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This is VAERS ID 982929

History of Changes from the VAERS Wayback Machine

First Appeared on 1/29/2021

VAERS ID: 982929
VAERS Form:2
Age:61.0
Sex:Female
Location:Maryland
Vaccinated:2020-12-30
Onset:2021-01-27
Submitted:0000-00-00
Entered:2021-01-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 1 AR / IM

Administered by: Work      Purchased by: ??
Symptoms: Cardiac arrest, Condition aggravated, Death, Diverticulitis, Unresponsive to stimuli

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2021-01-27
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: Cetirizine 10 mg, Haloperidol 5 mg, Sertraline 50 mg, Albuterol HFA 90 mcg (PRN), Diphenhydran 25 mg (PRN), Fluticasone 50cg PRN, Lactulose 10 gm/15 (PRN), Polyeth Glycol 17 gm (PRN), Neomycin/Polymyxin drop, Amoxicillan 500 mg, Methyldredn
Current Illness: Ongoing Sinus and ear infections being treated by PCP
Preexisting Conditions: COPD, Hypothyrodism, non-alcoholic fatty liver, diabetes type 2, hypertension, diverticulitis
Allergies: Quetiapine, Zyprexa
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Client was being treated with antibiotics by her PCP for diverticulitis flare up. It had not been resolved on the date of her death which occurred 01/27/21, She was found unresponsive by staff, 911 contacted, and paramedics pronounced her deceased at 7:48 AM. After consultation with PCP manner of death was noted as cardiac arrest. PCP was to sign off on death certificate.

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