National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 1230008

Government Disclaimer on use of this data

History of Changes from the VAERS Wayback Machine

First Appeared on 4/23/2021

VAERS ID: 1230008
VAERS Form:2
Age:73.0
Sex:Female
Location:Alabama
Vaccinated:2021-03-10
Onset:2021-04-16
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Angiogram pulmonary normal, Cardio-respiratory arrest, Chest pain, Death, Fibrin D dimer increased, Resuscitation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-16
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: No known allergies
Diagnostic Lab Data: D-Dimer on arrival to the ER was critically elevated. 2130 with our normal range being 0-400. Chest CTA negative for PE. Patient was being transferred to a Medical Center by helicopter. Five minutes after takeoff, the helicopter turned around and came back with patient coding. She had been talking and suddenly stopped. Attempts at resuscitation were not successful. The patient expired on 4/16/21.
CDC 'Split Type':

Write-up: Patient presented to ER on 4/16/21 complaining of chest pain. Patient stated she had the J&J vaccine a month ago and had been having problems. She was also being seen by a cardiologist.


Changed on 5/7/2021

VAERS ID: 1230008 Before After
VAERS Form:2
Age:73.0
Sex:Female
Location:Alabama
Vaccinated:2021-03-10
Onset:2021-04-16
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Angiogram pulmonary normal, Cardio-respiratory arrest, Chest pain, Death, Fibrin D dimer increased, Resuscitation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-16
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: No known allergies allergies
Diagnostic Lab Data: D-Dimer on arrival to the ER was critically elevated. 2130 with our normal range being 0-400. Chest CTA negative for PE. Patient was being transferred to a Medical Center by helicopter. Five minutes after takeoff, the helicopter turned around and came back with patient coding. She had been talking and suddenly stopped. Attempts at resuscitation were not successful. The patient expired on 4/16/21.
CDC 'Split Type':

Write-up: Patient presented to ER on 4/16/21 complaining of chest pain. Patient stated she had the J&J vaccine a month ago and had been having problems. She was also being seen by a cardiologist.


Changed on 5/14/2021

VAERS ID: 1230008 Before After
VAERS Form:2
Age:73.0
Sex:Female
Location:Alabama
Vaccinated:2021-03-10
Onset:2021-04-16
Submitted:0000-00-00
Entered:2021-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / UNK RA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Angiogram pulmonary normal, Cardio-respiratory arrest, Chest pain, Death, Fibrin D dimer increased, Resuscitation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-16
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies: No known allergies allergies
Diagnostic Lab Data: D-Dimer on arrival to the ER was critically elevated. 2130 with our normal range being 0-400. Chest CTA negative for PE. Patient was being transferred to a Medical Center by helicopter. Five minutes after takeoff, the helicopter turned around and came back with patient coding. She had been talking and suddenly stopped. Attempts at resuscitation were not successful. The patient expired on 4/16/21.
CDC 'Split Type':

Write-up: Patient presented to ER on 4/16/21 complaining of chest pain. Patient stated she had the J&J vaccine a month ago and had been having problems. She was also being seen by a cardiologist.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1230008&WAYBACKHISTORY=ON


Copyright © 2021 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166