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

Vaccines

VAX DATE: 07-01-2021| ONSET DATE: 07-27-2021| DAYS TO ONSET: 26
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) Unknown COVID19 PFIZER\BIONTECH Unknown Unknown

RECVDATE:07-27-2021
RPT_DATE:
CAGE_YR:13
CAGE_MO:
DIED:Y
DATEDIED:07-27-2021
L_THREAT:U
ER_VISIT:U
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
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:07-27-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:none
V_FUNDBY:

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