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From the 1/21/2022 release of VAERS data:

Found 22,607 cases where Vaccine targets COVID-19 (COVID19) and Patient Died

Government Disclaimer on use of this data



Case Details

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VAERS ID: 1756109 (history)  
Form: Version 2.0  
Age:   
Sex: Male  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Cognitive disorder, General physical health deterioration, Mental impairment, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-01
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USPFIZER INC202101292320

Write-up: declined fast mentally and physically and died in July; declined fast mentally and physically and died in July; he was a downward slope cognitively; weight loss; This is a spontaneous report from a contactable consumer. A male patient of an unspecified age received BNT162B2 (PFIZER-BIONTECH COVID-19 mRNA VACCINE, solution for injection) via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as dose number unknown, single for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. Per reporter, "mother''s boyfriend was better than her cognitively and would get them to events and meals etc. They were both vaccinated the same days with Pfizer. From about that time, he was a downward slope cognitively like mini strokes often and declined fast mentally and physically and died in Jul2021. Very, very odd. I hope things like that get studied as well. A few weeks ago, I was pondering the unusual occurrences in my head and then dawned on me to perhaps report. Maybe nothing, but could be studied in Real World Data. Not sure the medical diagnosis since my mother''s boyfriend was not our family, but talking to him there was an obvious and rapid change. He used to be the first to the musical events at their facility as he loved to sing and dance and would get my shy mother up there with him harmonizing and dancing with him. The facility would often make sure (Name) would participate because he added to the entertainment with his singing and dancing. He just declined so fast. First, I noticed the weight loss, but when we could finally get inside the facility and actually have real visits he was so "out there" the few months before he died". The patient died on Jul2021. It was unknown if autopsy was performed. The lot number for the vaccine, BNT162B2, was not provided and will be requested during follow up.; Reported Cause(s) of Death: he was a downward slope cognitively; weight loss; declined fast mentally and physically and died in July; declined fast mentally and physically and died in July


VAERS ID: 1756641 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-03
Onset:2021-09-23
   Days after vaccination:204
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EM9810 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-23
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: CAD, RHEUMATOID ARTHRITIS
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PT EXPIRED ON 09/22/2021


VAERS ID: 1756674 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-04-20
Onset:2021-09-26
   Days after vaccination:159
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-26
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT EXPIRED ON 09/26/2021


VAERS ID: 1756876 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-10
Onset:2021-09-17
   Days after vaccination:191
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Senior Living       Purchased by: ?
Symptoms: COVID-19, Death, Fall, Fracture, SARS-CoV-2 test positive
SMQs:, Accidents and injuries (narrow), Osteoporosis/osteopenia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-23
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Norco, duloxetine, midodrine, melatonin, calcium carbonate, amitriptyline, senna, lidocaine, nitrofurantoin, nystain,
Current Illness: depression, iron deficiency, repeated falls, constipation, dementia
Preexisting Conditions: dementia, anemia, depression
Allergies: morphine
Diagnostic Lab Data: Abbot rapid nasal covid swab on 09/17/2021 X 2, both with + results
CDC Split Type:

Write-up: Received covid vaccine at another (unknown) location prior to admission to facility. experienced multiple falls with significant fractures (prior to facility admission), which put her in the hospital, then needing rehab. transferred to this facility, facility sent to the hospital r/t medical concerns on 09/05/2021, returned to the facility on 09/10/2021, tested positive for covid 19 on 09/17/2021. was treated per facility APRN and MD, however, despite efforts, expired on 09/23/2021. Death is under investigation with health department for cause.


VAERS ID: 1756951 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-02-27
Onset:2021-09-07
   Days after vaccination:192
Submitted: 0000-00-00
Entered: 2021-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9261 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / 2 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19 pneumonia, Death, Intensive care
SMQs:, Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-17
   Days after onset: 10
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: During hospital stay patient was started on Rocephin and azithromycin along with remdesivir and dexamethasone. She had been on 3 L of oxygen since admission which was normal for her. Had her finish her 3 doses of remdesivir. She was discharged on cefdinir and was to have an outpatient follow-up with her PCP. Patient returned on 9/14 and was admitted to the ICU where she unfortunately passed from COVID-19 Pneumonia.


VAERS ID: 1757402 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-03-11
Onset:2021-08-01
   Days after vaccination:143
Submitted: 0000-00-00
Entered: 2021-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1802068 / 1 LA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Breath sounds absent, COVID-19, Catheter placement, Chest X-ray abnormal, Cough, Death, Decreased appetite, Diarrhoea, Dyspnoea, Endotracheal intubation, Heart sounds abnormal, Nausea, Oxygen saturation decreased, Pneumomediastinum, Pneumothorax, Pulse absent, Pupil fixed, Pyrexia, Respiratory failure, SARS-CoV-2 test positive, Subcutaneous emphysema, Unresponsive to stimuli, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-17
   Days after onset: 16
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 16 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: empagliflozin (Jardiance) 25 MG; glyBURIDE (DIABETA) 5 MG; meloxicam (MOBIC) 15 MG; pioglitazone (ACTOS) 15 MG Oral Tablet; rosuvastatin (CRESTOR) 10 MG Oral Tablet; SITAgliptin-metFORMIN (Janumet XR) 100-1000 MG Oral Tablet
Current Illness:
Preexisting Conditions: T2DM; HFpEF
Allergies: NKA
Diagnostic Lab Data: SARS-COV-2, NAA, Detected: 08/01/2021
CDC Split Type:

Write-up: Patient required hospitalization due to breakthrough infection. Patient received J&J vaccine on 03/11/21. Patient was hospitalized from 08/01/2021 - 08/17/2021. Below is copied from patients discharge (death) summary: Hospital Course: a 67 y.o. male with a PMH of Type II DM and HFpEF who initially presented to the ED complaining of shortness of breath with a recent COVID positive result. Patient stated this started around 7/26/2021 along with a nonproductive cough, subjective fevers, loss of appetite and nausea, with minimal diarrhea. He described the cough as being nonproductive. On the morning of 8/01/2021 the cough worsened which prompted him to call EMS. On arrival to the ED his SpO2 was at 81%-86% on room air. He was then placed on HFNC at 60L and FiO2 on 60% which brought his SpO2 at 94%. Pt stated he was vaccinated on March with J&J. He finished coverage. MICU consulted for increasing oxygen requirements. At the time of consult, he was sating 90% of max settings on HFNC, however pt was intubated on 8/9 due to respiratory failure. Upon discussion patient confirmed he is full code. On 8/10 pt desatted with development of SubQ emphysema. Stat CXR revealed large pneumomediastinum and pneumothorax. Emergent right sided Pigtail catheter was placed with increase in O2 sats. Patient self-extubated on 8/14 followed by desaturation to the 50s, he was subsequently re-intubated. I was called to patient?s bedside to pronounce that patient has expired. No spontaneous movements were present. There was not response to verbal or tactile stimuli. Pupils were dilated and fixed. No breath sounds were appreciated over either lung field. No carotid pulses or peripheral pulses were palpable. No heart sounds were auscultated over entire precordium. Patient pronounced dead at 1903. Dr. notified. Family were notified. Condolences offered. Chaplain and postmortem services offered. Pt was Full code. Time of death was 1903, confirmed and witnessed by Nurse.


VAERS ID: 1757610 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: Unknown  
Vaccinated:2020-09-24
Onset:2020-11-18
   Days after vaccination:55
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Death, Localised infection
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-22
   Days after onset: 245
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Prostate cancer (Received enzalutamide)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Deceased; Toe infection; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (Deceased) in a 90-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. Co-suspect product included non-company product ENZALUTAMIDE (ENZALUTAMIDE ASTELLAS) capsule for Prostate cancer. Concurrent medical conditions included Prostate cancer (Received enzalutamide). On 24-Sep-2020, the patient started ENZALUTAMIDE (ENZALUTAMIDE ASTELLAS) (Oral) 160 mg once a day. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 18-Nov-2020, the patient experienced LOCALISED INFECTION (Toe infection). The patient died on 22-Jul-2021. The cause of death was not reported. It is unknown if an autopsy was performed. At the time of death, LOCALISED INFECTION (Toe infection) outcome was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments. Concomitant product use was not provided by the reporter. No treatment information was provided. This case concerns a 90 year-old male patient with history of prostate cancer, who experienced the unexpected serious event of Death (unknown cause) and the unexpected non-serious event of Localised infection. The events occurred an unknown number of days after the first and second doses of mRNA-1273 vaccine. The history of prostate cancer with unknown onset may have contributed to the events. The benefit-risk relationship of mRNA-1273 vaccine is not affected by this report. The seriousness of criteria of Medically significant was overridden for the event of Localised infection based on medical judgement and review of source document that does not include information supporting seriousness criteria.; Sender''s Comments: This case concerns a 90 year-old male patient with history of prostate cancer, who experienced the unexpected serious event of Death (unknown cause) and the unexpected non-serious event of Localised infection. The events occurred an unknown number of days after the first and second doses of mRNA-1273 vaccine. The history of prostate cancer with unknown onset may have contributed to the events. The benefit-risk relationship of mRNA-1273 vaccine is not affected by this report. The seriousness of criteria of Medically significant was overridden for the event of Localised infection based on medical judgement and review of source document that does not include information supporting seriousness criteria.; Reported Cause(s) of Death: Deceased


VAERS ID: 1757635 (history)  
Form: Version 2.0  
Age: 16.0  
Sex: Female  
Location: Texas  
Vaccinated:2021-10-02
Onset:2021-10-03
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Death, Fatigue
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-03
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: none
Allergies: unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: fatigue then death


VAERS ID: 1757761 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: California  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: 3 deaths after the second dose of the Moderna vaccine; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (3 deaths after the second dose of the Moderna vaccine) in a female patient of an unknown age who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. Death occurred on an unknown date The cause of death was not reported. It is unknown if an autopsy was performed. Concomitant medications were not reported. Treatment medications were not reported. This case concerns a unspecified patient with no reported medical history experienced serious events of death after unspecified days after the second dose of Spikevax. The event''s causality considered possible by reporter. Patient experienced AEs after second dose and no information about the first dose is available rechallenge is not applicable . The benefit-risk relationship of Spikevax is not affected by this report. This case was linked to MOD-2021-334634, MOD-2021-334642 (Patient Link).; Sender''s Comments: This case concerns a unspecified patient with no reported medical history experienced serious events of death after unspecified days after the second dose of Spikevax. The event''s causality considered possible by reporter. Patient experienced AEs after second dose and no information about the first dose is available rechallenge is not applicable .The benefit-risk relationship of Spikevax is not affected by this report.; Reported Cause(s) of Death: unknown cause of death


VAERS ID: 1757762 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: California  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: 3 deaths after the second dose of the Moderna vaccine; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of DEATH (3 deaths after the second dose of the Moderna vaccine) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. Death occurred on an unknown date The cause of death was not reported. It is unknown if an autopsy was performed. Concomitant products were not provided. Treatment medication were not reported. Further information has been requested. This case concerns a patient of unknown age and gender, with no relevant medical history, who experienced the unexpected serious event of death (reported as 3 deaths after the second dose of the Moderna vaccine). The event occurred at an unknown day after the second dose of Spikevax. The rechallenge was not applicable as the events happened after the second dose and no additional dosing will be given (due to the outcome). The benefit-risk relationship of Spikevax is not affected by this report. This case was linked to MOD-2021-334634, MOD-2021-334640 (Patient Link).; Sender''s Comments: This case concerns a patient of unknown age and gender, with no relevant medical history, who experienced the unexpected serious event of death (reported as 3 deaths after the second dose of the Moderna vaccine). The event occurred at an unknown day after the second dose of Spikevax. The rechallenge was not applicable as the events happened after the second dose and no additional dosing will be given (due to the outcome). The benefit-risk relationship of Spikevax is not affected by this report.; Reported Cause(s) of Death: Unknown cause of death


VAERS ID: 1757766 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-09
Onset:2021-09-07
   Days after vaccination:241
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Chest tube insertion, Computerised tomogram thorax, Condition aggravated, Death, Deep vein thrombosis, Dyspnoea, Endotracheal intubation, Extubation, Infection, Lung opacity, Pneumonia, Pneumothorax, Pupil fixed, Renal cyst, SARS-CoV-2 test positive, Scan with contrast abnormal, Septic shock
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Interstitial lung disease (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-28
   Days after onset: 21
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 21 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Zyloprim Lipitor Synthroid Prinivil Bactrim
Current Illness: Shortness of Breath
Preexisting Conditions: Hypertension HLD Gout
Allergies: None
Diagnostic Lab Data: Covid positive TECHNIQUE: 1.Following the administration of intravenous contrast a CT angiogram of the chest/pulmonary arteries was performed. Sagittal and coronal images were generated. Dose reduction techniques were employed per ALARA protocol. 2. 3-D reconstruction of the pulmonary arteries was generated at a separate workstation and reviewed. FINDINGS: No pulmonary embolism. Normal caliber pulmonary arteries. Normal heart size. Trace pericardial fluid. Normal caliber aorta. Large areas of peripheral groundglass opacities filling both lungs. Findings consistent with COVID-19 pneumonia. No pleural effusion. No lymphadenopathy. Right renal cyst. No acute abnormality the included abdomen. IMPRESSION: 1. No pulmonary embolus. 2. Large areas of peripheral groundglass opacities filling both lungs. Findings consistent with COVID-19 pneumonia.
CDC Split Type:

Write-up: Pt is a 68 yoM vaccinated for COVID and hx of HTN, HLD, gout who presents with worsening shortness of breath found to have acute hypoxic respiratory failure 2/2 COVID pneumonia, given rapid worsening started on dexamethasone, remdesevir and barcitinib. He was also found to have a LLE DVT and given worsening oxygenation, possible PE. Pulm, Nephrology were consulted. He eventually needed to be intubated and then developed a pneumothorax requiring a chest tube. He then developed septic shock from superimposed HAP, completed therapy for it and meanwhile went into ARF, initially stable on diuretics, but eventually required HD. Had initial decline in neurologic status with nonresponsive R. Pupil, but unable to perform head imaging d/t clinical instability. Following another clinical decline on 9/26 where he was found to have another pneumothorax along with worsening s/s of infection. His family decided to make him comfort care at this point and plan to transition with terminal extubation and transfer to hospice scatterbed. He was terminally extubated and TOD was 9/28/21 0202.


VAERS ID: 1758643 (history)  
Form: Version 2.0  
Age: 88.0  
Sex: Female  
Location: New Hampshire  
Vaccinated:2021-08-27
Onset:2021-09-01
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 054C21A / 3 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-01
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: nystatin, Lasix, Toprol LX, Norco, Vitamin D3, mycophenolate, hydroxyzine, Protonix, Aldactone, Synthroid, betamethasone dipropionate
Current Illness: Chronic Lung disease, AS, right sided heart failure, LE edema, On oxygen via NC, mucositis,
Preexisting Conditions: Interstitial lung disease, right-sided heart failure, leg edema, neuralgia, dyslipidemia, hypertension, NASH
Allergies: Lisinopril, Morphine Sulfate, Oxycodone-acetaminophen, Sulfonamide Antibiotics
Diagnostic Lab Data: none
CDC Split Type:

Write-up: Patient died.


VAERS ID: 1758695 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-04-08
Onset:2021-10-03
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 202A21A / 1 - / -

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Death, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-03
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: TESTED POSITIVE FOR COVID-19 ON 10/1/2021 (BREAKTHROUGH CASE)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT TESTED POSITIVE FOR COVID-19 ON 10/1/2021 (BREAKTHROUGH CASE); PATIENT EXPIRED ON 10/3/2021


VAERS ID: 1758805 (history)  
Form: Version 2.0  
Age: 55.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-06
Onset:2021-09-25
   Days after vaccination:203
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Death, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-26
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: shortness of breath patient Deceased


VAERS ID: 1758808 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-05-27
Onset:2021-05-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 043A21A / 1 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Asthenia, Condition aggravated, Cough, Death, Escherichia infection, Fatigue, Hepatic cirrhosis, Hepatitis B, Hypertension, Jaundice, Laboratory test, Lymphoma, Malaise, Pain, Platelet count decreased, Platelet transfusion
SMQs:, Cholestasis and jaundice of hepatic origin (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Liver infections (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Guillain-Barre syndrome (broad), Hypertension (narrow), Malignant lymphomas (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Haematological malignant tumours (narrow), Infective pneumonia (broad), Opportunistic infections (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2021-08-10
   Days after onset: 74
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 22 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: High blood pressure
Allergies: None
Diagnostic Lab Data: Please check with the hospital, there were so many to list
CDC Split Type:

Write-up: Patient didn?t feel well the day after his COVID vaccine. He was extremely tired and he had body aches. This continued until his 1st visit to the hospital on July 1st. He was jaundice and weak. They diagnosed cirrhosis, high blood pressure and low blood platelets. He stayed in the hospital for 3-4 days and was released. 4-5 days later we went to the hospital again with the same symptoms. This time they told him he had hepatitis B along with the other things already diagnosed, again he was released from the hospital after a few days. 5-6 days later he had a doctors appointment, she told him he needed to go back to the hospital. This stay was for 16 days. He needed platelets and was then diagnosed with an aggressive form of lymphoma, received treatment and was released on July 30. That evening he started with a cough and felt progressively worse. August 3rd he was scheduled for more blood platelets, arrived to the hospital and was again admitted. They then diagnosed him with an ecoli infection which was to much for his weakened state and he passed away on August 10


VAERS ID: 1758810 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-02-23
Onset:2021-10-03
   Days after vaccination:222
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 - / -

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Death, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-03
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 30 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: PATIENT TESTED POSITIVE FOR COVID-19 ON 8/27/2021; EXPIRED ON 10/3/2021


VAERS ID: 1758912 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-02-26
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 1 UN / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Death, Inappropriate schedule of product administration, SARS-CoV-2 test positive
SMQs:, Medication errors (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-02
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient tested positive for COVID-19 9/23/2021. Hospitilized 9/23/2021. Patient was fully vaccinated 2/26/21 and 04/03/2021 with Moderna. Paitnet expired 10/02/2021


VAERS ID: 1758997 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-01
Onset:2021-07-31
   Days after vaccination:180
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-31
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Report of Examination, Office of the Medical Examiner, Department of Health, 30 Aug 2021
CDC Split Type:

Write-up: Death.


VAERS ID: 1759083 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-12
Onset:2021-03-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010A21A / 1 - / -

Administered by: Public       Purchased by: ?
Symptoms: Death, Myocardial infarction
SMQs:, Myocardial infarction (narrow), Embolic and thrombotic events, arterial (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: HEADACHES
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data: DEATH CERTIFICATE SAYS HEART ATTACK... STATED COULD HAVE BEEN BLOOD CLOTS
CDC Split Type:

Write-up: SON REPORTED THAT PATIENT DIED 2 DAYS AFTER GETTING THE VACCINE


VAERS ID: 1759157 (history)  
Form: Version 2.0  
Age: 98.0  
Sex: Male  
Location: Connecticut  
Vaccinated:2020-12-22
Onset:2020-12-23
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA EL0140 / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Communication disorder, Death, Decreased appetite
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-01-11
   Days after onset: 19
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Tylenol 650mg @ 9 AM/1 PM/5 PM
Current Illness: None
Preexisting Conditions: Dementia
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Cessation of talking and eating followed by death.


VAERS ID: 1759168 (history)  
Form: Version 2.0  
Age: 39.0  
Sex: Male  
Location: Ohio  
Vaccinated:2021-09-22
Onset:2021-09-27
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 AR / IM

Administered by: Work       Purchased by: ?
Symptoms: Chest pain, Death, Dyspnoea, Thrombosis, Ultrasound scan abnormal
SMQs:, Anaphylactic reaction (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Thrombophlebitis (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-27
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: Asthma
Allergies: N/A
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt.''s Sister states that after her brother received the 2nd dose of Phizer 09/22/2021, Pt. started experiencing shortness of breath and pain in the chest, Urgent Care visit 09/27/2021. Ultrasound preformed, treated with Updraft. Died 09/27/2021 2 Blood Clots located.


VAERS ID: 1759181 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-05-28
Onset:2021-10-03
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNKNOWN / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal wall haematoma, Acute kidney injury, Acute respiratory distress syndrome, Angiogram pulmonary abnormal, Anticoagulant therapy, Anuria, Biopsy cartilage, Blood culture positive, Blood loss anaemia, COVID-19, Chest discomfort, Culture positive, Death, Dyspnoea, Endotracheal intubation, Enterobacter infection, Hepatic failure, Herpes simplex, Intensive care, Metabolic acidosis, Multiple organ dysfunction syndrome, Nasal ulcer, Packed red blood cell transfusion, Pneumonia aspiration, Pulmonary embolism, Respiratory acidosis, SARS-CoV-2 test positive, Serratia infection, Shock, Skin culture positive
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Anaphylactic reaction (narrow), Angioedema (broad), Lactic acidosis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Interstitial lung disease (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Hypersensitivity (narrow), Myelodysplastic syndrome (broad), Tumour lysis syndrome (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), Sepsis (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-03
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Allopurinol, Cartia XT, Coreg, Colcrys, Maxidex eye drops, trulicity, Vasotec, metformin, novofine, crestor, xarelto kenalog ointment.
Current Illness:
Preexisting Conditions: OSA, dyslipidemia, right colectomy, eustachian tube dysfunction, homonymous hemianopsia due to cerebrovascular accident, left bundle branch block, chronic anticoagulation, protrusion of intervertebral disc, stenosis of cervical spine, laminectomy.
Allergies: NKA
Diagnostic Lab Data:
CDC Split Type:

Write-up: 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."


VAERS ID: 1759243 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-04-21
Onset:2021-09-13
   Days after vaccination:145
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0169 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Acute respiratory failure, Adenovirus test, Aortic valve incompetence, Atelectasis, Atrial fibrillation, Blood culture negative, Bordetella test negative, COVID-19, COVID-19 pneumonia, Cardiac failure acute, Cardiac failure congestive, Cardiomegaly, Central venous catheterisation, Chest X-ray abnormal, Chest tube insertion, Chlamydia test negative, Chronic obstructive pulmonary disease, Clostridium test negative, Coagulopathy, Computerised tomogram abdomen, Condition aggravated, Coronavirus test negative, Culture, Death, Dyspnoea, Echocardiogram abnormal, Enterovirus test negative, Fungal test, General physical health deterioration, Hiatus hernia, Human metapneumovirus test, Human rhinovirus test, Hypoxia, Illness, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Lactic acidosis, Left ventricular failure, Liver function test increased, Lung infiltration, Lung opacity, Malnutrition, Mycobacterium test negative, Mycoplasma test negative, Nephrolithiasis, Pleural effusion, Pneumonia bacterial, Pneumothorax, Pulmonary hypertension, Pulmonary oedema, Renal failure, Respiratory syncytial virus test negative, Respiratory tract congestion, Respiratory viral panel, SARS-CoV-2 test positive, Septic shock, Somnolence, Ultrasound Doppler abnormal, Ultrasound chest, Ultrasound liver abnormal, Urine output decreased, Viral test negative, X-ray
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Lactic acidosis (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-15
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 19 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen (TYLENOL) 650 mg 8 hr tablet acetaminophen (TYLENOL) 650 mg 8 hr tablet albuterol HFA (VENTOLIN HFA) 90 mcg/actuation inhaler alendronate (FOSAMAX) 70 mg tablet amLODIPine (NORVASC) 2.5 mg tablet ascorbic acid, vitamin C,
Current Illness:
Preexisting Conditions: Respiratory Chronic obstructive pulmonary disease with acute exacerbation Obstructive sleep apnea Acute respiratory failure with hypoxia Pleural effusion on right Hypoxia End stage COPD Circulatory Paroxysmal A-fib Hypotension Pulmonary hypertension, moderate to severe Aortic valve sclerosis Mitral stenosis Cerebral microvascular disease Left atrial thrombus Chronic diastolic congestive heart failure due to valvular disease Acute on chronic diastolic (congestive) heart failure Vegetation of heart valve Congestive heart failure, unspecified HF chronicity, unspecified heart failure type Endocarditis Digestive Obesity (BMI 35.0-39.9 without comorbidity) GERD (gastroesophageal reflux disease) Genitourinary History of urinary infection Endocrine/Metabolic Lactic acidosis Hematologic Erythrocytosis Relative polycythemia Other Positive blood culture History of cholecystectomy History of tonsillectomy Current smoker Unintended weight loss Dark stools Ground glass opacity present on imaging of lung Advanced directives, counseling/discussion
Allergies: MorphineShortness of breath / Dyspnea AcetazolamideHives / Urticaria Sulfa (Sulfonamide Antibiotics)Hives / Urticaria Golden Rod Ragweed CyclobenzaprineJittery / shaky DiclofenacDizziness / Lightheaded
Diagnostic Lab Data: 09/13/21 1432 Respiratory virus detection panel Collected: 09/13/21 1319 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result Detected Critical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected Procedure Component Value Ref Range Date/Time X-ray chest 1 view, Portable [3302832002] Resulted: 09/14/21 1407 Order Status: Completed Updated: 09/14/21 1407 Narrative: XR CHEST 1 VW PORT IMPRESSION: Persistent diffuse interstitial opacities bilaterally, similar to prior radiographs. END OF IMPRESSION: INDICATION: CHF, COVID 19 with increased O2 req. TECHNIQUE: AP upright projection of the chest is acquired. COMPARISON: Radiographs of 9/13/2021. FINDINGS: There is unchanged cardiomegaly. Right-sided PICC catheter and TAVR again noted. Right basilar chest tube again noted. Persistent diffuse interstitial opacities bilaterally, similar to prior radiographs. No evidence of pneumothorax. Hiatal hernia is noted. Little significant interval change compared to prior radiographs. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. Ultrasound liver [3302633235] Resulted: 09/13/21 1016 Order Status: Completed Updated: 09/13/21 1017 Narrative: US LIVER IMPRESSION: Nonobstructive calculus in the right lower pole of the kidney, 8 mm. Small right pleural effusion. Otherwise, no sonographic abnormality in the remaining right upper quadrant of the abdomen. END OF IMPRESSION: INDICATION: Elevated LFTs. TECHNIQUE: Grayscale ultrasonography and color Doppler of the right upper quadrant of the abdomen was performed. Permanently recorded images were obtained and stored. COMPARISON: Correlation made with CT of the abdomen and pelvis dated 8/15/2021 LIMITATIONS: None. FINDINGS: Liver size: Normal. Length: 14.1 cm. Liver echogenicity: Normal. Liver contour: Smooth. Liver mass: None. Liver vasculature: Normal. Bile ducts: Intrahepatic and extrahepatic bile ducts not dilated. Common bile duct: 2 mm. Gallbladder: Surgically absent. Pancreas: Head, body, and tail appear normal. Right kidney: No pelvicalyceal dilatation. Echogenic focus in the lower pole, 8 mm. Length: 11.4 cm. Perfusion: Normal. Inferior vena cava: Visualized portions appear normal in caliber. Ascites: None. Small right pleural effusion. Normal values: Liver length 15-18 cm; common duct <= 6 mm; gallbladder wall <= 3 mm, length <= 8-12 cm, and width <= 4 cm; kidney 9.5-11.5 +/-1.3 cm. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view [3302574370] Resulted: 09/13/21 0733 Order Status: Completed Updated: 09/13/21 0733 Narrative: XR CHEST 1 VW PORT IMPRESSION: 1. Stable chest. 2. See below report. END OF IMPRESSION: INDICATION: F/U hypoxia. TECHNIQUE: Single AP projection of the chest is acquired. COMPARISON: Chest radiograph dated September 11, 2021. FINDINGS: Cardiomegaly changes are stable. Cardiac valve repair changes are stable. Right-sided PICC line with tip in the SVC/RA junction is stable. Diffuse interstitial edema or infiltrates in perihilar region are stable. Cannot exclude perihilar pneumonia changes versus CHF. Right basilar chest tube is stable. Small left basilar effusion changes are stable. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view, Portable [3302413288] Resulted: 09/11/21 0721 Order Status: Completed Updated: 09/11/21 0721 Narrative: XR CHEST 1 VW PORT IMPRESSION: 1. Some increasing diffuse interstitial alveolar lung infiltrates. Increasing in the right upper lung. 2. Findings may be a combination of CHF and possible underlying pneumonia. 3. Otherwise stable chest. 4. See below report. END OF IMPRESSION: INDICATION: Congestion. TECHNIQUE: Single AP projection of the chest is acquired. COMPARISON: Chest radiograph dated September 9, 2021. FINDINGS: Moderate cardiomegaly changes are stable. Diffuse interstitial alveolar lung infiltrates are somewhat increased in the right lung. Right-sided PICC line with the tip in the SVC/RA junction is stable. Cardiac valve replacement changes are reidentified. No pneumothorax is noted. Patient is rotated to the right. Small bibasilar effusion changes are stable. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view, Portable [3301777237] Resulted: 09/09/21 0846 Order Status: Completed Updated: 09/09/21 0846 Narrative: XR CHEST 1 VW PORT IMPRESSION: Interval worsening of pulmonary edema. END OF IMPRESSION: INDICATION: Hypoxia. TECHNIQUE: AP upright projection of the chest is acquired. COMPARISON: AP chest 9/7/2021. FINDINGS: There has been interval worsening of diffuse interstitial opacities in bilateral lungs, indicating worsening of pulmonary edema. No additional changes are noted since the prior study. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view, Portable [3301430639] Resulted: 09/07/21 1416 Order Status: Completed Updated: 09/07/21 1416 Narrative: XR CHEST 1 VW PORT IMPRESSION: Bilateral perihilar and diffuse interstitial opacities slightly improved from prior likely reflecting improving interstitial edema. END OF IMPRESSION: INDICATION: hypoxia. TECHNIQUE: AP portable upright projection of the chest is acquired. COMPARISON: September 1, 2021 FINDINGS: Prosthetic cardiac valve stent is again noted. There is a right upper extremity PICC unchanged. There are bilateral perihilar and diffuse interstitial opacities slightly improved from prior likely reflecting improving interstitial edema. There is no significant pleural effusion. There is no pneumothorax. The cardiomediastinal silhouette is unchanged in size. Pleurx catheter at the right lung base is unchanged. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view [3300502907] Resulted: 09/01/21 1239 Order Status: Completed Updated: 09/01/21 1239 Narrative: XR CHEST 1 VW PORT IMPRESSION: 1. Prominence of the vascular pattern, worrisome for vascular failure. 2. Bibasilar atelectasis. 3. Improved right basilar opacity. END OF IMPRESSION: INDICATION: PNEUMOTHORAX pleural effusion. TECHNIQUE: AP upright projection of the chest is acquired. COMPARISON: Radiographs of 8/31/2021. FINDINGS: The cardiomediastinal silhouette is unchanged. Right-sided PICC catheter and right basilar Pleurx drainage catheter are unchanged position. Transarterial aortic valve replacement is unchanged. There is an intra-arterial occlusion device, unchanged. Even allowing for inspiratory effort, the vascular pattern is prominent and worrisome for vascular failure. Improved opacity at the right lung base. There is mild bibasilar atelectasis. No pneumothorax. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view [3300337828] Resulted: 08/31/21 1308 Order Status: Completed Updated: 08/31/21 1308 Narrative: XR CHEST 1 VW PORT IMPRESSION: 1. Small right-sided pleural effusion, slightly improved compared to prior radiographs. 2. Persistent small right apical pneumothorax with Pleurx catheter in place. 3. Mild pulmonary edema bilaterally. END OF IMPRESSION: INDICATION: PNEUMOTHORAX pleural effusion. TECHNIQUE: AP upright projection of the chest is acquired. COMPARISON: Radiographs of 8/31/2021. FINDINGS: There is unchanged cardiomegaly. Persistent right-sided pleural effusion, slightly improved compared to prior radiographs. Right-sided Pleurx catheter is in unchanged position. Right basilar opacity is again noted which may reflect atelectasis or reexpansion edema. There is mild pulmonary edema bilaterally. Redemonstrated is a small right apical pneumothorax. Right-sided PICC catheter is unchanged in position. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view, Portable [3300337830] Resulted: 08/31/21 0711 Order Status: Completed Updated: 08/31/21 0711 Narrative: XR CHEST 1 VW PORT IMPRESSION: 1. New small right apical pneumothorax. 2. Right greater than left pleural effusions and adjacent hazy airspace opacities, with improved aeration of the right lower lobe compared to the prior study. 3. Unchanged cardiomegaly. END OF IMPRESSION: INDICATION: sob, s/p pleurx cath today for effusion. TECHNIQUE: AP upright portable projection of the chest is acquired. COMPARISON: Chest radiograph performed on August 30, 2021. FINDINGS: Unchanged cardiomegaly. There is a small moderate right pleural effusion with adjacent hazy airspace opacity, decreased compared the prior study, with improved aeration of the right lower lobe. Hazy left lower lobe opacity, unchanged from the prior study, with probable minimal left pleural fluid. Unchanged prominence of the bilateral interstitial markings. There is a small right apical pneumothorax, new compared to the prior study. A right-sided chest catheter terminates in the right lower lung zone. A right-sided PICC line terminates in the atriocaval junction. An aortic stent is noted. Calcification of the aortic arch is identified. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. IR pleurx pleural catheter insertion [3300337812] Resulted: 08/30/21 1624 Order Status: Completed Updated: 08/30/21 1624 Narrative: IR PLEURX PLEURAL CATHETER INSERTION IMPRESSION: Right-sided tunneled pleural catheter placement with immediate drainage of 1400 mL of amber fluid. Plan: Tunneled pleural catheter ready for immediate use. Contact interventional radiology if issues with drainage. END OF IMPRESSION: _______________________________________________________________ Procedural Personnel Attending physician(s): M.D. Fellow physician(s): None Resident physician(s): None Advanced practice provider(s): None Pre-procedure diagnosis: Pleural effusion Post-procedure diagnosis: Same Indication: Non-malignant pleural effusion Additional clinical history: None Complications: No immediate complications. PROCEDURE SUMMARY: - Ultrasound and fluoroscopic-guided tunneled pleural catheter placement - Additional procedure(s): None PROCEDURE DETAILS: Pre-procedure Consent: Informed consent for the procedure including risks, benefits and alternatives was obtained and time-out was performed prior to the procedure. Preparation: The site was prepared and draped using maximal sterile barrier technique including cutaneous antisepsis. Anesthesia/sedation Level of anesthesia/sedation: No sedation Anesthesia/sedation administered by: Not applicable Total intra-service sedation time (minutes): 0 Limited thoracic ultrasound Limited thoracic ultrasound was performed. A safe window for catheter insertion was identified. Findings: There is a large right pleural effusion. Tunneled pleural catheter placement Local anesthesia was administered. The pleural cavity was accessed with a 17G needle and a wire was placed. A subcutaneous tunnel was anesthetized adjacent to the puncture site and the catheter was tunneled through the subcutaneous tissues. Serial dilation of the pleural access point was performed, and a peel-away sheath was placed. The catheter was passed into the sheath as it was peeled away. Pleural access technique: Real-time ultrasound guidance Catheter placed: BD PleurX Closure The pleural access site was closed and the catheter was secured to the skin. A sterile bandage was applied. Access site closure technique: Tissue adhesive Catheter securement technique: Non-absorbable suture Contrast Contrast agent: None Contrast volume (mL): 0 Radiation Dose Fluoroscopy time (minutes): 0.2 Reference air kerma (mGy): 1.35 Kerma area product (Gy-cm2): 0 Additional Details Additional description of procedure: None Equipment details: None Specimens removed: Pleural fluid Estimated blood loss (mL): Less than 10 Standardized report: SIR_TunneledPleuralCatheter_v3 Attestation Signer name: WITHHELD I attest that I was present for the entire procedure. I reviewed the stored images and agree with the report as written. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view [3300239920] Resulted: 08/30/21 0838 Order Status: Completed Updated: 08/30/21 0838 Narrative: XR CHEST 1 VW PORT IMPRESSION: Cardiomegaly with mild pulmonary venous cephalization and bilateral pleural effusions, right greater than left are not significantly changed. END OF IMPRESSION: INDICATION: Pneumothorax. Pleural effusion. TECHNIQUE: An AP upright portable projection of the chest was obtained on 8/30/2021 at 0539 hours. COMPARISON: 8/29/2021 FINDINGS: The heart size remains enlarged with evidence of valve repair. Mild pulmonary venous cephalization is noted. A right-sided PICC line terminates at the cavoatrial junction. A moderate-sized right pleural effusion and a small left pleural effusion are noted. There is associated right basilar atelectasis. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view, Portable [3300134426] Resulted: 08/29/21 0842 Order Status: Completed Updated: 08/29/21 0843 Narrative: XR CHEST 1 VW PORT IMPRESSION: 1. No change large right pleural effusion obscuring the inferior right hemithorax. 2. New minor left base atelectasis. END OF IMPRESSION: INDICATION: pleural effusion. TECHNIQUE: AP portable projection of the chest is acquired. COMPARISON: 8/27/2021 FINDINGS: Prior transcatheter valve replacement. Left lung clear except for minor opacity partly obscuring the left hemidiaphragm. No change large right pleural effusion obscuring the inferior hemithorax. Stable heart and mediastinum. Bones and soft tissues unchanged. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 2 views [3299258969] Resulted: 08/27/21 1512 Order Status: Completed Updated: 08/27/21 1512 Narrative: XR CHEST 2 VW IMPRESSION: New right pleural effusion. END OF IMPRESSION: INDICATION: SOB. TECHNIQUE: PA and lateral views of the chest were obtained. COMPARISON: August 23, 2021 FINDINGS: There is a moderate-sized right pleural effusion increased from prior study. Heart is enlarged. There is been aortic valve replacement. There is a PICC in the SVC. Results Procedure Component Value Ref Range Date/Time Respiratory virus detection panel [3302633241] (Abnormal) Collected: 09/13/21 1319 Order Status: Completed Specimen: Swab from Nasopharynx Updated: 09/13/21 1432 Adenovirus Not Detected Not Detected Chlamydophila pneumoniae Not Detected Not Detected COVID-19 SARS-CoV-2 Overall Result Detected Critical Not Detected Coronavirus Not Detected Not Detected Influenza A Not Detected Not Detected Influenza B Not Detected Not Detected Metapneumovirus Not Detected Not Detected Mycoplasma pneumoniae Not Detected Not Detected Parainfluenza Not Detected Not Detected Enterovirus/Rhinovirus Not Detected Not Detected Respiratory Syncytial Virus Not Detected Not Detected Bordetella pertussis Not Detected Not Detected Bordetella parapertussis Not Detected Not Detected Narrative: Testing performed by real-time polymerase chain reaction (PCR) and reverse transcriptase polymerase chain reaction (RT-PCR). The Dept. of Health has been notified of this result. Clostridium difficile PCR - Once [3302574341] (Normal) Collected: 09/12/21 1702 Order Status: Completed Specimen: Stool from Per Rectum Updated: 09/12/21 1807 C. diff PCR Not Detected Not Detected Narrative: Testing performed by real time polymerase chain reaction (PCR). Blood culture [3300502914] Collected: 09/01/21 1215 Order Status: Completed Specimen: Blood, Venous Updated: 09/06/21 1302 Blood Culture No growth at 120 hours Blood culture [3300502915] Collected: 09/01/21 1212 Order Status: Completed Specimen: Blood, Venous Updated: 09/06/21 1302 Blood Culture No growth at 120 hours Fungal culture - pleural, RIGHT [3300239957] Collected: 08/30/21 1606 Order Status: Sent Specimen: Body Fluid from Pleural Cavity, Right Updated: 09/03/21 2304 Narrative: The following orders were created for panel order Fungal culture - pleural, RIGHT. Procedure Abnormality Status --------- ----------- ------ Fungal culture, (Sputum...[3300337801] In process Fungal smear (Sputum/Ti...[3300337803] Final result Please view results for these tests on the individual orders. Fungal smear (Sputum/Tissue/Body Fluid/Urine) [3300337803] Collected: 08/30/21 1606 Order Status: Completed Specimen: Body Fluid from Pleural Cavity, Right Updated: 09/03/21 2304 Fungal Stain SEE BELOW Comment: SOURCE : BODY FLUID Result/Comment: No fungus seen on microscopic examination. Anaerobic culture - pleural, RIGHT - Tube 3 [3300239954] (Normal) Collected: 08/30/21 1606 Order Status: Completed Specimen: Body Fluid from Pleural Cavity, Right Updated: 09/02/21 1006 Anaerobic Culture No anaerobes isolated Body fluid culture - pleural, RIGHT - Tube 3 [3300239955] Collected: 08/30/21 1606 Order Status: Completed Specimen: Body Fluid from Pleural Cavity, Right Updated: 09/02/21 1006 Narrative: The following orders were created for panel order Body fluid culture - pleural, RIGHT - Tube 3. Procedure Abnormality Status --------- ----------- ------ Body fluid culture[3300337797] Final result Anaerobic culture[3300337799] Please view results for these tests on the individual orders. Body fluid culture [3300337797] Collected: 08/30/21 1606 Order Status: Completed Specimen: Body Fluid from Pleural Cavity, Right Updated: 09/02/21 1006 Body Fluid Culture No growth Body Fluid Culture Gram Stain Few Polymorphonuclear leukocytes No bacteria seen Specimen concentrated for Gram stain AFB culture - pleural, RIGHT - Tube 3 [3300239948] Collected: 08/30/21 1606 Order Status: Sent Specimen: Body Fluid from Pleural Cavity, Right Updated: 09/01/21 1037 Narrative: The following orders were created for panel order AFB culture - pleural, RIGHT - Tube 3. Procedure Abnormality Status --------- ----------- ------ AFB Culture Progressive...[3300337789] In process Mycobacteria Stain, Aci...[3300337791] Final result Please view results for these tests on the individual orders. Mycobacteria Stain, Acid-Fast, Fluorochrome [3300337791] Collected: 08/30/21 1606 Order Status: Completed Specimen: Body Fluid from Pleural Cavity, Right Updated: 09/01/21 1037 AFB Stain SEE BELOW Comment: Mycobacteria Stn,AF,Fluor SOURCE : BODY FLUID Result/Comment: No acid-fast bacilli seen. Mycobacteria smear result should be used as an adjunct to culture in diagnosing mycobacterial disease (e.g. tuberculosis). If intended, please ensure an order for Mycobacteria (Acid-Fast-Bacilli) culture has also been submitted. AFB Culture Progressive TB/MAI Probes, ID and TB/MAI Sensitivity [3300337789] Collected: 08/30/21 1606 Order Status: Sent Specimen: Body Fluid from Pleural Cavity, Right Updated: 08/30/21 1615 Fungal culture, (Sputum/Tissue/Body Fluid/Urine) [3300337801] Collected: 08/30/21 1606 Order Status: Sent Specimen: Body Fluid from Pleural Cavity, Right Updated: 08
CDC Split Type:

Write-up: ED to Hosp-Admission Discharged 8/27/2021 - 9/15/2021 (19 days) Last attending ? Treatment team Acute on chronic diastolic (congestive) heart failure Final Summary for Deceased Patient BRIEF OVERVIEW Admitting Provider: MD Discharge Provider: MD Primary Care Physician at Discharge: MD Admission Date: 8/27/2021 Discharge Date: 9/15/2021 Final Diagnosis Principal Problem: Acute on chronic diastolic (congestive) heart failure Active Problems: Paroxysmal A-fib Pulmonary hypertension, moderate to severe Chronic obstructive pulmonary disease with acute exacerbation Pleural effusion on right End stage COPD Congestive heart failure, unspecified HF chronicity, unspecified heart failure type Endocarditis Lactic acidosis DETAILS OF HOSPITAL STAY Date and time of death: September 15, 2021, 12:11 PM Cause of death: Septic shock from COVID-19 pneumonia Acute respiratory failure from COVID-19 and systolic heart failure Secondary diagnoses: Severe aortic insufficiency Superimposed bacterial pneumonia Acute renal failure Lactic acidosis Possible endocarditis Atrial fibrillation with rapid ventricular response End-stage COPD Elevated LFTs Coagulopathy from malnutrition and acute illness Hospital Course Patient is a 72-year-old female with history of COPD, atrial fibrillation on Coumadin, systolic heart failure, recent TMVR presented to the hospital with systolic heart failure. She is admitted to medical service and seen by the heart failure team. Echocardiogram showed severe aortic insufficiency and was being considered for valve intervention. She was treated with IV diuretics however her respiratory status did not improve. Hospital course was prolonged and she was hospitalized for 18 days. There is consideration of endocarditis given possible vegetations noted on aortic valve. CT surgery recommended aggressive antibiotic regimen and stated she was high risk for surgery. Initially was plan for IV antibiotics through October 4. She was treated with Lasix infusion, however urine output became marginal. Patient''s x-ray developed progressive infiltrates and on September 14 she was found to have COVID-19 infection. She was started on steroids and received plasma as well. Antibiotics were also broadened to cover potential superimposed bacterial pneumonia. Despite this, her clinical condition deteriorated. She developed progressive renal failure as well as elevated LFTs and coagulopathy. She became more somnolent and oxygen requirement escalated. She became progressively critically ill and was requiring vasopressors, and was maxed on norepinephrine. Unfortunately, she continued to deteriorate and passed away on September 15. I passed along my condolences to the patient''s son.


VAERS ID: 1759252 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-13
Onset:2021-09-23
   Days after vaccination:133
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain upper, Acute respiratory failure, Adrenal mass, Agitation, Anxiety, Biopsy, Biopsy adrenal gland abnormal, C-reactive protein increased, COVID-19, COVID-19 pneumonia, Chest pain, Computerised tomogram head abnormal, Computerised tomogram thorax, Computerised tomogram thorax abnormal, Condition aggravated, Decreased appetite, Dementia, Dysphonia, Dyspnoea, Dyspnoea exertional, Endoscopy, Fatigue, General physical health deterioration, Intensive care, Intentional medical device removal by patient, Laryngeal ventricle prolapse, Lung adenocarcinoma, Lymphadenopathy, Mass, Oxygen saturation decreased, Pleuritic pain, Positron emission tomogram abnormal, Pulmonary mass, Respiratory failure, SARS-CoV-2 test positive, Spleen disorder, Vocal cord bowing, Weight decreased
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Parkinson-like events (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Non-haematological malignant tumours (narrow), Infective pneumonia (narrow), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Atorvastatin (LIPITOR) 10 mg Oral Tab Sig: Take 1 tablet by mouth daily for cholesterol CYANOCOBALAMIN, VITAMIN B-12, (VITAMIN B-12 ORAL) Sig: None Entered Note (6/28/2016): LAST DOSE TAKEN @ 6/27/16 0700 ERGOCALCIFEROL, VITAMIN D2, (V
Current Illness: Alzheimers, Diabetes
Preexisting Conditions: 7/292021: Pt presented to PCP for complaint of hoarseness x2 weeks without odynophagia or dysphagia. Started on protonix. 8/3/21: Pt complaining of worsening hoarseness, stomach pain, and loss of appetite. Referral sent to ENT. 8/15/21: Pt presented to the ED for epigastric pain and shortness of breath. Also complaining of poor appetite and weight loss. CTA chest done showing 8cm left suprahilar mass with adjacent GGO and architectural distortion concerning for malignancy, enlarged medistinal lymph nodes, hypoattenuating area within the spleen which may represent malignancy. E-con sent to onc and recommended referral to pulm for bronch. 8/23/21: Pt had PET scan showing dominant hypermetabolic left perihilar/upper lobe lung mass (encasing left upper lobe bronchus, endoluminal component not excluded), extensive hypermetabolic left hilar, bilateral mediastinal, and upper abdominal/retreopertioneal lymphadenopathy, large hypermetabolic splenic mass, hypermetabolic bilateral adrenal masses. 8/25/21: Pt seen by ENT. Found to have true vocal cords without lesion but immobile L vocal fold with bowing and mild arytenoid prolapse noted, R VF mobile, compensatory supraglottic squeeze on phonation via endopscopy. 8/30/21: Seen by thoracic. Pt still complaining of shortness of breath. Referred (for adrenal biopsy) and pulm (for consideration of bronch/EBUS). 8/31/21: Seen by pulm. Additional history reveals that pt with increasing left sided pleuritic chest pain x2 months, only able to walk several hundred feet before having to stop and catch her breath. Pt expressed that she did not want any treatment of biopsies at that time and expresed importance of quality of life vs quantity of life. Per daughter, pt''s dementia seems to be worsening. Considered brain mets but pt claustrophobic so CT head ordered instead of MRI brain. 9/1/21: CT head suspicious for mets to right parietal lobe. Pulm contacted pt with results. Family agreeable for biopsy. 9/7: Given CT findings, prescribed decadron by pulm 9/17/21: Pt underwent IR guided biopsy of R adrenal mass. 9/21: Path results came back as metastatic adenocarcinoma consistent with lung. Pt also had COVID test which came back POSITIVE. Pt vaccine with Pfizer 4/22/21 and 5/13/21.
Allergies: nka
Diagnostic Lab Data: /292021: Pt presented to PCP for complaint of hoarseness x2 weeks without odynophagia or dysphagia. Started on protonix. 8/3/21: Pt complaining of worsening hoarseness, stomach pain, and loss of appetite. Referral sent to ENT. 8/15/21: Pt presented to the ED for epigastric pain and shortness of breath. Also complaining of poor appetite and weight loss. CTA chest done showing 8cm left suprahilar mass with adjacent GGO and architectural distortion concerning for malignancy, enlarged medistinal lymph nodes, hypoattenuating area within the spleen which may represent malignancy. E-con sent to onc and recommended referral to pulm for bronch. 8/23/21: Pt had PET scan showing dominant hypermetabolic left perihilar/upper lobe lung mass (encasing left upper lobe bronchus, endoluminal component not excluded), extensive hypermetabolic left hilar, bilateral mediastinal, and upper abdominal/retreopertioneal lymphadenopathy, large hypermetabolic splenic mass, hypermetabolic bilateral adrenal masses. 8/25/21: Pt seen by ENT. Found to have true vocal cords without lesion but immobile L vocal fold with bowing and mild arytenoid prolapse noted, R VF mobile, compensatory supraglottic squeeze on phonation via endopscopy. 8/30/21: Seen by thoracic. Pt still complaining of shortness of breath. Referred to IR (for adrenal biopsy) and pulm (for consideration of bronch/EBUS). 8/31/21: Seen by pulm. Additional history reveals that pt with increasing left sided pleuritic chest pain x2 months, only able to walk several hundred feet before having to stop and catch her breath. Pt expressed that she did not want any treatment of biopsies at that time and expresed importance of quality of life vs quantity of life. Per daughter, pt''s dementia seems to be worsening. Considered brain mets but pt claustrophobic so CT head ordered instead of MRI brain. 9/1/21: CT head suspicious for mets to right parietal lobe. Pulm contacted pt with results. Family agreeable for biopsy. 9/7: Given CT findings, prescribed decadron by pulm 9/17/21: Pt underwent IR guided biopsy of R adrenal mass. 9/21: Path results came back as metastatic adenocarcinoma consistent with lung. Pt also had COVID test which came back POSITIVE. Pt vaccine with Pfizer 4/22/21 and 5/13/21
CDC Split Type:

Write-up: 66 yo female with PMH of HTN, HLD, DM2, CKD (baseline creatinine 1.0-1.2), dementia (AOx 2-3), recently diagnosed metastatic lung adenocarcinoma (not yet formally seen by onc), hx of smoking (0.5pd x 30 years, quit 2013), COVID+ on 9/21/21 who presents 9/23/2021 with shortness of breath. Transferred to ICU on 9/25 for AHRF with likely in the setting of worsening COVID PNA and anxiety. From July-Sept, patient reported increasing fatigue, weight loss, and SOB. Patient was diagnosed with metastatic lung adenocarcinoma, following confirmatory biopsy on 9/17. Furthermore, patient tested positive for COVID on 9/21. Patient is vaccinated with pfizer (4/22/21 and 5/13/21). She was admitted on 9/23 with CRP of 13.2. While on the wards, patient was on 2-6 LPM O2. On 9/25, patient with desaturations and a rapid was called. Patient found to have accessory breathing and continual self-removement of HFNC/ NRB from anxiety. She was admitted to the ICU for escalation of O2 therapy in the setting of respiratory failure and precedex drip for agitation. CRP increased from to 25.9 (9/25). Empiric PE treatment with lovenox was started but CT PA was negative for PE. Despite treatment with remdesivir, decadron, and tocilizumab, patient''s condition worsened and eventually required maximum settings on HFNC, NRB, and iNO. Per palliative meeting on 9/28, family would like patient to be intubated if necessary if no family member can be by her side. Their main goal is to get the patient home and they are open to home hospice if the patient can be transported home while alive. Patient is scheduled to be transported via ambulance with HFNC and NRB on 9/30. Grandson, who is vaccinated, is approved to be present throughout the transition from hospital to home hospice.


VAERS ID: 1759308 (history)  
Form: Version 2.0  
Age: 92.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-04-01
Onset:2021-05-04
   Days after vaccination:33
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027L20A / 2 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Adult failure to thrive, Asymptomatic COVID-19, COVID-19, Death, Dementia, Dementia Alzheimer's type, Glaucoma, Hyperlipidaemia, Pulmonary hypertension, SARS-CoV-2 test positive, Sepsis, Vaccine breakthrough infection
SMQs:, Dyslipidaemia (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Dementia (narrow), Pulmonary hypertension (narrow), Noninfectious encephalopathy/delirium (broad), Glaucoma (narrow), Lipodystrophy (broad), Infective pneumonia (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-22
   Days after onset: 18
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Cardiovascular disease, Renal disease
Allergies:
Diagnostic Lab Data: 05/04/2021 PCR+ COVID-19 test
CDC Split Type:

Write-up: Asymptomatic breakthrough COVID-19 case. Death 5/22/2021. From Records cod = ALZHEIMER''S DEMENTIA, COVID 19, HYPERLIPIDEMIA, PULMONARY HYPERTENSION. Other patient details: pt has dementia, adult failure to thrive . glaucoma, and sepsis. place of death: HOSPITAL-EMERGENCY ROOM/OUTPATIENT; certified by: PRONOUNCING AND CERTIFYING PHYSICIAN; occupation: PLAYGROUND DIRECTOR-BOARD OF ELECTIONS


VAERS ID: 1759327 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2021-03-12
Onset:2021-09-06
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acquired diaphragmatic eventration, Acute respiratory failure, Adenovirus test, Angiogram pulmonary, Anticoagulant therapy, Anticoagulation drug level above therapeutic, Anxiety, Arteriosclerosis coronary artery, Asthenia, Bladder disorder, Bordetella test negative, Breath sounds abnormal, COVID-19, COVID-19 pneumonia, Chlamydia test negative, Computerised tomogram abdomen abnormal, Computerised tomogram thorax abnormal, Coronavirus test negative, Dyspnoea, Encephalopathy, Enterovirus test negative, Fatigue, Hiatus hernia, Hip fracture, Human metapneumovirus test, Human rhinovirus test, Hypothermia, Immunodeficiency, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, International normalised ratio increased, Lung infiltration, Lung opacity, Malaise, Multimorbidity, Mycoplasma test negative, Open reduction of fracture, Pneumobilia, Pneumonia viral, Renal cyst, Respiratory syncytial virus test negative, Respiratory viral panel, Restlessness, Rheumatoid arthritis, SARS-CoV-2 test positive, Scan with contrast abnormal, Unresponsive to stimuli, Uterine leiomyoma, Vena cava filter insertion
SMQs:, Liver related investigations, signs and symptoms (broad), Liver-related coagulation and bleeding disturbances (narrow), Anaphylactic reaction (broad), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Akathisia (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Accidents and injuries (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Other ischaemic heart disease (narrow), Osteoporosis/osteopenia (broad), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Arthritis (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-21
   Days after onset: 15
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness:
Preexisting Conditions: Nervous Chronic pain syndrome Peripheral neuropathy Phantom limb pain Generalized pain Encephalopathy Respiratory Acute hypoxemic respiratory failure Circulatory Chronic deep vein thrombosis (DVT) of proximal vein of left lower extremity Benign essential hypertension Digestive Adenomatous polyp of colon Vitamin B12 deficiency Genitourinary Hyperactivity of bladder Renal cyst Acute cystitis without hematuria Musculoskeletal Complete below knee amputation of right lower extremity DDD (degenerative disc disease), lumbar Degeneration, intervertebral disc, thoracic Facet arthropathy, lumbar Osteoarthritis of right shoulder Osteoporosis Thoracic spondylosis Primary osteoarthritis involving multiple joints Intertrigo Endocrine/Metabolic Hyperlipidemia Hematologic Supratherapeutic INR Infectious/Inflammatory COVID-19 Immune Immunosuppressed status Rheumatoid arthritis Other Abdominal adhesions Incisional hernia Lymphedema Spinal stenosis of lumbar region Controlled substance agreement signed Current use of long term anticoagulation Ambulatory dysfunction Medication management Long term (current) use of anticoagulants Poor prognosis
Allergies: CefuroximeChest Pain / Tightness AdhesiveRash AspirinOther (document details in comments) DoxycyclineNausea Only Nsaids (Non-steroidal Anti-inflammatory Drug)Other (document details in comments)
Diagnostic Lab Data: 09/21/21 1830 COVID-19 (SARS CoV-2,RNA Molecular Amplification) Collected: 09/21/21 1706 | Final result | Specimen: Swab from Nasopharynx COVID-19 SARS-CoV-2 Overall Result Detected Critical 09/21/21 1830 COVID-19 PCR - Pre-Procedure Screening (Asymptomatic) Collected: 09/21/21 1706 | Final result | Specimen: Swab from Nasopharynx 09/13/21 0332 Respiratory virus detection panel Collected: 09/13/21 0205 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result Detected Critical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected I have personally reviewed the radiology image CT abdomen pelvis with contrast Result Date: 9/13/2021 PROCEDURE INFORMATION: Exam: CT Abdomen And Pelvis With Contrast Exam date and time: 9/13/2021 3:27 AM Age: 69 years old Clinical indication: Other: N/a; Additional info: AMS, SOB TECHNIQUE: Imaging protocol: Computed tomography of the abdomen and pelvis with contrast. Radiation optimization: All CT scans at this facility use at least one of these dose optimization techniques: automated exposure control; mA and/or kV adjustment per patient size (includes targeted exams where dose is matched to clinical indication); or iterative reconstruction. Contrast material: OMNI 350; Contrast volume: 80 ml; Contrast route: INTRAVENOUS (IV); COMPARISON: CT ABDOMEN PELVIS W CONTRAST 2/14/2019 3:12 PM FINDINGS: Lungs: Bilateral diffuse infiltrates are noted as described in the chest CT report. Mediastinal space: A large hiatal hernia is present. Liver: Normal. No mass. Gallbladder and bile ducts: Pneumobilia is again noted as previously described. Pancreas: Normal. No ductal dilation. Spleen: Normal. No splenomegaly. Adrenal glands: Normal. No mass. Kidneys and ureters: Multiple bilateral renal cysts are unchanged, the largest measuring 4.8 cm in the lower pole on the right. Stomach and bowel: Unremarkable. No obstruction. No mucosal thickening. Appendix: No evidence of appendicitis. Intraperitoneal space: Unremarkable. No free air. No significant fluid collection. Vasculature: IVC filter is present. Lymph nodes: Unremarkable. No enlarged lymph nodes. Urinary bladder: The bladder is decompressed. Reproductive: Fibroid uterus is noted. This has a low-density portion to it centrally which may represent distended endometrium, this is new from the prior study. Bones/joints: Patient is status post ORIF left hip fracture. Soft tissues: Unremarkable. IMPRESSION: 1. No acute process identified. 2. New hypodensity within the uterus, this could represent distended endometrium, correlation with pelvic sonography recommended. 3. IVC filter. 4. Stable renal cysts. 5. Large hiatal hernia. 6. Bilateral pulmonary infiltrates consistent with probable viral pneumonia. COMMENTS: For patients with an IVC filter, recommend assessment for a management plan for the patient''s IVC filter. If there is no established management plan, recommend referral to an interventional clinician on a nonemergent basis for evaluation. THIS DOCUMENT HAS BEEN ELECTRONICALLY SIGNED CT angiogram chest pulmonary embolism with and without contrast Result Date: 9/13/2021 PROCEDURE INFORMATION: Exam: CTA Chest Without And With Contrast Exam date and time: 9/13/2021 3:27 AM Age: 69 years old Clinical indication: Other: N/a; Additional info: SOB. Covid positive ? pe TECHNIQUE: Imaging protocol: Computed tomographic angiography of the chest without and with contrast. 3D rendering (Not supervised by radiologist): MIP and/or 3D reconstructed images were created by the technologist. Radiation optimization: All CT scans at this facility use at least one of these dose optimization techniques: automated exposure control; mA and/or kV adjustment per patient size (includes targeted exams where dose is matched to clinical indication); or iterative reconstruction. Contrast material: OMNI 350; Contrast volume: 80 ml; Contrast route: INTRAVENOUS (IV); COMPARISON: CT ABDOMEN PELVIS W CONTRAST 2/14/2019 3:12 PM FINDINGS: Pulmonary arteries: Normal. No pulmonary emboli. Aorta: Unremarkable. No aortic aneurysm. No aortic dissection. Lungs: Extensive patchy ground-glass infiltrates are seen bilaterally involving all lung segments. Pleural spaces: Unremarkable. No pneumothorax. No pleural effusion. Heart: Coronary atherosclerosis is present. Lymph nodes: Unremarkable. No enlarged lymph nodes. Diaphragm: Elevation of the left hemidiaphragm is noted. Stomach and bowel: A large paraesophageal hernia is present most of the stomach resides in the lower thorax. Bones/joints: Unremarkable. No acute fracture. Soft tissues: Unremarkable. IMPRESSION: 1. No evidence of pulmonary embolus. 2. Extensive bilateral patchy ground-glass infiltrates.Commonly reported imaging features of COVID-19 pneumonia are present. Other processes such as influenza pneumonia and organizing pneumonia, as can be seen with drug toxicity and connective tissue disease, can cause a similar imaging pattern. (Reference:) 3. Large hiatal hernia. 4. Coronary atherosclerosis. Medical Decision Making/ Level of Risk: high
CDC Split Type:

Write-up: ED to Hosp-Admission Discharged 9/13/2021 - 9/18/2021 (5 days) Hospital Problems * (Principal) COVID-19 Yes Rheumatoid arthritis Yes RHEUMATOID ARTHRITIS; Current use of long term anticoagulation Not Applicable Supratherapeutic INR Yes Acute hypoxemic respiratory failure Yes Encephalopathy Yes Poor prognosis Yes Immunosuppressed status Yes Presenting Problem/History of Present Illness/Reason for Admission Acute hypoxemic respiratory failure Hospital Course 1. Acute hypoxic respiratory failure secondary to COVID-19 pneumonia: Patient has been continued on remdesivir IV, Decadron 6 mg IV, infectious disease consultation appreciated patient is not a candidate for baricitinib as she has immunosuppression. 2. Supratherapeutic INR: Patient got a dose of vitamin K 3. Known rheumatoid arthritis on multiple immunosuppressive medications including prednisone methotrexate and rinvoq , hold on medications until she recovers from COVID-19 pneumonia. 4. Hypothermia likely related to severe infection with COVID: resolved Because of the comorbidities, patient was extremely sick and was requiring very high oxygen she decided to change her CODE STATUS to comfort care, patient will be changed to hospice. Operative Procedures Performed Treatments: treated for Covid, changed to comfort care Procedures: none Consults: none Pertinent Test Results:none Physical Exam at Discharge Heart Rate: (!) 104 Resp: (!) 24 BP: 119/84 Temperature: 36.6 ?C (97.8 ?F) Weight: 71.9 kg (158 lb 8.2 oz) General: Patient seems very sick, seems anxious HEENT: Atraumatic normocephalic Neck supple CVs: S1-S2 regular rate and rhythm Respiratory: Patient has bilateral coarse breath sounds, requiring supplemental oxygen with nasal cannula Abdomen: Soft nontender bowel sounds present Neurologically: seems restless Patient has right BKA Discharge Instructions Condition at Discharge Discharge Condition: very sick Chief Complaint Patient presents with ? Shortness of Breath 1. Acute hypoxemic respiratory failure 2. COVID-19 3. Current use of long-term anticoagulation 4. Supratherapeutic INR 5. Poor prognosis 6. Encephalopathy Plan: Pulse oximetry continuously - high flow nasal cannula. Consult pulmonology. Decadron 6mg IV daily Remdesevir IV full course guidelines advise AGAINST routine plasma use in hospitalized patients. I do not believe benefits $g risks. Spoke to ED physician personally Given vitamin K to reverse INR $g 9.8 Critical care time spent 60 minutes o Nutrition: heart healthy if passes dysphagia screen o VTE prophylaxis: heparin o Full Code History of Present Illness a 69 y.o. female. I personally interviewed patient, reviewed chart, and reviewed emergency room resident history and agree with it in its following entirety unless otherwise noted below. " a 69 y.o. female w h/o DVT on coumadin, vaccinated against covid. presenting to the ED with weakness and fatigue for the past 2 weeks. Patient is not able to provide much history. Per her sister she has been ill for the past 2 weeks symptoms including weakness, fatigue, shortness of breath. She is normally alert and oriented x3, no history of dementia. She was seen in urgent care and prescribed antibiotics and steroids but she did not receive a Covid test. She continued to worsen on the next couple days and her neighbors who checked on her, and she was not very responsive so they called EMS. Per EMS patient was satting approximately 50% on room air and she was put on nonrebreather at 15 L and had improvement in saturation." Patient is on high flow nasal cannula saturating in the upper 90s. She has a very poor historian. Not coughing just short of breath. No edema No rashes Principal problem Acute hypoxic respiratory failure Covid pneumonia Rheumatoid arthritis-immunocompromised state Patient was admitted to Hospital on 9/13 with Covid pneumonia and acute hypoxic respiratory failure. She was requiring high flow nasal cannula at the time of admission. She was started on Decadron and IV remdesivir. Due to the requirement of high flow nasal cannula pulmonology was consulted and also infectious disease was also consulted. Per infectious disease immunomodulators are contraindicated in this immunosuppressed patient. Due to patient worsening respiratory state patient opted for comfort care and hospice. Patient was changed to comfort care and was consulted on 9/17. Patient is continued on comfort care medications with the help of the hospice Patient died on 9/21 at 2320


VAERS ID: 1759375 (history)  
Form: Version 2.0  
Age: 51.0  
Sex: Male  
Location: Unknown  
Vaccinated:2021-03-25
Onset:2021-08-27
   Days after vaccination:155
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 RA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8732 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, COVID-19 pneumonia, Death, Endotracheal intubation, Enterococcal infection, Fall, Hypotension, Hypoxia, Intensive care, Oxygen saturation decreased, Pneumonia, SARS-CoV-2 test positive, Staphylococcal infection, Tachycardia
SMQs:, Anaphylactic reaction (narrow), Angioedema (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Accidents and injuries (narrow), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-17
   Days after onset: 21
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 22 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Novel Coronavirus PCR- Detected (8/27/2021)
CDC Split Type:

Write-up: 51 yo male pt s/p Pfizer COVID vaccination: dose 1 on 3/4/21 and dose 2 on 3/25/21. PMH of ALL s/p MUD PBSCT 1/15/20 c/b GVHD of the skin and joints for which he is treated with tacrolimus, prednisone, and ruxolitinib at baseline; tacro and rux held on admission. Presented to the ED 8/26 after an assisted fall at home. Of note, he tested positive for COVID on 8/24 at outside institution. He underwent monoclonal antibody infusion and decompensated shortly afterward. Upon arrival to ED, he was found to be hypoxic requiring HHFNC and was admitted to hospital for further care. Received remdesivir and dexamethasone. Hospital course complicated by acute hypoxic respiratory failure in the setting of COVID PNA with superimposed PsA/MSSA/E. Faecalis PNA. Despite prolonged antibiotic treatment and heated high flow oxygen therapy, pt became increasingly tachycardic and acutely decompensated requiring intubation, 3-pressor support, inhaled veletri, proning, and bicarb infusion. His oxygen saturation continued to drop and he was profoundly hypotensive. After discussion with the patient''s wife and children, the decision was made to pursue comfort care. Pressor support was decreased and the patient expired shortly after at 10:30AM on 9/17.


VAERS ID: 1759405 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Arkansas  
Vaccinated:2021-02-23
Onset:2021-09-23
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood gases, Death, Endotracheal intubation, Fibrin D dimer, Intensive care
SMQs:, Angioedema (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-04
   Days after onset: 11
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: Coronary artery disease, Diabetes mellitus type 2
Allergies: ACE inhibitors
Diagnostic Lab Data: ABGs 10/3: 7.01. 10/4: 6.9 D-Diner 9/26 1.60, 10/2: 2.70
CDC Split Type:

Write-up: Admitted to COVID unit on 9/23. Was transferred to ICU and intubated on 10/2. Expired on 10/4


VAERS ID: 1759418 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-19
Onset:2021-10-02
   Days after vaccination:225
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032L20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA UNKNOWN / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Death, Intensive care, Positive airway pressure therapy, Respiratory failure, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-02
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Aspirin, lipitor, calcium carbonate, Zyrtec, temovate, vitamin B12, Avodart, Ferocon, Flonase, Neurontin, Zestril, Glucophage, Aleve, Saw Palmetto, Flomax, ultram, kenalog cream.
Current Illness:
Preexisting Conditions: Chronic back pain, HTN, DM2, extracranial carotid artery stenosis, arthritis, hyperlipidemia, B12 deficiency, cerebral thrombosis with cerebral infarction, vitiligo, obstructive pattern present on pulmonary function testing, aortic extasia (abdominal), monoclonal gammopathy of unknown significance, spinal stenosis, neuropathy, anemia, history of cerebrovascular accident, benign prostatic hyperplasia.
Allergies: "Seasonal allergies"
Diagnostic Lab Data: COVID positive swab on 09/19/21.
CDC Split Type:

Write-up: Fully COVID vaccinated patient who admitted through emergency department with COVID positive test on 09/19/21. Patients respiratory status continued to decline, he required CCU admission high flow oxygen, and subsquently BiPAP. Medical team reviewed ongoing respiratory decline and grave status with patient and family who declined intubation. Patient moved to comfort care and died on 10/02/21.


VAERS ID: 1759420 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-02-06
Onset:2021-09-20
   Days after vaccination:226
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038K20A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 030A1A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Chemotherapy, Decreased appetite, Fatigue, SARS-CoV-2 test positive
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-30
   Days after onset: 10
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt had a history of right lower lobe small cell lung cancer and emphysema. He reports a feeling of fatigue and loss of appetite. He is still receiving chemotherapy. He was found to be COVID positive.


VAERS ID: 1759433 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Female  
Location: Arkansas  
Vaccinated:2021-04-21
Onset:2021-09-28
   Days after vaccination:160
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-02
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: AAA, Arthritis, A. Fib, Emphysema, HTN, Hx of Hep A
Allergies: Celebrex, codeine, duricef, iodinated raiocontrast agents, liinopril, morphine, Pneumonoccal, tetanus, vancomycin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Admitted to COVID unit 9/28 with 2 liters. Oxygen requirements continued to increase. On date of death 70 L/min Heated High-flow.


VAERS ID: 1759458 (history)  
Form: Version 2.0  
Age: 84.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-03-28
Onset:2021-05-06
   Days after vaccination:39
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 028A21A / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Death, Intestinal perforation, Multiple organ dysfunction syndrome, SARS-CoV-2 test positive, Septic shock, Vaccine breakthrough infection
SMQs:, Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Gastrointestinal perforation (narrow), Ischaemic colitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-07
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 05/06/2021 PCR+ COVID-19 test at Hospital
CDC Split Type:

Write-up: Breakthrough COVID-19 case. Hospitalized on unknown date for unknown duration. Death 5/7/2021. From Records COD = SEPTIC SHOCK, MULTISYSTEM ORGAN FAILURE, BOWEL PERFORATION. place of death: HOSPITAL-INPATIENT; certified by: PRONOUNCING AND CERTIFYING PHYSICIAN; occupation: MAINTENANCE, HEAT AND AIR CONDITION


VAERS ID: 1759487 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-30
Onset:2021-09-15
   Days after vaccination:169
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 1 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Adenovirus test, Anaemia, Asthenia, Blood loss anaemia, Bordetella test negative, COVID-19, COVID-19 pneumonia, Cardiac failure congestive, Cardiogenic shock, Cardiomegaly, Chest X-ray abnormal, Chills, Chlamydia test negative, Chronic kidney disease, Condition aggravated, Coronavirus test negative, Cough, Dyspnoea, Ejection fraction decreased, Endotracheal intubation, Enterovirus test negative, Fibrin D dimer increased, Goitre, Human metapneumovirus test, Human rhinovirus test, Immunodeficiency, Influenza A virus test negative, Influenza B virus test, Influenza virus test negative, Intensive care, Lung infiltration, Lung opacity, Macrocephaly, Multiple organ dysfunction syndrome, Mycoplasma test negative, Oedema peripheral, Pyrexia, Renal cyst, Respiratory syncytial virus test negative, SARS-CoV-2 test positive, Sepsis, Septic shock, Transaminases increased, Transfusion, Type 2 diabetes mellitus, Ultrasound Doppler normal, Ultrasound kidney abnormal, Ultrasound scan normal, Vasodilatation, Ventilation/perfusion scan
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Anaphylactic reaction (broad), Angioedema (broad), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (narrow), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Congenital, familial and genetic disorders (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Hypothyroidism (broad), Hyperthyroidism (broad), Chronic kidney disease (narrow), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-30
   Days after onset: 15
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: amiodarone (PACERONE) 200 mg tablet amLODIPine (NORVASC) 10 mg tablet carvediloL (COREG) 6.25 mg tablet cyanocobalamin (VITAMIN B-12) 500 mcg tablet ezetimibe (ZETIA) 10 mg tablet furosemide (LASIX) 20 mg tablet glimepiride (AMARYL) 2
Current Illness:
Preexisting Conditions: Nervous Right lumbar radiculopathy Coronary artery disease of native artery of native heart with stable angina pectoris (HCC) Respiratory Hypoxia Pneumonia due to COVID-19 virus Circulatory Benign essential hypertension Carotid atherosclerosis Coronary artery disease Peripheral vascular disease (HCC) Type 2 diabetes mellitus with diabetic peripheral angiopathy without gangrene, without long-term current use of insulin (HCC) Abdominal aortic aneurysm (AAA) without rupture (HCC) Pulmonary hypertension (HCC) Chronic systolic heart failure (HCC) Paroxysmal atrial fibrillation (HCC) Acute on chronic systolic (congestive) heart failure (HCC) Demand ischemia (HCC) Atrial fibrillation with RVR (HCC) Cardiogenic shock (HCC) Genitourinary Chronic kidney disease, stage 3 (HCC) Acute renal failure superimposed on chronic kidney disease (HCC) Musculoskeletal Foot-drop Endocrine/Metabolic Type 2 diabetes mellitus, without long-term current use of insulin (HCC) Gout Hyperlipidemia Hypothyroidism Hematologic Myelodysplastic syndrome with 5q deletion (HCC) Anemia requiring transfusions Infectious/Inflammatory COVID-19 Septic shock (HCC) Other Need for subacute bacterial endocarditis prophylaxis History of left common carotid artery stent placement Status post four vessel coronary artery bypass Hospice care
Allergies: Shellfish DerivedSwelling Mushroom Spironolactone CodeineOther (document details in comments) Fish Containing ProductsOther (document details in comments) MetforminOther (document details in comments) PravastatinOther (document details in comments) Statins-hmg-coa Reductase Inhibitors
Diagnostic Lab Data: Updated Procedure 09/20/21 1526 Respiratory virus detection panel Collected: 09/20/21 1421 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result Detected Critical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected 09/15/21 1624 Respiratory virus detection panel Collected: 09/15/21 1428 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result Detected Critical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected X-ray chest 2 views Result Date: 9/15/2021 XR CHEST 2 VW IMPRESSION: 1. Moderate cardiomegaly. No edema or pneumonia. 2. Prior coronary bypass and port catheter placement END OF IMPRESSION: INDICATION: Suspected sepsis, SOB, fever, chills, dry cough Suspected sepsis. TECHNIQUE: AP and lateral projections of the chest are acquired. COMPARISON: 12/15/2020 FINDINGS: Prior coronary bypass. Interval right jugular port catheter with tip in SVC. Lungs clear. Stable moderate thyromegaly. Mediastinal pleural spaces clear. Bones and soft tissues within normal limits. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. Nuclear Medicine lung scan perfusion only Result Date: 9/16/2021 NM LUNG SCAN PERFUSION ONLY IMPRESSION: No definitive pulmonary embolus is identified on perfusion only study. **PIOPED criteria for diagnosis of PE is combination of ventilation and perfusion, plus x-ray. Without ventilation scan, the specificity for diagnosis of PE is lower. MODIFIED PIOPED CRITERIA FOR THE DIAGNOSIS OF PE (2008) LOW PROBABILITY: Non segmental perfusion defect. Any perfusion defect with a substantially larger CXR abnormality. Matched V/Q defects with a normal CXR. Small subsegmental perfusion defect. HIGH PROBABILITY: Two or more large mismatch segmental defects or equivalent mod/large defects with normal CXR. INTERMEDIATE PROBABILITY: Any V/Q scan abnormality between low and high probability. Significance: Low probability < 20% of probability of PE; intermediate probability: 20-80% probability of PE; High probability $g80% of probability of PE. END OF IMPRESSION: INDICATION: High d-dimer. Hypoxemia. TECHNIQUE: Following intravenous administration of 4.3 mCi of Tc-99m MAA using a sterile technique. Lung perfusion images were obtained in 8 projections: anterior, posterior, LPO, LAO, RPO, RAO, left lateral and right lateral. COMPARISON: Chest x-ray within 24 hours. FINDINGS: Chest X-ray: Cardiomegaly and post CABG changes. Ventilation scan: Not obtained per request. Perfusion scan: Mildly inhomogenous perfusion through the bilateral lungs. No segmental or subsegmental perfusion defects are identified This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. Ultrasound renal kidney Result Date: 9/17/2021 US RENAL COMPLETE IMPRESSION: No acute finding. END OF IMPRESSION: INDICATION: Acute renal failure. TECHNIQUE: Ultrasound evaluation of the kidneys and bladder performed. Permanently recorded images were obtained and stored. COMPARISON: CT of 11/22/2020. FINDINGS: Right Kidney: 12.1 cm. There is no hydronephrosis. There is increased cortical echotexture as can be seen in medical renal disease. Left Kidney: 11.9 cm. There is increased cortical echotexture as seen in medical renal disease. There is a large simple cyst along the posterior kidney measuring up to 19 x 9 x 9 cm, also identified on the patient''s CT. Adjacent 1 cm cyst is noted at the lower pole. There is no hydronephrosis. Bladder: Unremarkable. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. IR port placement Result Date: 8/30/2021 IR PORT PLACEMENT, RIGHT IMPRESSION: Status post right Port-A-Cath placement. END OF IMPRESSION: INDICATION: Need for long-term venous access. PERFORMING PROVIDER: DR, INTERVENTIONAL RADIOLOGIST TECHNIQUE: Informed consent was obtained. Access was obtained into the right jugular vein using single wall micropuncture technique during real time ultrasound guidance. Ultrasound was also used to document vein patency and sonogram image was obtained, documented and permanently stored. A subcutaneous pocket in the right anterior chest wall was then created over the anterior chest wall. A Port-A-Cath was positioned in the subcutaneous pocket and the catheter was tunneled through the anterior chest wall to the previously created dermatotomy. Under fluoroscopic guidance the catheter was positioned in the SVC. Position of the catheter was confirmed with spot film of the chest. The dermatotomy at the neck and the chest wall pocket were closed. The procedure was well tolerated. FLUOROSCOPY TIME: 1.3 minutes. CONSCIOUS SEDATION: No conscious sedation. ESTIMATED BLOOD LOSS: None. SPECIMENS OBTAINED: No. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. Ultrasound lower extremity venous bilateral Result Date: 9/16/2021 US LOWER EXTREMITY VENOUS BILATERAL IMPRESSION: No evidence of DVT, bilateral lower extremities. END OF IMPRESSION: INDICATION: Elevated d-dimer TECHNIQUE: Grayscale, color and duplex Doppler ultrasound images of the deep venous system of the bilateral lower extremities were obtained. Permanently recorded images were obtained and stored. FINDINGS: There is normal flow, compressibility, and augmentation in the visualized venous system including the common femoral, greater saphenous, superficial and profundus femoral and popliteal veins as well as the posterior tibial, peroneal, and small saphenous veins in the calf. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. Procedure Component Value Ref Range Date/Time X-ray chest 1 view, Portable [3305291742] Resulted: 09/27/21 1209 Order Status: Completed Updated: 09/27/21 1209 Narrative: XR CHEST 1 VW PORT IMPRESSION: Pulmonary infiltrates persist with questionable small right effusion. END OF IMPRESSION: INDICATION: Covid-19 pneumonia. Hypoxia. TECHNIQUE: An AP upright portable projection of the chest was obtained on 9/27/2021. COMPARISON: 9/24/2021 FINDINGS: The heart size remains enlarged with evidence of sternotomy with cardiac surgery. Pulmonary infiltrates persist bilaterally. Small right pleural effusion is questioned. Central port terminates in the right atrial superior vena cava junction. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view [3304931131] Resulted: 09/24/21 0834 Order Status: Completed Updated: 09/24/21 0834 Narrative: XR CHEST 1 VW PORT IMPRESSION: 1. Redemonstrated diffuse bilateral, lower lobe predominant airspace opacities. The right middle lung zone airspace opacities have increased compared to prior radiograph from September 22, 2021. 2. No pneumothorax or pleural effusion. END OF IMPRESSION: INDICATION: shortness of breath severe SOB, COVID. TECHNIQUE: Portable AP upright projection of the chest is acquired. COMPARISON: September 22, 2021 and priors FINDINGS: Redemonstrated right sided Port-A-Cath with the tip projected at the cavoatrial junction. Unchanged appearance of sternotomy wires. Surgical clips projected over the left neck and mediastinum. Partially visualized EVAR is noted in the upper abdomen. Redemonstrated cardiomegaly. There are again bilateral diffuse, hazy airspace opacities with a lower lobe predominance. The right middle lung zone airspace opacities have increased compared to prior radiograph from September 22, 2021. The pulmonary changes have overall progressed compared to radiograph from September 15, 2021. No pleural effusion is identified. There is no evidence of pneumothorax. There are again degenerative changes at the bilateral glenohumeral and acromioclavicular joints. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. Ultrasound lower extremity venous bilateral [3304646999] Resulted: 09/23/21 1314 Order Status: Completed Updated: 09/23/21 1314 Narrative: US LOWER EXTREMITY VENOUS BILATERAL IMPRESSION: Negative bilateral lower extremity venous ultrasound. END OF IMPRESSION: INDICATION: Clinical concern for DVT. TECHNIQUE: Multiple longitudinal and transverse 2D real-time ultrasound images were performed from groin to knee, and at the calf and ankle. Color and grayscale and duplex Doppler imaging was also performed. Permanently recorded images were obtained and stored. COMPARISON: Prior bilateral lower extremity DVT ultrasound September 15, 2021. FINDINGS: No evidence of deep venous thrombosis. On each side, there is normal flow, compressibility and augmentation in the common femoral, greater saphenous, superficial and deep femoral veins and popliteal veins. There is also normal compressibility in the posterior tibial veins, peroneal veins and small saphenous veins in the calves. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view, Portable [3304386815] Resulted: 09/22/21 0920 Order Status: Completed Updated: 09/22/21 0920 Narrative: XR CHEST 1 VW PORT IMPRESSION: Stable chest with no acute findings from the previous day. END OF IMPRESSION: INDICATION: Covid pneumonia follow-up. TECHNIQUE: AP portable projection of the chest is acquired. COMPARISON: AP portable dated 9/21/2021. FINDINGS: Right-sided venous port access catheter and median sternotomy surgical changes are stable. Bilateral diffuse perihilar airspace opacities remain unchanged. The cardiac silhouette remains enlarged. Negative for pleural effusion. Negative for pneumothorax. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view, Portable [3304140813] Resulted: 09/21/21 0930 Order Status: Completed Updated: 09/21/21 0930 Narrative: XR CHEST 1 VW PORT IMPRESSION: Mild increase in right upper lobe opacity above minor fissure. Developing pneumonia cannot be excluded. Continued follow-up with chest x-ray is recommended. No additional changes are noted. END OF IMPRESSION: INDICATION: CHF. TECHNIQUE: AP upright projection of the chest is acquired. COMPARISON: Portable AP chest 9/9/2021. FINDINGS: There is mild increase in density in the inferior aspect of right upper lobe. The cardiomegaly and diffuse interstitial opacities in bilateral lungs are stable. The right-sided central line is unchanged. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. X-ray chest 1 view - Portable [3303728484] Resulted: 09/20/21 1136 Order Status: Completed Updated: 09/20/21 1136 Narrative: XR CHEST 1 VW PORT IMPRESSION: 1. Unchanged cardiomegaly. 2. No acute cardiopulmonary abnormality identified. New mild bibasilar subsegmental atelectasis. END OF IMPRESSION: INDICATION: Dyspnea. TECHNIQUE: AP upright portable projection of the chest is acquired. COMPARISON: Chest radiographs performed on September 15, 2021. FINDINGS: Unchanged cardiomegaly. There is prominence of the bilateral interstitial markings, similar compared to the prior study. No pleural effusion, pneumothorax, or focal airspace consolidation. Mild bibasilar subsegmental atelectasis, new compared to the prior study. Unchanged right-sided tunneled central venous catheter with tip terminating near the distal SVC. Postoperative changes of prior median sternotomy and probable CABG. Calcification of the aortic arch is noted. There is bilateral shoulder degenerative arthropathy and multilevel thoracic spondylosis. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient.
CDC Split Type:

Write-up: ED to Hosp-Admission Discharged 9/15/2021 - 9/18/2021 (3 days). Last attending ? Treatment team Anemia requiring transfusions Principal problem Details of Hospital Stay Presenting Problem/History of Present Illness/Reason for Admission Chills [R68.83] Weakness [R53.1] Anemia requiring transfusions [D64.9] Acute kidney injury superimposed on CKD (HCC) [N17.9, N18.9] Hospital Course 1. Severe sepsis secondary to Covid pneumonia in a immunocompromise patient, patient also has endorgan damage which includes acute renal failure and transaminitis. Patient has been started on cefepime and doxycycline, Decadron. Time of discharge I have changed him to cefpodoxime and doxycycline for 2 more days, he will be on dexamethasone 6 mg oral for 5 more days Was not a candidate for convalescent plasma and remdesivir due to transaminits 2. Elevated D-dimer: VQ scan negative for pulmonary embolism, ultrasound lower extremity negative for DVT 3. Acute blood loss anemia related to MDS: Status post blood transfusion, outpatient follow-up with oncology as outpatient. 4.Acute Renal failure superimposed on CKD stage III: Nephrology has been consulted, holding on Entresto. At the time of discharge his renal function has improved, needs follow-up as outpatient with his family doctor 5. Systolic heart failure ejection fraction 30%: Holding on entresto, he could have as needed Lasix 20 mg for shortness of breath, follow-up with heart failure clinic as outpatient 6. Atrial fibrillation: Continued on home medication 7 coronary artery disease with CABG 2009, peripheral arterial disease with carotid stenting, AAA with endovascular repair: Not on aspirin due to MDS 8. Diabetes mellitus 2: On glipizide 9. Hypothyroidism: Continue Synthyroid Physical Exam at Discharge Heart Rate: (!) 55 Resp: 18 BP: 123/57 Temperature: 36.5 ?C (97.7 ?F) Weight: 96.8 kg (213 lb 6.5 oz) Physical Exam General : Patient is no acute distress, sitting comfortably HEENT: Atraumatic normocephalic Neck supple CVS: S1-S2 regular rate and rhythm Respiratory: Bilateral equal entry, no wheezing sounds heard Abdomen: Soft nontender bowel sounds present Neurologically: Alert and oriented x3, moving all extremities Extremities no edema ED to Hosp-Admission Discharged 9/20/2021 - 9/27/2021 (7 days) Last attending ? Treatment team COVID-19 Principal problem Presenting Problem/History of Present Illness/Reason for Admission Acute on chronic systolic (congestive) heart failure (HCC) [I50.23] Congestive heart failure, unspecified HF chronicity, unspecified heart failure type (HCC) [I50.9] 2019 novel coronavirus disease (COVID-19) [U07.1] Atrial fibrillation with rapid ventricular response (HCC) [I48.91] Diabetes type 2 Severe sepsis due to COVID-19 Cardiogenic versus septic shock Acute renal failure with ATN Hospital Course Patient was recently hospitalized for Covid infection. He tested positive on 9/15/2021. He was discharged on 9/18. He returned to the emergency department on 9/20/2021 with increased shortness of breath and weakness. He does have underlying immunocompromised state in the setting of myelodysplastic syndrome, receiving weekly infusions. He was receiving aggressive care on the medical floor for Covid with steroids and antibiotics, when he decompensated on 9/24/2021. He was transferred to the ICU. He was in atrial fibrillation with RVR with a heart rate of 140, blood pressure was 60 over 30s. He was presumed to be in cardiogenic versus septic shock. He has multisystem organ failure including heart failure, respiratory failure, kidney failure, and transaminitis. Initially he was full team. After discussion with patient and his wife, he is now DNR with short-term intubation only. He cannot receive remdesivir because of transaminitis. He cannot receive interleukin-6 because of immunocompromised state. His ICU course consisted of milrinone drip, Lasix infusion, amiodarone infusion, and brief requirement of norepinephrine. He has acute renal failure, likely ATN. He also has transaminitis, acute on chronic congestive heart failure, and worsening Covid pneumonia. He continues to have hypoxic respiratory failure requiring high flow nasal cannula +100% nonrebreather. He is essentially requiring a cumulative amount of 75 L of oxygen. Today he was initially agitated when discussing hospice and states "I will not talk to the death squad". He is insistent on going home, but cannot navigate the decision making process. He does not understand why he can''t go home (even though there is no one physically able to care for him at home). In discussion with his wife, the decision was made to transition him to hospice. He is uremic and hypoxemic, and likely cannot make high-level decisions. The patient does agree to go on hospice service. He was initially adamant about not receiving morphine. Therefore, we will use hydromorphone infusion as well as scheduled lorazepam and PRN dosing given his significant anxiety. He will be discharged, and readmitted under inpatient hospice. It is not feasible at this time for him to go home unfortunately. Operative Procedures Performed Physical Exam at Discharge Heart Rate: 60 Resp: (!) 10 BP: (!) 148/59 Temperature: 36.5 ?C (97.7 ?F) Weight: 96.5 kg (212 lb 11.9 oz) General: Elderly ill-appearing gentleman sitting upright, appears in mild distress Neck: neck veins are distended Cardiovascular: s1/2, rrr. Warm extremities with positive pulses Respiratory: Lungs are coarse throughout GI/GU: Abdomen is soft and nontender with positive bowel sounds Musculoskeletal: Trace lower extremity edema Integumentary: Skin is pale warm and dry Neurologic: Patient is alert. He is oriented to self, place and situation. He moves all extremities equally. Sensation intact Psychiatric: agitated, blunted affect Condition at Discharge Discharge Condition: poor


VAERS ID: 1759504 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-08-03
Onset:2021-09-17
   Days after vaccination:45
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NOT LISTED / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH NOT LISTED / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal pain, Acute respiratory failure, Angiogram pulmonary abnormal, COVID-19, Computerised tomogram abdomen abnormal, Condition aggravated, Death, Diarrhoea, Dyspnoea, Haemoptysis, Hypoxia, Lung disorder, Pancreatic atrophy, SARS-CoV-2 test positive, Sputum culture positive, Staphylococcal infection
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Asthma/bronchospasm (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-26
   Days after onset: 9
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler famotidine (PEPCID) 40 MG tablet furosemide (LASIX) 40 MG tablet glycerin-hypromellose-PEG 400 (ARTIFICIAL TEARS) 0.2-0.2-1 % SOLN HYDROcodone-acetaminoph
Current Illness: Hospital Admission/observation 09/17/2021-09/18/2021 Admission Diagnoses: Dehydration [E86.0] Confusion [R41.0] Fatigue [R53.83] Fever [R50.9] Headache [R51.9] Sepsis, due to unspecified organism, unspecified whether acute organ dysfunction present (HCC) [A41.9] Discharge Diagnoses: Acute encephalopathy Discharged Condition: stable Indication for Admission: AMS Covid 19 Positive Hospital Course: Hospital (09/17/2021-09/18/2021) The is a 73-year-old female patient with history of COPD on home oxygen, history of chronic pain on narcotic, who was admitted to the hospital with confusion. intermiitent fever And fatigue The patient on admission was slightly confused. The rest of the examination was unremarkable. The labs revealed normal blood gases. Troponin was negative. Labs revealed no evidence for acute kidney injury with sodium 137, potassium 3.7. The patient''s proBNP was 365. Ammonia level was 11. CRP 5.1. Lactate normal at 0.9, glucose 157. TSH 2.0. White count 6.7. Urine analysis revealed no infection. Ethanol negative. Urine drug screen was positive for opiates. Serum benzodiazepine screen was negative. Covid test was positive Chest x-ray revealed no acute changes. EKG is normal. CT abdomen and pelvis revealed no acute changes. The patient was admitted for observation. Her acute confusion resolved. We suspect her confusion was possibly due to polypharmacy including narcotic. The patient was given education and was discharged home to follow up with PCP in 1 week.
Preexisting Conditions: Moderate protein-calorie malnutrition (HCC) 09/24/2021 ? Chronic hypoxemic respiratory failure (HCC) ? Aortic stenosis ? Acute hypoxemic respiratory failure due to COVID-19 (HCC) ? Hemoptysis ? Diarrhea ? OSA (obstructive sleep apnea) ? Cecal cancer s/p robotic converted to open right colectomy and SBR with Dr. on 1/30/20 ? Hypothyroidism, unspecified type ? Chronic obstructive pulmonary disease, unspecified COPD type (HCC) ? Neuropathy ? Hyperlipidemia ? HTN (hypertension) ? Diabetes mellitus, type 2 (HCC) ? GERD (gastroesophageal reflux disease)
Allergies: Latex, sulfa and tape
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized 09/23/2021; COVID-19 positive 09/17/2021; fully vaccinated DETAILS OF HOSPITAL STAY: PRESENTING PROBLEM: Acute hypoxemic respiratory failure (HCC) [J96.01] Acute hypoxemic respiratory failure due to COVID-19 (HCC) [U07.1, J96.01] COVID-19 [U07.1] HOSPITAL COURSE: 73-year-old female with history of chronic respiratory failure on 3-4 L of oxygen at baseline, chronic obstructive pulmonary disease, previous colorectal cancer, OSA, and aortic stenosis who presented with worsening dyspnea, hypoxia, hemoptysis, abdominal pain, and diarrhea after being diagnosed with COVID-19 9-17. She had symptoms for 2 weeks prior to admission. The patient required non-rebreather while in the emergency department. CTA was negative for PE, but showed diffuse bilateral peripheral airspace disease. CT of the abdomen and pelvis showed an atrophic pancreas, but no acute process. Steroids were started in the emergency department and the patient was admitted to the hospitalist service for further continuation of care. The patient''s oxygen requirement worsened to the point where she was on 100% via high-flow nasal cannula. Her diarrhea and abdominal pain improved without intervention. IV vancomycin was started as her sputum culture grew Staph aureus. IV Lasix was administered. The patient was discussed with pulmonology who reported that prognosis was poor in the setting of her pre-existing lung disease. Goals of care were discussed with the patient by this provider. The patient was clear that she would not want intubation and mechanical ventilation in the case of worsening respiratory failure. The patient desaturated overnight 9-25 the and was hypoxic despite high-flow nasal cannula and non-rebreather. Comfort measures were initiated after discussion with the patient and her son. The patient passed away 09/26/2021 at 11:40 with family at bedside.


VAERS ID: 1759518 (history)  
Form: Version 2.0  
Age: 85.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-03-16
Onset:2021-09-15
   Days after vaccination:183
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6201 / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Acute pulmonary oedema, Adenovirus test, Anticoagulant therapy, Aortic arteriosclerosis, Blood creatinine increased, Blood urea increased, Bordetella test negative, COVID-19, COVID-19 pneumonia, Cardiac failure congestive, Cellulitis, Central venous catheterisation, Chest X-ray abnormal, Chills, Chlamydia test negative, Computerised tomogram head normal, Computerised tomogram thorax abnormal, Concussion, Condition aggravated, Confusional state, Death, Deep vein thrombosis, Dyspnoea, Enterovirus test negative, General physical health deterioration, Haemoglobin, Head injury, Human metapneumovirus test, Human rhinovirus test, Hypotension, Immunosuppression, Influenza A virus test negative, Influenza B virus test, Intensive care, Lung opacity, Lymphadenopathy, Mental status changes, Mycoplasma test negative, Oxygen saturation decreased, Pneumonia, Positive airway pressure therapy, Pulmonary oedema, Pyrexia, Respiratory distress, Respiratory failure, Respiratory syncytial virus test negative, SARS-CoV-2 test positive, Sepsis, Septic shock, Splenomegaly, Systemic inflammatory response syndrome, Tachypnoea, Troponin increased, Ultrasound Doppler abnormal, Urinary tract infection, White blood cell count increased, White matter lesion
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Thrombophlebitis (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-19
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: acalabrutinib 100 mg capsule aspirin 81 mg tablet cholestyramine (QUESTRAN) 4 gram packet gabapentin (NEURONTIN) 300 mg capsule rOPINIRole (REQUIP) 0.5 mg tablet tamsulosin (FLOMAX) 0.4 mg capsule
Current Illness:
Preexisting Conditions: Respiratory Chronic obstructive lung disease Pneumonia of right lower lobe due to infectious organism Malignant neoplasm of bronchus, unspecified laterality Acute respiratory failure with hypoxia Circulatory Arteriosclerosis of autologous vein coronary artery bypass graft Chronic ischemic heart disease Essential hypertension Digestive Viral gastritis Genitourinary Benign prostatic hyperplasia with urinary obstruction Musculoskeletal Generalized osteoarthritis Infected laceration Cellulitis of left upper extremity Endocrine/Metabolic Mixed hyperlipidemia Hematologic Chronic lymphocytic leukemia Platelets decreased Infectious/Inflammatory Septic shock COVID-19 virus infection Cellulitis Other Inguinal hernia without obstruction or gangrene Suspected urinary tract infection Elevated troponin Immunocompromised state
Allergies: NKA
Diagnostic Lab Data: 09/16/21 0022 Respiratory virus detection panel Collected: 09/15/21 2308 | Final result | Specimen: Swab from Nasopharynx Adenovirus Not Detected Mycoplasma pneumoniae Not Detected Chlamydophila pneumoniae Not Detected Parainfluenza Not Detected COVID-19 SARS-CoV-2 Overall Result Detected Critical Enterovirus/Rhinovirus Not Detected Coronavirus Not Detected Respiratory Syncytial Virus Not Detected Influenza A Not Detected Bordetella pertussis Not Detected Influenza B Not Detected Bordetella parapertussis Not Detected Metapneumovirus Not Detected Procedure Component Value Ref Range Date/Time Ultrasound lower extremity venous right [3303463186] (Abnormal) Resulted: 09/17/21 0638 Order Status: Completed Updated: 09/17/21 0638 Narrative: PROCEDURE INFORMATION: Exam: US Duplex Right Lower Extremity Veins, Limited Exam date and time: 9/17/2021 4:56 AM Age: 85 years old Clinical indication: Swelling (edema) of limb; Lower extremity, right; Additional info: Eval for dvt TECHNIQUE: Imaging protocol: Real-time Duplex ultrasound of the Right Lower Extremity with 2-D gray scale, color Doppler flow and spectral waveform analysis with image documentation. Limited exam was focused on the right lower extremity veins. COMPARISON: CT ABD PEL W 4/5/2018 9:13 AM FINDINGS: Right deep veins: DVT involving the right posterior tibialis vein. The common femoral, femoral, proximal profunda femoral and popliteal veins are patent without thrombus. Normal Doppler waveforms. Normal compressibility and/or augmentation response. Right superficial veins: Unremarkable. Saphenofemoral junction is patent without thrombus. Soft tissues: Partially visualized enlarged right inguinal lymph node. IMPRESSION: DVT involving the right posterior tibialis vein. No other area of deep venous thrombosis. X-ray chest 1 view, Portable [3303267489] Resulted: 09/16/21 0730 Order Status: Completed Updated: 09/16/21 0730 Narrative: XR CHEST 1 VW PORT IMPRESSION: Mild interstitial pulmonary edema. END OF IMPRESSION: INDICATION: Suspected sepsis Suspected sepsis. TECHNIQUE: AP view of the chest. COMPARISON: None. FINDINGS: Pulmonary vascular congestion and basilar interstitial prominence. Median sternotomy wires and mediastinal clips are redemonstrated. Cervical posterior fusion hardware partially imaged. The heart is not enlarged. Costophrenic angles are clear. No pleural effusion or pneumothorax. This report was created using Voice Recognition software. Thank you for allowing us to participate in the care of your patient. CT chest without contrast [3303272248] (Abnormal) Resulted: 09/16/21 0304 Order Status: Completed Updated: 09/16/21 0304 Narrative: PROCEDURE INFORMATION: Exam: CT Chest Without Contrast; Diagnostic Exam date and time: 9/16/2021 2:03 AM Age: 85 years old Clinical indication: Shortness of breath; Patient HX: Covid; Additional info: SOB TECHNIQUE: Imaging protocol: Diagnostic computed tomography of the chest without contrast. Radiation optimization: All CT scans at this facility use at least one of these dose optimization techniques: automated exposure control; mA and/or kV adjustment per patient size (includes targeted exams where dose is matched to clinical indication); or iterative reconstruction. COMPARISON: DX XR CHEST 1 VW 9/16/2021 1:46 AM FINDINGS: Lungs: Unremarkable. No consolidation. No masses. Pleural spaces: Unremarkable. No pneumothorax. No pleural effusion. Heart: Stable CABG procedure. Aorta: Unremarkable. No aortic aneurysm. Great vessels off aortic arch: Calcification of the thoracic aorta and/or great vessels consistent with atherosclerotic vessel disease. Lymph nodes: Calcified left hilar nodes and/or mediastinal nodes and/or lung granulomas consistent with old granulomatous disease. Calcified left hilar nodes and/or mediastinal nodes and/or lung granulomas consistent with old granulomatous disease. Moderate right lower lobe pneumonia with possible mild right hilar adenopathy. Spleen: 20 cm large splenomegaly. Bones/joints: Unremarkable. No acute fracture. Soft tissues: Unremarkable. Other findings: Examination is limited by artifact from one or both arms by the patient''s side. IMPRESSION: 1. Stable CABG procedure. 2. Moderate right lower lobe pneumonia with possible mild right hilar adenopathy. 3. 20 cm large splenomegaly. THIS DOCUMENT HAS BEEN ELECTRONICALLY SIGNED X-ray chest 1 view, Portable [3303286895] (Abnormal) Resulted: 09/16/21 0258 Order Status: Completed Updated: 09/16/21 0258 Narrative: PROCEDURE INFORMATION: Exam: XR Chest Exam date and time: 9/16/2021 1:41 AM Age: 85 years old Clinical indication: Other vascular access device placement or adjustment; Other: Central line; Prior surgery; Surgery date: Post-operative (0-2 days); Additional info: Post central line TECHNIQUE: Imaging protocol: XR of the chest. Views: 1 view. COMPARISON: DX XR CHEST 1 VW 9/15/2021 10:48 PM FINDINGS: Tubes, catheters and devices: Right IJ line placement with tip over the region of the azygos vein. Lungs: Stable mild nonspecific bilateral pulmonary opacities. Pleural spaces: Unremarkable. No pleural effusion. No pneumothorax. Heart/Mediastinum: Unremarkable. No cardiomegaly. Vasculature: Calcification of the thoracic aorta and/or great vessels consistent with atherosclerotic vessel disease. Bones/joints: Stable postoperative metallic fixation of the cervical spine with or without metallic artifact. Stable sternotomy. IMPRESSION: Right IJ line placement with tip over the region of the azygos vein. THIS DOCUMENT HAS BEEN ELECTRONICALLY SIGNED CT head without contrast [3303286897] (Abnormal) Resulted: 09/16/21 0247 Order Status: Completed Updated: 09/16/21 0247 Narrative: PROCEDURE INFORMATION: Exam: CT Head Without Contrast Exam date and time: 9/16/2021 2:03 AM Age: 85 years old Clinical indication: Injury or trauma; Fall; Concussion/head injury; Without loss of consciousness; Injury date: Today TECHNIQUE: Imaging protocol: Computed tomography of the head without contrast. Radiation optimization: All CT scans at this facility use at least one of these dose optimization techniques: automated exposure control; mA and/or kV adjustment per patient size (includes targeted exams where dose is matched to clinical indication); or iterative reconstruction. COMPARISON: No relevant prior studies available. FINDINGS: Brain: No acute intracranial hemorrhage, mass effect or midline shift. Nonspecific white matter hypodensities without mass effect suggesting chronic ischemic changes. No evidence of obvious acute large vessel territorial infarct. Cerebral ventricles: Moderate to marked diffuse ventricular and sulcal prominence. Paranasal sinuses: Moderate bilateral paranasal sinus thickening/opacification. Mastoid air cells: No mastoid effusion. Vasculature: Intracranial atherosclerosis. Bones/joints: No acute fracture. Soft tissues: Unremarkable. IMPRESSION: 1. No acute intracranial hemorrhage or obvious acute large vessel territorial infarct 2. If there is concern for acute CVA, follow-up/further evaluation with MRI may provide additional information.
CDC Split Type:

Write-up: ED to Hosp-Admission Discharged 9/15/2021 - 9/19/2021 (4 days) Last attending ? Treatment team Septic shock Principal problem Final Summary for Deceased Patient BRIEF OVERVIEW Admission Date: 9/15/2021 Discharge Date: 9/20/2021 Final Diagnosis Principal Problem: Septic shock Active Problems: Chronic lymphocytic leukemia Pneumonia of right lower lobe due to infectious organism Infected laceration COVID-19 virus infection Suspected urinary tract infection Elevated troponin Acute respiratory failure with hypoxia Immunocompromised state Cellulitis DETAILS OF HOSPITAL STAY Presenting Problem/History of Present Illness/Reason for Admission Acute pulmonary edema [J81.0] SIRS (systemic inflammatory response syndrome) [R65.10] Septic shock [A41.9, R65.21] Urinary tract infection without hematuria, site unspecified [N39.0] Congestive heart failure, unspecified HF chronicity, unspecified heart failure type [I50.9] COVID-19 [U07.1] Sepsis [A41.9] Pneumonia due to COVID-19 virus [U07.1, J12.82] Hospital Course: Please send details from H&P intensive care critical care note cardiology was done for neurologist as well as palliative care note In briefly 85-year-old male history of multiple comorbid condition including CLL with history colon cancer with hemicolectomy admitted with fever chills confusion found to have a right lower lobe pneumonia UTI sepsis septic shock left arm cellulitis. Complicated with septic shock secondary from pneumonia UTI with immunosuppressive state COVID-19 pneumonia patient progressively going downhill even with dopamine drip and continue having persistent hypotension including respiratory failure. Patient also found to have a right lower extremity DVT patient was initially started Lovenox changed to therapeutic since patient was continued required dopamine unable to discontinue dopamine because of persistent low blood pressure Case discussed with patient family palliative care was consulted and in spite of of all the antibiotic Maxipime and Zithromax and dexamethasone for COVID-19 patient progressively getting downhill palliative care was consulted patient family was involved with the case and since patient prognosis going downhill initially there may DO NOT RESUSCITATE and do not intubation and finally his 2 sons who is the power of attorney decided to comfort care only. Patient was discontinued dopamine as per policy and was only on oxygen comfort medication was started patient expired approximately September 19 approximately 1830. Because of that respiratory failure secondary from septic shock secondary from multifactorial including pneumonia UTI cellulitis COVID-19 and persistent hypotension in the setting of immunosuppressive patient with CLL colon cancer and lung mass. Operative Procedures Performed Treatments: As per hospital policy Procedures: ICU care including dopamine infusion Consults: Intensivist palliative care Pertinent Test Results: CT right lower lobe pneumonia right middle and lower lobe pneumonia POA * (Principal) Septic shock Yes Chronic lymphocytic leukemia Yes Acute nontraumatic kidney injury Yes Pneumonia of right lower lobe due to infectious organism Yes Infected laceration Yes Overview Signed 9/16/2021 7:31 AM Infected laceration left wrist with surrounding cellulitis COVID-19 virus infection Yes Suspected urinary tract infection Yes Elevated troponin Yes Overview Signed 9/16/2021 1:19 AM Probably due to demand Acute respiratory failure with hypoxia Yes Immunocompromised state Yes Overview Signed 9/16/2021 1:23 AM Due to Medical Problems Plan: 1. Sepsis with shock probably due to multifactorial, including right lower lobe pneumonia, infected laceration left wrist with cellulitis, suspected UTI. The patient will be started on vancomycin, cefepime, and Zithromax. Patient will be continued on Levophed which has been started in the emergency room. Respiratory treatment. Oxygen support. Continue with BiPAP. 2. Elevated troponin probably due to demand. Serial cardiac enzymes. If the troponi increase, we will get get an echocardiogram as well as start the patient on IV heparin drip. 3. Acute respiratory failure with hypoxia. The family does not want the patient to be intubated. The agreeable to using BiPAP. And they also agreeable to admitting the patient to the ICU and use ICU level medications to maintain the blood pressure. We will continue aggressive management with BiPAP. Respiratory treatment. 4. Acute kidney injury. Gentle IV hydration. If kidney function continues to discharge in the morning, consider nephrology consultation. VTE Prophylaxis: SCD Lovenox 40mg subcu daily DNR (Do Not Resuscitate) History of Present Illness Chief Complaint Patient presents with ? Fever ? Altered Mental Status Patient is an 85 y.o. male. Patient was brought to the emergency room and altered mental status and unable to give any history. According to the emergency room doctor, the patient was found in respiratory distress with O2 sat of 90% on room air but the patient was very tachypneic. Patient was also noted to be hypotensive with a blood pressure of 78/68. Temperature was 101.5. Patient has history of CLL. The white count in the emergency room was 94.6. Hemoglobin was 7.8. BUN was 41 with a serum creatinine of 2.53. Chest x-ray revealed bibasilar interstitial prominence. However, CT scan of the chest shows right lower lobe pneumonia. Assessment Review of Systems Unable to perform ROS: Mental status change


VAERS ID: 1759576 (history)  
Form: Version 2.0  
Age: 67.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-02-25
Onset:2021-07-26
   Days after vaccination:151
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 002A21A / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Acute respiratory failure, COVID-19, Death, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-27
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: OBESITY
Allergies:
Diagnostic Lab Data: 07/27/2021 PCR+ COVID-19 test at pharmacy
CDC Split Type:

Write-up: Breakthrough COVID-19 case with unknown symptom status. Death 7/26/2021. From Vital Records COD = ACUTE HYPOXIC RESPIRATORY FAILURE, COVID 19 INFECTION. Per vital records, COD ICD Codes include: Not yet coded ; Other Significant Conditions include: OBESITY UNKNOWN BUT SIGNIFICANT CARDIAC HISTORY. place of death: HOSPITAL-INPATIENT, HEALTH SYSTEM; certified by: PRONOUNCING AND CERTIFYING PHYSICIAN; occ/ind: CERTIFIED NURSE ASSISTANT, NURSE ASSISTANT


VAERS ID: 1759593 (history)  
Form: Version 2.0  
Age: 76.0  
Sex: Male  
Location: Wisconsin  
Vaccinated:2021-04-13
Onset:2021-09-06
   Days after vaccination:146
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 044B21A / 2 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Death
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-18
   Days after onset: 12
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Hospitalized for COVID-19 on 9/6/21. Passed away on 9/18/21.


VAERS ID: 1759634 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-22
Onset:2021-09-27
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 050E21A / 2 LA / IM
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 939902 / 1 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Acquired diaphragmatic eventration, Adult failure to thrive, Basophil count normal, Basophil percentage, Chest X-ray abnormal, Death, Dyspnoea, Eosinophil count normal, Eosinophil percentage, Fatigue, Haematocrit decreased, Haemoglobin decreased, Lung infiltration, Lymphocyte count decreased, Lymphocyte percentage decreased, Mean cell haemoglobin concentration normal, Mean cell haemoglobin normal, Mean cell volume normal, Mean platelet volume normal, Monocyte count normal, Monocyte percentage, Neutrophil count normal, Neutrophil percentage increased, Platelet count decreased, Prealbumin decreased, Red blood cell count decreased, Red cell distribution width increased
SMQs:, Anaphylactic reaction (broad), Haematopoietic erythropenia (narrow), Haematopoietic leukopenia (narrow), Haematopoietic thrombocytopenia (narrow), Haemorrhage laboratory terms (broad), Interstitial lung disease (narrow), Systemic lupus erythematosus (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-01
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: 4 oz. house supplement with meals. Administer SARS-COV-2 (COVID-19) vaccine, mRNA, spike protein, LNP, preservative free, 100 mcg/0.5 mL dose, 2-dose vaccine (Moderna) To receive dose #1 on 8/11/21 1 Administer SARS-COV-2 (COVID-19) vacc
Current Illness: Diagnoses: ANEMIA, UNSPECIFIED(D64.9), UNSPECIFIED PROTEIN-CALORIE MALNUTRITION(E46), ADULT FAILURE TO THRIVE(R62.7), PERSONAL HISTORY OF OTHER MALIGNANT NEOPLASM OF STOMACH(Z85.028), TYPE 2 DIABETES MELLITUS WITHOUT COMPLICATIONS(E11.9), ANXIETY DISORDER, UNSPECIFIED(F41.9), UNSPECIFIED FALL, SUBSEQUENT ENCOUNTER(W19.XXXD), DIAPHRAGMATIC HERNIA WITHOUT OBSTRUCTION OR GANGRENE(K44.9), DIFFICULTY IN WALKING, NOT ELSEWHERE CLASSIFIED(R26.2), MUSCLE WASTING AND ATROPHY, NOT ELSEWHERE CLASSIFIED, UNSPECIFIED SITE(M62.50), DYSPHAGIA, OROPHARYNGEAL PHASE(R13.12), LOW BACK PAIN(M54.5), IDIOPATHIC HYPOTENSION (I95.0), CONSTIPATION, UNSPECIFIED(K59.00), PRESSURE ULCER OF OTHER SITE, STAGE 1(L89.891), CHRONIC KIDNEY DISEASE, STAGE 3 UNSPECIFIED(N18.30)
Preexisting Conditions: Diagnoses: ANEMIA, UNSPECIFIED(D64.9), UNSPECIFIED PROTEIN-CALORIE MALNUTRITION(E46), ADULT FAILURE TO THRIVE(R62.7), PERSONAL HISTORY OF OTHER MALIGNANT NEOPLASM OF STOMACH(Z85.028), TYPE 2 DIABETES MELLITUS WITHOUT COMPLICATIONS(E11.9), ANXIETY DISORDER, UNSPECIFIED(F41.9), UNSPECIFIED FALL, SUBSEQUENT ENCOUNTER(W19.XXXD), DIAPHRAGMATIC HERNIA WITHOUT OBSTRUCTION OR GANGRENE(K44.9), DIFFICULTY IN WALKING, NOT ELSEWHERE CLASSIFIED(R26.2), MUSCLE WASTING AND ATROPHY, NOT ELSEWHERE CLASSIFIED, UNSPECIFIED SITE(M62.50), DYSPHAGIA, OROPHARYNGEAL PHASE(R13.12), LOW BACK PAIN(M54.5), IDIOPATHIC HYPOTENSION (I95.0), CONSTIPATION, UNSPECIFIED(K59.00), PRESSURE ULCER OF OTHER SITE, STAGE 1(L89.891), CHRONIC KIDNEY DISEASE, STAGE 3 UNSPECIFIED(N18.30)
Allergies: No Known Allergies
Diagnostic Lab Data: |AGE: 78 GENDER: M | DATE&TIME: | 07/16/21 11:49 | |RCVD: 07/16/21 | |RPTD: 07/16/21 | RM 133 R E S U L T S RBC 3.71(L) 4.10-6.20 10^6/uL HEMOGLOBIN 10.0(L) 13.5-17.5 g/dL HEMATOCRIT 29.8(L) 41.0-53.0 % MCV 80 80.0-97.0 fL MCH 27.0 26.0-32.0 pg/cell MCHC 33.6 32.0-37.0 g/dL RDW 17.9(H) 11.5-14.5 % MPV 10.3 7.5-11.2 fl PLATELET COUNT 97(L) 130-400 10^3/uL NEUTROPHIL% 81.1(H) 40.0-74.0 % LYMPHOCYTE% 11.3(L) 19.0-48.0 % MONOCYTES% 6.2 2.0-11.0 % EOSONOPHIL% 0.7 0.0-7.0 % BASOPHIL% 0.7 0.0-1.5 % NEUTROPHIL# 5.7 1.7-7.7 10^3/uL LYMPHOCYTE# 0.8(L) 1.0-4.8 10^3/uL MONOCYTE# 0.4 0.0-1.0 10^3/uL EOSINOPHIL# 0.1 0.04-0.45 10^3/uL BASOPHIL# 0.1 0.00-0.20 10^3/uL MI PRE-ALBUMIN 11(L) 17.0-34.0 mg/dL INTERPRETATION: Reason for Study: R06.02 SHORTNESS OF BREATH XRAY CHEST 1 VIEW See Note FINDINGS: The heart is normal in size and configuration. The mediastinum is normal without adenopathy. There is a minimal right lower lobe infiltrate. There is no venous congestion. The osseous structures are unremarkable. CONCLUSION: Minimal right lower lobe infiltrate . The right hemidiaphragm is elevated
CDC Split Type:

Write-up: Guest passed/expired within 10 days of dose #2 of COVID-19 vaccine series. Began transitioning on 9/27/21-- 5 days s/p Dose #2. Guest was a hospice resident prior to COVID-19 vaccine and overall was having general decline prior to vaccination. Signed on to hospice on 8/6/21. Had active diagnosis of adult failure to thrive and hx of gastric CA--declined PEG tube. Only acute side effect 2 days s/p dose 2 noted was fatigue. No side side effects were reported with dose #1.


VAERS ID: 1759662 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-02-16
Onset:2021-08-05
   Days after vaccination:170
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 006M20A / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Cardio-respiratory arrest, Death, End stage renal disease, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Chronic kidney disease (narrow), Respiratory failure (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-19
   Days after onset: 14
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 08/05/2021 PCR+ COVID-19 test at Hospital
CDC Split Type:

Write-up: Breakthrough COVID-19 case with unknown symptom status. Death 8/19/21. From Vital Records COD = CARDIOPULMONARY ARREST, COVID 19, END STAGE RENAL FAILURE. Per vital records, COD ICD Codes include: Not yet coded ; Other Significant Conditions include: None listed. place of death: HOSPITAL-INPATIENT, HOSPITAL; certified by: PRONOUNCING AND CERTIFYING PHYSICIAN; occ/ind: COMANPY


VAERS ID: 1759710 (history)  
Form: Version 2.0  
Age: 73.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-03-30
Onset:2021-08-05
   Days after vaccination:128
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP6955 / 2 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: Acute kidney injury, Acute respiratory failure, COVID-19, COVID-19 pneumonia, Death, Hyperkalaemia, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Chronic kidney disease (broad), Hypersensitivity (broad), Tumour lysis syndrome (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-20
   Days after onset: 15
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 08/05/2021 PCR+ COVID-19 test at MEDICAL CENTER; 08/10/2021 PCR+ COVID-19 test at Hospital
CDC Split Type:

Write-up: Breakthrough COVID-19 case with unknown symptom status. Hospitalized 8/10/2021. Death 8/20/2021. From Vital Records COD = SEVERE HYPERKALEMIA, ACUTE RENAL FAILURE, ACUTE HYPOXIC RESPIRATORY FAILURE, COVID 19 PNEUMONIA. Per vital records, COD ICD Codes include: Not yet coded ; Other Significant Conditions include: None listed. place of death: HOSPITAL-INPATIENT, HOSPITAL; certified by: PRONOUNCING AND CERTIFYING PHYSICIAN.


VAERS ID: 1759771 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-10
Onset:2021-08-05
   Days after vaccination:148
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / 1 LA / IM

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Death, Dyspnoea, Hypoxia, Pneumonia, Respiratory disorder, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-11
   Days after onset: 6
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 08/05/2021 Antigen+ COVID-19 test at MEDICAL CARE; 08/10/2021 PCR+ COVID-19 test
CDC Split Type:

Write-up: Breakthrough COVID-19 case with symptom onset 8/9/2021: shortness of breath. Hospitalized 8/10/2021-8/11/2021. Death 8/11/2021. Case-pt was diagnosed with hypoxia, pneumonia, difficulty breathing, shortness of breath, respiratory problems.


VAERS ID: 1759807 (history)  
Form: Version 2.0  
Age: 68.0  
Sex: Male  
Location: Mississippi  
Vaccinated:2021-09-27
Onset:2021-09-28
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Death, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-28
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: HCTZ, Mycophenolate Mofetil, Gabapentin, Prednisone, Nifedipine, Atorvastatin, Losartan, Omeprazole, Ferrous sulfate
Current Illness: HTN, Hyperlipidemia, ASHD, CHF, Aortic insufficiency, Mitral regurgitation, PSVT, AAA, TAA, SLE, Lupus glomerulonephritis, CKD3a, Anemia, GERD, History of CVA
Preexisting Conditions: See above
Allergies: None
Diagnostic Lab Data: None. Pt did have a CMP (metabolic panel) done 3 days before vaccine and this was stable with Cr 1.6 (CKD3a) and normal Glu, electrolytes, and liver tests.
CDC Split Type:

Write-up: Patient died suddenly at approximately 6AM on the following morning of 9/28/2021 after receiving the vaccine on 9/27/2021. Pt became acutely SOB and family called 911 for an ambulance but patient died before help could arrive. Pt''s wife unable to give much further history.


VAERS ID: 1760262 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-03-12
Onset:2021-10-02
   Days after vaccination:204
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6205 / 1 UN / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8733 / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Asthenia, COVID-19, Chills, Cough, Dyspnoea, Haematochezia, Headache, Myalgia, Oropharyngeal pain, Pneumonia, Pyrexia, Respiratory tract congestion, SARS-CoV-2 test positive
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal haemorrhage (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-02
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: pantoprazole; ibuprofen; HYDROcodone; cholecalciferol; simvastatin; loratadine; flunisolide; metoprolol tartrate;
Current Illness: unknown
Preexisting Conditions: COPD; HTN; dyslipidemia;
Allergies: unknown
Diagnostic Lab Data: 9/18/2021 tested positive for COVID-19 via PCR;
CDC Split Type:

Write-up: 9/18/2021 tested positive for COVID-19 via PCR; developed pneumonia, fever, chills, myalgia, sore throat, headache, cough, dyspnea, abdominal pain, congestion, bloody stool, weakness;


VAERS ID: 1760282 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-07-22
Onset:2021-09-29
   Days after vaccination:69
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0171 / 1 LA / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0170 / 2 LA / IM

Administered by: Private       Purchased by: ?
Symptoms: Atrial fibrillation, Cough, Death, Exposure to SARS-CoV-2, Fatigue, Heart rate increased, Hypoxia, Intensive care, Mechanical ventilation, Oxygen saturation decreased, Pain, Palpitations, Pyrexia
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Dehydration (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-29
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 9 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 83-year-old Caucasian female, initially seen in the emergency department with symptoms of cough, palpitations, body aches and fever. Patient had multiple family members positive COVID-19 in which she was in close contact. In the emergency department, patient required supplemental oxygen to keep O2 saturations above 88%. Patient also discovered to be atrial fibrillation with RVR. Patient was admitted to the hospitalist service, patient was started on COVID-19 protocol and isolation airborne precautions. Given dexamethasone 6 mg daily for 10 days and remdesivir for 5 days. Patient was started on therapeutic Lovenox. Cardiology was consulted for atrial fibrillation RVR, patient was to continue home amiodarone and started on a Cardizem drip. 21 September pulmonology is consulted with recommendations to keep potassium greater than 4 and magnesium greater than 2 in regards to atrial fibrillation. Treat hypoxia increasing O2 requirement to heated high-flow starting at 60 L at 100% FiO2. Patient''s oxygen requirements continue to become problematic patient eventually was transferred to the ICU and placed on noninvasive ventilation. Atrial fibrillation and heart rate remained to be problematic with rate into the 130 to 140s at times. 29 September patient expressed to family members that she was tired and was ready to die, code status changed to DNR patient was transition to comfort measures and expired 1917Hr


VAERS ID: 1760463 (history)  
Form: Version 2.0  
Age: 71.0  
Sex: Female  
Location: Tennessee  
Vaccinated:2021-03-17
Onset:2021-09-25
   Days after vaccination:192
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805031 / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Back pain, Cardiac arrest, Dyspnoea, Flank pain, Nausea
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-27
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Pace maker
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Backache/side ache most of the day on Sept 25th. My mother thought it might be a kidney stone so she took Ibuprofen every 4 hours. She also had nausea most of the morning of the 25th. She woke up around 2am on the 26th gasping for air and could barely breathe. She went into cardiac arrest.


VAERS ID: 1760635 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Arizona  
Vaccinated:2021-04-13
Onset:2021-05-01
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8734 / 1 UN / SYR

Administered by: Unknown       Purchased by: ?
Symptoms: Autopsy, Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-01
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Sleep apnea
Allergies: None
Diagnostic Lab Data: Autopsy shows heart was 710 grams at the time of death.
CDC Split Type:

Write-up: Death. My daughter passed away in her sleep .


VAERS ID: 1760669 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1822809 / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Death, Pain in extremity, Thrombosis
SMQs:, Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Thrombophlebitis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-04
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: unknown
Current Illness: unknown
Preexisting Conditions: none reported
Allergies: none
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: 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.


VAERS ID: 1761370 (history)  
Form: Version 2.0  
Age: 40.0  
Sex: Male  
Location: Colorado  
Vaccinated:2021-09-16
Onset:2021-09-27
   Days after vaccination:11
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 201A21A / 1 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Arthralgia, Cardiomegaly, Death, Influenza like illness, Malaise, Overweight, Skin warm
SMQs:, Cardiac failure (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Cardiomyopathy (broad), Arthritis (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-27
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Wife called to report a COVID-19 vaccine reaction. Patient received the J&J vaccine on 9/16 at Pharmacy. He did not feel well that night- achy joints, "fever skin", states skin felt as if he had the flu. He felt well after 3 days. On 9/27, Patient developed achy joints and stated he did not feel well. He died on their driveway. He was transported to Hospital and pronounced dead. Wife states she was informed he had an enlarged heart. Reports autopsy pending. States he was overweight, but had no medical history.


VAERS ID: 1761422 (history)  
Form: Version 2.0  
Age: 35.0  
Sex: Female  
Location: Unknown  
Vaccinated:2021-03-04
Onset:2021-09-14
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 037A21B / UNK - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Anaemia, B-cell lymphoma, Blood bilirubin increased, Blood glucose increased, COVID-19, Condition aggravated, Cough, Dehydration, Dyspnoea, Evans syndrome, Hypokalaemia, Hyponatraemia, Hypoxia, Leukopenia, Liver function test increased, Pancytopenia, Pneumonia, Pyrexia, SARS-CoV-2 test positive, Splenomegaly, Tachycardia, Vaccine breakthrough infection
SMQs:, Liver related investigations, signs and symptoms (narrow), Haemolytic disorders (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Agranulocytosis (narrow), Asthma/bronchospasm (broad), Haematopoietic cytopenias affecting more than one type of blood cell (narrow), Haematopoietic erythropenia (broad), Haematopoietic leukopenia (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Biliary system related investigations, signs and symptoms (narrow), Pulmonary hypertension (broad), Hyponatraemia/SIADH (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Malignant lymphomas (narrow), Myelodysplastic syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Haematological malignant tumours (narrow), Infective pneumonia (narrow), Dehydration (narrow), Hypokalaemia (narrow), Opportunistic infections (broad), Immune-mediated/autoimmune disorders (narrow), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-03
   Days after onset: 19
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Evan''s Syndrome, Cytomegalovirus, B-Cell Lymphoma
Allergies: No Known
Diagnostic Lab Data: Covid + 9/16/2021
CDC Split Type:

Write-up: Breakthrough Covid + 35 year old female with a Past Medical History of Evans Syndrome, Immune Deficiency Disorder, Lymph Node Abscess, B-cell Lymphoma, Cytomegalovirus, Pneumonia, Pneumothorax, Bone Marrow Biopsy, Port, and Lymph Node Biopsy. Admitted to Medical PCU for Low Grade Fever, COVID19, B-Cell Lymphoma, Evans Syndrome, Pneumonia, Splenomegaly, Elevated LFT''s, Elevated Bilirubin, Dehydration, Hypoxemia, Tachycardia, Leukopenia, Anemia, Pancytopenia, Elevated Blood Glucose, Hyponatremia, Hypokalemia, and Questionable Small Lesions within the Liver. Patient was admitted to the hospital for shortness of breath cough and fever. Symptoms have been progressively getting worse over last 1-2 days.


VAERS ID: 1761478 (history)  
Form: Version 2.0  
Age: 64.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-03-06
Onset:2021-08-31
   Days after vaccination:178
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6202 / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER2613 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Respiratory failure, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (broad), Respiratory failure (narrow), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-26
   Days after onset: 26
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 20 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: multivitamin, metoprolol, vitamin d, lipitor
Current Illness:
Preexisting Conditions: HTN, hyperthyroidism, SVT, IBS, Diabetes Type 2, Graves disease, obese
Allergies:
Diagnostic Lab Data: Tested positive on 8.31.21
CDC Split Type:

Write-up: Patient came in with respiratory failure


VAERS ID: 1761503 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Iowa  
Vaccinated:2021-09-07
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF2588 / 1 - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Death, Gastrointestinal disorder
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Decedent''s family are not sure
Current Illness: Not per the decedent''s family
Preexisting Conditions: Alcoholism
Allergies: No Allergies known per the decedent''s Son
Diagnostic Lab Data:
CDC Split Type:

Write-up: The Decedent''s son described that she was having GI issues between four days to a week before death (they could not be more specific). Unknown if this is related. She was reportedly also suffering from alcoholism per her son. Death of patient occurred 21 days after Vaccination. It is unknown at this time if this death is related in any way to the vaccination. This is being submitted at the request of Pathologist.


VAERS ID: 1761528 (history)  
Form: Version 2.0  
Age: 60.0  
Sex: Female  
Location: Michigan  
Vaccinated:2021-03-10
Onset:2021-10-05
   Days after vaccination:209
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA N/A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Acute respiratory distress syndrome, Anticoagulant therapy, Atrial fibrillation, COVID-19 pneumonia, Cardiac failure, Chest tube insertion, Condition aggravated, Death, Endotracheal intubation, General physical health deterioration, Hypoxia, Intensive care, Multiple organ dysfunction syndrome, Pneumothorax, Renal failure, Respiratory failure
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Anaphylactic reaction (broad), Angioedema (broad), Asthma/bronchospasm (broad), Interstitial lung disease (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Hypokalaemia (broad), Sepsis (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-05
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hypertension, anxiety, vitamin D deficiency, obesity class 3, obstructive apnea, allergic rhinitis, chronic kidney disease, atrial fibriliation.
Allergies: Hydrocodone (itching), Robitussin (chest tightness), soaps, animal dander, cosmetics.
Diagnostic Lab Data: COVID positive test on 09/20/21.
CDC Split Type:

Write-up: 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."


VAERS ID: 1761541 (history)  
Form: Version 2.0  
Age: 57.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-10-03
Onset:2021-10-03
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 039D21A / UNK LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-03
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Oxycodone Apap 10-325, Tizanidine 4mg, Gabapentin 300mg, Zolpidem 10mg, Alprazolam 1mg
Current Illness: unknown
Preexisting Conditions: unknown
Allergies: NKDA
Diagnostic Lab Data:
CDC Split Type:

Write-up: unknown patient representative contacted pharmacy to report the patient had died hours after getting the moderna vaccination


VAERS ID: 1761576 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-03
Onset:2021-08-09
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 28L20A0 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Death
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-24
   Days after onset: 15
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 15 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Chronic sinus infections
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fully vaccinated and later hospitalized then died due to Covid related causes.


VAERS ID: 1761633 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-04-20
Onset:2021-09-21
   Days after vaccination:154
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 042B21A / 2 AR / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Atrial fibrillation, COVID-19, Death, Renal failure, Respiratory failure, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Anaphylactic reaction (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Chronic kidney disease (narrow), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Hypokalaemia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-21
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 09/08/2021 PCR+ COVID-19 test at Hospital; 09/16/2021 PCR+ COVID-19 test at Medical Center
CDC Split Type:

Write-up: Breakthrough COVID-19 case with unknown symptom status. Death 9/21/2021. From Records COD= RESPIRATORY FAILURE, RENAL FAILURE, ATRIAL FIBRILLATION. Per records, Other Significant Conditions include: N/A. place of death: HOSPITAL-INPATIENT, MEDICAL CENTER; certified by: PRONOUNCING AND CERTIFYING PHYSICIAN; occupation: MACHINIST, MACHINERY ."Did the patient die?"marked YES; "Is this a COVID-related death?" marked YES.


VAERS ID: 1761641 (history)  
Form: Version 2.0  
Age: 87.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-02-12
Onset:2021-09-17
   Days after vaccination:217
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Death, Dyspnoea, SARS-CoV-2 test
SMQs:, Anaphylactic reaction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), COVID-19 (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-29
   Days after onset: 12
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Covid antigen test on 9/17/21 for admission and sx
CDC Split Type:

Write-up: pt was admitted on 9/17/21 with increased shortness of breath, pt was a DNR/DNI at time of hospitaliztion, pt was made hospice on 9/29/21 pt expired 9/29/21


VAERS ID: 1761668 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Tennessee  
Vaccinated:2021-03-09
Onset:2021-09-29
   Days after vaccination:204
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6199 / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Acute kidney injury, Acute myocardial infarction, Acute respiratory failure, Asthenia, COVID-19, COVID-19 pneumonia, Cardiac failure congestive, Chest pain, Chronic kidney disease, Cough, Death, Dyspnoea, Hypoxia, Pneumonia, Respiratory tract congestion, SARS-CoV-2 test positive, Sepsis, Ventricular fibrillation
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Myocardial infarction (narrow), Ventricular tachyarrhythmias (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Chronic kidney disease (narrow), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Dehydration (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-04
   Days after onset: 5
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness: UNKNOWN
Preexisting Conditions: PRIOR HX OF CVA WIHTOU DEFICIT HTN GOUT
Allergies: PENICILLINS
Diagnostic Lab Data: 9/29/21 COVID-19SARSAgFIA = DETECTED
CDC Split Type:

Write-up: 9/27/21 PATIENT REPORTED GENERALIZED WEAKNESS, COUGH , CHEST CONGESTION, SOB AND CHEST PAIN. 9/29/21 SEEN IN THE ER AT TURKEY CREEK MEDICAL CENTER WITH COMPLAINTS OF SOB AND WEAKNESS.SpO2= 95 DX WITH COVID-19 BILAT PNEUMONIA , HYPOXIA ADMITTED TO INPATIENT HOSPITAL STATUS. 4 L OF OXYGEN. ALSO NOTED TO HAVE CHRONIC KIDNEY DISEAE WITH UNKNOWN STAGE. dIED ON 10/4/21 WITH THE FOLLOWING DX: NSTEMI LIKLEY TYPE 1, ACUTE HYPOXIC RESP FAILURE, SEPSIS SECONDRAY TO COVID 19 PNEUMONIA AND POSSIBLE BACTERIAL PNEUMONIA, ACUTE CHF, ACUTE RENAL FAILURE,. CAUSE OF DEATH: V.FIB DUE TO NSTEMI.


VAERS ID: 1761752 (history)  
Form: Version 2.0  
Age: 83.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-02-10
Onset:2021-09-24
   Days after vaccination:226
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 016M20A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-24
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Norco, Zaroxolyn, Mag-ox, Imdur, Cozaar, Vit D3, metformin, aspirin, Namenda, Klor-Con, Lasix, Aricept, Pravachol, Lopressor, Dulcolax, Guaisfensin, Nitroglycerin, Tylenol
Current Illness:
Preexisting Conditions:
Allergies: Benazepril
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient passed away on 09/24/2021.


VAERS ID: 1761787 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-04-09
Onset:2021-09-25
   Days after vaccination:169
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 027B21A / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-25
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Roxicodone, Colace, Lopressor, Lasix, Tylenol, Atarax, Senokot, Lyrica, Protonix, Pepcid, Effexor, Forteo, Pamelor, calcium carbonate, Vit D3. Abilify, Lipitor, Keppra, Narcan, Voltaren, Tums
Current Illness:
Preexisting Conditions:
Allergies: Tramadol, Duloxetine, Tizanidine, Motrin, Spironolactone
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient passed away on 09/25/2021.


VAERS ID: 1761801 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-03
Onset:2021-09-29
   Days after vaccination:210
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 036A21A / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-29
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Ceclor, Codeine, Penicillin, Sulfa drugs, Tramadol
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient passed away on 09/29/2021


VAERS ID: 1761807 (history)  
Form: Version 2.0  
Age: 82.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-02-24
Onset:2021-09-24
   Days after vaccination:212
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 013L20A / 1 - / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 040A21A / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Death, Dyspnoea, Gastrointestinal carcinoma, Hypoxia, SARS-CoV-2 test positive
SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Non-haematological malignant tumours (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-24
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Coviid antigen test positve on 9/20
CDC Split Type:

Write-up: pt admitted 9/20 with sob found to be hypoxic pt made comfort care and expired on 9/24 pt had of GI cancer,


VAERS ID: 1761825 (history)  
Form: Version 2.0  
Age: 95.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-20
Onset:2021-09-05
   Days after vaccination:228
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-05
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: No known allergies
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient passed away on 09/05/2021.


VAERS ID: 1761843 (history)  
Form: Version 2.0  
Age: 96.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-04-07
Onset:2021-09-01
   Days after vaccination:147
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-01
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Morphine
Current Illness:
Preexisting Conditions:
Allergies: Cephalexin
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient passed away on 09/01/2021.


VAERS ID: 1761852 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-01-13
Onset:2021-09-20
   Days after vaccination:250
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-20
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ativan, Dilaudid, Neurontin, Zofran, Tylenol
Current Illness:
Preexisting Conditions:
Allergies: Aspirin, Lactose, Prednisone
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient passed away on 09/20/2021.


VAERS ID: 1761858 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-01-28
Onset:2021-09-01
   Days after vaccination:216
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Death
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-01
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fully vaccinated and died due to Covid related causes.


VAERS ID: 1761864 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-10-01
Onset:2021-10-04
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1808986 / UNK - / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Death, Hyperhidrosis, Pallor, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-04
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL, XANAX, AMIODORONE, ELIQUIS, LASIX, HYDROCHLORIQUINE, SYNTHROID, MELATONIN, MIDODRINE, PRILOSEC, PLAQUENAL, PREDNISONE, SENNA PLUS, SPIRONOLACTONE, VIT D, prn: DULCOLAX SUPPOSITORY, MIRALAX, MILK OF MAGNESIA, ZOFRAN, ULTRAM
Current Illness: ADMITTED TO FACILITY 9/29/21 AFTER FALLS AT HOME. RECEIVED J&J VACCINE FROM PHARMACY ON 10/1/21. ON 10/4, STAFF PRESENT IN ROOM, RESIDENT BECAME DIAPHORETIC, PALE, AND UNRESPONSIVE. SHE EXPIRED MOMENTS LATER.
Preexisting Conditions: PMH: LUPUS, HYPOTHYROIDISM, OSTEOPOROSIS, ANXIETY, PAC, HTN, CHF, BRONCHITIS, CKD, PNA, INFLUENZA A, MITRAL VALVE REG. MITRAL STENOSIS, CERVICAL FX 2019
Allergies: AMLODIPINE, CELEBREX
Diagnostic Lab Data: N/A
CDC Split Type:

Write-up: ADMITTED TO FACILITY 9/29/21 AFTER FALLS AT HOME. RECEIVED J&J VACCINE FROM PHARMACY ON 10/1/21. ON 10/4, STAFF PRESENT IN ROOM, RESIDENT BECAME DIAPHORETIC, PALE, AND UNRESPONSIVE. 911 CALLED, RESIDENT EXPIRED MOMENTS LATER.


VAERS ID: 1761871 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Illinois  
Vaccinated:2021-03-10
Onset:2021-09-02
   Days after vaccination:176
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 026A21 / 1 - / -
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 032B21A / 2 - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Death, Dyspnoea, Endotracheal intubation, Positive airway pressure therapy, SARS-CoV-2 test positive, Septic shock, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Angioedema (broad), Arrhythmia related investigations, signs and symptoms (broad), Toxic-septic shock conditions (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-12
   Days after onset: 10
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: antigen Covid test positive on 9/2
CDC Split Type:

Write-up: pt admitted on 9/2 syncopy and sob, pt placed on cpap in er condition continued to worse, pt intubated pt went into septic shock and expired on 9/12/21


VAERS ID: 1761895 (history)  
Form: Version 2.0  
Age: 63.0  
Sex: Female  
Location: Minnesota  
Vaccinated:2021-03-04
Onset:2021-08-25
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 010M20A / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-25
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: Penicillin''s, tape
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient passed away on 08/25/2021.


VAERS ID: 1761916 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Female  
Location: Massachusetts  
Vaccinated:2021-09-29
Onset:2021-10-04
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FF8841 / 3 LA / IM

Administered by: Senior Living       Purchased by: ?
Symptoms: Body temperature increased, Chest X-ray abnormal, Lung infiltration
SMQs:, Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-04
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Multiple medications, recently started on IM Rocephin for dx of Pnuemonia on 10/1/2021.
Current Illness: Dementia, HTN, Malignant neoplasm of colon, hx of COVID-19, CKD, Atherosclerotic heart disease, Hx of MRSA pneumonia, GI Bleed. Plus many more diagnoses.
Preexisting Conditions: Recieved Booster Pfizer Vaccine on 9/29/21, on 9/30/21 had temp of 106.0, then 103.0, 102.0. CXR showed bilat infiltrates, started on rocephin., temp down to 97.9 on 10/1/21. Multiple long standing chronic health conditions, active with Hospice Services. DNR/DNI. On Aspiration Precautions.
Allergies: Gabapentin, diclofenac, ibuprofen, morphine, ranitidine
Diagnostic Lab Data: CXR DONE 10/1/21 SHOWED BILATERAL INFILTRATES
CDC Split Type:

Write-up: Recieved Booster Pfizer Vaccine on 9/29/21, on 9/30/21 had temp of 106.0, then 103.0, 102.0. CXR showed bilat infiltrates, started on rocephin., temp down to 97.9 on 10/1/21. Multiple long standing chronic health conditions, active with Hospice Services. DNR/DNI. On Aspiration Precautions.


VAERS ID: 1761982 (history)  
Form: Version 2.0  
Age: 61.0  
Sex: Male  
Location: Michigan  
Vaccinated:2021-09-08
Onset:2021-09-17
   Days after vaccination:9
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / IM
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0183 / 1 AR / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Abdominal distension, Abdominal wall oedema, Acidosis, Acute kidney injury, Ammonia increased, Antibody test negative, Anticoagulant therapy, Blood creatinine decreased, Brain injury, Bronchial secretion retention, Bronchoscopy abnormal, Cardiac arrest, Cardiac disorder, Chest discomfort, Chest tube insertion, Cognitive disorder, Computerised tomogram abdomen abnormal, Computerised tomogram head normal, Computerised tomogram thorax abnormal, Cor pulmonale acute, Culture negative, Death, Decreased bronchial secretion, Disseminated intravascular coagulation, Echocardiogram abnormal, Ejection fraction decreased, Electrocardiogram ST segment depression, Electroencephalogram abnormal, Endotracheal intubation, Epilepsy, Fracture, Generalised oedema, Haematology test, Haemoglobin decreased, Haemoperitoneum, Haemothorax, Heparin-induced thrombocytopenia test, Hypernatraemia, Hypervolaemia, Hypoperfusion, Immune thrombocytopenia, Infusion, Intensive care, Ischaemic hepatitis, Laboratory test abnormal, Lactic acidosis, Liver function test decreased, Lung consolidation, Magnetic resonance imaging abnormal, Mechanical ventilation, Mental status changes, Mesenteric haemorrhage, Metabolic acidosis, Muscle strain, Myocardial necrosis marker increased, Normocytic anaemia, Obstructive shock, Platelet count decreased, Pleural effusion, Pulmonary embolism, Pulseless electrical activity, Renal impairment, Renal infarct, Renal tubular necrosis, Resuscitation, Right ventricular dilatation, Right ventricular dysfunction, Seizure, Shock, Status epilepticus, Syncope, Thrombocytopenia, Thrombolysis, Transaminases increased, Transfusion, Traumatic haemothorax, Ultrasound Doppler
SMQs:, Torsade de pointes/QT prolongation (broad), Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Liver related investigations, signs and symptoms (narrow), Hepatitis, non-infectious (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Haematopoietic erythropenia (broad), Haematopoietic thrombocytopenia (narrow), Lactic acidosis (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Systemic lupus erythematosus (narrow), Myocardial infarction (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Dementia (broad), Convulsions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Embolic and thrombotic events, venous (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Cardiac arrhythmia terms, nonspecific (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Other ischaemic heart disease (broad), Osteoporosis/osteopenia (broad), Renovascular disorders (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Chronic kidney disease (broad), Hypersensitivity (narrow), Tumour lysis syndrome (narrow), Tubulointerstitial diseases (broad), Respiratory failure (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-01
   Days after onset: 14
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 15 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: brimonidine (ALPHAGAN) 0.2 % ophthalmic solution gabapentin (NEURONTIN) 300 MG capsule hydroCHLOROthiazide (MICROZIDE) 12.5 MG capsule latanoprost (XALATAN) 0.005 % ophthalmic solution timolol (TIMOPTIC) 0.5 % ophthalmic solution
Current Illness: NA
Preexisting Conditions: glaucoma, HTN, hyperlipemia
Allergies: NKDA
Diagnostic Lab Data: Brief History and Medical Decision-Making: This is a 61 year old male patient with past medical hx significant for glaucoma, HTN, hyperlipemia, recently received the second dose of COVID-19 pfizer vaccine ( first dose on 8//18 and second dose on 9/8/2021) presented to ED with syncope, had PEA cardiac arrest on PEA 4 times ( s/p 7 rounds of CPR, then 2 rounds, then 1 round and then 2 rounds per nursing report) achieved ROSC, was found to have bilateral PE ( massive PE) s/p TPA started in ED ( after discussion with IR), at time of transfer to Intensive Care, he was noted to be in shock ( most likely obstructive due to PE versus cardiogenic ) requiring epinephrine, initial labs remarkable for lactic acidosis, worsening kidney function and thrombocytopenia and slight drop in hemoglobin from 11.9 to 9.2. Shock and lactic acidosis seems to be improving post TPA, echocardiogram showed moderate to severe decreased RV function. Given the drop in platelets and recent receipt of vaccine, there is concern for vaccine induced immune thrombotic thrombocytopenia (VITT), we will obtain PF-4 Abs and serotonin release assay, we also consult hematology and use argatroban until results of PF-4 Abs is back. We will follow serial Hemoglobin to make sure no bleeding post TPA and post CPR. In addition to PE, he he was noted to have renal infarctions on CT abdomen for which we are using AC. EKG showed ST segment depressions in lateral and inferior leads and cardiac enzymes are elevated, we will consult cardiology for that (concern for ACS) and follow serial cardiac enzymes. Acute kidney injury is most likely due to ATN in the setting of cardiac arrest, no immediate indications for dialysis. We will continue to follow serial electrolytes and assess need for dialysis. We will not cool the patient given the increased risk of bleeding with thrombocytopenia and being on TPA.
CDC Split Type:

Write-up: 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.


VAERS ID: 1761992 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-05-20
Onset:2021-08-14
   Days after vaccination:86
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Death, Vaccine breakthrough infection
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-07
   Days after onset: 24
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 24 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID breakthrough and death related to illness.


VAERS ID: 1761994 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Florida  
Vaccinated:2021-09-15
Onset:2021-09-16
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest discomfort, Chest pain, Cough, Death, Dyspnoea, Feeling abnormal, Malaise, Respiratory tract congestion, Somnolence
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-24
   Days after onset: 8
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Gabapentin, Busiprone, cyclobenzaprine, insuline
Current Illness:
Preexisting Conditions: Type-2 Diabetes with well maintained blood sugar levels.
Allergies: NKA
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: 09/16/2021-09/19/2021 Patient remained in bed coughing, feeling ill, drinking fluids and eating but slept mostly. 09/20/2021-Patient complained about being congested so she took mucus relief and cough drops 09/21/2021-09/23/2021-Patient began moving around the house feeling short of breath and a little foggy but symptoms felt to be slowly disipating and she was glad to be out of bed. Took a shower and sat outside to get fresh air and discussed how 09/16-09/19 she had never felt the burning in her chest and tightness like anything before and was glad it was over with. She was given water and left to her own accord at 10:30 pm. 09/24/21- At approximately 9:30 patient was discovered in her bed having died sometime throughout the night.


VAERS ID: 1762006 (history)  
Form: Version 2.0  
Age: 36.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-08-10
Onset:2021-08-26
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Death
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-29
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Died of COVID illness.


VAERS ID: 1762030 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-03-18
Onset:2021-09-09
   Days after vaccination:175
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: COVID-19, Death, Illness
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-21
   Days after onset: 12
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Illness and death related to COVID.


VAERS ID: 1762046 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Male  
Location: Hawaii  
Vaccinated:2021-04-01
Onset:2021-09-22
   Days after vaccination:174
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Unknown       Purchased by: ?
Symptoms: COVID-19, Death
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-22
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: COVID illness and death.


VAERS ID: 1762101 (history)  
Form: Version 2.0  
Age: 80.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-02-17
Onset:2021-08-03
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 013M20A / 2 UN / IM

Administered by: Private       Purchased by: ?
Symptoms: Abdominal pain, Acute kidney injury, Acute respiratory failure, Asthenia, Atrial fibrillation, Blood creatinine increased, Blood culture, Blood lactic acid, Blood pressure decreased, Blood sodium decreased, Body temperature increased, Brain natriuretic peptide increased, Breath sounds abnormal, Bronchial wall thickening, COVID-19, Cardiac failure, Cardiac telemetry, Catheterisation cardiac abnormal, Cellulitis, Chest X-ray abnormal, Chills, Chronic kidney disease, Condition aggravated, Confusional state, Coronary artery stenosis, Culture urine, Death, Decreased appetite, Dizziness, Dyspnoea, Echocardiogram abnormal, Ejection fraction decreased, Endotracheal intubation, Erythema, Fall, Feeding tube user, Heart rate increased, Hypotension, Hypoxia, Injury, Intensive care, Left ventricular end-diastolic pressure increased, Legionella test, Lung opacity, Mechanical ventilation, Mental status changes, Metabolic function test, Mitral valve incompetence, Mitral valve prolapse, Oxygen saturation decreased, Palpitations, Peripheral swelling, Pneumonia, Respiratory failure, SARS-CoV-2 test positive, Sepsis, Septic shock, Skin lesion, Skin warm, Skin weeping, Slow response to stimuli, Sputum culture, Tachycardia, Tachypnoea, Viral infection, White blood cell count increased
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Cardiac failure (narrow), Anaphylactic reaction (narrow), Acute pancreatitis (broad), Angioedema (broad), Asthma/bronchospasm (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Interstitial lung disease (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Dementia (broad), Acute central respiratory depression (narrow), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (narrow), Hostility/aggression (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (narrow), Eosinophilic pneumonia (broad), Other ischaemic heart disease (narrow), Vestibular disorders (broad), Chronic kidney disease (narrow), Hypersensitivity (broad), Tumour lysis syndrome (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Hypoglycaemia (broad), Infective pneumonia (narrow), Dehydration (broad), Hypokalaemia (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-04
   Days after onset: 32
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 18 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: albuterol, minocyline, ondansetron, pantoprozole, ibrutinib
Current Illness:
Preexisting Conditions: PMH of A-fib (on Eliquis), severe MVR, HTN, HLD, CAD s/p 2xDES (2005), Saddle PE (2017), reduced LVEF, Waldenstrom macroglobulinemia (on imbruvica) past surgical history that includes Cardiac catheterization (N/A, 07/22/2021); cardiac stent (N/A, 02/11/2005); Rotator cuff repair (Left); Total knee arthroplasty (Left); and Back surgery (N/A).
Allergies: Amoxicillin (Rash) 2/2019
Diagnostic Lab Data: 8/3/2021 COVID-19 Tested positive 8/23/2021 COVID-19 Tested positive
CDC Split Type:

Write-up: Patient vaccinated for COVID on 2/17/2021, admitted on 8/3/2021, tested positive for COVID 8/3/2021. discharged 8/8/2021 patient admitted again on 8/23/2021, tested positive for COVID 8/23/2021. Patient passed away on 9/4/2021 History Of Present Illness a 80 y.o. male with a PMH of A-fib (on Eliquis), severe MVR, HTN, HLD, CAD s/p 2xDES (2005), Saddle PE (2017), reduced LVEF, Waldenstrom macroglobulinemia (on imbruvica) who presents with worsening weakness, dizziness, SOA, chills and decreased appetite over the past 1.5 wks. Associated with mild abdominal pain. Symptoms started back in June, but acutely worsened. He was evaluated for these issues. His cardiologist performed a LHC showing 50% LAD stenosis, severe MR, LVEF 30-35%, LVEDP of 40. Given these findings, he was referred to another doctor for evaluation for potential MV replacement. However, given his worsening symptoms, he presented to the ED. Patient denies recent sick contacts. No fevers, N/V/D. He is vaccinated against COVID. He was given lasix to take for 2 wks if he had significant weight gain- states he only took it 3 times and had not since. Compliant with all meds. Review of Systems Constitutional: Positive for activity change, appetite change and chills. Negative for fever. HENT: Negative for trouble swallowing. Respiratory: Positive for shortness of breath. Negative for cough, chest tightness and wheezing. Cardiovascular: Positive for palpitations and leg swelling. Negative for chest pain. Gastrointestinal: Positive for abdominal pain. Negative for constipation, diarrhea, nausea and vomiting. Assessment and Plan He is an 80 y/o male with PMH of A-fib (on Eliquis), severe MVR, HTN, HLD, CAD s/p 2xDES (2005), Saddle PE (2017), reduced LVEF, Waldenstrom macroglobulinemia (on imbruvica) who presents with worsening weakness, dizziness, SOA, chills and decreased appetite over the past 1.5 wks noted to have Covid Infection. #COVID Infection -Now needing 3 l of O2 -CXR- Peribronchial thickening and interstitial opacification may be associated with viral infection -Patient states he was previously vaccinated. -Given patient''s hypoxia, will start dexamethasone 6 for 10 days and also Remdesivir -Encourage Pul toilet, BD and Proning -Monitor AKI on CKD -baseline Cr 1.6 -Likely due to prerenal in the context of IV lasix on admission with N BNP -Monitor in the background of Remdesivir -Hold further diuresis -avoid nephrotoxic agents -Repeat CMP in AM #Severe Mitral Regurgitation #Mitral Valve Prolapse #HFrEF #CAD s/p DES - Baptist LHC 6/22/2001 - 50% LAD stenosis, severe MR, LVEF 30-35%, LVEDP of 40 - ECHO 12/2015 - bileaflet prolapse with posterior mitral cleft with severe MR. - ECHO 8/2018- shows MV prolapse with severe MR. - ECHO 6/30/2021- severe MR. No sig mitral valve stenosis is present. LVEF 45-50%. - BNP- 864, Na 135, Cr 1.6 (baseline). - CXR- Peribronchial thickening and interstitial opacification may be associated with viral infection A/ Overall believe patient''s symptoms are 2/2 to Covid infection and his worsening, severe MR. He was diuresed well with 40 of IV lasix. Will have evaluation from CT surgery. If they believe valve is the root cause of his issues and do not feel surgical intervention is warranted, will consider interventional cardiology consultation. Plan: - CT Surgery Consulted - Hold further diuresis given severe MR and improvement in symptoms #A-fib - Patient on eliquis and atenolol -C/w eliquis and atenolol #Waldenstrom macroglobulinemia - Started on imbruvica for treatment. Patient states he does not take venclexta Plan: - Consult oncology in AM for approval of imbruvica Chronic Conditions -Benzodiazepine dependence- Tranxene 15 mg nightly; recommended weaning and discontinuing as outpt -Skin Lesions- multiple lesions on abdomen and UEs- continue doxycycline. -HLD- pravastatin 40 -HTN- on atenolol only -GERD- PPI F: po E: po N: Cardiac, low salt; DVT Ppx: Hold eliquis, heparin 5000 q8hrs Code:code status: do not resuscitate, okay to intubate. POA- Son. Has living will. Hospitalization Admit Date/Time: 8/3/2021 9:47 AM Discharge Date: 08/08/21 Chief Concern, Brief History of Present Illness, and Hospital Course He is an 80 y.o. male with a history of A-fib (on Eliquis), severe MVR, HTN, HLD, CAD s/p 2xDES (2005), Saddle PE (2017), reduced LVEF, Waldenstrom macroglobulinemia (on imbruvica) who presents with worsening weakness, dizziness, SOA, chills, mild abdominal pain and decreased appetite over the past 1.5 wks and noted to have Covid Infection. He was here for the mitral valve surgery and found to have COVID. He transiently required oxygen and was off oxygen at the time of discharge. He was treated with dexamethasone and remdesivir. Hematology advised to hold ibrutinib in the setting of COVID infection and upcoming surgery and follow up with patients OSH hematologist to decide about ibrutinib. CTS will follow up with the patient regarding surgery which is likely to be in a month as per my discussion with CTS. The details of A&P while in the hospital is listed below. #COVID Infection # Acute Hypoxic Respiratory failure (resolved) -discharged on room air. -CXR- Peribronchial thickening and interstitial opacification may be associated with viral infection -Patient states he was previously vaccinated. -Given patient''s hypoxia, c/w dexamethasone 6mg for 10 days and Remdesivir AKI on CKD-Resolved. Discharge Disposition/Condition Disposition: Home Condition: Stable (s/sx potential problems absent or manageable) second admission 8/23/2021 Patient admitted for altered mental status Chief Complaint Chief Complaint Patient presents with ? Trauma Alert ? Fall ? Epidemic Concern ? Altered Mental Status History Of Present Illness He is an 80 yo male with PMH waldenstrom macroglobulinemia (on imbruvica), Afib (on Eliquis), severe MVR, HTN, HLD, CAD s/p 2xDES (2005), Saddle PE (2017), reduced LVEF. Who presented to the Emergency Department after a fall at home. History is obtained from son who is at bedside and prior records as patient is currently altered and minimally responsive to exam. Per the son the patient had become increasingly confused over the past 2 days where he was "talking off the wall". After falling to his left side, son brought him to emergency department for further evaluation. On arrival the patient was saturating in the low 80s on room air and tachycardic to 120s with normotension. He was administered 2 L of fluid and placed on high-flow nasal cannula. His oxygenation improved, however he developed A-fib RVR with HR up to 180s. His blood pressure dropped with this to maps in the low 70s. At this time MICU was consulted for further evaluation. On exam the patient is altered, alert to person only. He also has notable swelling and erythema to his left forearm which is hot to touch. Noteworthy labs include WBC 20.67, Creatinine 2.15, and Lactate 4.5. Patient will be admitted to ICU with plan for Amio gtt for A-fib RVR and management of Sepsis. Pulmonary: Breath sounds: No stridor. Decreased breath sounds present. No wheezing or rhonchi. An 80 y/o male with PMH of Afib on Eliquis, severe MVR, HTN, HLD, CAD s/p DES. PE (in 2007), HFrEF (50% EF), CKD, Waldenstrom macroglobulinemia, recent COVID infection who is being admitted for sepsis likely 2/2 SSTI of L arm. #Sepsis and Septic Shock - Patient presented with F 101.2F, Tachycardia, tachypnea, hypotension and had elevated WBC at 20.67 - L arm swollen, erythematous, warm to touch and weeping. L arm cellulitis appears to be the likely source. - Blood cultures pending. Check urine cultures, sputum cultures, S pneumo and legionella. - S/p Vanc and Zosyn. Continue broad spectrum antibiotics and tailor them pending culture results. - 2L fluid given in boluses. Due to HFrEF will hold off on any more IV boluses. Can give gentle maintenance fluids. - Lactic acid elevated at 4.5. Follow post resuscitation levels. Dispo - Admit to ICU - DNR/I a 80 y.o. male with past medical history significant for atrial fibrillation on Eliquis, severe mitral valve regurgitation, hypertension, hyperlipidemia, chronic systolic heart failure, CAD, previous saddle PE, Waldenstrom macroglobinemia, and critical aortic stenosis, who presented to ED with after a fall at home. Per report, the patient was diagnosed with COVID-19 on the 3rd of this month and has been living with his son while he has been recovering. Of note, the patient was due to undergo evaluation for surgical repair of his symptomatic valvular heart disease, however this was postponed due to his COVID-19 infection. His son states that for the past 2 days, he has become increasingly confused with worsening mentation from his baseline. His son noticed that his father became acutely tachypneic today and suffered a mechanical fall from standing, landing on his left side. He was brought to the ED as a trauma alert with subsequent workup significant for oxygen saturation of 84% on room air, tachycardia with HR between 150-180, and breathing at 30-35 breaths per minute. He was given 2L of fluid, IV antibiotics per sepsis protocol, and Tylenol for symptomatic relied. He continues to be tachycardic in the 170''s on average at this time with high flow nasal cannula required for adequate oxygen saturations above 90%. Hospital medicine was consulted for admission given concern for this patient''s clinical presentation and unstable vital signs. He was eventually endotracheally and transferred to the ICU for further care. He was treated for assumed pneumonia and on workup was found to have severe mitral regurgitation. With diuresis and antibiotics, the patient''s mechanical ventilation was eventually weaned and the patient was extubated. CTS was consulted for his severe MR and potential surgical options, however given the patient''s age and level of illness and debilitation, this was not possible. The family was consulted at every stage of the decision making process and they elected to make him DNR/DNI and palliative care was consulted. On 9/3 comfort care measures were instituted and the patient passed away peacefully with his family at bedside. Hospitalization Admit Date/Time: 8/23/2021 11:42 AM Discharge Date: 9/3/2021 1. Severe mitral regurgitation with respiratory failure- patient and his son understand that there are longer medical or surgical options for his valve disease. Their goal is to focus on comfort care duing his last days of life. It is important to them that he lives for the next several days in order for his son to complete the sell of patients home on Tuesday. This will allow them to avoid escrow and gift the house to a family that is important to him. Should he decline to dying before then we will not attempt to prolong his life. However in the interrim we will continue hi flo oxygen as any attempt at weaning will shorten life now. Will also continue tube feeds but allow to eat and drink for pleasurer and not replace tube if becomes removed. Comfort Care Only Goals of care- comfort care plan, allow natural death with no escalation of care -can dc lab draws -do not increase oxygen supplementation past current hi flo setting -can stop telemetry, rapid response -dc scd -allow food and drink for pleasure Patient Expired during this admission and was discharged to morgue.


VAERS ID: 1762271 (history)  
Form: Version 2.0  
Age: 74.0  
Sex: Male  
Location: Minnesota  
Vaccinated:2021-03-17
Onset:2021-09-20
   Days after vaccination:187
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 6/21 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Death, Fall, Haemorrhage, Insomnia
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-20
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown. None identified.
Current Illness: None.
Preexisting Conditions: None. Patient had an operation to removed suspected cancer 2 year previous but was recently given a clean bill of health by the clinic.
Allergies: None.
Diagnostic Lab Data: Unknown. Medical investigator refused to engage.
CDC Split Type:

Write-up: The patient was found dead on 28th September. The deceased seemed to have struggled to stand up and fell onto the floor. There was a great deal of blood. The medical investigator immediately declared this death to be natural causes and refused to file a Vaers report stating that it had been too long (6 months and 2 weeks) and she would only file one up to 6 months; or carry out an autopsy which was requested by the various next of kin who were contacted, stating the body wasn''t ''fresh enough''. Communications suggest the death occurred on 20th of September on the evening that the deceased had attended (and lead) a Meeting.


VAERS ID: 1762703 (history)  
Form: Version 2.0  
Age: 58.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-10-04
Onset:2021-10-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 019F21A / 1 LA / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR UT7319KA / 1 RA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: Cardiac arrest, Death
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (broad), Cardiomyopathy (broad), Respiratory failure (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-04
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: None discussed or known.
Preexisting Conditions: Pt discussed having heart issues and diabetes during administration, as we discussed possibly considering other vaccines such as pneumonia and shingles vaccines in the future. Nothing documented. Pt did not fill maintenance medications at our pharmacy. Was a new patient to us at time of vaccination.
Allergies: None
Diagnostic Lab Data: unknown
CDC Split Type:

Write-up: Pt received vaccines at our pharmacy the morning of 10/4/21. She was monitored for 15 minutes after vaccination and no reactions were noted or observed in the patient waiting time. She left without any known complications. On 10/5/21, the Coroner came to the pharmacy with documents to retrieve medical records for the patient as she had "went into cardiac arrest yesterday and needed these records for the autopsy investigation." After contacting my direct supervisor and he contacted necessary persons to confirm the release of the PHI, we called him back to inform him he could come to pick up records. There was no communication in between the time the patient left the pharmacy without complications from the vaccines and the time the coroner came to pharmacy to retrieve patient records for her death.


VAERS ID: 1762722 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-08-02
Onset:2021-08-28
   Days after vaccination:26
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8833 / 1 - / SYR
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8835 / 2 - / SYR

Administered by: Pharmacy       Purchased by: ?
Symptoms: Dizziness, Dyspnoea
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-30
   Days after onset: 2
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NO
Current Illness: NO
Preexisting Conditions: NO
Allergies: NO
Diagnostic Lab Data: NO
CDC Split Type:

Write-up: Shortness of breath, dizziness and lightheaded


VAERS ID: 1762881 (history)  
Form: Version 2.0  
Age: 46.0  
Sex: Male  
Location: California  
Vaccinated:2021-02-17
Onset:2021-02-20
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-02-20
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: sleep apnea, asthma, hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death within 7 days of receiving vaccine.


VAERS ID: 1762892 (history)  
Form: Version 2.0  
Age: 50.0  
Sex: Male  
Location: California  
Vaccinated:2021-04-09
Onset:2021-04-15
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-15
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Severe obesity, osteomyelitis, recurrent infections, cholecystitis
Allergies: Unknown
Diagnostic Lab Data:
CDC Split Type:

Write-up: None stated.


VAERS ID: 1763088 (history)  
Form: Version 2.0  
Age: 66.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-01-24
Onset:2021-08-26
   Days after vaccination:214
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-27
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Cardiovascular disease, Chronic Renal disease, Cerebrovascular disease
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient is fully vaccinated and later hospitalized and died a day later


VAERS ID: 1763094 (history)  
Form: Version 2.0  
Age: 52.0  
Sex: Female  
Location: California  
Vaccinated:2021-05-12
Onset:2021-05-14
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 021C21A / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-05-14
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: ALCOHOL USE DISORDER, MEDICATION NON-COMPLIANCE, ESRD
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death within 48 hours of vaccine


VAERS ID: 1763098 (history)  
Form: Version 2.0  
Age: 53.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-15
Onset:2021-03-22
   Days after vaccination:7
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-22
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Morbid obesity, OSA, DM2, CKD, renal anasarca
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death within 7 days of vaccine


VAERS ID: 1763101 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-02-01
Onset:2021-06-08
   Days after vaccination:127
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011L20A / UNK - / -

Administered by: Public       Purchased by: ?
Symptoms: COVID-19, Death
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-06-08
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Persistent Atrial Fibrillation, LOWER EXTREMITY EDEMA OPEN WOUND HYPOTENSION
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fully vaccinated and died of Covid related causes.


VAERS ID: 1763115 (history)  
Form: Version 2.0  
Age: 56.0  
Sex: Female  
Location: California  
Vaccinated:2021-04-26
Onset:2021-04-30
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 014C21A / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-30
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: CHR, CKDIII, DM2
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death within 7 days of receiving vaccine


VAERS ID: 1763118 (history)  
Form: Version 2.0  
Age: 93.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-04
Onset:2021-08-15
   Days after vaccination:192
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL9264 / UNK - / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Death
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-15
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fully vaccinated and died due to Covid related causes.


VAERS ID: 1763122 (history)  
Form: Version 2.0  
Age: 62.0  
Sex: Male  
Location: California  
Vaccinated:2021-03-17
Onset:2021-03-19
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 031A21A / 1 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-19
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death within 7 days of vaccination


VAERS ID: 1763701 (history)  
Form: Version 2.0  
Age: 75.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-01-29
Onset:2021-08-11
   Days after vaccination:194
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Death, Exposure to SARS-CoV-2
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-11
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fully vaccinated and died due to Covid related causes. Patient believes was exposed from husband


VAERS ID: 1763702 (history)  
Form: Version 2.0  
Age: 78.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-24
Onset:2021-08-10
   Days after vaccination:167
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3302 / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Death
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-10
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Diabetes, Cardiovascular Disease, Chronic Renal Disease
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient fully vaccinated and died due to Covid related causes


VAERS ID: 1763922 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Death, Vaccination failure, Vaccine breakthrough infection
SMQs:, Lack of efficacy/effect (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Comments: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211000761

Write-up: DEATH; BREAK THROUGH COVID-19 INFECTION; SUSPECTED CLINICAL VACCINATION FAILURE; This spontaneous report received from a patient via a company representative from social media concerned multiple patients. No past medical histories or concurrent conditions were reported. The patients received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown and expiry: Unknown) dose, 1 total, start therapy date were not reported for prophylactic vaccination. The batch numbers were not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On unspecified dates, multiple patient experienced death (14 fully vaccinated patients), breakthrough covid-19 infection (12.2 percent of 3223 covid breakthrough case), and suspected clinical vaccination failure. On 2021, the patient died from unknown cause of death. It was unknown if an autopsy was performed for multiple patient (14 patients). As per the reporter, "The county has reported 3,223 Covid breakthrough cases. Out of those cases, 14 fully vaccinated people have died. Of the county''s fully vaccinated residents, 65.8 percent received the Pfizer vaccine, 26.6 percent got the Moderna vaccine and 8.2 percent got the single-shot Janssen covid-19 vaccine and of the 3,223 county residents with breakthrough Covid cases, 66.7 percent received the Pfizer vaccine, 21.1 percent got the Moderna vaccine and 12.2 percent got Janssen covid-19 vaccine.'''' The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patients died of death on 2021, and the outcomes for multiple patient with breakthrough covid-19 infection and suspected clinical vaccination failure was not reported. This report was serious (Death, and Other Medically Important Condition). Additional information was received from company representative on 30-SEP-2021. It was determined that 20211000794 was a duplicate of this case. All relevant information regarding this case will be submitted under 20211000761.; Sender''s Comments: V0: 20211000761-covid-19 vaccine ad26.cov2.s ?Death, Breakthrough COVID-19 infection. 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). 20211000761-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


VAERS ID: 1763938 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211004088

Write-up: DIED; This spontaneous report received from a consumer via social media via a company representative concerned an elderly female of unspecified age, race and ethnic origin. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received Covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration not reported, batch number: unknown expiry: unknown) dose, start therapy date were not reported, frequency time 1 total administered for prophylactic vaccination. The batch number was not reported. The Company is unable to perform follow-up to request batch/lot numbers. No concomitant medications were reported. On an unspecified date after two weeks of vaccination, the patient died from an unknown cause of death and it was unknown if an autopsy was performed The action taken with Covid-19 vaccine ad26.cov2.s was not applicable. The patient died from unknown cause of death. This report was serious (Death). This case, from the same reporter is linked to 20211004677 and 20211004116.; Sender''s Comments: V0. 20211004088-COVID-19 VACCINE AD26.COV2.S- Died. This event is considered unassessable. The event 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.; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH


VAERS ID: 1763976 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN UNKNOWN / UNK - / -

Administered by: Other       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USJNJFOC20211006389

Write-up: PASSES FROM LIFE TO DEATH; This spontaneous report received from a consumer via social media via a company representative concerned a female of unspecified age, race and ethnicity. The patient''s height, and weight were not reported. No past medical history or concurrent conditions were reported. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: Unknown expiry: Unknown) dose, 1 total, start therapy date were not reported for prophylactic vaccination. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported. On an unspecified date, as per the reporter "my mom passes from life to death from your vaccine". Patient died from unknown cause of death. It was unspecified if an autopsy was performed. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. This report was serious (Death).; Sender''s Comments: V0: 20211006389-covid-19 vaccine ad26.cov2.s -Death. 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).; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH


VAERS ID: 1764092 (history)  
Form: Version 2.0  
Age:   
Sex: Unknown  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Death
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: 1 person died after regular shots; Based on the current case data, this case has been classified as invalid. This spontaneous case was reported by a consumer and describes the occurrence of DEATH (1 person died after regular shots) in a patient of an unknown age and gender who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. No Medical History information was reported. On an unknown date, the patient received dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. Death occurred on an unknown date The cause of death was not reported. It is unknown if an autopsy was performed. No concomitant medications were provided by the reporter. No treatment information details was provided by the reporter. It was reported that one person died after regular shots and reporter thinks it was moderna vaccine but was not sure about it. This case concerns a patient of unknown age and gender with no relevant medical history, who experienced the expected fatal event of Death, with no cause of death provided. The event occurred at an unknown date after a dose of Spikevax (unknown dose). The rechallenge was not applicable due to the fatal outcome. The benefit-risk relationship of Spikevax is not affected by this report. This case was linked to MOD-2021-332581 (Patient Link).; Sender''s Comments: This case concerns a patient of unknown age and gender with no relevant medical history, who experienced the expected fatal event of Death, with no cause of death provided. The event occurred at an unknown date after a dose of Spikevax (unknown dose). The rechallenge was not applicable due to the fatal outcome. The benefit-risk relationship of Spikevax is not affected by this report.; Reported Cause(s) of Death: Unknown cause of death


VAERS ID: 1764194 (history)  
Form: Version 2.0  
Age: 79.0  
Sex: Male  
Location: South Carolina  
Vaccinated:2021-05-11
Onset:2021-07-20
   Days after vaccination:70
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / 1 - / OT

Administered by: Unknown       Purchased by: ?
Symptoms: Cerebrovascular accident, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Ischaemic central nervous system vascular conditions (narrow), Haemorrhagic central nervous system vascular conditions (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-07-20
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: USMODERNATX, INC.MOD20213

Write-up: Swelling and bumps; Double stroke; This spontaneous case was reported by a consumer and describes the occurrence of CEREBROVASCULAR ACCIDENT (Double stroke) in a 79-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 11-May-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 20-Jul-2021, the patient experienced CEREBROVASCULAR ACCIDENT (Double stroke) (seriousness criteria death and medically significant). On an unknown date, the patient experienced SWELLING (Swelling and bumps). The patient died on 20-Jul-2021. The reported cause of death was double stroke. It is unknown if an autopsy was performed. At the time of death, SWELLING (Swelling and bumps) outcome was unknown. Patient passed away after getting Moderna COVID-19 Vaccine. No relevant concomitant medications were reported. No treatment information was reported.; Sender''s Comments: This case concerns a 75 year old male with no relevant medical history who experienced serious unexpected fatal event of CVA approximately 2 months after the first dose of the vaccine. Rechallenge was not applicable. The benefit-risk relationship is not affected by this report.; Reported Cause(s) of Death: Double Stroke


VAERS ID: 1764619 (history)  
Form: Version 2.0  
Age: 65.0  
Sex: Female  
Location: Georgia  
Vaccinated:2021-03-22
Onset:2021-03-24
   Days after vaccination:2
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8730 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Death, SARS-CoV-2 test positive, Septic shock
SMQs:, Toxic-septic shock conditions (narrow), Infective pneumonia (broad), Sepsis (narrow), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-04-07
   Days after onset: 14
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 04/06/2021 PCR+ COVID-19 test at Hospital
CDC Split Type:

Write-up: Hospitalized 3/24/2021 to 4/7/2021. Death 4/7/2021. From Records COD = SEPTIC SHOCK, COVID - 19. place of death: HOSPITAL-INPATIENT; certified by: PRONOUNCING AND CERTIFYING PHYSICIAN; occupation: HOMEMAKER, NONE


VAERS ID: 1764717 (history)  
Form: Version 2.0  
Age: 81.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-02-02
Onset:2021-08-18
   Days after vaccination:197
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3248 / 2 LA / IM

Administered by: Pharmacy       Purchased by: ?
Symptoms: COVID-19, Confusional state, Death, Decreased appetite, SARS-CoV-2 antibody test positive, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-09-03
   Days after onset: 16
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 8 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Alzheimer''s dementia, hypertension, diabetes mellitus type 2, depression, chronic heart failure preserved EF, paroxysmal atrial fibrillation, peripheral vascular disease, coronary artery disease, and chronic anemia.
Allergies:
Diagnostic Lab Data: 08/18/2021 Antigen+ COVID-19 test at Rehab; 08/28/2021 IGG+ COVID-19 t
CDC Split Type:

Write-up: Breakthrough COVID-19 case with symptom onset 8/18/2021: worsening confusion and loss of appetite. Hospitalized 8/26/2021-9/3/2021. Death 9/3/2021. Vital Records data not available yet


VAERS ID: 1764754 (history)  
Form: Version 2.0  
Age: 90.0  
Sex: Male  
Location: Georgia  
Vaccinated:2021-03-10
Onset:2021-08-19
   Days after vaccination:162
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 RA / IM

Administered by: Public       Purchased by: ?
Symptoms: Asthenia, COVID-19, Death, Fall, Fatigue, SARS-CoV-2 antibody test positive, SARS-CoV-2 test positive, Vaccine breakthrough infection
SMQs:, Guillain-Barre syndrome (broad), Accidents and injuries (narrow), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-08-24
   Days after onset: 5
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Patient had a hx of diabetes, hypertension, cardiovascular disease, and prostate cancer
Allergies:
Diagnostic Lab Data: 08/19/2021 PCR+ COVID-19 test at hospital; 08/21/2021 IGG+ COVID-19 test at hospital
CDC Split Type:

Write-up: Breakthrough COVID-19 case with unknown symptom onset date: Fatigue or tiredness and weakness. Patient presented to ED on 08/19/2021 after a fall with weakness and feeling tired. Patient death reported by hospital. Patient was admitted on 08/20/2021 and died on 08/24/2021.


VAERS ID: 1764763 (history)  
Form: Version 2.0  
Age: 77.0  
Sex: Female  
Location: Kentucky  
Vaccinated:2021-01-20
Onset:2021-09-01
   Days after vaccination:224
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL1284 / 1 LA / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 LA / -

Administered by: Senior Living       Purchased by: ?
Symptoms: COVID-19, Death, Malaise, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UTI, COPD, DIABETES MELLITUS, ENCEPHALOPATHY
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: BECAME SYMPTOMATIC AND TESTED POSITIVE FOR COVID19 ON 8/13/21. DIED 9/1/21


VAERS ID: 1764836 (history)  
Form: Version 2.0  
Age: 72.0  
Sex: Male  
Location: Kentucky  
Vaccinated:2021-01-20
Onset:2021-09-07
   Days after vaccination:230
Submitted: 0000-00-00
Entered: 2021-10-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ1284 / 1 LA / -
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL3249 / 2 LA / -

Administered by: Senior Living       Purchased by: ?
Symptoms: COVID-19, Death, Malaise, SARS-CoV-2 test positive
SMQs:, Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-10-06
   Days after onset: 29
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: BECAME SYMPTOMATIC AND TESTED COVID POSITIVE 8/13/21. DIED 9/7/21


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