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This is VAERS ID 1124195

History of Changes from the VAERS Wayback Machine

First Appeared on 3/26/2021

VAERS ID: 1124195
VAERS Form:2
Age:86.0
Sex:Female
Location:Nebraska
Vaccinated:2021-03-17
Onset:2021-03-17
Submitted:0000-00-00
Entered:2021-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Abdominal pain, Abdominal pain upper, Cardiac arrest, Death, Diarrhoea, Fatigue, Headache, Myalgia, Nausea, Brain injury

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-22
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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen albuterol: 2 puff, INHALATION, QID, PRN (for wheezing) albuterol: 2.5 mg = 3 mL, NEBULIZED, Q6H, PRN (for wheezing) atorvastatin: 1 TAB, By Mouth, QHS calcium-vitamin D: 1 TAB, BY MOUTH, DAILY docusate: 100 mg = 1 CAP, BY
Current Illness: Past medical history of atrial fibrillation on chronic anticoagulation on warfarin, COPD on 2 L O2, pulmonary hypertension, cor pulmonale, hypertension and GERD. She was recently admitted at Medicine from 2/13?2/22 after initially presenting to ER with right-sided chest pain after mechanical fall she suffered on 2/7. She was found to have multiple right-sided rib fractures (#5?9). A chest tube was placed in the ER for right-sided hemothorax, went to IR on 2/14 for coil embolization of the right ninth intercostal artery. She developed right chest wall hematoma. On 2/17 she underwent ORIF of ribs #4 through 9 with plates placed on #5 through 6. She did require intermittent diuresis. Oxygen requirements were stable on discharge on 2 L which is her baseline. Echocardiogram 2/15 showed EF 65% with severe pulmonary hypertension and grade 3 diastolic dysfunction. She was discharged from SNF to home on 3/16 with family/caregiver support with planned transition to assisted living. She presented to the ER via EMS from home on 3/19 with right upper quadrant pain, nausea, and diarrhea. Symptom onset occurred after 1st Pfizer COVID-19 vaccination on 3/17. Patient is an 86-year-old female with past medical history of atrial fibrillation on chronic anticoagulation on warfarin, COPD on 2 L O2, pulmonary hypertension, cor pulmonale, hypertension and GERD. She was recently admitted at Facility from 2/13?2/22 after initially presenting to ER with right-sided chest pain after mechanical fall she suffered on 2/7. She was found to have multiple right-sided rib fractures (#5?9). A chest tube was placed in the ER for right-sided hemothorax, went to IR on 2/14 for coil embolization of the right ninth intercostal artery. She developed right chest wall hematoma. On 2/17 she underwent ORIF of ribs #4 through 9 with plates placed on #5 through 6. She did require intermittent diuresis however was discharged to SNF on her home torsemide dose. Oxygen requirements were stable on discharge on 2 L which is her baseline. Echocardiogram 2/15 showed EF 65% with severe pulmonary hypertension and grade 3 diastolic dysfunction. She was discharged from SNF to home on 3/16 with family/caregiver support with planned transition to ALF. She presented to the ER via EMS from home on 3/19 with right upper quadrant pain, nausea, and diarrhea. Symptom onset occurred after 1st Pfizer COVID-19 vaccination on 3/17. While in the ER she had cardiac arrest x2.
Preexisting Conditions: Bronchial-Asthma-COPD overlap syndrome Chronic atrial fibrillation Chronic cor pulmonale Chronic hypoxemic respiratory failure Chronic UTI (urinary tract infection) GERD (gastroesophageal reflux disease) Glaucoma History of herpes zoster Hypercholesterolemia Hypertension Lumbar radiculopathy Mild mitral regurgitation Osteoporosis Spinal stenosis
Allergies: Opana (Migraine) Avelox (Rash) Cymbalta (Fatigue) Demerol (Nausea) HYDROcodone (Anxiety) Keflex (Rash) Nubain (Hives) Ultracet (Vomiting, Lightheadedness) Zonegran (Unknown) codeine (Chest tightness) penicillins (Shortness of breath)
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Abdominal pain, nausea, diarrhea, headache, muscle aches, and fatigue1-2 days after vaccination prompting transport via EMS to ER from home. Had cardiac arrest while in the ER x2, subsequent anoxic brain injury and death following removal of ventilator support.


Changed on 5/7/2021

VAERS ID: 1124195 Before After
VAERS Form:2
Age:86.0
Sex:Female
Location:Nebraska
Vaccinated:2021-03-17
Onset:2021-03-17
Submitted:0000-00-00
Entered:2021-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Abdominal pain, Abdominal pain upper, Cardiac arrest, Death, Diarrhoea, Fatigue, Headache, Myalgia, Nausea, Brain injury

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-22
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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: acetaminophen albuterol: 2 puff, INHALATION, QID, PRN (for wheezing) albuterol: 2.5 mg = 3 mL, NEBULIZED, Q6H, PRN (for wheezing) atorvastatin: 1 TAB, By Mouth, QHS calcium-vitamin D: 1 TAB, BY MOUTH, DAILY docusate: 100 mg = 1 CAP, BY
Current Illness: Past medical history of atrial fibrillation on chronic anticoagulation on warfarin, COPD on 2 L O2, pulmonary hypertension, cor pulmonale, hypertension and GERD. She was recently admitted at Medicine from 2/13?2/22 after initially presenting to ER with right-sided chest pain after mechanical fall she suffered on 2/7. She was found to have multiple right-sided rib fractures (#5?9). A chest tube was placed in the ER for right-sided hemothorax, went to IR on 2/14 for coil embolization of the right ninth intercostal artery. She developed right chest wall hematoma. On 2/17 she underwent ORIF of ribs #4 through 9 with plates placed on #5 through 6. She did require intermittent diuresis. Oxygen requirements were stable on discharge on 2 L which is her baseline. Echocardiogram 2/15 showed EF 65% with severe pulmonary hypertension and grade 3 diastolic dysfunction. She was discharged from SNF to home on 3/16 with family/caregiver support with planned transition to assisted living. She presented to the ER via EMS from home on 3/19 with right upper quadrant pain, nausea, and diarrhea. Symptom onset occurred after 1st Pfizer COVID-19 vaccination on 3/17. Patient is an 86-year-old female with past medical history of atrial fibrillation on chronic anticoagulation on warfarin, COPD on 2 L O2, pulmonary hypertension, cor pulmonale, hypertension and GERD. She was recently admitted at Facility from 2/13?2/22 after initially presenting to ER with right-sided chest pain after mechanical fall she suffered on 2/7. She was found to have multiple right-sided rib fractures (#5?9). A chest tube was placed in the ER for right-sided hemothorax, went to IR on 2/14 for coil embolization of the right ninth intercostal artery. She developed right chest wall hematoma. On 2/17 she underwent ORIF of ribs #4 through 9 with plates placed on #5 through 6. She did require intermittent diuresis however was discharged to SNF on her home torsemide dose. Oxygen requirements were stable on discharge on 2 L which is her baseline. Echocardiogram 2/15 showed EF 65% with severe pulmonary hypertension and grade 3 diastolic dysfunction. She was discharged from SNF to home on 3/16 with family/caregiver support with planned transition to ALF. She presented to the ER via EMS from home on 3/19 with right upper quadrant pain, nausea, and diarrhea. Symptom onset occurred after 1st Pfizer COVID-19 vaccination on 3/17. While in the ER she had cardiac arrest x2.
Preexisting Conditions: Bronchial-Asthma-COPD overlap syndrome Chronic atrial fibrillation Chronic cor pulmonale Chronic hypoxemic respiratory failure Chronic UTI (urinary tract infection) GERD (gastroesophageal reflux disease) Glaucoma History of herpes zoster Hypercholesterolemia Hypertension Lumbar radiculopathy Mild mitral regurgitation Osteoporosis Spinal stenosis
Allergies: Opana (Migraine) Avelox (Rash) Cymbalta (Fatigue) Demerol (Nausea) HYDROcodone (Anxiety) Keflex (Rash) Nubain (Hives) Ultracet (Vomiting, Lightheadedness) Zonegran (Unknown) codeine (Chest tightness) penicillins (Shortness of breath) breath)
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Abdominal pain, nausea, diarrhea, headache, muscle aches, and fatigue1-2 days after vaccination prompting transport via EMS to ER from home. Had cardiac arrest while in the ER x2, subsequent anoxic brain injury and death following removal of ventilator support.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1124195&WAYBACKHISTORY=ON


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