VAERS ID: 1505250

AGE: 13| SEX: F|STATE: MD (United States)

Description

patient arrived in ventricular tachycardia via EMS, but responsive. deteoriarated to pulseless ventricular tachycardia, PEA and ultimately death.

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Symptoms

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

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 Unknown

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

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