| Days after vaccination:||7
|Vaccination / Manufacturer
||Lot / Dose
||Site / Route|
|COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH
||EL6205 / 2
||RA / SYR
Administered by: Military Purchased by: ?
Symptoms: Abdominal pain upper,
Multiple organ dysfunction syndrome,
SMQs:, Rhabdomyolysis/myopathy (broad), Acute renal failure (narrow), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (broad), Torsade de pointes, shock-associated conditions (broad), Hypovolaemic shock conditions (broad), Toxic-septic shock conditions (broad), Anaphylactic/anaphylactoid shock conditions (broad), Hypoglycaemic and neurogenic shock conditions (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Chronic kidney disease (narrow), Noninfectious diarrhoea (narrow), Tumour lysis syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Sepsis (broad)
Life Threatening? No
Birth Defect? No
Date died: 2021-03-23
Days after onset: 8
Permanent Disability? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 7 days
Extended hospital stay? No
Other Medications: Diabetic insulin, Water pills to thin blood, Stool softeners, Breathing treatments twice a day,
Current Illness: A weakening of the heart was being looked into, Blood thinners to help his blood not clot and make it easier for his heart.
Preexisting Conditions: COPD and Diabetic. Past heart bypass surgery. Weakening of the heart.
Allergies: None known
Diagnostic Lab Data: Multiple organ failure. Weaking of lungs and heart. Kidney failure.
CDC Split Type:
Write-up: Fever and diarrhea following a couple days after the vaccine Being administered. The day prior to hospital emergency admission uncontrollable throwing up extreme side/Stomach/chest pain. Was taken by ambulance to emergency.