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This is VAERS ID 1211776

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1211776
VAERS Form:2
Age:83.0
Sex:Male
Location:Foreign
Vaccinated:2021-03-26
Onset:2021-03-26
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER9470 / 1 RA / OT

Administered by: Other      Purchased by: ??
Symptoms: Blood glucose, Electrocardiogram, Loss of consciousness, Blood pressure measurement, Hypotensive crisis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-26
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? No
Previous Vaccinations:
Other Medications: LOSARTAN POTASICO HIDROCLOROTIAZIDA; PANTOPRAZOLE; AVODART; MADOPAR; TAMSULOSIN HYDROCHLORIDE; TRITTICO
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Barrett''s esophagus; Benign prostatic hypertrophy; Bladder cancer; Cognitive deterioration; Extrapyramidal syndrome; Hypertension arterial
Allergies:
Diagnostic Lab Data: Test Date: 20210326; Test Name: blood sugar; Test Result: 115 mg/dl; Test Date: 20210326; Test Name: Electrocardiogram; Result Unstructured Data: Test Result:no pathological abnormalities; Test Date: 20210326; Test Name: blood pressure; Result Unstructured Data: Test Result:improvement; Comments: after 1 hour
CDC 'Split Type': ITPFIZER INC2021380399

Write-up: Loss of consciousness 30 minutes after the vaccine with severe hypotensive crisis; Loss of consciousness 30 minutes after the vaccine with severe hypotensive crisis; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority-WEB IT-MINISAL02-707250. An 83-year-old male patient received the first dose of bnt162b2 (COMIRNATY, lot number: ER9470; expiration date: 31Jul2021), intramuscular, administered in arm right on 26Mar2021 15:07 as single dose (at the age of 83-years-old) for covid-19 immunisation. Medical history included cognitive deterioration, bladder cancer, barrett''s oesophagus, extrapyramidal syndrome, benign prostatic hypertrophy and hypertension arterial; all from an unknown date and unknown if ongoing. Concomitant medications included hydrochlorothiazide, losartan potassium (LOSARTAN POTASICO HIDROCLOROTIAZIDA); pantoprazole; dutasteride (AVODART); benserazide hydrochloride, levodopa (MADOPAR); tamsulosin hydrochloride; trazodone hydrochloride (TRITTICO); all were taken for an unspecified indication, start and stop date were not reported. On 26Mar2021, the patient experienced loss of consciousness 30 minutes after the vaccine with severe hypotensive crisis. The patient underwent lab tests and procedures which included blood sugar: 115 mg/dl and electrocardiogram (ECG): no pathological abnormalities both on 26Mar2021. The patient was treated with physiological solution, adrenaline, betamethasone and emergency 118 intervention. After about 1 hour, the patient returned to being alert with improvement in blood pressure. The patient was stable until 10:00 PM, time of death. The patient died on 26Mar2021. Cause of death were loss of consciousness and severe hypotensive crisis. The outcome of the events was fatal. It was unknown if an autopsy was performed. Sender Comment: The Patient is a resident in a nursing home. Clinical report will follow. Update of 30Mar2021: the clinical report drawn up by the reporting doctor and the 118 intervention report are attached. It should be noted that the doctor, informed by the emergency medical service who has ascertained the death of the case, has notified the carabinieri; a post-mortem swab was requested by the Public Prosecutor''s Office. Update 01Apr2021: the autopsy examination will be performed on 02Apr2021 on the request of the Prosecutor''s Office. No follow-up attempts are needed. No further information is expected.; Reported Cause(s) of Death: Loss of consciousness 30 minutes after the vaccine with severe hypotensive crisis; Loss of consciousness 30 minutes after the vaccine with severe hypotensive crisis

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