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This is VAERS ID 1241518

History of Changes from the VAERS Wayback Machine

First Appeared on 7/2/2021

VAERS ID: 1241518
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2020-05-20
Onset:2021-01-28
Submitted:0000-00-00
Entered:2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EJ6795 / 1 - / OT
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / OT

Administered by: Other      Purchased by: ??
Symptoms: Computerised tomogram, Platelet count, Vomiting, Cerebellar haematoma

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-02-19
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: CORDARONE; RISPERDAL; PARACETAMOL
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: AFib (complete atrial fibrillation arrhythmia); Dementia NOS; Hypertension arterial; Joint pain; Rectal neoplasm NOS (rectal tumor leading to a stop of DOAs and switch to LMWH)
Allergies:
Diagnostic Lab Data: Test Date: 20210129; Test Name: CT scan; Result Unstructured Data: Test Result:found a large acute cerebellar hematoma; Comments: found a large acute cerebellar hematoma Secondary to the fall? spontaneous?; Test Date: 20210129; Test Name: platelets; Result Unstructured Data: Test Result:282000
CDC 'Split Type': FRPFIZER INC2021420705

Write-up: Cerebellar haematoma; food vomiting; This is a spontaneous report from a contactable pharmacist downloaded from the Medicines Agency (MA) FR-AFSSAPS-PA20210456 and received via Regulatory Authority . An 87-year-old male patient received first dose of BNT162B2 (Pfizer vaccine, Lot: EJ6795) via intramuscular on 12Jan2021 at single dose for COVID-19 immunisation, enoxaparin sodium (LOVENOX) via subdermal from 20May2020 to 29Jan2021 at 0.4 mL, 1x/day for Anticoagulant therapy. Medical history included Dementia NOS, AFib (complete atrial fibrillation arrhythmia), Rectal neoplasm NOS (rectal tumor leading to a stop of DOAs (direct oral anticoagulant) and switch to LMWH (low molecular weight heparin)), Hypertension arterial, joint pain. Concomitant medications included amiodarone hydrochloride (Cordarone) since at least Mar2019, risperidone (RISPERDAL) since at least Mar2019, paracetamol if joint pain. The patient experienced cerebellar haematoma on 29Jan2021 and food vomiting on 28Jan2021. Patient was died on 19Feb2021 due to cerebellar haematoma. It was reported that during the night of January 28th to 29th: the patient was found on the ground around 1:45 am with phasic expression disorders +/- comprehension and major balance disorders. Cerebral CT scan of 29Jan2021 found a large acute cerebellar hematoma. "Secondary to the fall? spontaneous?" LMWH (low molecular weight heparin) stop, platelets 282,000 on 29Jan2021. Recusal in major neurology surgery, the patient died on 19Feb2021. Request made to the notifier to have the complete biological assessment and in particular the renal assessment and dosage of anti Xa activity. Action taken for enoxaparin sodium was permanently withdrawn on 29Jan2021. The patient died on 19Feb2021. Outcome of food vomiting was unknown. It was unknown if autopsy was performed. No follow-up attempts possible. No further information expected.; Reported Cause(s) of Death: Large cerebellar hematoma

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