| VAERS ID: |
970976 (history) |
| Form: |
Version 2.0 |
| Age: |
95.0 |
| Sex: |
Female |
| Location: |
Connecticut |
| Vaccinated: | 2021-01-20 |
| Onset: | 2021-01-20 |
| Days after vaccination: | 0 |
| Submitted: |
0000-00-00 |
| Entered: |
2021-01-25 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EL8982 / 1 |
LA / IM |
Administered by: Senior Living Purchased by: ? Symptoms: Death,
Dyspnoea,
Hypotension,
Lethargy,
Oxygen saturation decreased,
Rales,
Tachycardia,
Unresponsive to stimuli SMQs:, Anaphylactic reaction (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Respiratory failure (broad), Hypoglycaemia (broad), Infective pneumonia (broad), Dehydration (broad), Hypokalaemia (broad)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-01-21
Days after onset: 1
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: VEntolin inhaler, Ursodial, Protonix, MVI, Mirtazapine, Lasix, Coumadin Current Illness: Admitted from home to hospital on 1/5 for pancreatitis, Chocystitis, GI bleed. HAd a biliary stent placed. TEsted positive for Covid 19 on 1/7/21. Transferred from hospital to a covid recovery Short term facility and transferred to this facility on 1/18/21 for long term care. She was admitted on comfort measures due to prior decline Preexisting Conditions: as above. Allergies: NKA Diagnostic Lab Data: n/a CDC Split Type:
Write-up: At approximately 12:15 pm the resident had a brief unresponsive episode that resolved quickly. Her Vital signs were stable and her mentation was at baseline. Later that evening approximately 10 pm she had labored respirations, shortness of breath, lethargy with bilateral crackles, Oxygen desaturated to 76% on room air, tachycardia and hypotension. She expired at 6:30 a.m. the following day. |