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This is VAERS ID 1153762

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1153762
VAERS Form:2
Age:82.0
Sex:Male
Location:Foreign
Vaccinated:2021-03-02
Onset:2021-03-02
Submitted:0000-00-00
Entered:2021-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP9598 / UNK - / OT

Administered by: Other      Purchased by: ??
Symptoms: Blood albumin, Blood bilirubin, Blood creatinine, Bradykinesia, C-reactive protein, Computerised tomogram, Dyspnoea, Echocardiogram, Fall, Haemoglobin, Haemoglobin decreased, Hypotension, Jaundice, Lumbar puncture, Lung disorder, Lymphadenopathy, Metabolic acidosis, Respiratory failure, Thrombocytopenia, Decreased appetite, Renal impairment, Procalcitonin, Stenotrophomonas test positive, Serratia test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-17
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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: LASIX [FUROSEMIDE]; ZYLORIC
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Chronic renal failure; Diabetes mellitus; Hypertension arterial; Hyperuricemia; MGUS; Prostatic hypertrophy (benign) (declared "prostatic hypertrophy")
Allergies:
Diagnostic Lab Data: Test Name: albuminemia; Test Result: 2.1 [iU]; Comments: 2.1 INTERNATIONAL UNIT(S)-(UNDER 100); Test Name: Bilirubin; Test Result: 10.38 [iU]; Comments: 10,38 INTERNATIONAL UNIT(S)-(UNDER 1000); Test Name: creatininemia; Test Result: 6 [iU]; Comments: 6 INTERNATIONAL UNIT(S)-(UNDER 100); Test Name: Whole body CAT; Result Unstructured Data: Test Result:multiple polydistrict lymphadenopathies; Comments: multiple polydistrict lymphadenopathies, right supleural lung lesion of 2 cm ndd, right renal expansion; Test Name: C-reactive protein; Test Result: 150 [iU]; Comments: 150 INTERNATIONAL UNIT(S)-(UNDER 1000); Test Name: Transesophageal echocardiogram; Result Unstructured Data: Test Result:negative; Test Name: Haemoglobin; Test Result: 8.4 [iU]; Comments: 8.4 INTERNATIONAL UNIT(S)-(UNDER 100); Test Name: Spinal tap; Result Unstructured Data: Test Result:Negative; Test Name: Procalcitonin; Test Result: 4.88 [iU]; Comments: 4.88 INTERNATIONAL UNIT(S)-(UNDER 100); Test Name: Serratia test positive; Result Unstructured Data: Test Result:positive; Test Name: Stenotrophomonas test positive; Result Unstructured Data: Test Result:positive; Test Name: Thrombopenia; Test Result: 19000 k[iU]
CDC 'Split Type': ITPFIZER INC2021323049

Write-up: stenotrophomonas test positive; serratia test positive; haemoglobin: 8.4 IU; thrombocytopenia: 19000 kiu; multiple polydistrict lymphadenopathies; right supleural lung lesion; ideomotor slowdown; Dyspnea; loss of appetite appears; worsening jaundice; metabolic acidosis; fell to the ground; worsening of renal function; arterial hypotension; severe respiratory insufficiency; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB, regulatory authority number IT-MINISAL02-701777. A 82-years-old male patient received bnt162b2 (COMIRNATY, Formulation: Solution for injection, Lot Number: EP9598, Expiry date: Unknown) via intramuscularly on 02Mar2021 as single dose for covid-19 immunisation. Medical history included hypertension, hyperuricaemia, diabetes mellitus, benign prostatic hyperplasia declared (prostatic hypertrophy), chronic kidney disease, hypergammaglobulinaemia benign monoclonal. Concomitant medications included Furosemide (LASIX) and Allopurinol (ZYLORIC) taken for an unspecified indication. On 02Mar2021, the patient experienced ideomotor slowdown, dyspnea, loss of appetite appears, worsening jaundice, metabolic acidosis, fell to the ground, worsening of renal function, arterial hypotension and severe respiratory insufficiency. The patient arrived in the Emergency Room in on 07Mar2021 and was hospitalized in the Emergency Room from which he was transferred to the Hospital on 09Mar due to lack of beds. The patient underwent lab tests and procedures which included blood albumin: 2.1 IU (international units) (under 100) , blood bilirubin: 10.38 IU (under 1000), blood creatinine: 6 IU (under 100), computerised tomogram: multiple polydistrict lymphadenopathies, right supleural lung lesion of 2 cm ndd, right renal expansion, c-reactive protein: 150 IU (under 1000), echocardiogram: negative, haemoglobin: 8.4 IU (under 100), lumbar puncture: negative, procalcitonin: 4.88 IU (under 100), serratia test positive: positive, stenotrophomonas test positive: positive, thrombocytopenia: 19000 kiu. Therapeutic measures were taken with tracheal intubation and mechanical intubation, antibiotic therapy, vasopressors, CVVH (renal replacement therapy). The patient died on 17Mar2021. It was not reported if an autopsy was performed. The outcome of the event was fatal.; Reporter''s Comments: Initial information dated 18Mar2021: - concomitant use of other products: ''no'';; Reported Cause(s) of Death: Unknown cause of death

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