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This is VAERS ID 1366598

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1366598
VAERS Form:2
Age:86.0
Sex:Female
Location:Minnesota
Vaccinated:2021-03-24
Onset:2021-05-09
Submitted:0000-00-00
Entered:2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6208 / 2 LA / SYR

Administered by: Private      Purchased by: ??
Symptoms: Death, Haemoglobin decreased, Upper gastrointestinal haemorrhage, Rectal examination, Blood test, Endoscopy gastrointestinal abnormal, Electrocauterisation, Internal haemorrhage, Computerised tomogram intestine, Blood loss anaemia, Intestinal mucosal tear

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-22
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? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Furosemide, acidophilus, allopurinol, ferrous sulfate, latanaprost, levothyroxine, magnesium oxide, multivitamin, potassium chloride. ascorbic acid. B complex, diltiazem, metoprolol succinate, vitamin D-3, warfarin
Current Illness: Congestive heart failure Atrial fibrillation Lymphadema
Preexisting Conditions: Congestive heart failure Atrial fibrillation Previous replacement of aortic valve
Allergies: Erythromycin
Diagnostic Lab Data: 05/12/21 lab (blood) tests hemoglobin 5.6 and rectal exam to determine source of bleeding. CT Scan, Endoscopy resulting in cauterization of tear in lower intestine. Unable to view all tears. Next blood test shows hemoglobin 5.2.
CDC 'Split Type':

Write-up: Onset acute blood loss due to internal bleeding on approximately 05/09/21, upper GI bleeding and anemia. Hemoglobin dropped to 5.2 resulting in death. Hospitalization on 05/12/21 discharged to Hospice Care 05/15/21 loss of life on 05/22/21.

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