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This is VAERS ID 1247180

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1247180
VAERS Form:2
Age:50.0
Sex:Female
Location:Maryland
Vaccinated:2021-03-17
Onset:2021-04-04
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038A21A / 1 UN / SYR

Administered by: Public      Purchased by: ??
Symptoms: Sudden death, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-04
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: Opiramate 50 mg/day, Escitalopram oxolate 30 mg/day, Bupropion HCL ER 300 mg/day, Alprazolam 0.25 mg as needed (2x/day)
Current Illness: none (had foot surgery -- bunionectomy -- 2 days prior to vaccine administration)
Preexisting Conditions: none (though overweight)
Allergies: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient passed away suddenly and unexpectedly at home the morning of April 4, 2021. The ER doctor was unable to ascertain a cause. The preliminary autopsy conducted by the medical examiner within 24 hours of death was inconclusive, but I''m told tests of samples are ongoing.


Changed on 5/7/2021

VAERS ID: 1247180 Before After
VAERS Form:2
Age:50.0
Sex:Female
Location:Maryland
Vaccinated:2021-03-17
Onset:2021-04-04
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038A21A / 1 UN / SYR

Administered by: Public      Purchased by: ??
Symptoms: Sudden death, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-04
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: Opiramate 50 mg/day, Escitalopram oxolate 30 mg/day, Bupropion HCL ER 300 mg/day, Alprazolam 0.25 mg as needed (2x/day)
Current Illness: none (had foot surgery -- bunionectomy -- 2 days prior to vaccine administration)
Preexisting Conditions: none (though overweight)
Allergies: none none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient passed away suddenly and unexpectedly at home the morning of April 4, 2021. The ER doctor was unable to ascertain a cause. The preliminary autopsy conducted by the medical examiner within 24 hours of death was inconclusive, but I''m told tests of samples are ongoing.


Changed on 5/14/2021

VAERS ID: 1247180 Before After
VAERS Form:2
Age:50.0
Sex:Female
Location:Maryland
Vaccinated:2021-03-17
Onset:2021-04-04
Submitted:0000-00-00
Entered:2021-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 038A21A / 1 UN / SYR

Administered by: Public      Purchased by: ??
Symptoms: Sudden death, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-04-04
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: Opiramate 50 mg/day, Escitalopram oxolate 30 mg/day, Bupropion HCL ER 300 mg/day, Alprazolam 0.25 mg as needed (2x/day)
Current Illness: none (had foot surgery -- bunionectomy -- 2 days prior to vaccine administration)
Preexisting Conditions: none (though overweight)
Allergies: none none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient passed away suddenly and unexpectedly at home the morning of April 4, 2021. The ER doctor was unable to ascertain a cause. The preliminary autopsy conducted by the medical examiner within 24 hours of death was inconclusive, but I''m told tests of samples are ongoing.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1247180&WAYBACKHISTORY=ON


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