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This is VAERS ID 1775727

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First Appeared on 10/15/2021

VAERS ID: 1775727
VAERS Form:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Pharmacy      Purchased by: ??
Symptoms: Angiogram pulmonary, Arteriogram carotid, Carotid arterial embolus, Cerebrovascular accident, Echocardiogram, Pulmonary embolism, Pulse absent, Subclavian artery embolism, Thrombectomy, Ultrasound Doppler, Deep vein thrombosis, Angiogram cerebral, Computerised tomogram thorax, Computerised tomogram abdomen, Scan with contrast, Perfusion brain scan, Magnetic resonance imaging head

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Lisinopril 10mg qday, HCTZ 25mg qday, naproxen 500mg PRN
Current Illness: L fibular fracture about 3 weeks prior to presentation to ED
Preexisting Conditions: HTN
Allergies: shellfish
Diagnostic Lab Data: CTA head/neck. CT perfusion. CTA chest. BLE dopplers. MRI brain. Echo. CT C/A/P w/ contrast.
CDC 'Split Type':

Write-up: Development of DVT w/ massive saddle pulmonary emboli requiring mechanical thrombectomy. R carotid artery emboli as well as R subclavian emboli w/ pulseless arm also requiring mechanical thrombectomies. Multiple showering CVAs/strokes.

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