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This is VAERS ID 1084203

History of Changes from the VAERS Wayback Machine

First Appeared on 3/11/2021

VAERS ID: 1084203
VAERS Form:2
Age:65.0
Sex:Male
Location:Alabama
Vaccinated:2021-02-24
Onset:2021-03-08
Submitted:0000-00-00
Entered:2021-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNK / UNK UN / IM

Administered by: Private      Purchased by: ??
Symptoms: Apnoeic attack, Dyspnoea, Heart rate irregular, Heart rate normal, Pulse absent, Resuscitation, Mechanical ventilation, Endotracheal intubation

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-03-08
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: Cardiac Arrest
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies: NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt was visiting dr for routine checkup. Pt began to experience difficulty breathing, 911 called. I showed up to pt apneic, pulseless. CPR initiated. Return of spontaneous circulation in ambulance (without Rx). Pt intubated, ventilations continued throughout contact. Pt still had spontaneous pulse upon delivery ti ED, placed on vent in our presence. Pt later transported to Level 1 hospital on vent.


Changed on 5/7/2021

VAERS ID: 1084203 Before After
VAERS Form:2
Age:65.0
Sex:Male
Location:Alabama
Vaccinated:2021-02-24
Onset:2021-03-08
Submitted:0000-00-00
Entered:2021-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNK / UNK UN / IM

Administered by: Private      Purchased by: ??
Symptoms: Apnoeic attack, Dyspnoea, Heart rate irregular, Heart rate normal, Pulse absent, Resuscitation, Mechanical ventilation, Endotracheal intubation

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-03-08
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: Cardiac Arrest
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies: NKDA NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt was visiting dr for routine checkup. Pt began to experience difficulty breathing, 911 called. I showed up to pt apneic, pulseless. CPR initiated. Return of spontaneous circulation in ambulance (without Rx). Pt intubated, ventilations continued throughout contact. Pt still had spontaneous pulse upon delivery ti ED, placed on vent in our presence. Pt later transported to Level 1 hospital on vent.


Changed on 5/14/2021

VAERS ID: 1084203 Before After
VAERS Form:2
Age:65.0
Sex:Male
Location:Alabama
Vaccinated:2021-02-24
Onset:2021-03-08
Submitted:0000-00-00
Entered:2021-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH UNK / UNK UN / IM

Administered by: Private      Purchased by: ??
Symptoms: Apnoeic attack, Dyspnoea, Heart rate irregular, Heart rate normal, Pulse absent, Resuscitation, Mechanical ventilation, Endotracheal intubation

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-03-08
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations: Cardiac Arrest
Other Medications: unk
Current Illness: unk
Preexisting Conditions: unk
Allergies: NKDA NKDA
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pt was visiting dr for routine checkup. Pt began to experience difficulty breathing, 911 called. I showed up to pt apneic, pulseless. CPR initiated. Return of spontaneous circulation in ambulance (without Rx). Pt intubated, ventilations continued throughout contact. Pt still had spontaneous pulse upon delivery ti ED, placed on vent in our presence. Pt later transported to Level 1 hospital on vent.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1084203&WAYBACKHISTORY=ON

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