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VAERS ID: 1505250

AGE: 13| SEX: F|State: MD

Description

patient arrived in ventricular tachycardia via EMS, but responsive. deteoriarated to pulseless ventricular tachycardia, PEA and ultimately death.

Symptoms

Blood glucose increased, SARS-CoV-2 test negative, Death, Ventricular tachycardia, Full blood count, Metabolic function test normal, Pulseless electrical activity

Vaccines

VAX DATE: 30 June 2021 | ONSET DATE: 26 July 2021 | DAYS TO ONSET: 26
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • UNK

RECVDATE:26 July 2021
CAGE_YR:13
CAGE_MO:
RPT_DATE:
DIED:Y
DATEDIED:26 July 2021
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:N
LAB_DATA:CBC, CMP normal except slightly elevated glucose COVID PCR negative
V_ADMINBY:PVT
OTHER_MEDS:one dose of dramamine given in the evening prior to arrival.
CUR_ILL:none
HISTORY:none, remote history of asthma
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:2
TODAYS_DATE:26 July 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:none
V_FUNDBY:
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