Adverse Event Reporting
| VAERS ID | 1902018 |
|---|---|
| Gender | Male |
| Age | 88 |
| StateCode | IL |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | EW0170 |
| Number of vaccinations | 2 |
| Vaccinated | 2021-06-02 |
| Onset | 2021-11-22 |
| Condition | Hospitalized Died |
Symptoms
- Confusional state
- Pyrexia
- Intensive care
- Mental status changes
- SARS-CoV-2 test positive
- Blood glucose decreased
- COVID-19
- Ventricular tachycardia
- Exposure to SARS-CoV-2
- Death
- Hypoxia
Current Illness
Preexisting Conditions
Acute on chronic renal insufficiency DM type 2 (diabetes mellitus, type 2) Essential hypertension Pacemaker PAF (paroxysmal atrial fibrillation) SSS (sick sinus syndrome)
Other Medications
acetaminophen, 650 mg= 2 TAB, PO, Q4H (Every 4 hours), PRN amLODIPine, 2.5 mg= 1 TAB, PO, Daily aspirin, 81 mg= 1 TAB, PO, Daily atorvastatin, 80 mg= 2 TAB, PO, QHS (At bedtime) cholecalciferol, 1000 Inter_Units= 1 TAB, PO, Daily clopi
Previous Vaccinations
Allergies
fleet phospho soda
Laboratory Data
11/12/21 Sars COV2 RAPID positive
Write-up
[ 89-year-old with past history coronary disease congestive heart failure diabetes pacemaker presents to for altered mental status.
Patient was be confused this morning at his nursing blood glucose was checked was 50 so was given dextrose.
Also noted be hypoxic.
Apparently patient did have a COVID exposure recently had a fever yesterday however is COVID test was pending.
At time of evaluation patient is now alert still little confused is A&O x2.
No chest pain, abdominal pain vomiting or diarrhea.
Of no, EMS found him to be in V-tach at 1 point during transport.
This seems to have converted spontaneously.
] Patient hospitalized in ICU from 11/12/21 through 11/22/2021 Patient expired on 11/22/2021