormal PET scan imaging and recommendationsShe has chest pain and shortness of breath on exertion cardiac cath on 6/29/2016 showed the left main 30 to 40% stenosis distally LAD 40 to 60% segmental stenosis and normal LV function at that time.   61 yo woman previously evaluated in office for CAD, who was involved in a MVA.  She was seen and cleared by NS to have CABG.  She has not been in a neck brace since initial visit.  Patient denies any issues or changes since last visit."
	"1876991-1"	"1876991-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"Patient is a 61 yr/o female who presents today for  cardiac evaluation   for chest pain, abnormal EKG and prior history of coronary artery disease.  Conference for discussion of abnormal PET scan imaging and recommendationsShe has chest pain and shortness of breath on exertion cardiac cath on 6/29/2016 showed the left main 30 to 40% stenosis distally LAD 40 to 60% segmental stenosis and normal LV function at that time.   61 yo woman previously evaluated in office for CAD, who was involved in a MVA.  She was seen and cleared by NS to have CABG.  She has not been in a neck brace since initial visit.  Patient denies any issues or changes since last visit."
	"1876991-1"	"1876991-1"	"CORONARY ARTERY BYPASS"	"10011077"	"60-64 years"	"60-64"	"Patient is a 61 yr/o female who presents today for  cardiac evaluation   for chest pain, abnormal EKG and prior history of coronary artery disease.  Conference for discussion of abnormal PET scan imaging and recommendationsShe has chest pain and shortness of breath on exertion cardiac cath on 6/29/2016 showed the left main 30 to 40% stenosis distally LAD 40 to 60% segmental stenosis and normal LV function at that time.   61 yo woman previously evaluated in office for CAD, who was involved in a MVA.  She was seen and cleared by NS to have CABG.  She has not been in a neck brace since initial visit.  Patient denies any issues or changes since last visit."
	"1876991-1"	"1876991-1"	"CORONARY ARTERY DISEASE"	"10011078"	"60-64 years"	"60-64"	"Patient is a 61 yr/o female who presents today for  cardiac evaluation   for chest pain, abnormal EKG and prior history of coronary artery disease.  Conference for discussion of abnormal PET scan imaging and recommendationsShe has chest pain and shortness of breath on exertion cardiac cath on 6/29/2016 showed the left main 30 to 40% stenosis distally LAD 40 to 60% segmental stenosis and normal LV function at that time.   61 yo woman previously evaluated in office for CAD, who was involved in a MVA.  She was seen and cleared by NS to have CABG.  She has not been in a neck brace since initial visit.  Patient denies any issues or changes since last visit."
	"1876991-1"	"1876991-1"	"DYSPNOEA EXERTIONAL"	"10013971"	"60-64 years"	"60-64"	"Patient is a 61 yr/o female who presents today for  cardiac evaluation   for chest pain, abnormal EKG and prior history of coronary artery disease.  Conference for discussion of abnormal PET scan imaging and recommendationsShe has chest pain and shortness of breath on exertion cardiac cath on 6/29/2016 showed the left main 30 to 40% stenosis distally LAD 40 to 60% segmental stenosis and normal LV function at that time.   61 yo woman previously evaluated in office for CAD, who was involved in a MVA.  She was seen and cleared by NS to have CABG.  She has not been in a neck brace since initial visit.  Patient denies any issues or changes since last visit."
	"1876991-1"	"1876991-1"	"ELECTROCARDIOGRAM ABNORMAL"	"10014363"	"60-64 years"	"60-64"	"Patient is a 61 yr/o female who presents today for  cardiac evaluation   for chest pain, abnormal EKG and prior history of coronary artery disease.  Conference for discussion of abnormal PET scan imaging and recommendationsShe has chest pain and shortness of breath on exertion cardiac cath on 6/29/2016 showed the left main 30 to 40% stenosis distally LAD 40 to 60% segmental stenosis and normal LV function at that time.   61 yo woman previously evaluated in office for CAD, who was involved in a MVA.  She was seen and cleared by NS to have CABG.  She has not been in a neck brace since initial visit.  Patient denies any issues or changes since last visit."
	"1876991-1"	"1876991-1"	"POSITRON EMISSION TOMOGRAM ABNORMAL"	"10036221"	"60-64 years"	"60-64"	"Patient is a 61 yr/o female who presents today for  cardiac evaluation   for chest pain, abnormal EKG and prior history of coronary artery disease.  Conference for discussion of abnormal PET scan imaging and recommendationsShe has chest pain and shortness of breath on exertion cardiac cath on 6/29/2016 showed the left main 30 to 40% stenosis distally LAD 40 to 60% segmental stenosis and normal LV function at that time.   61 yo woman previously evaluated in office for CAD, who was involved in a MVA.  She was seen and cleared by NS to have CABG.  She has not been in a neck brace since initial visit.  Patient denies any issues or changes since last visit."
	"1876991-1"	"1876991-1"	"ROAD TRAFFIC ACCIDENT"	"10039203"	"60-64 years"	"60-64"	"Patient is a 61 yr/o female who presents today for  cardiac evaluation   for chest pain, abnormal EKG and prior history of coronary artery disease.  Conference for discussion of abnormal PET scan imaging and recommendationsShe has chest pain and shortness of breath on exertion cardiac cath on 6/29/2016 showed the left main 30 to 40% stenosis distally LAD 40 to 60% segmental stenosis and normal LV function at that time.   61 yo woman previously evaluated in office for CAD, who was involved in a MVA.  She was seen and cleared by NS to have CABG.  She has not been in a neck brace since initial visit.  Patient denies any issues or changes since last visit."
	"1877085-1"	"1877085-1"	"ABDOMINAL DISTENSION"	"10000060"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"ABDOMINAL PAIN"	"10000081"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"ABSCESS DRAINAGE"	"10000279"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"ADENOCARCINOMA METASTATIC"	"10083456"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"ANTICOAGULANT THERAPY"	"10053468"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"ATRIAL FIBRILLATION"	"10003658"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"ATRIAL NATRIURETIC PEPTIDE NORMAL"	"10053411"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"BACTERIAL INFECTION"	"10060945"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"BIOPSY LIVER ABNORMAL"	"10004792"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"BIOPSY LUNG ABNORMAL"	"10004795"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"BLOOD POTASSIUM INCREASED"	"10005725"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"BLOOD SODIUM DECREASED"	"10005802"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"BLOOD TEST ABNORMAL"	"10061016"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"BRONCHOSCOPY"	"10006479"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"CATHETER PLACEMENT"	"10052915"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"CHEMOTHERAPY"	"10061758"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"CHEST TUBE INSERTION"	"10050522"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"COMPUTERISED TOMOGRAM THORAX ABNORMAL"	"10057799"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"DEVICE LEAKAGE"	"10012587"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"DRAIN PLACEMENT"	"10072795"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"ELECTROCARDIOGRAM NORMAL"	"10014373"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"GASTROINTESTINAL TUBE INSERTION"	"10053050"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"HAEMOGLOBIN NORMAL"	"10018890"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"ILEUS"	"10021328"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"IMMUNOCHEMOTHERAPY"	"10077345"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"INCOMPLETE COURSE OF VACCINATION"	"10072103"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"LABORATORY TEST"	"10059938"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"LUNG ADENOCARCINOMA STAGE IV"	"10025038"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"MAGNETIC RESONANCE IMAGING"	"10078223"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"METASTASES TO BONE"	"10027452"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"METASTASES TO LIVER"	"10027457"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"METASTASES TO LYMPH NODES"	"10027459"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"PERICARDIAL DRAINAGE"	"10034471"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"PERICARDIAL EFFUSION"	"10034474"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"PLATELET COUNT DECREASED"	"10035528"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"PLEURAL EFFUSION"	"10035598"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"POSITRON EMISSION TOMOGRAM"	"10036220"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"PULMONARY MASS"	"10056342"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"PULMONARY OEDEMA"	"10037423"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"SCAN WITH CONTRAST"	"10059696"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"TOTAL LUNG CAPACITY DECREASED"	"10044100"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"ULTRASOUND DOPPLER NORMAL"	"10045414"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"ULTRASOUND SCAN"	"10045434"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"VACCINE ASSOCIATED ENHANCED DISEASE"	"10085491"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1877085-1"	"1877085-1"	"WHITE BLOOD CELL COUNT DECREASED"	"10047942"	"60-64 years"	"60-64"	"We were completely unaware of an underlying severe health condition: Inoperable, Stage 4 Adenocarcinoma that had metastasized to his liver, lymph nodes, bones, blood.  The Moderna Shot triggered the cancer to become aggressive resulting in rapid atrial fibrillation and subsequent pleural effusion progressively getting worse until on August 14, 2021 patient was admitted to Hospital. A drain port was installed and a right lung catheter and later after his first round of chemo a left lung catheter was installed.  After two rounds of chemotherapy (the second round included immunotherapy) and a mismanagement of meds, patient died of cardiac arrest during a routine NG tube insertion procedure one Saturday, October 16, 2021."
	"1880482-1"	"1880482-1"	"BLOOD CULTURE POSITIVE"	"10005488"	"60-64 years"	"60-64"	"COVID SSX BEGAN 9/22/21 WHILE PATIENT INCARCERATED. TRANSFERRED TO HOSPITAL DUE TO WORSENING SHORTNESS OF BREATH. ADMITTED TO ICU, PUT ON PRESSORS. INTUBATED ON 10/4/21. DEVELOPED WORSENING KIDNEY FAILURE AND BLOOD CULTURES + FOR SALMONELLA. MAXED OUT ON VENT AND PRESSORS. PATIENT MADE DNR BY FAMILY, CODED & DIED 10/12/2021."
	"1880482-1"	"1880482-1"	"CARDIO-RESPIRATORY ARREST"	"10007617"	"60-64 years"	"60-64"	"COVID SSX BEGAN 9/22/21 WHILE PATIENT INCARCERATED. TRANSFERRED TO HOSPITAL DUE TO WORSENING SHORTNESS OF BREATH. ADMITTED TO ICU, PUT ON PRESSORS. INTUBATED ON 10/4/21. DEVELOPED WORSENING KIDNEY FAILURE AND BLOOD CULTURES + FOR SALMONELLA. MAXED OUT ON VENT AND PRESSORS. PATIENT MADE DNR BY FAMILY, CODED & DIED 10/12/2021."
	"1880482-1"	"1880482-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"COVID SSX BEGAN 9/22/21 WHILE PATIENT INCARCERATED. TRANSFERRED TO HOSPITAL DUE TO WORSENING SHORTNESS OF BREATH. ADMITTED TO ICU, PUT ON PRESSORS. INTUBATED ON 10/4/21. DEVELOPED WORSENING KIDNEY FAILURE AND BLOOD CULTURES + FOR SALMONELLA. MAXED OUT ON VENT AND PRESSORS. PATIENT MADE DNR BY FAMILY, CODED & DIED 10/12/2021."
	"1880482-1"	"1880482-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"COVID SSX BEGAN 9/22/21 WHILE PATIENT INCARCERATED. TRANSFERRED TO HOSPITAL DUE TO WORSENING SHORTNESS OF BREATH. ADMITTED TO ICU, PUT ON PRESSORS. INTUBATED ON 10/4/21. DEVELOPED WORSENING KIDNEY FAILURE AND BLOOD CULTURES + FOR SALMONELLA. MAXED OUT ON VENT AND PRESSORS. PATIENT MADE DNR BY FAMILY, CODED & DIED 10/12/2021."
	"1880482-1"	"1880482-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"COVID SSX BEGAN 9/22/21 WHILE PATIENT INCARCERATED. TRANSFERRED TO HOSPITAL DUE TO WORSENING SHORTNESS OF BREATH. ADMITTED TO ICU, PUT ON PRESSORS. INTUBATED ON 10/4/21. DEVELOPED WORSENING KIDNEY FAILURE AND BLOOD CULTURES + FOR SALMONELLA. MAXED OUT ON VENT AND PRESSORS. PATIENT MADE DNR BY FAMILY, CODED & DIED 10/12/2021."
	"1880482-1"	"1880482-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"COVID SSX BEGAN 9/22/21 WHILE PATIENT INCARCERATED. TRANSFERRED TO HOSPITAL DUE TO WORSENING SHORTNESS OF BREATH. ADMITTED TO ICU, PUT ON PRESSORS. INTUBATED ON 10/4/21. DEVELOPED WORSENING KIDNEY FAILURE AND BLOOD CULTURES + FOR SALMONELLA. MAXED OUT ON VENT AND PRESSORS. PATIENT MADE DNR BY FAMILY, CODED & DIED 10/12/2021."
	"1880482-1"	"1880482-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"COVID SSX BEGAN 9/22/21 WHILE PATIENT INCARCERATED. TRANSFERRED TO HOSPITAL DUE TO WORSENING SHORTNESS OF BREATH. ADMITTED TO ICU, PUT ON PRESSORS. INTUBATED ON 10/4/21. DEVELOPED WORSENING KIDNEY FAILURE AND BLOOD CULTURES + FOR SALMONELLA. MAXED OUT ON VENT AND PRESSORS. PATIENT MADE DNR BY FAMILY, CODED & DIED 10/12/2021."
	"1880482-1"	"1880482-1"	"LUNG INFILTRATION"	"10025102"	"60-64 years"	"60-64"	"COVID SSX BEGAN 9/22/21 WHILE PATIENT INCARCERATED. TRANSFERRED TO HOSPITAL DUE TO WORSENING SHORTNESS OF BREATH. ADMITTED TO ICU, PUT ON PRESSORS. INTUBATED ON 10/4/21. DEVELOPED WORSENING KIDNEY FAILURE AND BLOOD CULTURES + FOR SALMONELLA. MAXED OUT ON VENT AND PRESSORS. PATIENT MADE DNR BY FAMILY, CODED & DIED 10/12/2021."
	"1880482-1"	"1880482-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"COVID SSX BEGAN 9/22/21 WHILE PATIENT INCARCERATED. TRANSFERRED TO HOSPITAL DUE TO WORSENING SHORTNESS OF BREATH. ADMITTED TO ICU, PUT ON PRESSORS. INTUBATED ON 10/4/21. DEVELOPED WORSENING KIDNEY FAILURE AND BLOOD CULTURES + FOR SALMONELLA. MAXED OUT ON VENT AND PRESSORS. PATIENT MADE DNR BY FAMILY, CODED & DIED 10/12/2021."
	"1880482-1"	"1880482-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"COVID SSX BEGAN 9/22/21 WHILE PATIENT INCARCERATED. TRANSFERRED TO HOSPITAL DUE TO WORSENING SHORTNESS OF BREATH. ADMITTED TO ICU, PUT ON PRESSORS. INTUBATED ON 10/4/21. DEVELOPED WORSENING KIDNEY FAILURE AND BLOOD CULTURES + FOR SALMONELLA. MAXED OUT ON VENT AND PRESSORS. PATIENT MADE DNR BY FAMILY, CODED & DIED 10/12/2021."
	"1880482-1"	"1880482-1"	"RENAL FAILURE"	"10038435"	"60-64 years"	"60-64"	"COVID SSX BEGAN 9/22/21 WHILE PATIENT INCARCERATED. TRANSFERRED TO HOSPITAL DUE TO WORSENING SHORTNESS OF BREATH. ADMITTED TO ICU, PUT ON PRESSORS. INTUBATED ON 10/4/21. DEVELOPED WORSENING KIDNEY FAILURE AND BLOOD CULTURES + FOR SALMONELLA. MAXED OUT ON VENT AND PRESSORS. PATIENT MADE DNR BY FAMILY, CODED & DIED 10/12/2021."
	"1880482-1"	"1880482-1"	"SALMONELLOSIS"	"10039447"	"60-64 years"	"60-64"	"COVID SSX BEGAN 9/22/21 WHILE PATIENT INCARCERATED. TRANSFERRED TO HOSPITAL DUE TO WORSENING SHORTNESS OF BREATH. ADMITTED TO ICU, PUT ON PRESSORS. INTUBATED ON 10/4/21. DEVELOPED WORSENING KIDNEY FAILURE AND BLOOD CULTURES + FOR SALMONELLA. MAXED OUT ON VENT AND PRESSORS. PATIENT MADE DNR BY FAMILY, CODED & DIED 10/12/2021."
	"1880771-1"	"1880771-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"pt presents to ED with c/o dyspnea and dry cough; pt with intellectual disability; PMH:  HTN, hyperlipidemia, depression; placed on Vapotherm; dexamethasone; remdesivir; O2 sats declined requiring intubation; developed ARF requiring CRRT; experienced cardiac arrest; CPR administered and medications per protocol; pt died in the hospital"
	"1880771-1"	"1880771-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"pt presents to ED with c/o dyspnea and dry cough; pt with intellectual disability; PMH:  HTN, hyperlipidemia, depression; placed on Vapotherm; dexamethasone; remdesivir; O2 sats declined requiring intubation; developed ARF requiring CRRT; experienced cardiac arrest; CPR administered and medications per protocol; pt died in the hospital"
	"1880771-1"	"1880771-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"pt presents to ED with c/o dyspnea and dry cough; pt with intellectual disability; PMH:  HTN, hyperlipidemia, depression; placed on Vapotherm; dexamethasone; remdesivir; O2 sats declined requiring intubation; developed ARF requiring CRRT; experienced cardiac arrest; CPR administered and medications per protocol; pt died in the hospital"
	"1880771-1"	"1880771-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"pt presents to ED with c/o dyspnea and dry cough; pt with intellectual disability; PMH:  HTN, hyperlipidemia, depression; placed on Vapotherm; dexamethasone; remdesivir; O2 sats declined requiring intubation; developed ARF requiring CRRT; experienced cardiac arrest; CPR administered and medications per protocol; pt died in the hospital"
	"1880771-1"	"1880771-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"pt presents to ED with c/o dyspnea and dry cough; pt with intellectual disability; PMH:  HTN, hyperlipidemia, depression; placed on Vapotherm; dexamethasone; remdesivir; O2 sats declined requiring intubation; developed ARF requiring CRRT; experienced cardiac arrest; CPR administered and medications per protocol; pt died in the hospital"
	"1880771-1"	"1880771-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"pt presents to ED with c/o dyspnea and dry cough; pt with intellectual disability; PMH:  HTN, hyperlipidemia, depression; placed on Vapotherm; dexamethasone; remdesivir; O2 sats declined requiring intubation; developed ARF requiring CRRT; experienced cardiac arrest; CPR administered and medications per protocol; pt died in the hospital"
	"1880771-1"	"1880771-1"	"HAEMOFILTRATION"	"10053090"	"60-64 years"	"60-64"	"pt presents to ED with c/o dyspnea and dry cough; pt with intellectual disability; PMH:  HTN, hyperlipidemia, depression; placed on Vapotherm; dexamethasone; remdesivir; O2 sats declined requiring intubation; developed ARF requiring CRRT; experienced cardiac arrest; CPR administered and medications per protocol; pt died in the hospital"
	"1880771-1"	"1880771-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"pt presents to ED with c/o dyspnea and dry cough; pt with intellectual disability; PMH:  HTN, hyperlipidemia, depression; placed on Vapotherm; dexamethasone; remdesivir; O2 sats declined requiring intubation; developed ARF requiring CRRT; experienced cardiac arrest; CPR administered and medications per protocol; pt died in the hospital"
	"1880771-1"	"1880771-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"pt presents to ED with c/o dyspnea and dry cough; pt with intellectual disability; PMH:  HTN, hyperlipidemia, depression; placed on Vapotherm; dexamethasone; remdesivir; O2 sats declined requiring intubation; developed ARF requiring CRRT; experienced cardiac arrest; CPR administered and medications per protocol; pt died in the hospital"
	"1881307-1"	"1881307-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Case suffered massive brain bleed and  cardiac arrest while Covid positive 6 months after completing the Covid vaccine.  Case died."
	"1881307-1"	"1881307-1"	"CEREBRAL HAEMORRHAGE"	"10008111"	"60-64 years"	"60-64"	"Case suffered massive brain bleed and  cardiac arrest while Covid positive 6 months after completing the Covid vaccine.  Case died."
	"1881307-1"	"1881307-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Case suffered massive brain bleed and  cardiac arrest while Covid positive 6 months after completing the Covid vaccine.  Case died."
	"1881307-1"	"1881307-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Case suffered massive brain bleed and  cardiac arrest while Covid positive 6 months after completing the Covid vaccine.  Case died."
	"1881307-1"	"1881307-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Case suffered massive brain bleed and  cardiac arrest while Covid positive 6 months after completing the Covid vaccine.  Case died."
	"1885029-1"	"1885029-1"	"ABDOMINAL DISTENSION"	"10000060"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"ABDOMINAL PAIN"	"10000081"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"ADRENAL MASS"	"10053235"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"ALVEOLAR LUNG DISEASE"	"10073344"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"ARTERIOSCLEROSIS"	"10003210"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"ASCITES"	"10003445"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"ATELECTASIS"	"10003598"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"BLOOD CULTURE NEGATIVE"	"10005486"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"CENTRAL VENOUS CATHETERISATION"	"10053377"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"CHEST X-RAY"	"10008498"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"COLECTOMY"	"10061778"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"COLON CANCER METASTATIC"	"10055114"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"COMPUTERISED TOMOGRAM ABDOMEN ABNORMAL"	"10057798"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"DEEP VEIN THROMBOSIS"	"10051055"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"ECHOCARDIOGRAM"	"10014113"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"ECHOCARDIOGRAM NORMAL"	"10014115"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"EJECTION FRACTION NORMAL"	"10064144"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"EXPLORATIVE LAPAROTOMY"	"10053361"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"GASTROINTESTINAL CARCINOMA"	"10017940"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"HYPOTENSION"	"10021097"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"INFERIOR VENA CAVAL OCCLUSION"	"10058987"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"INTESTINAL PERFORATION"	"10022694"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"LARGE INTESTINAL OBSTRUCTION"	"10062062"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"LUNG DISORDER"	"10025082"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"LUNG OPACITY"	"10081792"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"LYMPHADENOPATHY MEDIASTINAL"	"10025205"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"METASTASES TO LIVER"	"10027457"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"METASTASES TO LUNG"	"10027458"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"METASTASES TO PELVIS"	"10070913"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"METASTASES TO PERITONEUM"	"10051676"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"NECROTIC LYMPHADENOPATHY"	"10085419"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"OEDEMA"	"10030095"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"OSTEOLYSIS"	"10031248"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"PLEURAL EFFUSION"	"10035598"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"PNEUMONIA"	"10035664"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"PNEUMOPERITONEUM"	"10048299"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"PORTAL VEIN OCCLUSION"	"10058989"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"RENAL ATROPHY"	"10038381"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"RETROPERITONEAL NEOPLASM METASTATIC"	"10062485"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"SCAN WITH CONTRAST ABNORMAL"	"10062152"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"SEPSIS"	"10040047"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"SEPTIC SHOCK"	"10040070"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"SHOCK"	"10040560"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"SMALL INTESTINAL RESECTION"	"10041105"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"SPINAL COMPRESSION FRACTURE"	"10041541"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"SPLENIC INFARCTION"	"10041648"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"TENDERNESS"	"10043224"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"THROMBOSIS"	"10043607"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885029-1"	"1885029-1"	"VENA CAVA FILTER INSERTION"	"10048932"	"60-64 years"	"60-64"	"Patient expired 11/15/2021.  HOSPITAL COURSE: PRESENTING PROBLEM: Shock [R57.9] Colon cancer metastasized to multiple sites [C18.9] Septic shock [A41.9, R65.21] Small bowel cancer [C17.9]  Patient is a 62 y.o. male with history of metastatic stage 4 colon cancer who presented to the emergency department with new bowel perforation of a known right colonic mass. He was hypotensive and unstable at the time of presentation. He was taken for an emergent exploratory laparotomy with a right colectomy and small bowel resection. During the case, he had increasing pressor requirements and worsening hypotension. Decision was made to transfer to the SICU and leave the patient in discontinuity with an abthera for temporary closure.    Patient was therefore transferred to the SICU. He was started on multiple pressors including norepinephrine, vasopressin, and epinephrine to maintain his blood pressure. Despite these interventions, he continued to be unstable. Family made the decision to make him DNR/DNI, however with continued aggressive care and interventions on 11/14. He continued to be on the ventilator with progressively increasing pressor requirements. On the morning of 11/15, family made the decision to transition to comfort care measures. Propofol was stopped, and pressors were stopped shortly after. Family desired extubation and patient was extubated at 0625. Time of death was 0647 on 11/15/2021  Preliminary Cause of Death: Colon cancer metastasized to multiple sites"
	"1885720-1"	"1885720-1"	"AUTOPSY"	"10050117"	"60-64 years"	"60-64"	"Patient found deceased in facility.  Medical Examiner cause of death:  A. Ketoacidosis B. due to COVID-19 vaccination complicating undiagnosed diabetes mellitus.  Contributory: Hypertensive cardiovascular disease.;   Autopsy report was signed on 11/4/2021"
	"1885720-1"	"1885720-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient found deceased in facility.  Medical Examiner cause of death:  A. Ketoacidosis B. due to COVID-19 vaccination complicating undiagnosed diabetes mellitus.  Contributory: Hypertensive cardiovascular disease.;   Autopsy report was signed on 11/4/2021"
	"1885720-1"	"1885720-1"	"HYPERTENSIVE HEART DISEASE"	"10020823"	"60-64 years"	"60-64"	"Patient found deceased in facility.  Medical Examiner cause of death:  A. Ketoacidosis B. due to COVID-19 vaccination complicating undiagnosed diabetes mellitus.  Contributory: Hypertensive cardiovascular disease.;   Autopsy report was signed on 11/4/2021"
	"1885720-1"	"1885720-1"	"KETOACIDOSIS"	"10023379"	"60-64 years"	"60-64"	"Patient found deceased in facility.  Medical Examiner cause of death:  A. Ketoacidosis B. due to COVID-19 vaccination complicating undiagnosed diabetes mellitus.  Contributory: Hypertensive cardiovascular disease.;   Autopsy report was signed on 11/4/2021"
	"1885720-1"	"1885720-1"	"VACCINATION COMPLICATION"	"10046861"	"60-64 years"	"60-64"	"Patient found deceased in facility.  Medical Examiner cause of death:  A. Ketoacidosis B. due to COVID-19 vaccination complicating undiagnosed diabetes mellitus.  Contributory: Hypertensive cardiovascular disease.;   Autopsy report was signed on 11/4/2021"
	"1890301-1"	"1890301-1"	"ANTICOAGULANT THERAPY"	"10053468"	"60-64 years"	"60-64"	"Patient is a 63 y.o. male admitted  on 10/19/21 with Covid-19 (symptom onset around 10/15) and admitted on 10/24 for worsening symptoms. He was treated with decadron and tocilizumab. Remdesivir was contraindicated due to CKD IV. Due to worsening respiratory status and elevated d-dimer he had V/Q scan on 11/1 which was low probability for a PE. He has been transferred out of the Covid unit as he is off precautions.   Initially he was being weaned from oxygen, awaiting a level low enough for discharge. He had increased oxygen requirements on 11/14. Pulmonary Medicine was consulted. It was opted to started empiric lovenox for VTE. Patient did not want to have CT for PE done, due to concern for contrast injury. needing dialysis. LE venous US was negative for DVT. V/Q scan was done on 11/16 with high probability for PE. TTE with evidence of severe pulmonary HTN, dilated RA but no evidence of RV Strain and normal LVEF. clinically worsening.  Discussed imaging findings which suggest signficant lung damage likely still related to his COVID infection and PE"
	"1890301-1"	"1890301-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient is a 63 y.o. male admitted  on 10/19/21 with Covid-19 (symptom onset around 10/15) and admitted on 10/24 for worsening symptoms. He was treated with decadron and tocilizumab. Remdesivir was contraindicated due to CKD IV. Due to worsening respiratory status and elevated d-dimer he had V/Q scan on 11/1 which was low probability for a PE. He has been transferred out of the Covid unit as he is off precautions.   Initially he was being weaned from oxygen, awaiting a level low enough for discharge. He had increased oxygen requirements on 11/14. Pulmonary Medicine was consulted. It was opted to started empiric lovenox for VTE. Patient did not want to have CT for PE done, due to concern for contrast injury. needing dialysis. LE venous US was negative for DVT. V/Q scan was done on 11/16 with high probability for PE. TTE with evidence of severe pulmonary HTN, dilated RA but no evidence of RV Strain and normal LVEF. clinically worsening.  Discussed imaging findings which suggest signficant lung damage likely still related to his COVID infection and PE"
	"1890301-1"	"1890301-1"	"ECHOCARDIOGRAM ABNORMAL"	"10061593"	"60-64 years"	"60-64"	"Patient is a 63 y.o. male admitted  on 10/19/21 with Covid-19 (symptom onset around 10/15) and admitted on 10/24 for worsening symptoms. He was treated with decadron and tocilizumab. Remdesivir was contraindicated due to CKD IV. Due to worsening respiratory status and elevated d-dimer he had V/Q scan on 11/1 which was low probability for a PE. He has been transferred out of the Covid unit as he is off precautions.   Initially he was being weaned from oxygen, awaiting a level low enough for discharge. He had increased oxygen requirements on 11/14. Pulmonary Medicine was consulted. It was opted to started empiric lovenox for VTE. Patient did not want to have CT for PE done, due to concern for contrast injury. needing dialysis. LE venous US was negative for DVT. V/Q scan was done on 11/16 with high probability for PE. TTE with evidence of severe pulmonary HTN, dilated RA but no evidence of RV Strain and normal LVEF. clinically worsening.  Discussed imaging findings which suggest signficant lung damage likely still related to his COVID infection and PE"
	"1890301-1"	"1890301-1"	"EJECTION FRACTION NORMAL"	"10064144"	"60-64 years"	"60-64"	"Patient is a 63 y.o. male admitted  on 10/19/21 with Covid-19 (symptom onset around 10/15) and admitted on 10/24 for worsening symptoms. He was treated with decadron and tocilizumab. Remdesivir was contraindicated due to CKD IV. Due to worsening respiratory status and elevated d-dimer he had V/Q scan on 11/1 which was low probability for a PE. He has been transferred out of the Covid unit as he is off precautions.   Initially he was being weaned from oxygen, awaiting a level low enough for discharge. He had increased oxygen requirements on 11/14. Pulmonary Medicine was consulted. It was opted to started empiric lovenox for VTE. Patient did not want to have CT for PE done, due to concern for contrast injury. needing dialysis. LE venous US was negative for DVT. V/Q scan was done on 11/16 with high probability for PE. TTE with evidence of severe pulmonary HTN, dilated RA but no evidence of RV Strain and normal LVEF. clinically worsening.  Discussed imaging findings which suggest signficant lung damage likely still related to his COVID infection and PE"
	"1890301-1"	"1890301-1"	"EMBOLISM VENOUS"	"10014522"	"60-64 years"	"60-64"	"Patient is a 63 y.o. male admitted  on 10/19/21 with Covid-19 (symptom onset around 10/15) and admitted on 10/24 for worsening symptoms. He was treated with decadron and tocilizumab. Remdesivir was contraindicated due to CKD IV. Due to worsening respiratory status and elevated d-dimer he had V/Q scan on 11/1 which was low probability for a PE. He has been transferred out of the Covid unit as he is off precautions.   Initially he was being weaned from oxygen, awaiting a level low enough for discharge. He had increased oxygen requirements on 11/14. Pulmonary Medicine was consulted. It was opted to started empiric lovenox for VTE. Patient did not want to have CT for PE done, due to concern for contrast injury. needing dialysis. LE venous US was negative for DVT. V/Q scan was done on 11/16 with high probability for PE. TTE with evidence of severe pulmonary HTN, dilated RA but no evidence of RV Strain and normal LVEF. clinically worsening.  Discussed imaging findings which suggest signficant lung damage likely still related to his COVID infection and PE"
	"1890301-1"	"1890301-1"	"FIBRIN D DIMER INCREASED"	"10016581"	"60-64 years"	"60-64"	"Patient is a 63 y.o. male admitted  on 10/19/21 with Covid-19 (symptom onset around 10/15) and admitted on 10/24 for worsening symptoms. He was treated with decadron and tocilizumab. Remdesivir was contraindicated due to CKD IV. Due to worsening respiratory status and elevated d-dimer he had V/Q scan on 11/1 which was low probability for a PE. He has been transferred out of the Covid unit as he is off precautions.   Initially he was being weaned from oxygen, awaiting a level low enough for discharge. He had increased oxygen requirements on 11/14. Pulmonary Medicine was consulted. It was opted to started empiric lovenox for VTE. Patient did not want to have CT for PE done, due to concern for contrast injury. needing dialysis. LE venous US was negative for DVT. V/Q scan was done on 11/16 with high probability for PE. TTE with evidence of severe pulmonary HTN, dilated RA but no evidence of RV Strain and normal LVEF. clinically worsening.  Discussed imaging findings which suggest signficant lung damage likely still related to his COVID infection and PE"
	"1890301-1"	"1890301-1"	"IMAGING PROCEDURE ABNORMAL"	"10077446"	"60-64 years"	"60-64"	"Patient is a 63 y.o. male admitted  on 10/19/21 with Covid-19 (symptom onset around 10/15) and admitted on 10/24 for worsening symptoms. He was treated with decadron and tocilizumab. Remdesivir was contraindicated due to CKD IV. Due to worsening respiratory status and elevated d-dimer he had V/Q scan on 11/1 which was low probability for a PE. He has been transferred out of the Covid unit as he is off precautions.   Initially he was being weaned from oxygen, awaiting a level low enough for discharge. He had increased oxygen requirements on 11/14. Pulmonary Medicine was consulted. It was opted to started empiric lovenox for VTE. Patient did not want to have CT for PE done, due to concern for contrast injury. needing dialysis. LE venous US was negative for DVT. V/Q scan was done on 11/16 with high probability for PE. TTE with evidence of severe pulmonary HTN, dilated RA but no evidence of RV Strain and normal LVEF. clinically worsening.  Discussed imaging findings which suggest signficant lung damage likely still related to his COVID infection and PE"
	"1890301-1"	"1890301-1"	"LUNG DISORDER"	"10025082"	"60-64 years"	"60-64"	"Patient is a 63 y.o. male admitted  on 10/19/21 with Covid-19 (symptom onset around 10/15) and admitted on 10/24 for worsening symptoms. He was treated with decadron and tocilizumab. Remdesivir was contraindicated due to CKD IV. Due to worsening respiratory status and elevated d-dimer he had V/Q scan on 11/1 which was low probability for a PE. He has been transferred out of the Covid unit as he is off precautions.   Initially he was being weaned from oxygen, awaiting a level low enough for discharge. He had increased oxygen requirements on 11/14. Pulmonary Medicine was consulted. It was opted to started empiric lovenox for VTE. Patient did not want to have CT for PE done, due to concern for contrast injury. needing dialysis. LE venous US was negative for DVT. V/Q scan was done on 11/16 with high probability for PE. TTE with evidence of severe pulmonary HTN, dilated RA but no evidence of RV Strain and normal LVEF. clinically worsening.  Discussed imaging findings which suggest signficant lung damage likely still related to his COVID infection and PE"
	"1890301-1"	"1890301-1"	"PULMONARY EMBOLISM"	"10037377"	"60-64 years"	"60-64"	"Patient is a 63 y.o. male admitted  on 10/19/21 with Covid-19 (symptom onset around 10/15) and admitted on 10/24 for worsening symptoms. He was treated with decadron and tocilizumab. Remdesivir was contraindicated due to CKD IV. Due to worsening respiratory status and elevated d-dimer he had V/Q scan on 11/1 which was low probability for a PE. He has been transferred out of the Covid unit as he is off precautions.   Initially he was being weaned from oxygen, awaiting a level low enough for discharge. He had increased oxygen requirements on 11/14. Pulmonary Medicine was consulted. It was opted to started empiric lovenox for VTE. Patient did not want to have CT for PE done, due to concern for contrast injury. needing dialysis. LE venous US was negative for DVT. V/Q scan was done on 11/16 with high probability for PE. TTE with evidence of severe pulmonary HTN, dilated RA but no evidence of RV Strain and normal LVEF. clinically worsening.  Discussed imaging findings which suggest signficant lung damage likely still related to his COVID infection and PE"
	"1890301-1"	"1890301-1"	"PULMONARY HYPERTENSION"	"10037400"	"60-64 years"	"60-64"	"Patient is a 63 y.o. male admitted  on 10/19/21 with Covid-19 (symptom onset around 10/15) and admitted on 10/24 for worsening symptoms. He was treated with decadron and tocilizumab. Remdesivir was contraindicated due to CKD IV. Due to worsening respiratory status and elevated d-dimer he had V/Q scan on 11/1 which was low probability for a PE. He has been transferred out of the Covid unit as he is off precautions.   Initially he was being weaned from oxygen, awaiting a level low enough for discharge. He had increased oxygen requirements on 11/14. Pulmonary Medicine was consulted. It was opted to started empiric lovenox for VTE. Patient did not want to have CT for PE done, due to concern for contrast injury. needing dialysis. LE venous US was negative for DVT. V/Q scan was done on 11/16 with high probability for PE. TTE with evidence of severe pulmonary HTN, dilated RA but no evidence of RV Strain and normal LVEF. clinically worsening.  Discussed imaging findings which suggest signficant lung damage likely still related to his COVID infection and PE"
	"1890301-1"	"1890301-1"	"RESPIRATORY DISORDER"	"10038683"	"60-64 years"	"60-64"	"Patient is a 63 y.o. male admitted  on 10/19/21 with Covid-19 (symptom onset around 10/15) and admitted on 10/24 for worsening symptoms. He was treated with decadron and tocilizumab. Remdesivir was contraindicated due to CKD IV. Due to worsening respiratory status and elevated d-dimer he had V/Q scan on 11/1 which was low probability for a PE. He has been transferred out of the Covid unit as he is off precautions.   Initially he was being weaned from oxygen, awaiting a level low enough for discharge. He had increased oxygen requirements on 11/14. Pulmonary Medicine was consulted. It was opted to started empiric lovenox for VTE. Patient did not want to have CT for PE done, due to concern for contrast injury. needing dialysis. LE venous US was negative for DVT. V/Q scan was done on 11/16 with high probability for PE. TTE with evidence of severe pulmonary HTN, dilated RA but no evidence of RV Strain and normal LVEF. clinically worsening.  Discussed imaging findings which suggest signficant lung damage likely still related to his COVID infection and PE"
	"1890301-1"	"1890301-1"	"RIGHT ATRIAL DILATATION"	"10067282"	"60-64 years"	"60-64"	"Patient is a 63 y.o. male admitted  on 10/19/21 with Covid-19 (symptom onset around 10/15) and admitted on 10/24 for worsening symptoms. He was treated with decadron and tocilizumab. Remdesivir was contraindicated due to CKD IV. Due to worsening respiratory status and elevated d-dimer he had V/Q scan on 11/1 which was low probability for a PE. He has been transferred out of the Covid unit as he is off precautions.   Initially he was being weaned from oxygen, awaiting a level low enough for discharge. He had increased oxygen requirements on 11/14. Pulmonary Medicine was consulted. It was opted to started empiric lovenox for VTE. Patient did not want to have CT for PE done, due to concern for contrast injury. needing dialysis. LE venous US was negative for DVT. V/Q scan was done on 11/16 with high probability for PE. TTE with evidence of severe pulmonary HTN, dilated RA but no evidence of RV Strain and normal LVEF. clinically worsening.  Discussed imaging findings which suggest signficant lung damage likely still related to his COVID infection and PE"
	"1890301-1"	"1890301-1"	"ULTRASOUND DOPPLER NORMAL"	"10045414"	"60-64 years"	"60-64"	"Patient is a 63 y.o. male admitted  on 10/19/21 with Covid-19 (symptom onset around 10/15) and admitted on 10/24 for worsening symptoms. He was treated with decadron and tocilizumab. Remdesivir was contraindicated due to CKD IV. Due to worsening respiratory status and elevated d-dimer he had V/Q scan on 11/1 which was low probability for a PE. He has been transferred out of the Covid unit as he is off precautions.   Initially he was being weaned from oxygen, awaiting a level low enough for discharge. He had increased oxygen requirements on 11/14. Pulmonary Medicine was consulted. It was opted to started empiric lovenox for VTE. Patient did not want to have CT for PE done, due to concern for contrast injury. needing dialysis. LE venous US was negative for DVT. V/Q scan was done on 11/16 with high probability for PE. TTE with evidence of severe pulmonary HTN, dilated RA but no evidence of RV Strain and normal LVEF. clinically worsening.  Discussed imaging findings which suggest signficant lung damage likely still related to his COVID infection and PE"
	"1890301-1"	"1890301-1"	"VENTILATION/PERFUSION SCAN ABNORMAL"	"10047265"	"60-64 years"	"60-64"	"Patient is a 63 y.o. male admitted  on 10/19/21 with Covid-19 (symptom onset around 10/15) and admitted on 10/24 for worsening symptoms. He was treated with decadron and tocilizumab. Remdesivir was contraindicated due to CKD IV. Due to worsening respiratory status and elevated d-dimer he had V/Q scan on 11/1 which was low probability for a PE. He has been transferred out of the Covid unit as he is off precautions.   Initially he was being weaned from oxygen, awaiting a level low enough for discharge. He had increased oxygen requirements on 11/14. Pulmonary Medicine was consulted. It was opted to started empiric lovenox for VTE. Patient did not want to have CT for PE done, due to concern for contrast injury. needing dialysis. LE venous US was negative for DVT. V/Q scan was done on 11/16 with high probability for PE. TTE with evidence of severe pulmonary HTN, dilated RA but no evidence of RV Strain and normal LVEF. clinically worsening.  Discussed imaging findings which suggest signficant lung damage likely still related to his COVID infection and PE"
	"1893818-1"	"1893818-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Received the Booster shot 12pm on 11/5/2021,  had chest pain at 9pm  11/5/2021. Was hospitalized at 10pm on 11/5/2021. Heart stopped on 11/10/2021 was revived and placed on a ventilator. Heart stopped again on 11/11/2021 at around 7pm was again revived.  Died on 11/13/2021"
	"1893818-1"	"1893818-1"	"CHEST PAIN"	"10008479"	"60-64 years"	"60-64"	"Received the Booster shot 12pm on 11/5/2021,  had chest pain at 9pm  11/5/2021. Was hospitalized at 10pm on 11/5/2021. Heart stopped on 11/10/2021 was revived and placed on a ventilator. Heart stopped again on 11/11/2021 at around 7pm was again revived.  Died on 11/13/2021"
	"1893818-1"	"1893818-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Received the Booster shot 12pm on 11/5/2021,  had chest pain at 9pm  11/5/2021. Was hospitalized at 10pm on 11/5/2021. Heart stopped on 11/10/2021 was revived and placed on a ventilator. Heart stopped again on 11/11/2021 at around 7pm was again revived.  Died on 11/13/2021"
	"1893818-1"	"1893818-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Received the Booster shot 12pm on 11/5/2021,  had chest pain at 9pm  11/5/2021. Was hospitalized at 10pm on 11/5/2021. Heart stopped on 11/10/2021 was revived and placed on a ventilator. Heart stopped again on 11/11/2021 at around 7pm was again revived.  Died on 11/13/2021"
	"1893818-1"	"1893818-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Received the Booster shot 12pm on 11/5/2021,  had chest pain at 9pm  11/5/2021. Was hospitalized at 10pm on 11/5/2021. Heart stopped on 11/10/2021 was revived and placed on a ventilator. Heart stopped again on 11/11/2021 at around 7pm was again revived.  Died on 11/13/2021"
	"1894208-1"	"1894208-1"	"ARTHRALGIA"	"10003239"	"60-64 years"	"60-64"	"Pt stated the morning after getting his booster shot he had severe body aches, joint pain, severe fatigue and light headedness. On 11/20/2021 he reported he started coughing up blood. On 11/22/2021 he stated he had a fever and ended up having a Grand Mal Seizure.  All symptoms lasted until he was pronounced dead on 11/23/2021."
	"1894208-1"	"1894208-1"	"BLOOD LACTIC ACID"	"10005632"	"60-64 years"	"60-64"	"Pt stated the morning after getting his booster shot he had severe body aches, joint pain, severe fatigue and light headedness. On 11/20/2021 he reported he started coughing up blood. On 11/22/2021 he stated he had a fever and ended up having a Grand Mal Seizure.  All symptoms lasted until he was pronounced dead on 11/23/2021."
	"1894208-1"	"1894208-1"	"CHEST X-RAY"	"10008498"	"60-64 years"	"60-64"	"Pt stated the morning after getting his booster shot he had severe body aches, joint pain, severe fatigue and light headedness. On 11/20/2021 he reported he started coughing up blood. On 11/22/2021 he stated he had a fever and ended up having a Grand Mal Seizure.  All symptoms lasted until he was pronounced dead on 11/23/2021."
	"1894208-1"	"1894208-1"	"COMPUTERISED TOMOGRAM HEAD"	"10054003"	"60-64 years"	"60-64"	"Pt stated the morning after getting his booster shot he had severe body aches, joint pain, severe fatigue and light headedness. On 11/20/2021 he reported he started coughing up blood. On 11/22/2021 he stated he had a fever and ended up having a Grand Mal Seizure.  All symptoms lasted until he was pronounced dead on 11/23/2021."
	"1894208-1"	"1894208-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pt stated the morning after getting his booster shot he had severe body aches, joint pain, severe fatigue and light headedness. On 11/20/2021 he reported he started coughing up blood. On 11/22/2021 he stated he had a fever and ended up having a Grand Mal Seizure.  All symptoms lasted until he was pronounced dead on 11/23/2021."
	"1894208-1"	"1894208-1"	"DIZZINESS"	"10013573"	"60-64 years"	"60-64"	"Pt stated the morning after getting his booster shot he had severe body aches, joint pain, severe fatigue and light headedness. On 11/20/2021 he reported he started coughing up blood. On 11/22/2021 he stated he had a fever and ended up having a Grand Mal Seizure.  All symptoms lasted until he was pronounced dead on 11/23/2021."
	"1894208-1"	"1894208-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	"Pt stated the morning after getting his booster shot he had severe body aches, joint pain, severe fatigue and light headedness. On 11/20/2021 he reported he started coughing up blood. On 11/22/2021 he stated he had a fever and ended up having a Grand Mal Seizure.  All symptoms lasted until he was pronounced dead on 11/23/2021."
	"1894208-1"	"1894208-1"	"FULL BLOOD COUNT"	"10017411"	"60-64 years"	"60-64"	"Pt stated the morning after getting his booster shot he had severe body aches, joint pain, severe fatigue and light headedness. On 11/20/2021 he reported he started coughing up blood. On 11/22/2021 he stated he had a fever and ended up having a Grand Mal Seizure.  All symptoms lasted until he was pronounced dead on 11/23/2021."
	"1894208-1"	"1894208-1"	"GENERALISED TONIC-CLONIC SEIZURE"	"10018100"	"60-64 years"	"60-64"	"Pt stated the morning after getting his booster shot he had severe body aches, joint pain, severe fatigue and light headedness. On 11/20/2021 he reported he started coughing up blood. On 11/22/2021 he stated he had a fever and ended up having a Grand Mal Seizure.  All symptoms lasted until he was pronounced dead on 11/23/2021."
	"1894208-1"	"1894208-1"	"HAEMOPTYSIS"	"10018964"	"60-64 years"	"60-64"	"Pt stated the morning after getting his booster shot he had severe body aches, joint pain, severe fatigue and light headedness. On 11/20/2021 he reported he started coughing up blood. On 11/22/2021 he stated he had a fever and ended up having a Grand Mal Seizure.  All symptoms lasted until he was pronounced dead on 11/23/2021."
	"1894208-1"	"1894208-1"	"METABOLIC FUNCTION TEST"	"10062191"	"60-64 years"	"60-64"	"Pt stated the morning after getting his booster shot he had severe body aches, joint pain, severe fatigue and light headedness. On 11/20/2021 he reported he started coughing up blood. On 11/22/2021 he stated he had a fever and ended up having a Grand Mal Seizure.  All symptoms lasted until he was pronounced dead on 11/23/2021."
	"1894208-1"	"1894208-1"	"PAIN"	"10033371"	"60-64 years"	"60-64"	"Pt stated the morning after getting his booster shot he had severe body aches, joint pain, severe fatigue and light headedness. On 11/20/2021 he reported he started coughing up blood. On 11/22/2021 he stated he had a fever and ended up having a Grand Mal Seizure.  All symptoms lasted until he was pronounced dead on 11/23/2021."
	"1894208-1"	"1894208-1"	"PYREXIA"	"10037660"	"60-64 years"	"60-64"	"Pt stated the morning after getting his booster shot he had severe body aches, joint pain, severe fatigue and light headedness. On 11/20/2021 he reported he started coughing up blood. On 11/22/2021 he stated he had a fever and ended up having a Grand Mal Seizure.  All symptoms lasted until he was pronounced dead on 11/23/2021."
	"1894208-1"	"1894208-1"	"URINE ANALYSIS"	"10046614"	"60-64 years"	"60-64"	"Pt stated the morning after getting his booster shot he had severe body aches, joint pain, severe fatigue and light headedness. On 11/20/2021 he reported he started coughing up blood. On 11/22/2021 he stated he had a fever and ended up having a Grand Mal Seizure.  All symptoms lasted until he was pronounced dead on 11/23/2021."
	"1894527-1"	"1894527-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Could not breath, was admitted to Hosp on Aug 2, 2021 around 11a and passed away Aug 16, 2021"
	"1894527-1"	"1894527-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Could not breath, was admitted to Hosp on Aug 2, 2021 around 11a and passed away Aug 16, 2021"
	"1895092-1"	"1895092-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"the vaccine recepient died 9/9/2021, 2 weeks after receiving the J&J covid vaccine"
	"1897825-1"	"1897825-1"	"CHEST TUBE INSERTION"	"10050522"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/01/2021.  PMHx significant for COPD heart failure and CKD3. Presented to ED on 11/16/2021 with shortness of breath for several days, noted to have severe respiratory distress with oxygen saturation in 50's requiring intubation in ED. CXR in ED confirmed pneumothorax requiring chest tube. Due to chronic lung disease and Covid-19 infx lung status remained poor with persistent air leak.  Family decided to withdraw life support on 11/19/2021."
	"1897825-1"	"1897825-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/01/2021.  PMHx significant for COPD heart failure and CKD3. Presented to ED on 11/16/2021 with shortness of breath for several days, noted to have severe respiratory distress with oxygen saturation in 50's requiring intubation in ED. CXR in ED confirmed pneumothorax requiring chest tube. Due to chronic lung disease and Covid-19 infx lung status remained poor with persistent air leak.  Family decided to withdraw life support on 11/19/2021."
	"1897825-1"	"1897825-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/01/2021.  PMHx significant for COPD heart failure and CKD3. Presented to ED on 11/16/2021 with shortness of breath for several days, noted to have severe respiratory distress with oxygen saturation in 50's requiring intubation in ED. CXR in ED confirmed pneumothorax requiring chest tube. Due to chronic lung disease and Covid-19 infx lung status remained poor with persistent air leak.  Family decided to withdraw life support on 11/19/2021."
	"1897825-1"	"1897825-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/01/2021.  PMHx significant for COPD heart failure and CKD3. Presented to ED on 11/16/2021 with shortness of breath for several days, noted to have severe respiratory distress with oxygen saturation in 50's requiring intubation in ED. CXR in ED confirmed pneumothorax requiring chest tube. Due to chronic lung disease and Covid-19 infx lung status remained poor with persistent air leak.  Family decided to withdraw life support on 11/19/2021."
	"1897825-1"	"1897825-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/01/2021.  PMHx significant for COPD heart failure and CKD3. Presented to ED on 11/16/2021 with shortness of breath for several days, noted to have severe respiratory distress with oxygen saturation in 50's requiring intubation in ED. CXR in ED confirmed pneumothorax requiring chest tube. Due to chronic lung disease and Covid-19 infx lung status remained poor with persistent air leak.  Family decided to withdraw life support on 11/19/2021."
	"1897825-1"	"1897825-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/01/2021.  PMHx significant for COPD heart failure and CKD3. Presented to ED on 11/16/2021 with shortness of breath for several days, noted to have severe respiratory distress with oxygen saturation in 50's requiring intubation in ED. CXR in ED confirmed pneumothorax requiring chest tube. Due to chronic lung disease and Covid-19 infx lung status remained poor with persistent air leak.  Family decided to withdraw life support on 11/19/2021."
	"1897825-1"	"1897825-1"	"PNEUMOTHORAX"	"10035759"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/01/2021.  PMHx significant for COPD heart failure and CKD3. Presented to ED on 11/16/2021 with shortness of breath for several days, noted to have severe respiratory distress with oxygen saturation in 50's requiring intubation in ED. CXR in ED confirmed pneumothorax requiring chest tube. Due to chronic lung disease and Covid-19 infx lung status remained poor with persistent air leak.  Family decided to withdraw life support on 11/19/2021."
	"1897825-1"	"1897825-1"	"PULMONARY AIR LEAKAGE"	"10067826"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/01/2021.  PMHx significant for COPD heart failure and CKD3. Presented to ED on 11/16/2021 with shortness of breath for several days, noted to have severe respiratory distress with oxygen saturation in 50's requiring intubation in ED. CXR in ED confirmed pneumothorax requiring chest tube. Due to chronic lung disease and Covid-19 infx lung status remained poor with persistent air leak.  Family decided to withdraw life support on 11/19/2021."
	"1897825-1"	"1897825-1"	"RESPIRATORY DISTRESS"	"10038687"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/01/2021.  PMHx significant for COPD heart failure and CKD3. Presented to ED on 11/16/2021 with shortness of breath for several days, noted to have severe respiratory distress with oxygen saturation in 50's requiring intubation in ED. CXR in ED confirmed pneumothorax requiring chest tube. Due to chronic lung disease and Covid-19 infx lung status remained poor with persistent air leak.  Family decided to withdraw life support on 11/19/2021."
	"1897825-1"	"1897825-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Pfizer BioNTech COVID-19 Vaccine EUA: COVID-19 case resulting in Hospitalization / Death. Patient received Pfizer Vaccines on 3/11/2021 and 4/01/2021.  PMHx significant for COPD heart failure and CKD3. Presented to ED on 11/16/2021 with shortness of breath for several days, noted to have severe respiratory distress with oxygen saturation in 50's requiring intubation in ED. CXR in ED confirmed pneumothorax requiring chest tube. Due to chronic lung disease and Covid-19 infx lung status remained poor with persistent air leak.  Family decided to withdraw life support on 11/19/2021."
	"1897869-1"	"1897869-1"	"BLOOD GLUCOSE INCREASED"	"10005557"	"60-64 years"	"60-64"	"Difficulty breathing starting at approximately 1254, upon EMS arrival she was unresponsive, absent pulse and absent breath sounds. Blood glucose 390. CPR initiated. initially in asystole then 1 episode of a shockable rhythm and was defibrillated at 150 joules, but then returned to asystole. Transferred to hospital. During transport received 5 rounds of epinephrine and supraglottic airway in place with ETCO2 at 25 and chest compression administered via LUCAS device. 1L of NS given during transport and sodium bicarb. Arrived at hospital unresponsive time 45-50 minutes."
	"1897869-1"	"1897869-1"	"BREATH SOUNDS ABSENT"	"10062285"	"60-64 years"	"60-64"	"Difficulty breathing starting at approximately 1254, upon EMS arrival she was unresponsive, absent pulse and absent breath sounds. Blood glucose 390. CPR initiated. initially in asystole then 1 episode of a shockable rhythm and was defibrillated at 150 joules, but then returned to asystole. Transferred to hospital. During transport received 5 rounds of epinephrine and supraglottic airway in place with ETCO2 at 25 and chest compression administered via LUCAS device. 1L of NS given during transport and sodium bicarb. Arrived at hospital unresponsive time 45-50 minutes."
	"1897869-1"	"1897869-1"	"CARDIAC ARREST"	"10007515"	"60-64 years"	"60-64"	"Difficulty breathing starting at approximately 1254, upon EMS arrival she was unresponsive, absent pulse and absent breath sounds. Blood glucose 390. CPR initiated. initially in asystole then 1 episode of a shockable rhythm and was defibrillated at 150 joules, but then returned to asystole. Transferred to hospital. During transport received 5 rounds of epinephrine and supraglottic airway in place with ETCO2 at 25 and chest compression administered via LUCAS device. 1L of NS given during transport and sodium bicarb. Arrived at hospital unresponsive time 45-50 minutes."
	"1897869-1"	"1897869-1"	"CARDIOVERSION"	"10007661"	"60-64 years"	"60-64"	"Difficulty breathing starting at approximately 1254, upon EMS arrival she was unresponsive, absent pulse and absent breath sounds. Blood glucose 390. CPR initiated. initially in asystole then 1 episode of a shockable rhythm and was defibrillated at 150 joules, but then returned to asystole. Transferred to hospital. During transport received 5 rounds of epinephrine and supraglottic airway in place with ETCO2 at 25 and chest compression administered via LUCAS device. 1L of NS given during transport and sodium bicarb. Arrived at hospital unresponsive time 45-50 minutes."
	"1897869-1"	"1897869-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"Difficulty breathing starting at approximately 1254, upon EMS arrival she was unresponsive, absent pulse and absent breath sounds. Blood glucose 390. CPR initiated. initially in asystole then 1 episode of a shockable rhythm and was defibrillated at 150 joules, but then returned to asystole. Transferred to hospital. During transport received 5 rounds of epinephrine and supraglottic airway in place with ETCO2 at 25 and chest compression administered via LUCAS device. 1L of NS given during transport and sodium bicarb. Arrived at hospital unresponsive time 45-50 minutes."
	"1897869-1"	"1897869-1"	"PULSE ABSENT"	"10037469"	"60-64 years"	"60-64"	"Difficulty breathing starting at approximately 1254, upon EMS arrival she was unresponsive, absent pulse and absent breath sounds. Blood glucose 390. CPR initiated. initially in asystole then 1 episode of a shockable rhythm and was defibrillated at 150 joules, but then returned to asystole. Transferred to hospital. During transport received 5 rounds of epinephrine and supraglottic airway in place with ETCO2 at 25 and chest compression administered via LUCAS device. 1L of NS given during transport and sodium bicarb. Arrived at hospital unresponsive time 45-50 minutes."
	"1897869-1"	"1897869-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"Difficulty breathing starting at approximately 1254, upon EMS arrival she was unresponsive, absent pulse and absent breath sounds. Blood glucose 390. CPR initiated. initially in asystole then 1 episode of a shockable rhythm and was defibrillated at 150 joules, but then returned to asystole. Transferred to hospital. During transport received 5 rounds of epinephrine and supraglottic airway in place with ETCO2 at 25 and chest compression administered via LUCAS device. 1L of NS given during transport and sodium bicarb. Arrived at hospital unresponsive time 45-50 minutes."
	"1897869-1"	"1897869-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Difficulty breathing starting at approximately 1254, upon EMS arrival she was unresponsive, absent pulse and absent breath sounds. Blood glucose 390. CPR initiated. initially in asystole then 1 episode of a shockable rhythm and was defibrillated at 150 joules, but then returned to asystole. Transferred to hospital. During transport received 5 rounds of epinephrine and supraglottic airway in place with ETCO2 at 25 and chest compression administered via LUCAS device. 1L of NS given during transport and sodium bicarb. Arrived at hospital unresponsive time 45-50 minutes."
	"1897981-1"	"1897981-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"The patient had a heart attack and died two days after his second COVID-19 vaccine. He was taken to the hospital. Their phone number is (Privacy)."
	"1897981-1"	"1897981-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"The patient had a heart attack and died two days after his second COVID-19 vaccine. He was taken to the hospital. Their phone number is (Privacy)."
	"1898729-1"	"1898729-1"	"ANGIOGRAM PULMONARY ABNORMAL"	"10002441"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"BLOOD CULTURE POSITIVE"	"10005488"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"CHEST X-RAY NORMAL"	"10008500"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"COMPUTERISED TOMOGRAM ABDOMEN ABNORMAL"	"10057798"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"COMPUTERISED TOMOGRAM HEAD"	"10054003"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"COMPUTERISED TOMOGRAM SPINE"	"10081777"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"COMPUTERISED TOMOGRAM THORAX ABNORMAL"	"10057799"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"ENCEPHALOPATHY"	"10014625"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"ENDOTRACHEAL INTUBATION"	"10067450"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"LACTIC ACIDOSIS"	"10023676"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"LUMBAR PUNCTURE ABNORMAL"	"10025000"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"MECHANICAL VENTILATION"	"10067221"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"MENTAL STATUS CHANGES"	"10048294"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"PNEUMATOSIS INTESTINALIS"	"10057030"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"RESPIRATION ABNORMAL"	"10038647"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"RHABDOMYOLYSIS"	"10039020"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"STAPHYLOCOCCAL INFECTION"	"10058080"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"UNRESPONSIVE TO STIMULI"	"10045555"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1898729-1"	"1898729-1"	"XANTHOCHROMIA"	"10048213"	"60-64 years"	"60-64"	"Patient is deceased.  Hospitalized (11.17.21);  COVID-19 positive (11.17.21);  Fully vaccinated PLUS booster. Admission Date: 11/17/2021 Date of Death: 11/23/21 Time of Death:  2:13 AM Preliminary Cause of Death: COVID-19 DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Lactic acidosis  Encephalopathy acute  Non-traumatic rhabdomyolysis  AMS (altered mental status)  COVID-19  HOSPITAL COURSE: Patient is a 64 year old male with past medical history significant for alcohol abuse, cirrhosis, prior hepatitis C infection, diabetes, left BKA. He presented to the ER 11/17 after being found unresponsive at home (reportedly found by program after several uncollected meals left on doorstep). CT head with possible subdural hygroma. CT spine without acute abnormality. CT t/a/p with possible contusion to left upper arm and left anterior chest wall, liver cirrhosis with portal hypertension. He was incidentally found to be COVID positive but was admitted on room air. Patient was orientated x0 but was protecting airway and was admitted to hospitalist service. Overnight, patient became more obtunded and was transferred to ICU 11/18am and emergently intubated. Blood cultures from admission 2:2 positive for staph aureus. Neurology and infectious disease consulted. CT thoracic and lumbar imaging without evidence of abscess (currently unable to obtain MRI due to inability to complete questionnaire).  Pt was breath stacking, therefore changed into PSV mode.  During turns, pt suddenly desatted requiring full vent support and 100% FIO2.  Stat CXR was done and NEG for pneumothorax.  CTA chest was ordered and demonstrated pneumotosis of colon, portal venous system and gastric.  LP + for Xanthochromia.  Family was updated and decided not to pursue ongoing aggressive care.  He was pronounced at 02:13 on 11/23/2021. Brother was called and updated."
	"1902165-1"	"1902165-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"60-64 years"	"60-64"	"patient admitted for stroke 10/20-11/2/2021. received Pfizer vaccine 10/28/2021. discharged to SAR 11/2/2021. date of death = 11/20/2021."
	"1902165-1"	"1902165-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"patient admitted for stroke 10/20-11/2/2021. received Pfizer vaccine 10/28/2021. discharged to SAR 11/2/2021. date of death = 11/20/2021."
	"1902165-1"	"1902165-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"patient admitted for stroke 10/20-11/2/2021. received Pfizer vaccine 10/28/2021. discharged to SAR 11/2/2021. date of death = 11/20/2021."
	"1904084-1"	"1904084-1"	"BRAIN DEATH"	"10049054"	"60-64 years"	"60-64"	"On November 4th, 2021 he had a catastrophic stroke due to blood clots in his brain. He was declared brain dead on November 6th, 2021 at 12:00 pm. We believe these clots were caused by the covid 19 vaccination. He also had a flu shot in addition weeks prior, which he was advised to get by medical professionals."
	"1904084-1"	"1904084-1"	"CEREBRAL THROMBOSIS"	"10008132"	"60-64 years"	"60-64"	"On November 4th, 2021 he had a catastrophic stroke due to blood clots in his brain. He was declared brain dead on November 6th, 2021 at 12:00 pm. We believe these clots were caused by the covid 19 vaccination. He also had a flu shot in addition weeks prior, which he was advised to get by medical professionals."
	"1904084-1"	"1904084-1"	"CEREBROVASCULAR ACCIDENT"	"10008190"	"60-64 years"	"60-64"	"On November 4th, 2021 he had a catastrophic stroke due to blood clots in his brain. He was declared brain dead on November 6th, 2021 at 12:00 pm. We believe these clots were caused by the covid 19 vaccination. He also had a flu shot in addition weeks prior, which he was advised to get by medical professionals."
	"1904084-1"	"1904084-1"	"COMPUTERISED TOMOGRAM HEAD ABNORMAL"	"10072168"	"60-64 years"	"60-64"	"On November 4th, 2021 he had a catastrophic stroke due to blood clots in his brain. He was declared brain dead on November 6th, 2021 at 12:00 pm. We believe these clots were caused by the covid 19 vaccination. He also had a flu shot in addition weeks prior, which he was advised to get by medical professionals."
	"1904084-1"	"1904084-1"	"LABORATORY TEST ABNORMAL"	"10023547"	"60-64 years"	"60-64"	"On November 4th, 2021 he had a catastrophic stroke due to blood clots in his brain. He was declared brain dead on November 6th, 2021 at 12:00 pm. We believe these clots were caused by the covid 19 vaccination. He also had a flu shot in addition weeks prior, which he was advised to get by medical professionals."
	"1904084-1"	"1904084-1"	"THROMBECTOMY"	"10043530"	"60-64 years"	"60-64"	"On November 4th, 2021 he had a catastrophic stroke due to blood clots in his brain. He was declared brain dead on November 6th, 2021 at 12:00 pm. We believe these clots were caused by the covid 19 vaccination. He also had a flu shot in addition weeks prior, which he was advised to get by medical professionals."
	"1905343-1"	"1905343-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Lap Right Colectomy on 11/15/21 11/18/21:10:28 received Covid 19 booster 11/18/21: 8 pm, moaning and discomfort-given tylenol and ultram at 9:45 pm 11/19/21: 2 am, tossing and turning 11/19/21: 7 am, vomited, doctor contacted for ondansetron 11/19/21:7:15 am, patient expired"
	"1905343-1"	"1905343-1"	"DISCOMFORT"	"10013082"	"60-64 years"	"60-64"	"Lap Right Colectomy on 11/15/21 11/18/21:10:28 received Covid 19 booster 11/18/21: 8 pm, moaning and discomfort-given tylenol and ultram at 9:45 pm 11/19/21: 2 am, tossing and turning 11/19/21: 7 am, vomited, doctor contacted for ondansetron 11/19/21:7:15 am, patient expired"
	"1905343-1"	"1905343-1"	"FULL BLOOD COUNT"	"10017411"	"60-64 years"	"60-64"	"Lap Right Colectomy on 11/15/21 11/18/21:10:28 received Covid 19 booster 11/18/21: 8 pm, moaning and discomfort-given tylenol and ultram at 9:45 pm 11/19/21: 2 am, tossing and turning 11/19/21: 7 am, vomited, doctor contacted for ondansetron 11/19/21:7:15 am, patient expired"
	"1905343-1"	"1905343-1"	"METABOLIC FUNCTION TEST"	"10062191"	"60-64 years"	"60-64"	"Lap Right Colectomy on 11/15/21 11/18/21:10:28 received Covid 19 booster 11/18/21: 8 pm, moaning and discomfort-given tylenol and ultram at 9:45 pm 11/19/21: 2 am, tossing and turning 11/19/21: 7 am, vomited, doctor contacted for ondansetron 11/19/21:7:15 am, patient expired"
	"1905343-1"	"1905343-1"	"MOANING"	"10027783"	"60-64 years"	"60-64"	"Lap Right Colectomy on 11/15/21 11/18/21:10:28 received Covid 19 booster 11/18/21: 8 pm, moaning and discomfort-given tylenol and ultram at 9:45 pm 11/19/21: 2 am, tossing and turning 11/19/21: 7 am, vomited, doctor contacted for ondansetron 11/19/21:7:15 am, patient expired"
	"1905343-1"	"1905343-1"	"VOMITING"	"10047700"	"60-64 years"	"60-64"	"Lap Right Colectomy on 11/15/21 11/18/21:10:28 received Covid 19 booster 11/18/21: 8 pm, moaning and discomfort-given tylenol and ultram at 9:45 pm 11/19/21: 2 am, tossing and turning 11/19/21: 7 am, vomited, doctor contacted for ondansetron 11/19/21:7:15 am, patient expired"
	"1909575-1"	"1909575-1"	"ACUTE KIDNEY INJURY"	"10069339"	"60-64 years"	"60-64"	"This is a 61-year-old female with history of chronic back pain, hypertension, GERD who was recently discharged after being admitted to hospital for acute kidney injury, monomorphic V-tach, paroxysmal atrial fibrillation, hematuria and pancytopenia with UTI. She was at the subacute rehabilitation center Bartley. She was doing okay until last few days when she started having some diarrhea, and urinary frequency, urine analysis and cultures were sent and she was started empirically on ciprofloxacin. Yesterday in the morning patient became acutely short of breath and had severe sore throat with acute hypoxia down to 70s and hypotension with systolic blood pressure in 70s as well hence she was referred to the ER. Her covid test came out positive. In the ER patient was started on empiric antibiotics as per sepsis protocol after cultures were sent, she did not respond to fluid resuscitation hence she was started on Levophed and admitted to ICU."
	"1909575-1"	"1909575-1"	"ATRIAL FIBRILLATION"	"10003658"	"60-64 years"	"60-64"	"This is a 61-year-old female with history of chronic back pain, hypertension, GERD who was recently discharged after being admitted to hospital for acute kidney injury, monomorphic V-tach, paroxysmal atrial fibrillation, hematuria and pancytopenia with UTI. She was at the subacute rehabilitation center Bartley. She was doing okay until last few days when she started having some diarrhea, and urinary frequency, urine analysis and cultures were sent and she was started empirically on ciprofloxacin. Yesterday in the morning patient became acutely short of breath and had severe sore throat with acute hypoxia down to 70s and hypotension with systolic blood pressure in 70s as well hence she was referred to the ER. Her covid test came out positive. In the ER patient was started on empiric antibiotics as per sepsis protocol after cultures were sent, she did not respond to fluid resuscitation hence she was started on Levophed and admitted to ICU."
	"1909575-1"	"1909575-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	"This is a 61-year-old female with history of chronic back pain, hypertension, GERD who was recently discharged after being admitted to hospital for acute kidney injury, monomorphic V-tach, paroxysmal atrial fibrillation, hematuria and pancytopenia with UTI. She was at the subacute rehabilitation center Bartley. She was doing okay until last few days when she started having some diarrhea, and urinary frequency, urine analysis and cultures were sent and she was started empirically on ciprofloxacin. Yesterday in the morning patient became acutely short of breath and had severe sore throat with acute hypoxia down to 70s and hypotension with systolic blood pressure in 70s as well hence she was referred to the ER. Her covid test came out positive. In the ER patient was started on empiric antibiotics as per sepsis protocol after cultures were sent, she did not respond to fluid resuscitation hence she was started on Levophed and admitted to ICU."
	"1909575-1"	"1909575-1"	"CULTURE"	"10061447"	"60-64 years"	"60-64"	"This is a 61-year-old female with history of chronic back pain, hypertension, GERD who was recently discharged after being admitted to hospital for acute kidney injury, monomorphic V-tach, paroxysmal atrial fibrillation, hematuria and pancytopenia with UTI. She was at the subacute rehabilitation center Bartley. She was doing okay until last few days when she started having some diarrhea, and urinary frequency, urine analysis and cultures were sent and she was started empirically on ciprofloxacin. Yesterday in the morning patient became acutely short of breath and had severe sore throat with acute hypoxia down to 70s and hypotension with systolic blood pressure in 70s as well hence she was referred to the ER. Her covid test came out positive. In the ER patient was started on empiric antibiotics as per sepsis protocol after cultures were sent, she did not respond to fluid resuscitation hence she was started on Levophed and admitted to ICU."
	"1909575-1"	"1909575-1"	"DIARRHOEA"	"10012735"	"60-64 years"	"60-64"	"This is a 61-year-old female with history of chronic back pain, hypertension, GERD who was recently discharged after being admitted to hospital for acute kidney injury, monomorphic V-tach, paroxysmal atrial fibrillation, hematuria and pancytopenia with UTI. She was at the subacute rehabilitation center Bartley. She was doing okay until last few days when she started having some diarrhea, and urinary frequency, urine analysis and cultures were sent and she was started empirically on ciprofloxacin. Yesterday in the morning patient became acutely short of breath and had severe sore throat with acute hypoxia down to 70s and hypotension with systolic blood pressure in 70s as well hence she was referred to the ER. Her covid test came out positive. In the ER patient was started on empiric antibiotics as per sepsis protocol after cultures were sent, she did not respond to fluid resuscitation hence she was started on Levophed and admitted to ICU."
	"1909575-1"	"1909575-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"This is a 61-year-old female with history of chronic back pain, hypertension, GERD who was recently discharged after being admitted to hospital for acute kidney injury, monomorphic V-tach, paroxysmal atrial fibrillation, hematuria and pancytopenia with UTI. She was at the subacute rehabilitation center Bartley. She was doing okay until last few days when she started having some diarrhea, and urinary frequency, urine analysis and cultures were sent and she was started empirically on ciprofloxacin. Yesterday in the morning patient became acutely short of breath and had severe sore throat with acute hypoxia down to 70s and hypotension with systolic blood pressure in 70s as well hence she was referred to the ER. Her covid test came out positive. In the ER patient was started on empiric antibiotics as per sepsis protocol after cultures were sent, she did not respond to fluid resuscitation hence she was started on Levophed and admitted to ICU."
	"1909575-1"	"1909575-1"	"HAEMATURIA"	"10018867"	"60-64 years"	"60-64"	"This is a 61-year-old female with history of chronic back pain, hypertension, GERD who was recently discharged after being admitted to hospital for acute kidney injury, monomorphic V-tach, paroxysmal atrial fibrillation, hematuria and pancytopenia with UTI. She was at the subacute rehabilitation center Bartley. She was doing okay until last few days when she started having some diarrhea, and urinary frequency, urine analysis and cultures were sent and she was started empirically on ciprofloxacin. Yesterday in the morning patient became acutely short of breath and had severe sore throat with acute hypoxia down to 70s and hypotension with systolic blood pressure in 70s as well hence she was referred to the ER. Her covid test came out positive. In the ER patient was started on empiric antibiotics as per sepsis protocol after cultures were sent, she did not respond to fluid resuscitation hence she was started on Levophed and admitted to ICU."
	"1909575-1"	"1909575-1"	"HYPOTENSION"	"10021097"	"60-64 years"	"60-64"	"This is a 61-year-old female with history of chronic back pain, hypertension, GERD who was recently discharged after being admitted to hospital for acute kidney injury, monomorphic V-tach, paroxysmal atrial fibrillation, hematuria and pancytopenia with UTI. She was at the subacute rehabilitation center Bartley. She was doing okay until last few days when she started having some diarrhea, and urinary frequency, urine analysis and cultures were sent and she was started empirically on ciprofloxacin. Yesterday in the morning patient became acutely short of breath and had severe sore throat with acute hypoxia down to 70s and hypotension with systolic blood pressure in 70s as well hence she was referred to the ER. Her covid test came out positive. In the ER patient was started on empiric antibiotics as per sepsis protocol after cultures were sent, she did not respond to fluid resuscitation hence she was started on Levophed and admitted to ICU."
	"1909575-1"	"1909575-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	"This is a 61-year-old female with history of chronic back pain, hypertension, GERD who was recently discharged after being admitted to hospital for acute kidney injury, monomorphic V-tach, paroxysmal atrial fibrillation, hematuria and pancytopenia with UTI. She was at the subacute rehabilitation center Bartley. She was doing okay until last few days when she started having some diarrhea, and urinary frequency, urine analysis and cultures were sent and she was started empirically on ciprofloxacin. Yesterday in the morning patient became acutely short of breath and had severe sore throat with acute hypoxia down to 70s and hypotension with systolic blood pressure in 70s as well hence she was referred to the ER. Her covid test came out positive. In the ER patient was started on empiric antibiotics as per sepsis protocol after cultures were sent, she did not respond to fluid resuscitation hence she was started on Levophed and admitted to ICU."
	"1909575-1"	"1909575-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"This is a 61-year-old female with history of chronic back pain, hypertension, GERD who was recently discharged after being admitted to hospital for acute kidney injury, monomorphic V-tach, paroxysmal atrial fibrillation, hematuria and pancytopenia with UTI. She was at the subacute rehabilitation center Bartley. She was doing okay until last few days when she started having some diarrhea, and urinary frequency, urine analysis and cultures were sent and she was started empirically on ciprofloxacin. Yesterday in the morning patient became acutely short of breath and had severe sore throat with acute hypoxia down to 70s and hypotension with systolic blood pressure in 70s as well hence she was referred to the ER. Her covid test came out positive. In the ER patient was started on empiric antibiotics as per sepsis protocol after cultures were sent, she did not respond to fluid resuscitation hence she was started on Levophed and admitted to ICU."
	"1909575-1"	"1909575-1"	"OROPHARYNGEAL PAIN"	"10068319"	"60-64 years"	"60-64"	"This is a 61-year-old female with history of chronic back pain, hypertension, GERD who was recently discharged after being admitted to hospital for acute kidney injury, monomorphic V-tach, paroxysmal atrial fibrillation, hematuria and pancytopenia with UTI. She was at the subacute rehabilitation center Bartley. She was doing okay until last few days when she started having some diarrhea, and urinary frequency, urine analysis and cultures were sent and she was started empirically on ciprofloxacin. Yesterday in the morning patient became acutely short of breath and had severe sore throat with acute hypoxia down to 70s and hypotension with systolic blood pressure in 70s as well hence she was referred to the ER. Her covid test came out positive. In the ER patient was started on empiric antibiotics as per sepsis protocol after cultures were sent, she did not respond to fluid resuscitation hence she was started on Levophed and admitted to ICU."
	"1909575-1"	"1909575-1"	"PANCYTOPENIA"	"10033661"	"60-64 years"	"60-64"	"This is a 61-year-old female with history of chronic back pain, hypertension, GERD who was recently discharged after being admitted to hospital for acute kidney injury, monomorphic V-tach, paroxysmal atrial fibrillation, hematuria and pancytopenia with UTI. She was at the subacute rehabilitation center Bartley. She was doing okay until last few days when she started having some diarrhea, and urinary frequency, urine analysis and cultures were sent and she was started empirically on ciprofloxacin. Yesterday in the morning patient became acutely short of breath and had severe sore throat with acute hypoxia down to 70s and hypotension with systolic blood pressure in 70s as well hence she was referred to the ER. Her covid test came out positive. In the ER patient was started on empiric antibiotics as per sepsis protocol after cultures were sent, she did not respond to fluid resuscitation hence she was started on Levophed and admitted to ICU."
	"1909575-1"	"1909575-1"	"POLLAKIURIA"	"10036018"	"60-64 years"	"60-64"	"This is a 61-year-old female with history of chronic back pain, hypertension, GERD who was recently discharged after being admitted to hospital for acute kidney injury, monomorphic V-tach, paroxysmal atrial fibrillation, hematuria and pancytopenia with UTI. She was at the subacute rehabilitation center Bartley. She was doing okay until last few days when she started having some diarrhea, and urinary frequency, urine analysis and cultures were sent and she was started empirically on ciprofloxacin. Yesterday in the morning patient became acutely short of breath and had severe sore throat with acute hypoxia down to 70s and hypotension with systolic blood pressure in 70s as well hence she was referred to the ER. Her covid test came out positive. In the ER patient was started on empiric antibiotics as per sepsis protocol after cultures were sent, she did not respond to fluid resuscitation hence she was started on Levophed and admitted to ICU."
	"1909575-1"	"1909575-1"	"RESUSCITATION"	"10038749"	"60-64 years"	"60-64"	"This is a 61-year-old female with history of chronic back pain, hypertension, GERD who was recently discharged after being admitted to hospital for acute kidney injury, monomorphic V-tach, paroxysmal atrial fibrillation, hematuria and pancytopenia with UTI. She was at the subacute rehabilitation center Bartley. She was doing okay until last few days when she started having some diarrhea, and urinary frequency, urine analysis and cultures were sent and she was started empirically on ciprofloxacin. Yesterday in the morning patient became acutely short of breath and had severe sore throat with acute hypoxia down to 70s and hypotension with systolic blood pressure in 70s as well hence she was referred to the ER. Her covid test came out positive. In the ER patient was started on empiric antibiotics as per sepsis protocol after cultures were sent, she did not respond to fluid resuscitation hence she was started on Levophed and admitted to ICU."
	"1909575-1"	"1909575-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	"This is a 61-year-old female with history of chronic back pain, hypertension, GERD who was recently discharged after being admitted to hospital for acute kidney injury, monomorphic V-tach, paroxysmal atrial fibrillation, hematuria and pancytopenia with UTI. She was at the subacute rehabilitation center Bartley. She was doing okay until last few days when she started having some diarrhea, and urinary frequency, urine analysis and cultures were sent and she was started empirically on ciprofloxacin. Yesterday in the morning patient became acutely short of breath and had severe sore throat with acute hypoxia down to 70s and hypotension with systolic blood pressure in 70s as well hence she was referred to the ER. Her covid test came out positive. In the ER patient was started on empiric antibiotics as per sepsis protocol after cultures were sent, she did not respond to fluid resuscitation hence she was started on Levophed and admitted to ICU."
	"1909575-1"	"1909575-1"	"URINARY TRACT INFECTION"	"10046571"	"60-64 years"	"60-64"	"This is a 61-year-old female with history of chronic back pain, hypertension, GERD who was recently discharged after being admitted to hospital for acute kidney injury, monomorphic V-tach, paroxysmal atrial fibrillation, hematuria and pancytopenia with UTI. She was at the subacute rehabilitation center Bartley. She was doing okay until last few days when she started having some diarrhea, and urinary frequency, urine analysis and cultures were sent and she was started empirically on ciprofloxacin. Yesterday in the morning patient became acutely short of breath and had severe sore throat with acute hypoxia down to 70s and hypotension with systolic blood pressure in 70s as well hence she was referred to the ER. Her covid test came out positive. In the ER patient was started on empiric antibiotics as per sepsis protocol after cultures were sent, she did not respond to fluid resuscitation hence she was started on Levophed and admitted to ICU."
	"1909575-1"	"1909575-1"	"URINE ANALYSIS"	"10046614"	"60-64 years"	"60-64"	"This is a 61-year-old female with history of chronic back pain, hypertension, GERD who was recently discharged after being admitted to hospital for acute kidney injury, monomorphic V-tach, paroxysmal atrial fibrillation, hematuria and pancytopenia with UTI. She was at the subacute rehabilitation center Bartley. She was doing okay until last few days when she started having some diarrhea, and urinary frequency, urine analysis and cultures were sent and she was started empirically on ciprofloxacin. Yesterday in the morning patient became acutely short of breath and had severe sore throat with acute hypoxia down to 70s and hypotension with systolic blood pressure in 70s as well hence she was referred to the ER. Her covid test came out positive. In the ER patient was started on empiric antibiotics as per sepsis protocol after cultures were sent, she did not respond to fluid resuscitation hence she was started on Levophed and admitted to ICU."
	"1909575-1"	"1909575-1"	"VENTRICULAR TACHYCARDIA"	"10047302"	"60-64 years"	"60-64"	"This is a 61-year-old female with history of chronic back pain, hypertension, GERD who was recently discharged after being admitted to hospital for acute kidney injury, monomorphic V-tach, paroxysmal atrial fibrillation, hematuria and pancytopenia with UTI. She was at the subacute rehabilitation center Bartley. She was doing okay until last few days when she started having some diarrhea, and urinary frequency, urine analysis and cultures were sent and she was started empirically on ciprofloxacin. Yesterday in the morning patient became acutely short of breath and had severe sore throat with acute hypoxia down to 70s and hypotension with systolic blood pressure in 70s as well hence she was referred to the ER. Her covid test came out positive. In the ER patient was started on empiric antibiotics as per sepsis protocol after cultures were sent, she did not respond to fluid resuscitation hence she was started on Levophed and admitted to ICU."
	"1909882-1"	"1909882-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Died of heart attack on May 3."
	"1909882-1"	"1909882-1"	"MYOCARDIAL INFARCTION"	"10028596"	"60-64 years"	"60-64"	"Died of heart attack on May 3."
	"1912626-1"	"1912626-1"	"COAGULOPATHY"	"10009802"	"60-64 years"	"60-64"	"Passed away. Swollen body, blue lips, oxygen deprived, clotting"
	"1912626-1"	"1912626-1"	"CYANOSIS"	"10011703"	"60-64 years"	"60-64"	"Passed away. Swollen body, blue lips, oxygen deprived, clotting"
	"1912626-1"	"1912626-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Passed away. Swollen body, blue lips, oxygen deprived, clotting"
	"1912626-1"	"1912626-1"	"OXYGEN SATURATION DECREASED"	"10033318"	"60-64 years"	"60-64"	"Passed away. Swollen body, blue lips, oxygen deprived, clotting"
	"1912626-1"	"1912626-1"	"SWELLING"	"10042674"	"60-64 years"	"60-64"	"Passed away. Swollen body, blue lips, oxygen deprived, clotting"
	"1913091-1"	"1913091-1"	"CHRONIC OBSTRUCTIVE PULMONARY DISEASE"	"10009033"	"60-64 years"	"60-64"	""pt found deceased at home on 7/27/2021, ""apparent natural death"" but noted ""prior COVID 19, COPD"" under the ""chain of events that directly caused the death"" on the death certificate from Dr.; PMH:  CHF, CVA, COPD, DM, lung CA; Dr. also reports pt had a positive COVID test on 12/16/2020; no other medical information available at this time""
	"1913091-1"	"1913091-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	""pt found deceased at home on 7/27/2021, ""apparent natural death"" but noted ""prior COVID 19, COPD"" under the ""chain of events that directly caused the death"" on the death certificate from Dr.; PMH:  CHF, CVA, COPD, DM, lung CA; Dr. also reports pt had a positive COVID test on 12/16/2020; no other medical information available at this time""
	"1913091-1"	"1913091-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""pt found deceased at home on 7/27/2021, ""apparent natural death"" but noted ""prior COVID 19, COPD"" under the ""chain of events that directly caused the death"" on the death certificate from Dr.; PMH:  CHF, CVA, COPD, DM, lung CA; Dr. also reports pt had a positive COVID test on 12/16/2020; no other medical information available at this time""
	"1915672-1"	"1915672-1"	"ANAEMIA"	"10002034"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"APHASIA"	"10002948"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"ATRIAL FIBRILLATION"	"10003658"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"CHRONIC OBSTRUCTIVE PULMONARY DISEASE"	"10009033"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"CULTURE POSITIVE"	"10061449"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"DYSPNOEA EXERTIONAL"	"10013971"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"DYSPNOEA PAROXYSMAL NOCTURNAL"	"10013974"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"HAEMOPTYSIS"	"10018964"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"HYPOTENSION"	"10021097"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"MALAISE"	"10025482"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"ORTHOPNOEA"	"10031123"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"OXYGEN SATURATION"	"10033316"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"PACKED RED BLOOD CELL TRANSFUSION"	"10033359"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"PLATELET TRANSFUSION"	"10035543"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"RENAL FAILURE"	"10038435"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"RESPIRATORY FAILURE"	"10038695"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"RESPIRATORY VIRAL PANEL"	"10075165"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"THROMBOCYTOPENIA"	"10043554"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"VACCINATION FAILURE"	"10046862"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"VENTILATION/PERFUSION SCAN"	"10047264"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"VENTILATION/PERFUSION SCAN NORMAL"	"10047266"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1915672-1"	"1915672-1"	"WHEEZING"	"10047924"	"60-64 years"	"60-64"	"DEATH; APHASIA; THROMBOCYTOPENIA; PACKED RED BLOOD CELL TRANSFUSION; PLATELET TRANSFUSION; ANAEMIA; RESPIRATORY VIRAL PANEL; VENTILATION PERFUSION SCAN NORMAL; WHEEZING; SUSPECTED CLINICAL VACCINATION FAILURE; ATRIAL FIBRILLATION; COVID-19 PNEUMONIA; RESPIRATORY FAILURE; RENAL FAILURE; CHRONIC OBSTRUCTIVE PULMONARY DISEASE; CONDITION AGGRAVATED; COUGH; CULTURE POSITIVE; DYSPNOEA; DYSPNOEA EXERTIONAL; DYSPNOEA PAROXYSMAL NOCTURNAL; HAEMOPTYSIS; HYPOTENSION; INTENSIVE CARE; MALAISE; ORTHOPNOEA; This spontaneous report received from a health care professional via a Regulatory Authority Vaccine Adverse Event Reporting System (VAER reference number 1828685) concerned a 64 year old female of unspecified race and ethnicity. The patient's height, and weight were not reported. The patient's concurrent conditions included: chronic obstructive pulmonary disease, chronic kidney disease, hepatitis c, anemia, depression, atrial fibrillation, gastrooesophageal reflux disease, hypothyroidism, hypersensitivity lung disease, and hypertension. The patient experienced anaphylaxis when treated with lisinopril.  The patient received covid-19 vaccine ad26.cov2.s (Janssen series 1) (suspension for injection, intramuscular, batch number: 205A21A expiry: unknown) dose was not reported, 1 total, administered on 26-AUG-2021 for an unspecified indication. The drug start period was 37 days. Concomitant medications included amlodipine 10 mg once daily, calcitriol 0.25 mcg once daily, fluticasone propionate/salmeterol xinafoate 250/50 once daily, furosemide 40 mg twice daily, metoprolol 50 mg twice daily, mirtazapine 15 mg once daily, ondansetron 4 mg three times a day, salbutamol nebulization PRN, and simvastatin8 10 mg once daily.  On 02-OCT-2021, the patient experienced condition aggravated, culture positive, haemoptysis, hypotension, intensive care, malaise, respiratory viral panel, ventilation perfusion scan normal. Laboratory data included: Respiratory viral panel (NR: not provided) Not Reported, and Ventilation/perfusion scan (NR: not provided) Normal. The patient was presented to emergency department for shortness of breath coughing and wheezing. Patient was feeling unwell for a week and had worsening dyspnea on exertion Paroxysmal nocturnal dyspnea (PND) and orthopnea. The patient also mentioned stopped all of medications for two days because of feeling too unwell 4 days ago. The shortness of breath worsened and had been dusting and that dust made her wheezing and coughing worse. Shortness of breath became severe enough that patient needed to come to the emergency department. The patient was admitted on 03-OCT-2021 for Chronic Obstructive Pulmonary Disease (COPD) exacerbation and Covid pneumonia (Suspected clinical vaccination failure). The patient developed worsening hypoxemic respiratory failure with increasing HFNC(High flow nasal cannula)requirements and was subsequently transferred to the intensive care unit (ICU) on 11-OCT-2021. The patients renal failure worsened so a femoral quinton catheter was placed but the patient became very hypotensive and hypoxic with every attempt at hemodialysis or Continuous renal replacement therapy (CRRT). The patient decided that she would not want to pursue intubation in the setting of further respiratory deterioration. Dialysis made the patient too hypoxic while already on HFNC (High flow nasal cannula). The decision was made to not pursue further dialysis and the quinton was removed. Then the patient's pneumonia panel came back positive for pseudomonas and her respiratory culture indicated the presence of mold and was started on cefepime and cresemba. The oxygen requirements decreased and was transferred back to the floor on 19-OCT-2021. However ON 20-OCT-2021 was again brought back to the ICU(Intensive care unit) once again for worsening hypoxia requiring 60L 90% on HFNC. The patient also developed hemoptysis anemia and thrombocytopenia requiring transfusion of platelets and Packet red blood cell ( (PRBC). V/Q (Ventilation/perfusion) scan was negative for pulmonary embolism (PE). On 23-OCT-2021 the patient developed acute word finding difficulty while speaking with family member (aphasia) in the setting of a brief run of atrial fibrillation and ongoing thrombocytopenia CT (Computed tomography) brain was ordered to assess for stroke bleed. However after discussion with the patient and her daughter the decision was made to withdraw all support and was started on comfort care. On 24-OCT-2021 patient was deceased. The cause of death was unknown. It was unknown if an autopsy was performed.  Laboratory data (dates unspecified) included: Culture positive (NR: not provided) Presence of mold, Oxygen saturation (NR: not provided) 90 %, Respiratory viral panel (NR: not provided) Positive for pseudomonas, and V/Q (Ventilation/perfusion) scan (NR: not provided) Negative for pulmonary embolism.  Treatment medications (dates unspecified) included: cefepime, and isavuconazonium sulfate.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient died of death, thrombocytopenia, atrial fibrillation, covid-19 pneumonia, respiratory failure, renal failure, anaemia, aphasia, chronic obstructive pulmonary disease, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing on 24-OCT-2021, and the outcome of suspected clinical vaccination failure was not reported. This report was serious (Death, Hospitalization Caused / Prolonged, and Life Threatening). This report was associated with product quality complaint: 90000203020. The suspected product quality complaint has been confirmed to be the reported allegation could not be confirmed. a manufacturing related root cause could not be identified. based on the PQC evaluation/investigation performed.  Additional information received from Central Complaint Vigilance department on 29-NOV-2021. The following information was updated and incorporated into the case narrative: The product quality complaint investigation result was added.; Sender's Comments: V2: This version updates- The product quality complaint investigation result was added. This updated information does not alter the causality of previously reported events  20211129989-COVID-19 VACCINE AD26.COV2.S-death, thrombocytopenia, covid-19 pneumonia, respiratory failure, aphasia, condition aggravated, cough, culture positive, dyspnoea, dyspnoea exertional, dyspnoea paroxysmal nocturnal, haemoptysis, hypotension, intensive care, malaise, orthopnoea, packed red blood cell transfusion, platelet transfusion, respiratory viral panel, ventilation perfusion scan normal and wheezing . This event(s) is considered unassessable. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s).  20211129989-COVID-19 VACCINE AD26.COV2.S-atrial fibrillation, renal failure, chronic obstructive pulmonary disease, anemia. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY  V0; 20211129989-COVID-19 VACCINE AD26.COV2.S-suspected clinical vaccination failure. This event(s) is considered not related. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: SPECIAL SITUATIONS; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH"
	"1917035-1"	"1917035-1"	"CARDIAC FAILURE"	"10007554"	"60-64 years"	"60-64"	"Trembles, Diaforesis, Hepatomegalia,  Insomnia and Death by Heart Failure"
	"1917035-1"	"1917035-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	"Trembles, Diaforesis, Hepatomegalia,  Insomnia and Death by Heart Failure"
	"1917035-1"	"1917035-1"	"HEPATOMEGALY"	"10019842"	"60-64 years"	"60-64"	"Trembles, Diaforesis, Hepatomegalia,  Insomnia and Death by Heart Failure"
	"1917035-1"	"1917035-1"	"HYPERHIDROSIS"	"10020642"	"60-64 years"	"60-64"	"Trembles, Diaforesis, Hepatomegalia,  Insomnia and Death by Heart Failure"
	"1917035-1"	"1917035-1"	"INSOMNIA"	"10022437"	"60-64 years"	"60-64"	"Trembles, Diaforesis, Hepatomegalia,  Insomnia and Death by Heart Failure"
	"1917035-1"	"1917035-1"	"TREMOR"	"10044565"	"60-64 years"	"60-64"	"Trembles, Diaforesis, Hepatomegalia,  Insomnia and Death by Heart Failure"
	"1917807-1"	"1917807-1"	"ACIDOSIS"	"10000486"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"AGITATION"	"10001497"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"ANURIA"	"10002847"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"BLOOD ALKALINE PHOSPHATASE NORMAL"	"10005310"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"BLOOD BICARBONATE"	"10005357"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"BLOOD CREATININE INCREASED"	"10005483"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"BLOOD LACTIC ACID"	"10005632"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"BLOOD PH DECREASED"	"10005706"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"BLOOD POTASSIUM INCREASED"	"10005725"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"CHEST X-RAY ABNORMAL"	"10008499"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"COMPUTERISED TOMOGRAM HEAD NORMAL"	"10072167"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"COMPUTERISED TOMOGRAM SPINE"	"10081777"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"CONDITION AGGRAVATED"	"10010264"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"COUGH"	"10011224"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"COVID-19"	"10084268"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"COVID-19 PNEUMONIA"	"10084380"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"DEATH"	"10011906"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"DYSPNOEA"	"10013968"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"ENCEPHALOPATHY"	"10014625"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"FALL"	"10016173"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"FATIGUE"	"10016256"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"HYPOTENSION"	"10021097"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"HYPOTHERMIA"	"10021113"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"HYPOXIA"	"10021143"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"INTENSIVE CARE"	"10022519"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"LUNG OPACITY"	"10081792"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"MENTAL DISORDER"	"10061284"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"RENAL IMPAIRMENT"	"10062237"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"SARS-COV-2 TEST POSITIVE"	"10084271"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"SEPTIC SHOCK"	"10040070"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"SHOCK"	"10040560"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"TACHYCARDIA"	"10043071"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
	"1917807-1"	"1917807-1"	"TACHYPNOEA"	"10043089"	"60-64 years"	"60-64"	""Patient is deceased (11.26.21);  Hospitalized 11.25.21;  COVID-19 positive (11.22.21);  fully vaccinated  Admission Date: 11/25/2021;  Discharge Disposition: Deceased (11.26.21) DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Pneumonia due to COVID-19 virus [U07.1, J12.82] Septic shock (HCC) [A41.9, R65.21] HOSPITAL COURSE: Patient is a 64-year-old woman past medical history significant for type 2 diabetes, peptic ulcer disease, paroxysmal atrial fibrillation not on home anticoagulation was admitted for septic shock secondary to COVID-19 pneumonia.   Upon arrival to the emergency department, patient was initially hypothermic, tachypneic, hypotensive, hypoxic requiring high-flow nasal cannula and peripheral pressors.  Initial labs were notable for pH of 6.78, creatinine 8.36, potassium 6, bicarb to, ALP 112, lactic acid 16.2.  CXR demonstrated patchy multifocal opacities. Patient was administered 1 L of normal saline, calcium chloride 3 g, 1 amp of bicarb. While awaiting transfer to the medical intensive care unit, patient underwent a fall in her room.  CT head was negative, CT C-spine was notable for severe motion degradation artifact but no evidence of C-spine injury on visualized segments. No injuries noted secondary to fall.  Upon arrival to the medical intensive care unit, patient was significantly encephalopathic and agitated.  Discussion with her son at bedside confirmed wishes for code status of do not resuscitate/DNI as identified in the emergency department by the social worker.  Patient was altered and agitated. She was gasping for air while attempting to get up from bed. She is requiring pressor support, continues to be tachycardic and tachypnic and HFNC @ 50% FiO2. Patient is not producing urine. Fluid status +5.5L since admission. She remained profoundly acidemic with 3 pressors but still had low blood pressures. With her agitation, it will be difficult to place a dialysis catheter without complications or needing to intubate her to place the vascath.  Patient's current condition, treatments, and prognosis was shared with the patient , and family.  Patient continued at this point have worsening septic shock requiring 3 pressors this morning and worsening renal function for which she would be a candidate for renal replacement therapy.  To further pursue renal replacement therapy, patient would likely need to be intubated.  At this point, both son and husband wished to pursue and respect patient's wishes she previously expressed ""that she would not want to be on a mechanical ventilator lifelong, or even for short duration if this was only brief while requiring renal replacement therapy."" Patient was deemed DNR/DNI per their wishes. After husband arrived to the hospital, patient was transitioned to comfort care and shortly thereafter Dr. was contacted of patient's passing.  Dr's saw the patient at bedside and performed a death examination. Patient was pronounced dead at 5:45 pm likely due to profound shock. I requested for a medical examiner because the patient died within 24 hours of admission and also had a fall while in the emergency department. I spoke with Dr. from the Medical Examiner's office who determined this is not a medical examiner case and does not require autopsy therefore autopsy will not be performed. Ok to release to funeral home.""
"---"
"Dataset: The Vaccine Adverse Event Reporting System (VAERS)"
"Query Parameters:"
"Title: 211214 CDC covid VAERS report - all reports.txt"
"Age: 60-64 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 3:41:59 PM"
"---"
"Suggested Citation: Accessed at http://wonder.cdc.gov/vaers.html on Dec 14, 2021 3:41:59 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 637 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>"