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This is VAERS ID 1375561

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First Appeared on 7/9/2021

VAERS ID: 1375561
VAERS Form:2
Age:
Sex:Male
Location:Foreign
Vaccinated:2021-03-11
Onset:2021-03-01
Submitted:0000-00-00
Entered:2021-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ET1831 / 2 - / OT

Administered by: Other      Purchased by: ??
Symptoms: Blood gases, Blood glucose, Computerised tomogram, Dehydration, Dysarthria, Dyspnoea, Electrocardiogram, Fibrin D dimer, Heart rate, Hyperchromic anaemia, Hypernatraemia, Hypokalaemia, Inflammation scan, Oxygen saturation, Platelet count, Red blood cell count, Respiratory failure, Respiratory rate, Supraventricular extrasystoles, Thrombocytopenia, Cardiopulmonary failure, Computerised tomogram thorax, Renal function test, Blood test, Coma scale, Vital signs measurement, Blood pressure measurement, SARS-CoV-2 test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-03-25
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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications: ACIDUM FOLICUM; FURON [FUROSEMIDE]; SPIOLTO RESPIMAT; NOLPAZA; SORBIFER DURULES [ASCORBIC ACID;FERROUS SULFATE]; CARVEDILOL; URSOSAN; CALTRATE [CALCIUM CARBONATE]
Current Illness: Hypoacusis
Preexisting Conditions: Medical History/Concurrent Conditions: Arterial hypertension; Atherosclerosis; Chronic heart failure (Left ventricular ejection fraction increased (45-50%)); Chronic kidney disease (stage G2); Chronic obstructive pulmonary disease (GOLD III-IV/C, hospitalisation in Aug2020 for COPD exacerbation); Cirrhosis liver (exotoxic etiology); COVID-19; Encephalopathy (etyltoxic); Femur fracture (Femur pertrochanteric and subtrochanteric fracture); Haemorrhoidectomy; Immobilisation syndrome; Ischemic heart disease; Living in residential institution; Polyneuropathy (etyltoxic); Therapeutic embolisation (hospitalisation for COPD exacerbation, pulmonary arterial embolisation); Thrombosis mesenteric vein; Thrombosis portal vein
Allergies:
Diagnostic Lab Data: Test Date: 202103; Test Name: ABG (arterial blood gas test); Result Unstructured Data: Test Result:hypoxemic-hypercapnic respiratory insufficiency; Test Date: 202103; Test Name: glycemia; Result Unstructured Data: Test Result:6.8 mmol/L; Comments: During the transport; Test Date: 202103; Test Name: Blood pressure; Result Unstructured Data: Test Result:140/80 mmHg; Comments: During the transport; Test Date: 202103; Test Name: Blood pressure; Result Unstructured Data: Test Result:140/75 mmHg; Comments: During the transport; Test Date: 202103; Test Name: markers for cardiac failure; Result Unstructured Data: Test Result:slightly increased; Test Date: 202103; Test Name: Glasgow Coma Scale; Result Unstructured Data: Test Result:15; Comments: During the transport; Test Date: 202103; Test Name: CT scan of brain; Result Unstructured Data: Test Result:small ischaemic loci of older date; Comments: result of small ischaemic loci of older date without other pathologic signs; Test Date: 202103; Test Name: CT pulmonary angiogram; Result Unstructured Data: Test Result:without signs of pulmonary embolism and inflammato; Comments: without signs of pulmonary embolism and inflammatory process; Test Date: 202103; Test Name: ECG; Result Unstructured Data: Test Result:with SVES (supraventricular extrasystoles); Comments: without ischemic signs; Test Date: 202103; Test Name: D-dimer; Result Unstructured Data: Test Result:increased; Test Date: 202103; Test Name: Heart rate; Result Unstructured Data: Test Result:76/81/min; Comments: During the transport; Test Date: 202103; Test Name: inflammatory parameters; Result Unstructured Data: Test Result:increased; Test Date: 202103; Test Name: oxygen saturation; Test Result: 91 %; Comments: During the transport; Test Date: 202103; Test Name: oxygen saturation; Test Result: 96 %; Comments: During the transport; Test Date: 202103; Test Name: oxygen saturation; Test Result: 98 %; Comments: During the transport; Test Date: 202103; Test Name: platelet count; Result Unstructured Data: Test Result:thrombocytopenia (light stage); Test Date: 202103; Test Name: RBC; Result Unstructured Data: Test Result:macrocytic hyperchromic anaemia (light stage); Test Date: 202103; Test Name: renal laboratory parameters; Result Unstructured Data: Test Result:worsened during the hospitalisation; Comments: it was found dehydratation, hyperosmolar hypernatraemia, hypokalaemia mild stage; Test Date: 202103; Test Name: respiratory rate; Result Unstructured Data: Test Result:28-24/min; Comments: During the transport; Test Date: 20210316; Test Name: COVID-19 PCR test; Test Result: Negative ; Test Date: 20210318; Test Name: COVID-19 PCR test; Test Result: Negative ; Test Date: 20210325; Test Name: vital signs; Result Unstructured Data: Test Result:without vital signs
CDC 'Split Type': SKPFIZER INC2021617897

Write-up: Breathing difficult / after 2nd dose of vaccine it had worsened / aggravated difficulty breathing; Cardio-respiratory failure; SVES; macrocytic hyperchromic anaemia (light stage); thrombocytopenia (light stage); dehydratation; hyperosmolar hypernatraemia; hypokalaemia mild stage; hypoxemic hypercapnic respiratory insufficiency; dysarthria; This is a spontaneous report from a contactable consumer and contactable physician downloaded from a regulatory authority- WEB (Regulatory Authority number SK-SUKLSK-20213025). An 81 years old male patient received the second single dose of BNT162B2 (COMIRNATY) intramuscular, on 11Mar2021 (lot ET1831), for COVID-19 immunisation. Medical history included chronic obstructive pulmonary disease (GOLD III-IV/C), arterial hypertension, chronic heart failure (left ventricular ejection fraction increased (45-50%)), thrombosis mesenteric superior vein, thrombosis portal vein, cirrhosis liver (exotoxic etiology), femur pertrochanteric and subtrochanteric fracture, immobilisation syndrome, atherosclerosis, chronic kidney disease (stage G2), polyneuropathy (etyltoxic), encephalopathy (etyltoxic), haemorrhoidectomy in 2014, COVID-19 in Apr2020, hospitalisation in Aug2020 for chronic obstructive pulmonary disease exacerbation, pulmonary arterial embolization, ongoing hypoacusis. The patient received the first dose of Comirnaty on 11Feb2021 (Batch / Lot number: EJ6790) and experienced dyspnoea, oedema of lower limbs and coughing grey sputum. Concomitant medications included acidum folicum orally, 1 DF, 1x/day 1-0-0, furosemide (FURON; 40 mg) orally, 1.5 DF 1-1/2-0, olodaterol hydrochloride, tiotropium bromide monohydrate (SPIOLTO RESPIMAT; 2.5 ug + 2.5 ug) 2 DF, 2-0-0, pantoprazole sodium sesquihydrate (NOLPAZA; 40 mg) orally, 1 DF, 1-0-0, ascorbic acid, ferrous sulfate (SORBIFER DURULES) orally, 1 DF, 1x/day, 1-0-0, carvedilol (12.5 mg) orally, 1/2-0-1/4, ursodeoxycholic acid (URSOSAN; 250 mg) orally, 2 DF, 0-0-2 and calcium carbonate (CALTRATE; 600 mg) orally, 1 DF, 1x/day, 0-1-0. The patient lived in social service home, where he reported difficulty breathing since an unspecified date in Mar2021. The patient had problems with breathing in the last 22 years, but after 2nd dose of vaccine it had worsened. For about 3 days he felt aggravated difficulty breathing and could not walk more than 4,5 m because of dyspnoea due to which emergency service was needed and the patient was hospitalised from 16Mar2021 to 25Mar2021. During the transport the following investigations were performed: blood pressure: 140/80 mmHg, 140/75 mmHg, heart rate: 76/81 min, respiratory rate: 28-24/min, oxygen saturation: 91, 96, 98%, glycemia 6.8 mmol/l, GCS (Glasgow Coma Scale) 15. Corrective treatment was administered during the transport including intravenous aminophylline (SYNTOPHYLLIN) 40 mg and intravenous furosemide 2 x20 mg. During the admission to the hospital, the physician reported difficulty communication with the patient because of hypoacusis. The patient had no other difficulties (as pain on chest, cough, heart throbbing, body temperature, pain, faint). The patient was cardio-pulmonary decompensated (signs of anasarca), hypoxemic with a spastic breathing. ECG with SVES (supraventricular extrasystoles), without ischemic signs. Laboratory tests: inflammatory parameters increased (not specified), markers for cardiac failure (slightly increased), macrocytic hyperchromic anaemia (light stage), thrombocytopenia (light stage). Because of dyspnoea and increased D-dimer it was made CT pulmonary angiogram without signs of pulmonary embolism and inflammatory process. Because of dysarthria, it was performed CT scan of brain with the result of small ischaemic loci of older date without other pathologic signs. During the hospitalisation the renal laboratory parameters were worsened, it was found dehydratation, hyperosmolar hypernatraemia, hypokalaemia mild stage, ABG (arterial blood gas test) test with hypoxemic hypercapnic respiratory insufficiency. COVID-19 PCR test was negative on 16Mar2021 and on 18Mar2021. On 19Mar2021 the patient was transferred in another department and the treatment was continued. Despite of the treatment, the patient condition was unfavorable, he was found by the healthcare staff without vital signs and on 25Mar2021 at 08 30 a.m. he was pronounced dead. Cardio-respiratory failure was reported with a fatal outcome. Breathing difficult had not resolved at the time of patient death. The other events outcome was unknown. Reporter comment: Cardio-respiratory failure was considered as the immediate cause of death by the physician. The patologist assessed the causality as not related to vaccination (unlikely). The physician recommended an autopsy (but it was unknown if it was performed or not). Sender Comment: The causality was verified by the patologist and was assessed as not related (unlikely). No follow-up attempts are possible. No further information is expected.; Reporter''s Comments: Cardio-respiratory failure was considered as the immediate cause of death by the physician. The patologist assessed the causality as not related to vaccination (unlikely).; Sender''s Comments: Linked Report(s) : SK-PFIZER INC-2021621163 same patient/vaccine, different dose/events; Reported Cause(s) of Death: Cardio-respiratory failure

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