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This is VAERS ID 1304080

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First Appeared on 7/2/2021

VAERS ID: 1304080
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-03-13
Onset:2021-03-15
Submitted:0000-00-00
Entered:2021-05-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER7812 / 2 - / OT

Administered by: Other      Purchased by: ??
Symptoms: Abdominal distension, Atrial fibrillation, Body temperature, Cardiac failure congestive, Cholangitis, Complications of transplanted kidney, Confusional state, Dyspnoea, Jaundice, Malaise, Oedema peripheral, Oxygen saturation, Oxygen saturation decreased, Physical examination, Pulmonary oedema, Pyrexia, Respiratory failure, Sepsis, Ocular icterus, Multiple organ dysfunction syndrome, SARS-CoV-2 test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-24
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Ankylosing spondylitis (on treatment with adalimumab); Chronic kidney disease; Cognitive impairment (oriented as dementia); Dementia; Ex-smoker; Hypertension; Hypertensive retinopathy (grade II-III); Hyperuricemia; Kidney failure; Kidney graft dysfunction (requiring hemodialysis); Kidney transplant (Cadaveric donor kidney transplant with suboptimal graft function and kidney failure.); Major depression (with ideas of autolysis); Physical impairment (oriented as dementia)
Allergies:
Diagnostic Lab Data: Test Date: 20210315; Test Name: temperature; Result Unstructured Data: Test Result:37.5 Centigrade; Comments: low-grade fever; Test Date: 20210315; Test Name: saturation; Test Result: 86 %; Test Date: 20210315; Test Name: palpation; Result Unstructured Data: Test Result:with crackles at the bases and a distended and tym; Comments: with crackles at the bases and a distended and tympanic abdomen that was not painful; Test Date: 20210209; Test Name: Ag SARS.CoV2 test; Test Result: Negative ; Test Date: 20210324; Test Name: SARS.CoV2 PCR; Test Result: Negative
CDC 'Split Type': ESPFIZER INC2021491362

Write-up: sepsis due to probable cholangitis; sepsis due to probable cholangitis; decompensated congestive heart failure (CHF); atrial fibrillation with rapid ventricular response; hyperactive confusional syndrome; multiple organ failure; Acute pulmonary oedema/acute lung edema with respiratory failure; Acute pulmonary oedema/acute lung edema with respiratory failure; deterioration in graft function/Cadaveric donor kidney transplant with suboptimal graft function; saturation of 86%; dyspnea; conjunctival jaundice; distended and tympanic abdomen; mild skin jaundice; malaise; edema in both LES (lower extremities); low-grade fever (37.5C); This is as spontaneous report received from a contactable physician downloaded from the Agency Regulatory Authority-WEB. The regulatory authority report number is ES-AEMPS-845123. A 67-year-old male patient received bnt162b2 (COMIRNATY, solution for injection), on 20Feb2021 (Lot: EM0477) as 1 st dose, single and on 13Mar2021 (Lot: ER7812) as 2 nd dose, 0.3 mL, single; both intramuscular for covid-19 immunisation. Medical history included hypertension; hypertensive retinopathy (grade II-III); ankylopoietic spondylitis (on treatment with adalimumab); hyperuricemia; major depression (with ideas of autolysis); former smoker; chronic kidney disease in 2004; kidney transplant (Cadaveric donor kidney transplant with suboptimal graft function and kidney failure.) on 27Nov2018; cognitive and functional impairment (oriented as dementia); dementia; kidney failure and suboptimal graft function (requiring hemodialysis). No known allergies. The patient''s concomitant medications were not reported. The patient previously took bleomycin, dacarbazine, doxorubicin hydrochloride, vinblastine sulfate (ABVD) and experienced dependent (institutionalized). Rapid Ag SARS.CoV2 test on 09Feb2021 was negative. On 15Mar2021 (two days after receiving the second dose), she presented conjunctival jaundice and mild skin jaundice, malaise, dyspnea, and edema in both lower extremities (LES). At 24 hours (on 15Mar2021), he presented a low-grade fever (37.5C), increased dyspnea, circulation and saturation of 86%, with crackles at the bases and a distended and tympanic abdomen that was not painful on palpation. He was admitted with sepsis due to probable cholangitis, which triggered decompensated congestive heart failure (CHF) refractory to diuretic treatment and acute lung edema with respiratory failure. He also presented deterioration in graft function, requiring hemodialysis, atrial fibrillation with rapid ventricular response, and hyperactive confusional syndrome. SARS.CoV2 PCR 24Mar2021 was negative. Despite the treatment instituted, no clinical or analytical improvement was observed, triggering multiple organ failure. The outcome of the event dyspnoea was not recovered while for sepsis, cholangitis, cardiac failure congestive, atrial fibrillation, confusional state, ocular icterus, jaundice, malaise, oedema peripheral, pyrexia, oxygen saturation decreased and abdominal distention was unknown. Given the baseline situation of the patient, comfort measures were prioritized, with death on 24Mar2021. The patient died due multiple organ failure and acute pulmonary oedema/acute lung edema with respiratory failure on 24Mar2021. It was unknown if an autopsy was performed. Main Diagnosis was acute respiratory failure due to acute pulmonary edema. Other diagnostics decompensated heart failure refractory to diuretic treatment; Sepsis due to probable acute obstructive cholangitis; deterioration of kidney graft function; atrial fibrillation with rapid ventricular response; Hyperactive confusional syndrome and cognitive impairment. No follow-up attempts are possible. No further information is expected.; Reported Cause(s) of Death: Acute pulmonary oedema/acute lung edema with respiratory failure; Acute pulmonary oedema/acute lung edema with respiratory failure; Multiple organ failure

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