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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1197638



Case Details

VAERS ID: 1197638 (history)  
Form: Version 2.0  
Age: 38.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-03-13
Onset:2021-03-19
   Days after vaccination:6
Submitted: 0000-00-00
Entered: 2021-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN - / 1 - / IM

Administered by: Public       Purchased by: ?
Symptoms: Abdominal pain, Blood fibrinogen decreased, Blood lactic acid, Disseminated intravascular coagulation, Fibrin D dimer, Intensive care, Laparotomy, Mesenteric artery thrombosis, Platelet count decreased, Small intestinal resection, Small intestine gangrene, Thrombocytopenia
SMQs:, Liver-related coagulation and bleeding disturbances (narrow), Acute pancreatitis (broad), Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Systemic lupus erythematosus (broad), Retroperitoneal fibrosis (broad), Embolic and thrombotic events, arterial (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 23 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: morbid obesity, alcohol use.
Preexisting Conditions: morbid obesity
Allergies: nkda
Diagnostic Lab Data: Platelets 20000 on 3/20/21. Lactate 13.9 on 3/20/21. fibrinogen 127 on 3/20/21. D-Dimer 10.10 on 3/20/21.
CDC Split Type:

Write-up: Patient presented with acute abdominal pain, DIC , thrombocytopenia and found have small bowel gangrene due to SMA thrombosis. Underwent Laparotomy with small bowel resection. Was in the ICU and currently on TPN and IV antibiotics.


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Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1197638

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