Adverse Event Reporting
| VAERS ID | 2013593 |
|---|---|
| Gender | Female |
| Age | |
| StateCode | FR |
| Pharmaceutical Company | PFIZER\BIONTECH |
| Lot Number | |
| Number of vaccinations | 2 |
| Vaccinated | 2021-06-01 |
| Onset | 2021-06-01 |
| Condition | Life Threatening Died |
Symptoms
- Dyspepsia
- Arrhythmia
- Resuscitation
- Autopsy
- Cardiac failure acute
Current Illness
Preexisting Conditions
Other Medications
Previous Vaccinations
Allergies
Laboratory Data
Test Name: Autopsy; Result Unstructured Data: Test Result:bellow; Comments: The autopsy report was received 28/Sep/2021, and the death is assumed to have been caused by ACUTE HEART FAILURE due to acute ARRHYTHMIA.
Reference number: 2021-0682.
Write-up
death is thought to be due to acute heart failure due to acute cardiac arrhythmia.
; CPR and eventually advanced CPR were implemented immediately; death is thought to be due to acute heart failure due to acute cardiac arrhythmia.
; The patient complained some about HEARTBURN the first week after dose No.
2.
; This is a spontaneous report received from non-contactable reporter(s) (Consumer or other non HCP, Physician and Other HCP) from the Regulatory Authority.
Regulatory number: NO-NOMAADVRE-PASRAPP-2021-U2zxm1 (Agency).
Other Case identifier(s): NO-NOMAADVRE-E2B_00064943 (Agency).
A 63 year-old female patient received bnt162b2 (COMIRNATY), intramuscular, administered in arm left, administration date Jun2021 (Lot number: Unknown) as dose 2, single for covid-19 immunisation.
The patient's relevant medical history and concomitant medications were not reported.
Vaccination history included: Covid-19 vaccine (1st dose, MANUFACTURER UNKNOWN), for Covid-19 immunisation.
The following information was reported: CARDIAC FAILURE ACUTE (death, medically significant, life threatening) with onset 04Jul2021, outcome "fatal", ARRHYTHMIA (death, medically significant, life threatening) with onset 04Jun2021, outcome "fatal" and all described as "death is thought to be due to acute heart failure due to acute cardiac arrhythmia.
"; DYSPEPSIA (life threatening) with onset Jun2021, outcome "unknown", described as "The patient complained some about HEARTBURN the first week after dose No.
2.
"; RESUSCITATION (medically significant, life threatening) with onset 04Jul2021, outcome "unknown", described as "CPR and eventually advanced CPR were implemented immediately".
The patient underwent the following laboratory tests and procedures: autopsy: bellow, notes: The autopsy report was received 28/Sep/2021, and the death is assumed to have been caused by ACUTE HEART FAILURE due to acute ARRHYTHMIA.
Reference number: 2021-0682.
The patient date of death was 04Jul2021.
The autopsy revealed "acute heart failure" (acute heart failure).
No follow-up attempts are possible; information about lot/batch number cannot be obtained.
No further information is expected.
; Autopsy-determined Cause(s) of Death: ACUTE HEART FAILURE