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This is VAERS ID 1339302

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History of Changes from the VAERS Wayback Machine

First Appeared on 7/9/2021

VAERS ID: 1339302
VAERS Form:2
Age:
Sex:Female
Location:Foreign
Vaccinated:2021-05-08
Onset:2021-05-09
Submitted:0000-00-00
Entered:2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH FA 5831 / 2 - / -

Administered by: Other      Purchased by: ??
Symptoms: Blood bicarbonate, Blood creatinine, Blood gases, Blood lactic acid, Body temperature, Electrocardiogram, Hyperpyrexia, Hypotension, Nausea, Oxygen saturation, PCO2, PO2, Computerised tomogram head, Sopor, pH body fluid, Blood pressure measurement

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-05-10
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: DOPAMINE; SYMBICORT; EMAGEL; CARDICOR; PLASIL [METOCLOPRAMIDE]; TRITTICO; LASIX [FUROSEMIDE]; OXYGENE LIQUID AIR LIQUID MEDICAL; CRESTOR; MYCOSTATIN; LANTUS; XARELTO; NOVORAPID; LANSOPRAZOLE; PERFALGAN
Current Illness:
Preexisting Conditions: Medical History/Concurrent Conditions: Acute renal failure (the patient was hospitalized for acute renal failure on chronic dehydration; creatinine 4.1 all); Bradycardia-tachycardia syndrome; Candida of mouth; Chronic obstructive bronchopneumopathy; Decompensation cardiac; Dehydration; Dyslipidaemia; Hospitalization; Hypertensive heart disease; Insomnia; Permanent atrial fibrillation; Type 2 diabetes mellitus
Allergies:
Diagnostic Lab Data: Test Name: HCO3; Result Unstructured Data: Test Result:25 mmol/L; Test Name: creatinine; Result Unstructured Data: Test Result:4.1; Test Date: 20210510; Test Name: Blood gases; Result Unstructured Data: Test Result:unknown results; Test Name: lactates; Result Unstructured Data: Test Result:7.7; Test Date: 20210509; Test Name: blood pressure; Result Unstructured Data: Test Result:90/50 mmHg; Test Date: 20210509; Test Name: blood pressure; Result Unstructured Data: Test Result:65/45 mmHg; Test Date: 20210509; Test Name: blood pressure; Result Unstructured Data: Test Result:100/60 mmHg; Test Date: 20210510; Test Name: blood pressure; Result Unstructured Data: Test Result:90/50 mmHg; Test Date: 20210510; Test Name: blood pressure; Result Unstructured Data: Test Result:80/40 mmHg; Comments: at 6:40; Test Date: 20210509; Test Name: body temperature; Result Unstructured Data: Test Result:38.7 Centigrade; Test Date: 20210509; Test Name: body temperature; Result Unstructured Data: Test Result:37.5 Centigrade; Test Date: 20210510; Test Name: body temperature; Result Unstructured Data: Test Result:37.8 Centigrade; Test Date: 20210510; Test Name: brain computed tomography; Result Unstructured Data: Test Result:negative for acute events; Test Date: 20210510; Test Name: electrocardiography; Result Unstructured Data: Test Result:unknown results; Test Name: saturation; Test Result: 90 %; Test Name: pCO2; Result Unstructured Data: Test Result:32 mmHg; Test Name: ph; Result Unstructured Data: Test Result:7.47; Test Name: pO2; Result Unstructured Data: Test Result:52 mmHg
CDC 'Split Type': ITPFIZER INC2021560645

Write-up: Sopor; Hyperpyrexia; Nausea; Hypotension; This is a spontaneous report received from a contactable physician downloaded from a regulatory authority-WEB. The regulatory authority report number is IT-MINISAL02-728650. A 90-year-old female patient received second dose of BNT162B2 (COMIRNATY), via an unspecified route of administration on 08May2021 19:20 (lot number FA 5831) at single dose for COVID-19 immunization. Medical history included Decompensation cardiac, Type 2 diabetes mellitus, the patient was hospitalized for acute renal failure on chronic dehydration; creatinine 4.1 all, Permanent atrial fibrillation, Bradycardia-tachycardia syndrome, Chronic obstructive bronchopneumopathy, Hypertensive heart disease, Insomnia, Dyslipidaemia, Candida of mouth. Concomitant medications included dopamine, budesonide, formoterol fumarate (SYMBICORT) for Chronic obstructive bronchopneumopathy, polygeline (EMAGEL), bisoprolol fumarate (CARDICOR) for Hypertensive heart disease, metoclopramide (PLASIL), trazodone hydrochloride (TRITTICO) from 08May2021 to 09May2021 for Insomnia, furosemide (LASIX), oxygen (OXYGENE LIQUID AIR LIQUID MEDICAL), rosuvastatin calcium (CRESTOR) for Dyslipidaemia, nystatin (MYCOSTATIN) for Candida of mouth, insulin glargine (LANTUS) for Diabetes mellitus non-insulin-dependent, rivaroxaban (XARELTO) from 03May2021 to 09May2021 for Permanent atrial fibrillation, insulin aspart (NOVORAPID) for Diabetes mellitus non-insulin-dependent, lansoprazole, paracetamol (PERFALGAN). Historical Vaccine included first dose of Comirnaty on 16Apr2021 for COVID-19 immunization. The patient experienced Hyperpyrexia with nausea from 18:00 on 09May2021, subsequent hypotension: Temperature 38.7 Centigrade arterial tension 90/50 mmHg; after 1 vial Perfalgan Temperature 37.5 Centigrade arterial tension 65/45 mmHg; after 1 vial iv of Emagel arterial tension 100/60 mmHg; at 00:15 of 10May2021 sopor patient with blood pressure 90/50 mmHg, electrocardiography, blood gas analysis performed and oxygen therapy started; 1:24 hours marbled, not awakened, brain computed tomography performed (negative for acute events), Central venous catheter positioned for infusions, pumped Lasix and Dopamine; 6:40 blood pressure 80/40 mmHg body temperature 37.8 Centigrade, repositioned ice locally. Died at 7:50. It was unknown if autopsy was done. Measures Taken: Prescribed and administered: Perfalgan 1 vial intravenous, Emagel 1 vial intravenous, Plasil 1 vial in saline. 100 ml intravenous, Dopamina 1 vial in saline. 45cc in syringe pump at 1.8cc / hour then increased to 2cc / h, oxygen therapy 35% 8 liters / min, Lasix 250ml in syringe pump at 0.5cc / hour. Blood gas analysis result: pH 7.47; pCO2 32 mmHg; pO2 52 mmHg; HCO3 25 mmol / L; lactates 7.7; sO2 90%. The outcome of the events were fatal.; Reported Cause(s) of Death: Hyperpyrexia; Nausea; Hypotension; Sopor

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