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This is VAERS ID 1369811

History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1369811
VAERS Form:2
Age:54.0
Sex:Male
Location:Ohio
Vaccinated:2021-04-30
Onset:2021-05-01
Submitted:0000-00-00
Entered:2021-06-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0172 / 2 AR / SYR

Administered by: Private      Purchased by: ??
Symptoms: Arrhythmia, Arteriosclerosis, Condition aggravated, Hypertensive heart disease, Unresponsive to stimuli, Autopsy, Cardiac disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-01
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? No
Previous Vaccinations:
Other Medications: None.
Current Illness: None.
Preexisting Conditions: Patient was not aware of the fact that he had Hypertensive Atherosclerotic Cardiovascular Disease.
Allergies: None.
Diagnostic Lab Data: An Autopsy was performed. Awaiting the detailed results, however enough information was obtained to document a cause on the death certificate.
CDC 'Split Type':

Write-up: Patient went swimming at a fitness center the day after he had his 2nd COVID-19 vaccine and was found unresponsive at the bottom of the shallow 4.5 deep pool while exercising. He was not able to be revived. The death certificate says that the immediate cause of death was Arrhythmia resulting from Hypertensive Atherosclerotic Cardiovascular Disease.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1369811&WAYBACKHISTORY=ON

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