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This is VAERS ID 1366129

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1366129
VAERS Form:2
Age:69.0
Sex:Female
Location:Alabama
Vaccinated:2021-02-01
Onset:2021-05-14
Submitted:0000-00-00
Entered:2021-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6200 / 2 UN / IM

Administered by: Other      Purchased by: ??
Symptoms: Cardio-respiratory arrest, Death, Pulmonary embolism, Pulse absent, Respiratory arrest, Resuscitation, Syncope, Autopsy, Tracheal haemorrhage, Endotracheal intubation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-14
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: oxycodone/tylenol 10/325 one TID PRN
Current Illness: lumbar DJD
Preexisting Conditions: lumbar DJD
Allergies: No known drug, food, or environmental allergy
Diagnostic Lab Data: A complete autopsy was performed with results pending. A death certificate has been issued but the listed cause of death is unknown at this time.
CDC 'Split Type':

Write-up: Abrupt syncope with cessation of pulse and respirations at 11:15AM at main office. CPR was started by the workers present. 911 activated and code was activated by EMS and continued during transport and arrival at ER. All resuscitation efforts failed to restore breathing and cardiac activity. A large amount of blood was encountered upon intubation, so Dr. informed next of kin that cause of death was likely a large pulmonary embolus.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1366129&WAYBACKHISTORY=ON

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