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This is VAERS ID 1759418

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First Appeared on 10/8/2021

VAERS ID: 1759418
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown      Purchased by: ??
Symptoms: Death, Intensive care, Respiratory failure, COVID-19, SARS-CoV-2 test positive, Positive airway pressure therapy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-10-02
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: Aspirin, lipitor, calcium carbonate, Zyrtec, temovate, vitamin B12, Avodart, Ferocon, Flonase, Neurontin, Zestril, Glucophage, Aleve, Saw Palmetto, Flomax, ultram, kenalog cream.
Current Illness:
Preexisting Conditions: Chronic back pain, HTN, DM2, extracranial carotid artery stenosis, arthritis, hyperlipidemia, B12 deficiency, cerebral thrombosis with cerebral infarction, vitiligo, obstructive pattern present on pulmonary function testing, aortic extasia (abdominal), monoclonal gammopathy of unknown significance, spinal stenosis, neuropathy, anemia, history of cerebrovascular accident, benign prostatic hyperplasia.
Allergies: "Seasonal allergies"
Diagnostic Lab Data: COVID positive swab on 09/19/21.
CDC 'Split Type':

Write-up: Fully COVID vaccinated patient who admitted through emergency department with COVID positive test on 09/19/21. Patients respiratory status continued to decline, he required CCU admission high flow oxygen, and subsquently BiPAP. Medical team reviewed ongoing respiratory decline and grave status with patient and family who declined intubation. Patient moved to comfort care and died on 10/02/21.

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