VAERS ID: |
929359 (history) |
Form: |
Version 2.0 |
Age: |
76.0 |
Sex: |
Male |
Location: |
Florida |
Vaccinated: | 2021-01-06 |
Onset: | 2021-01-06 |
Days after vaccination: | 0 |
Submitted: |
0000-00-00 |
Entered: |
2021-01-08 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EK9231 / 2 |
LA / IM |
Administered by: Senior Living Purchased by: ? Symptoms: Breath sounds abnormal,
Death,
Oxygen saturation decreased SMQs:, Acute central respiratory depression (narrow), Respiratory failure (narrow), Infective pneumonia (broad)
Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2021-01-08
Days after onset: 2
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: none Current Illness: Cerebral Atherosclerosis, malnutrition, thrombocytopenia, cva, hypothyroidism Preexisting Conditions: Cerebral Atherosclerosis, malnutrition, thrombocytopenia, cva, hypothyroidism Allergies: none Diagnostic Lab Data: none CDC Split Type:
Write-up: 3:07 pm lung sounds diminished oxygen sats 68%, oxygen applied Oxygen sats remained low for next 36 hours ( patient on Hospice care ) expired 6:22 am 1-8-21 |