VAERS ID: 1002931

AGE: 77| SEX: M|STATE: (United States)

Description

CARDIAC ARREST, DEATH Narrative: The patient presents to the emergency department in cardiopulmonary arrest. CPR was continued upon arrival. The Combi tube was removed and an endotracheal tube was placed without complications. ROSC was obtained multiple times but the patient continued to go into PEA. The patient was seen in the emergency department by both critical care and Cardiology. EKG shows ST elevations, but the patient was unstable to go to catheterization. The patient had 1 episode of asystole. Despite best efforts and multiple attempts we were unable to resuscitate the patient. Time of death 1253 on 1/24/21.

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Symptoms

Cardiac arrest, Electrocardiogram ST segment elevation, Death, Cardio-respiratory arrest, Endotracheal intubation, Resuscitation, Pulseless electrical activity, Absence of immediate treatment response

Vaccines

VAX DATE: 01-21-2021| ONSET DATE: 01-24-2021| DAYS TO ONSET: 3
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (MODERNA)) 1 COVID19 MODERNA 029L20A IM RA

RECVDATE:02-03-2021
RPT_DATE:
CAGE_YR:76
CAGE_MO:
DIED:Y
DATEDIED:01-24-2021
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:
V_ADMINBY:OTH
OTHER_MEDS:
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:02-02-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:Y
ALLERGIES:
V_FUNDBY:

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