Adverse Event Reporting
| VAERS ID | 1168221 |
|---|---|
| Gender | Female |
| Age | 78 |
| StateCode | IL |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | EL3246 |
| Number of vaccinations | 2 |
| Vaccinated | 2021-01-27 |
| Onset | 2021-03-17 |
| Condition | Died |
Symptoms
- Hypertension
- Tachycardia
- Tachypnoea
- Respiratory distress
- Acute respiratory failure
- Septic shock
- Pneumonia aspiration
Current Illness
Preexisting Conditions
Other Medications
Current Outpatient Medications: ? acetaminophen (TYLENOL) 325 MG tablet, Take 650 mg by mouth every 4 hours as needed for Pain, Disp: , Rfl: ? amLODIPine (NORVASC) 5 MG tablet, Take 5 mg by mouth daily, Disp: , Rfl: ? ARIPiprazole (AB
Previous Vaccinations
Allergies
Allergen Reactions ? Lurasidone Other/Unknown (See Comments) ? Other Other/Unknown (See Comments) Nicotine patch ? Prednisone Other/Unknown (See Comments)
Laboratory Data
Write-up
ER HPI: 78 y.
o.
female who presents with respiratory distress.
Patient is transported to the emergency room via emergency medical services from local long-term care facility.
Patient is unable to give any history due to acuity and severity of current condition.
On arrival to the emergency room patient is in obvious distress she is hypertensive with a blood pressure of 74/51 she is tachycardic with a rate of about 140 she is tachypneic with a rate of the 29th at 30 her oxygen saturation on a non-rebreather are 82% and her temperature is 102.
9°.
FINAL IMPRESSION ICD-10-CM ICD-9-CM 1.
Septic shock (HCC) A41.
9 038.
9 R65.
21 785.
52 995.
92 2.
Aspiration pneumonia of right lower lobe due to gastric secretions (HCC) J69.
0 507.
0 3.
Acute hypoxemic respiratory failure (HCC) J96.
01 518.
81