Received Oct 2, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| MNQ | MENINGOCOCCAL CONJUGATE (MENVEO) | NOVARTIS VACCINES AND DIAGNOSTICS | 2 | — | IM / LA |
| MNQ | MENINGOCOCCAL CONJUGATE (MENVEO) | NOVARTIS VACCINES AND DIAGNOSTICS | 2 | AMVB079A | IM / LA |
Responding Nurse: Patient was seen in clinic today for an appointment. This nurse was walking towards Immunization around 1107 am when I heard a yell for help. Upon my arrival to the immunization room, the patient was laying on the floor on his back. Patient was somewhat coherent and was able to state his location as facility and why he was at the clinic. The immunization nurse stated, "He received his shot and passed out. He fell face first." Other staff arrived; vitals were taken and the patient's legs were held up. Dr. was the physician who took charge. Vitals signs taken: 1110 92/53 BP; 62 P; 99% sat on RA laying on floor 1123 106/68 BP; 65 P; 98% sat on RA sitting on floor 1127 110/72 BP; 75 P; 97% sat on RA sitting up on bed Provider: Patient was evaluated after vaso vagal/pre-syncopal episode after MCV4 vaccine given. Vitals stable and patient started to feel better after a few minutes laying supine. he was able to sit up and then get up onto chair. VS remained stable and patient was able to leave with his mother who was accompanying him during office visit.
General Surgery Wound Clinic follow-up 9/5/25: F/u for local wound evaluation & dressing change (Post-Operative Pilonidal Cyst Excision and NPWT application, surgery performed 4/16/25)
allergic rhinitis, heartburn, wheezing, sacral/presacral hirsutism, pilonidal cyst w/ abscess, overweight, valgus deformity of ankle & knee, external bilateral hip rotation
Adult multivitamin, 1 tab PO daily for supplementation
No known allergies
Vitals signs taken 9/30/25 immediately post incident: 1110 92/53 BP; 62 P; 99% sat on RA laying on floor 1123 106/68 BP; 65 P; 98% sat on RA sitting on floor 1127 110/72 BP; 75 P; 97% sat on RA sitting up on bed