Adverse Event Reporting

VAERS ID 1075378
Gender Male
Age 35
StateCode KY
Pharmaceutical Company JANSSEN
Lot Number 1805025
Number of vaccinations 1
Vaccinated 2021-03-05
Onset 2021-03-05
Condition Recovered
Symptoms
  • Hyperhidrosis
  • Blood pressure increased
  • Cold sweat
  • Pallor
  • Fall
  • Loss of consciousness
  • Head injury
  • Lip injury

Current Illness

SINUS INFECTION

Preexisting Conditions

HIGH BLOOD PRESSURE

Other Medications

AMOXICILLIN, NORVASC, XYZOL

Previous Vaccinations

Allergies

CECLOR

Laboratory Data

BLOOD PRESSURE, HEART RATE, EYE EXAM

Write-up

PATIENT RECEIVED VACCINATION AND WAS THEN ASKED TO SIT IN LOBBY.
AFTER BEING SEATED PATIENT PASSED OUT AND FELL OUT OF CHAIR, HITTING HIS HEAD AND BITING HIS LIP IN THE PROCESS.
911 WAS CALLED AND EPI PEN WAS RETRIEVED.
PATIENT CAME TO AND WAS PALE, SWEATY, AND HAD CLAMMY HANDS.
PATIENT REPORTED NO DIFFICULTY IN BREATHING OR FEELING OF THROAT SWELLING SO EPI PEN WAS NOT ADMINISTERED.
BP WAS CHECK AND WAS EXTREMELY ELEVATED.
AMBULANCE ARRIVED A FEW MOMENTS LATER AND EMTS ASSESSED PATIENT.
PATIENTS BP HAD RETURNED TO NORMAL RANGE, COLOR WAS IMPROVED AND HE WAS NO LONGER SWEATING.
EMTS ASKED PATIENT IF HE WANTED TO BE TAKEN TO THE ER FOR FURTHER EVALUATION AND PATIENT REFUSED.
PATIENT SAT IN THE PHARMACY FOR A FEW MORE MINUTES AND WAS THEN DRIVEN BACK TO WORK.