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From the 1/7/2022 release of VAERS data:

This is VAERS ID 1339906

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Case Details

VAERS ID: 1339906 (history)  
Form: Version 2.0  
Age: 86.0  
Sex: Female  
Location: Foreign  
Vaccinated:2021-03-09
Onset:2021-03-14
   Days after vaccination:5
Submitted: 0000-00-00
Entered: 2021-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EP2166 / 2 - / -

Administered by: Other       Purchased by: ?
Symptoms: Echocardiogram, Electrocardiogram, Pulmonary embolism
SMQs:, Embolic and thrombotic events, venous (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2021-03-15
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Test Name: Targeted heart / VCI emergency ultrasound; Result Unstructured Data: Test Result:strong suspicion of obstructive shock due to massi; Comments: emergency ultrasound heart / VCI: wide right system, D-shape septum, McCullen sign +, empty left ventricle with moderate LVF, VCI wide, does not collapse. No pericardial fluid. Conclusion: clear signs of legal burden with positive mc cullen sign, strong suspicion of obstructive shock due to massive pulmonary embolism.; Test Name: ECG; Result Unstructured Data: Test Result:80; Comments: SR 80/min
CDC Split Type: NLPFIZER INC2021544894

Write-up: massive pulmonary embolism; This is a spontaneous report from a contactable physician downloaded from the Regulatory Authority NL-LRB-00535901. An 86-year-old female patient received second dose bnt162b2 (COMIRNATY), via an unspecified route of administration on 09Mar2021 (Batch/Lot Number: EP2166) at single dose for COVID-19 immunisation. The patient medical history and concomitant medications were not reported. The patient received first dose bnt162b2 (COMIRNATY), via an unspecified route of administration on 02Feb2021 at single dose for COVID-19 immunisation and experienced no adverse event. The patient experienced massive pulmonary embolism on 14Mar2021. Targeted heart / vci emergency ultrasound (ER): wide right system, D-shape septum, Mc cullen sign +, empty left ventricle with moderate Left ventricular failure (LVF), VCI wide, does not collapse. No pericardial fluid. Conclusion: clear signs of legal tax with positive mc cullen sign, strong suspicion of obstructive shock due to massive pulmonary embolism. Electrocardiogram (ECG): SR 80 / min, normal cardiac axis, normal conductances, minimum segment (ST) depressions in I, V5-V6, no segment (ST) elevations, normal T-waves. After one-time filling (started from ambulance) no improvement, hemodynamics. With clear signs of legal tax on targeted emergency ultrasound with high suspicion of obstructive shock pulmonary embolism now no longer filled (due to worsening of circulatory situation in case of obstruction of the right system). Considering that it is too unstable for Computed tomography (CT) hemodynamically, consult IC about yes / no thrombolysis given deep shock and clear desire not to resuscitate want to become. Decided after assessment by intensivis. The patient did not have previous COVID-19 infection. The patient died on 15Mar2021 due to lung embolism. It was not reported if an autopsy was performed. No follow-up attempts possible. No further information expected. ; Reported Cause(s) of Death: massive pulmonary embolism


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