VAERS ID: 1094130

AGE: 64| SEX: M|STATE: SC (United States)

Description

ICD difibrillator fired 14 hours later for first time

Open in Wayback Machine
(If this is a foreign report without a description you will be able to read the description in the Wayback Machine on Medalerts if the report became public for the first time before November 18, 2022.)

Symptoms

Cardiac assistance device user

Vaccines

VAX DATE: 03-09-2021| ONSET DATE: 03-10-2021| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH EN6202 IM LA

RECVDATE:03-12-2021
RPT_DATE:
CAGE_YR:64
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:
V_ADMINBY:PHM
OTHER_MEDS:Mexilitine Sotalol Lipitor Plavix Entresto
CUR_ILL:
HISTORY:Heart disease
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:03-12-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:U
ALLERGIES:Crucsteacens
V_FUNDBY:

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