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This is VAERS ID 993112

History of Changes from the VAERS Wayback Machine

First Appeared on 2/4/2021

VAERS ID: 993112
VAERS Form:2
Age:62.0
Sex:Female
Location:California
Vaccinated:2020-12-01
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / SYR

Administered by: Senior Living      Purchased by: ??
Symptoms: Aphasia, Cardiac arrest, Death, Dependence on respirator, Decreased appetite, SARS-CoV-2 test positive

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-02-01
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: Aspirin ec 81mg, xarelto 20 mg, propranolol 40 mg, Vita-B1 100mg Trazodone 50mg, Clonidine HCL 0.1 mg tablet, Divalproex 80D DR 25mg, CHLORPROMAZINE 10mg, folic acid 1 mg ,Benztropine mes 1mg, cetirizine HCL 10mg, SPIriva 18 MCG CP-handihal
Current Illness: Broken ankle
Preexisting Conditions: Mid intellectual Disabilities, Schizoaffective Disorders, Obesity, Unspecified Heart Disease, Unspecified Hypothyroidism, unspecified Allergic rhinitis
Allergies: PCN,Lactose Intol
Diagnostic Lab Data: Hospital would not share any information at all
CDC 'Split Type':

Write-up: she was injected, sh stopped eating and talking, the doctor watched her for 2 days. had her transported to the hospital. i was told she had tested positive for COVID 2 times once at the home and once at the hospital. with in 2 DAYS at the hospital she wa on a ventilator 2 days later she died. i talked with the rehab center and confirmed she tested negative for COVID on Dec 27th 2020 and was given the Vaccine on the 29th Dec 202 was in the hospital 4 day later, was on a ventilator 4 days after that then died a few day later as her heart stopped beating. all the while i had POA and was not contacted by Hospital staff until after they had made the next step.


Changed on 5/7/2021

VAERS ID: 993112 Before After
VAERS Form:2
Age:62.0
Sex:Female
Location:California
Vaccinated:2020-12-01
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / SYR

Administered by: Senior Living      Purchased by: ??
Symptoms: Aphasia, Cardiac arrest, Death, Dependence on respirator, Decreased appetite, SARS-CoV-2 test positive

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-02-01
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: Aspirin ec 81mg, xarelto 20 mg, propranolol 40 mg, Vita-B1 100mg Trazodone 50mg, Clonidine HCL 0.1 mg tablet, Divalproex 80D DR 25mg, CHLORPROMAZINE 10mg, folic acid 1 mg ,Benztropine mes 1mg, cetirizine HCL 10mg, SPIriva 18 MCG CP-handihal
Current Illness: Broken ankle
Preexisting Conditions: Mid intellectual Disabilities, Schizoaffective Disorders, Obesity, Unspecified Heart Disease, Unspecified Hypothyroidism, unspecified Allergic rhinitis
Allergies: PCN,Lactose Intol Intol
Diagnostic Lab Data: Hospital would not share any information at all
CDC 'Split Type':

Write-up: she was injected, sh stopped eating and talking, the doctor watched her for 2 days. had her transported to the hospital. i was told she had tested positive for COVID 2 times once at the home and once at the hospital. with in 2 DAYS at the hospital she wa on a ventilator 2 days later she died. i talked with the rehab center and confirmed she tested negative for COVID on Dec 27th 2020 and was given the Vaccine on the 29th Dec 202 was in the hospital 4 day later, was on a ventilator 4 days after that then died a few day later as her heart stopped beating. all the while i had POA and was not contacted by Hospital staff until after they had made the next step.


Changed on 5/14/2021

VAERS ID: 993112 Before After
VAERS Form:2
Age:62.0
Sex:Female
Location:California
Vaccinated:2020-12-01
Onset:2021-01-01
Submitted:0000-00-00
Entered:2021-02-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 - / SYR

Administered by: Senior Living      Purchased by: ??
Symptoms: Aphasia, Cardiac arrest, Death, Dependence on respirator, Decreased appetite, SARS-CoV-2 test positive

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2021-02-01
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: Aspirin ec 81mg, xarelto 20 mg, propranolol 40 mg, Vita-B1 100mg Trazodone 50mg, Clonidine HCL 0.1 mg tablet, Divalproex 80D DR 25mg, CHLORPROMAZINE 10mg, folic acid 1 mg ,Benztropine mes 1mg, cetirizine HCL 10mg, SPIriva 18 MCG CP-handihal
Current Illness: Broken ankle
Preexisting Conditions: Mid intellectual Disabilities, Schizoaffective Disorders, Obesity, Unspecified Heart Disease, Unspecified Hypothyroidism, unspecified Allergic rhinitis
Allergies: PCN,Lactose Intol Intol
Diagnostic Lab Data: Hospital would not share any information at all
CDC 'Split Type':

Write-up: she was injected, sh stopped eating and talking, the doctor watched her for 2 days. had her transported to the hospital. i was told she had tested positive for COVID 2 times once at the home and once at the hospital. with in 2 DAYS at the hospital she wa on a ventilator 2 days later she died. i talked with the rehab center and confirmed she tested negative for COVID on Dec 27th 2020 and was given the Vaccine on the 29th Dec 202 was in the hospital 4 day later, was on a ventilator 4 days after that then died a few day later as her heart stopped beating. all the while i had POA and was not contacted by Hospital staff until after they had made the next step.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=993112&WAYBACKHISTORY=ON

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