VAERS ID: 1002937

AGE: 73| SEX: M|STATE: (United States)

Description

death Narrative: Pt attended arthritis clinic appt 0900; labs shortly after; rec'd vaccine in clinic ~ 1113; seen on surveillance camera walking to parking garage ~ 1145; medical center rec'd call from wife ~ 1900 that pt never returned home; police found vehicle running in parking garage, code called, pt obviously deceased by that time 1930, body sent to medical examiner for autopsy.

Open in Wayback Machine
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Symptoms

Death, Cardio-respiratory arrest, Autopsy

Vaccines

VAX DATE: 02-01-2021| ONSET DATE: 02-01-2021| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 0 COVID19 PFIZER\BIONTECH EL3249 IM LA

RECVDATE:02-03-2021
RPT_DATE:
CAGE_YR:72
CAGE_MO:
DIED:Y
DATEDIED:02-01-2021
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:N
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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