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This is VAERS ID 1632692

History of Changes from the VAERS Wayback Machine

First Appeared on 8/27/2021

VAERS ID: 1632692
VAERS Form:2
Age:92.0
Sex:Male
Location:Kentucky
Vaccinated:2021-01-02
Onset:2021-07-13
Submitted:0000-00-00
Entered:2021-08-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EL8982 / 2 LA / IM

Administered by: Pharmacy      Purchased by: ??
Symptoms: Colonoscopy, Death, Gastrointestinal haemorrhage, General physical health deterioration, Polypectomy, COVID-19, SARS-CoV-2 test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-07-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? Yes
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: acetaminophen (TYLENOL) 325 MG tablet Take 650 mg by mouth Every 6 (Six) Hours As Needed for Mild Pain amiodarone (PACERONE) 200 MG tablet Take 200 mg by mouth Daily. aspirin 81 MG chewable tablet Chew 81 mg Daily. baclofen (LIORESAL) 1
Current Illness: No acute illness known
Preexisting Conditions: Dementia
Allergies: NKDA
Diagnostic Lab Data: 7/19 Respiratory viral panel COVID 19+
CDC 'Split Type':

Write-up: Patient is a resident of a SNF - found to be COVID 19 + 6 days prior to admission on 7/19. Pt reported to have minimal symptoms - on O2, but unknown if this is baseline. Patient admitted with GI Bleed; underwent colonoscopy and removal of a oozing polyp. Patient tolerated procedure well, but continued to decline in terms of mentation during hospitalization including the use of sedative medications and restraints. On 7/25 patient and family decided to proceed with comfort/palliative care. Patient passed on 7/26. Although patient was COVID positive, there is no indication that his death was directly due to COVID.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1632692&WAYBACKHISTORY=ON

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