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This is VAERS ID 1257204

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/30/2021

VAERS ID: 1257204
VAERS Form:2
Age:39.0
Sex:Female
Location:Missouri
Vaccinated:2021-03-03
Onset:2021-03-23
Submitted:0000-00-00
Entered:2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Cardiac arrest, Death, Gait disturbance, Pain, Pulmonary embolism, Resuscitation, Peripheral embolism, Transfusion, Internal haemorrhage, Multiple organ dysfunction syndrome

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-03-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Birth Control pills
Current Illness:
Preexisting Conditions: obesity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient began experiencing pain and difficulty walking on Tuesday, March 23. Later that afternoon she was taken to an Urgent care, who sent her to the ER for evaluation. She was diagnosed with a very large blood clot in her leg, spanning from just above the knee to her groin area. They admitted her and began treating her with blood thinners. While undergoing that treatment, her heart stopped 3 times and she had to be resuscitated. They discovered a pulmonary embolism. While removing a large clot from her lungs, the doctor found that her lungs were riddled with hundreds of tiny blood clots. They also said that she was bleeding internally, very heavily, from an unknown location. In all, they gave her 20 units of blood, and none of it stayed in her veins. The doctor said it seemed to just disintegrate. At that point, her brain and organs had begun shutting down and family made the decision to remove her from life support. She passed away Thursday evening, March 25, 2021.


Changed on 5/7/2021

VAERS ID: 1257204 Before After
VAERS Form:2
Age:39.0
Sex:Female
Location:Missouri
Vaccinated:2021-03-03
Onset:2021-03-23
Submitted:0000-00-00
Entered:2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Cardiac arrest, Death, Gait disturbance, Pain, Pulmonary embolism, Resuscitation, Peripheral embolism, Transfusion, Internal haemorrhage, Multiple organ dysfunction syndrome

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-03-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Birth Control pills
Current Illness:
Preexisting Conditions: obesity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient began experiencing pain and difficulty walking on Tuesday, March 23. Later that afternoon she was taken to an Urgent care, who sent her to the ER for evaluation. She was diagnosed with a very large blood clot in her leg, spanning from just above the knee to her groin area. They admitted her and began treating her with blood thinners. While undergoing that treatment, her heart stopped 3 times and she had to be resuscitated. They discovered a pulmonary embolism. While removing a large clot from her lungs, the doctor found that her lungs were riddled with hundreds of tiny blood clots. They also said that she was bleeding internally, very heavily, from an unknown location. In all, they gave her 20 units of blood, and none of it stayed in her veins. The doctor said it seemed to just disintegrate. At that point, her brain and organs had begun shutting down and family made the decision to remove her from life support. She passed away Thursday evening, March 25, 2021.


Changed on 5/21/2021

VAERS ID: 1257204 Before After
VAERS Form:2
Age:39.0
Sex:Female
Location:Missouri
Vaccinated:2021-03-03
Onset:2021-03-23
Submitted:0000-00-00
Entered:2021-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 011A21A / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Cardiac arrest, Death, Gait disturbance, Pain, Pulmonary embolism, Resuscitation, Peripheral embolism, Transfusion, Internal haemorrhage, Multiple organ dysfunction syndrome

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-03-25
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Birth Control pills
Current Illness:
Preexisting Conditions: obesity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient began experiencing pain and difficulty walking on Tuesday, March 23. Later that afternoon she was taken to an Urgent care, who sent her to the ER for evaluation. She was diagnosed with a very large blood clot in her leg, spanning from just above the knee to her groin area. They admitted her and began treating her with blood thinners. While undergoing that treatment, her heart stopped 3 times and she had to be resuscitated. They discovered a pulmonary embolism. While removing a large clot from her lungs, the doctor found that her lungs were riddled with hundreds of tiny blood clots. They also said that she was bleeding internally, very heavily, from an unknown location. In all, they gave her 20 units of blood, and none of it stayed in her veins. The doctor said it seemed to just disintegrate. At that point, her brain and organs had begun shutting down and family made the decision to remove her from life support. She passed away Thursday evening, March 25, 2021.

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