Received Oct 10, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| FLU3 | INFLUENZA (SEASONAL) (FLUAD) | SEQIRUS, INC. | UNK | 407244 | IM / RA |
Result type: Oncology Office/Clinic Note Result date: October 10, 2025 9:10 PDT Result status: Modified Result title: Flu vaccine reaction Performed by: MD on October 10, 2025 9:43 PDT Verified by: MD on October 10, 2025 9:43 PDT Encounter info: HemOnc, Ambulatory PCA, 10/10/2025 - * Final Report * Document Contains Addenda pt in clinic for Flu vaccine @ 0855, ( Fluad Influeza Vaccine,Adjuvanted) NDC# 70461-025-04/lot# 407244/ Exp. 2026 APR23 within minutes after administering flu vaccine (Left Deltoid, IM) to pt, pt complained of chest pain down center of back down to her tailbone, severe chest pain w/ forehead hyperhidrosis. Dr. was advised and present, Rapid Response was called at 0900 a.m, vitals were taken at 0901 a.m., L arm with BP 165/72 O2 sat. 99% HR 85 Rapid Response Team arrived and pt was transported to E.R for further evaluation Signature Line Electronically Signed By: MD On 10/10/25 09:43 Co Signature By: Modify Signature By: MA On 10/10/25 09:27 Addendum by MA on October 10, 2025 9:50 PDT (Verified) Correction Vaccine administered Right Deltoid, IM Signature Line Electronically Signed By: MA On 10/10/25 09:51 Co Signature By: Modify Signature By: MA On 10/10/25 09:50
healthy
hx of adenocarcinoma of pancreas, hx of adenocarcinoma of stomach, hx of iron def. anemia
calcium carbonate 500,estradiol topical (Yuvafem 10 mcg vaginal tablet), omeprazole 40 mg oral enteric coated, pancrelipase (Creon 24,000 units oral delayed release, TNF Medication (Magnesium CAOS), zoledronic acid (Reclast 5 mg/100mg ml, I
Ambien, cephalexin, Keflex, Latex, PCN, sulfa drugs, zolpidem
Result type: Oncology Office/Clinic Note Result date: October 10, 2025 9:10 PDT Result status: Modified Result title: Flu vaccine reaction Performed by: MD on October 10, 2025 9:43 PDT Verified by: MD on October 10, 2025 9:43 PDT Encounter info: HemOnc, Ambulatory PCA, 10/10/2025 - * Final Report * Document Contains Addenda pt in clinic for Flu vaccine @ 0855, ( Fluad Influeza Vaccine,Adjuvanted) NDC# 70461-025-04/lot# 407244/ Exp. 2026 APR23 within minutes after administering flu vaccine (Left Deltoid, IM) to pt, pt complained of chest pain down center of back down to her tailbone, severe chest pain w/ forehead hyperhidrosis. Dr. was advised and present, Rapid Response was called at 0900 a.m, vitals were taken at 0901 a.m., L arm with BP 165/72 O2 sat. 99% HR 85 Rapid Response Team arrived and pt was transported to E.R for further evaluation Signature Line Electronically Signed By: MD On 10/10/25 09:43 Co Signature By: Modify Signature By: MA On 10/10/25 09:27 Addendum by MA on October 10, 2025 9:50 PDT (Verified) Correction Vaccine administered Right Deltoid, IM Signature Line Electronically Signed By: MA On 10/10/25 09:51 Co Signature By: Modify Signature By: MA On 10/10/25 09:50