VAERS ID: 1002636

AGE: 90| SEX: F|STATE: WA (United States)

Description

On 1/17/2021 patient woke and began her day as usual, was found down by family member 1 hour later conscious but unable to speak and unable to move her R side. She was admitted to the hospital - Initial NIHSS was 26 and CT imaging showed no acute hemorrhage but mild hypodensity of greater than 1/3 of the MCA territory (TPA not recommended). CTA did show distal L M1/M2 occulsion and she was transferred to larger facility for thrombectomy. Unfortunately the patient had persistent severe neurological deficits after thrombectomy. Was discharged home on hospice care and expired on 1/23/21.

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Symptoms

Movement disorder, Aphasia, Nervous system disorder, Fall, Death, Computerised tomogram head, Computerised tomogram abnormal, Angiogram, Thrombectomy, Angiogram cerebral abnormal, Cerebral artery occlusion, NIH stroke scale score increased

Vaccines

VAX DATE: 12-28-2020| ONSET DATE: 01-17-2021| DAYS TO ONSET: 20
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 1 COVID19 MODERNA 025J20A IM LA

RECVDATE:02-04-2021
RPT_DATE:
CAGE_YR:90
CAGE_MO:
DIED:Y
DATEDIED:01-23-2021
L_THREAT:Y
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:3
X_STAY:U
DISABLE:Y
RECOVD:N
LAB_DATA:CT 1/17/21 (no acute hemorrhage but mild hypodensity of greater than 1/3 of the MCA territory) and CT Angiogram on 1/17/21 ( distal L M1/M2 occulsion).
V_ADMINBY:OTH
OTHER_MEDS:ASA 81 mg, allopurinol, potassium chloride, furosemide, diltiazem, metoprolol, tiotropium, albuterol, diclofenac gel topical
CUR_ILL:None - had exposure to COVID19 + case on 12/18/2020 but tested negative.
HISTORY:CHF, HTN, hyperlipidemia, atrial fibrillation, COPD (O2 dependent) , CKD Stage 4, type 2 diabetes (diet controlled).
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:02-04-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:Y
ALLERGIES:Oxycodone, Percodan, atenolol, PCN VK
V_FUNDBY:

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