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VAERS ID: 2152560

AGE: 7| SEX: M|State: WA

Description

Patient presented to Emergency Department (ED) lethargic and listless. He proceeded to a shock state and had a cardiac arrest. He was not able to be resuscitated and died in the ED.

Symptoms

Atrioventricular block, Cardiac arrest, Electrocardiogram T wave inversion, Pyrexia, Vomiting, Blood glucose normal, Death, International normalised ratio increased, QRS axis abnormal, Blood lactic acid, Electrocardiogram QT prolonged, Lethargy, Resuscitation, Brain natriuretic peptide increased, Electrocardiogram ST segment depression, Listless, Shock, Carbon dioxide decreased, Electrocardiogram T wave abnormal, Prothrombin time prolonged, Troponin I increased

Vaccines

VAX DATE: 02 February 2022 | ONSET DATE: 15 February 2022 | DAYS TO ONSET: 13
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • 1
  • IM
  • RA
  • FK5618

RECVDATE:
01 March 2022
CAGE_YR:
7
CAGE_MO:
RPT_DATE:
DIED:
Y
DATEDIED:
15 February 2022
L_THREAT:
ER_VISIT:
HOSPITAL:
HOSPDAYS:
X_STAY:
DISABLE:
RECOVD:
N
LAB_DATA:
Notable Labs between 12:55 am and Glucose 180 mg/dl Electrolyte CO2 13 mmol/L Troponin I 26.97 ng/ml (0-0.4 nl range) PT 14.2 (nl 9.5-12.1 sec); INR 1.4 (0.9-1.1) BNP 2096 pg/nL ( 0-99 nl) Lactate 20 mmol/L (0-2.0 nl) Initial ECG Rate 151; right axis deviation; non-specific intra-ventricular conduction block; T wave inversion in inferior leads Later ECG Rate 86; Low voltage QRS, ST depression in inferior and anterolateral leads; non-specific T wave abnormality; borderline prolonged QT
V_ADMINBY:
PVT
OTHER_MEDS:
None
CUR_ILL:
None noted. Emergency Department (ED) visit note stated that patient had a fever in the last 24 hours, had no respiratory symptoms but became lethargic. Vomited on way to the ED and was listless and lethargic on presentation. No history of rashes, ingestion or trauma.
HISTORY:
None. Primary care visit in 2021 showed BMI 62
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
2
TODAYS_DATE:
01 March 2022
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
Y
ALLERGIES:
None
V_FUNDBY:
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