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This is VAERS ID 1165565

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1165565
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-02-25
Onset:2021-03-17
Submitted:0000-00-00
Entered:2021-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP9598 / 1 - / OT

Administered by: Other      Purchased by: ??
Symptoms: Cerebral haemorrhage, International normalised ratio, Unresponsive to stimuli, Computerised tomogram head

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: MAREVAN; DAROB MITE; LESCOL XL
Current Illness: Chronic kidney disease; Dermatosis bullous; Urinary retention
Preexisting Conditions: Medical History/Concurrent Conditions: Cerebral infarction; Spinal cord ischemia
Allergies:
Diagnostic Lab Data: Test Date: 20210317; Test Name: Head CT scan; Result Unstructured Data: Test Result:extensive bleeding; Comments: extensive bleeding in the right basal ganglion area spreading to the right thalamus and mesencephalon to the right, blood penetration into the ventricles, cerebral herniation transterritorially and through the foramen magnum; Test Date: 20210317; Test Name: INR; Result Unstructured Data: Test Result:2.79
CDC 'Split Type': SIPFIZER INC2021341652

Write-up: massive cerebral hemorrhage; unresponsive; This is a spontaneous report from a contactable physician downloaded from the Agency Regulatory Authority-WEB [SI-JAZMP-NCPHV-2021SI0341_0341]. A 78-year-old male patient received bnt162b2 (COMIRNATY, Lot Number: EP9598; Expiration Date: 30Jun2021), intramuscular first dose on 25Feb2021 at single dose for Covid-19 immunization. The patient''s medical history included ongoing Urinary retention, Cerebral infarction (condition after CVI years ago (cerebral infarction left)), ongoing Dermatosis bullous, ongoing Chronic kidney disease, and Spinal cord ischemia (condition after ischemic lesion in the cervical spinal cord). The patient''s concomitant medications includes warfarin sodium (MAREVAN) from 05Jun2007 to 18Mar2021 at 3 mg, sotalol hydrochloride (DAROB MITE) from 10May2007 to 18Mar2021 at 80 mg, and fluvastatin sodium (LESCOL XL) from 15Apr2008 to 18Mar2021 at 80 mg. On 17Mar2021, the patient was found unresponsive on the bathroom floor and experienced massive cerebral hemorrhage. The patient was hospitalized on 17Mar2021. A head CT scan of the head was performed, which showed: extensive bleeding in the right basal ganglion area spreading to the right thalamus and mesencephalon to the right, blood penetration into the ventricles, cerebral herniation transterritorially and through the foramen magnum. The patient was receiving anticoagulant therapy, international normalized ratio was 2.79. The patient died on an unspecified date. It was not reported if an autopsy was performed. Senders comment: Follow up data and assessment of the case are expected in due course. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: massive cerebral hemorrhage; unresponsive

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