Client was being treated with antibiotics by her PCP for diverticulitis flare up. It had not been resolved on the date of her death which occurred 01/27/21, She was found unresponsive by staff, 911 contacted,

VACCINE TYPE(S):

• COVID19

VACCINE NAME(S):

• COVID19 (COVID19 (PFIZER-BIONTECH))

SYMPTOM(S):

• Cardiac arrest, 
• Condition aggravated, 
• Unresponsive to stimuli, 
• Diverticulitis, 
• Death

VACCINE TYPE(S):

• COVID19

VACCINE NAME(S):

• COVID19 (COVID19 (PFIZER-BIONTECH))

SYMPTOM(S):

• Hypotension, 
• Confusional state, 
• Hypothermia, 
• Intestinal perforation, 
• White blood cell count normal, 
• Chest X-ray, 
• Large intestine perforation, 
• Diverticulitis, 
• Death, 
• C-reactive protein increased, 
• Computerised tomogram abnormal, 
• Abdominal tenderness, 
• Fibrin D dimer increased, 
• Slow response to stimuli, 
• SARS-CoV-2 test negative

bowel perforation; pain in her upper abdomen; This is a spontaneous report from a contactable consumer. An 86-year-old female patient received the 2nd dose of bnt162b2 (BNT162B2) at single dose on 13Jan2021

VACCINE TYPE(S):

• COVID19

VACCINE NAME(S):

• COVID19 (COVID19 (PFIZER-BIONTECH))

SYMPTOM(S):

• Intestinal perforation, 
• Abdominal pain upper, 
• Death, 
• Computerised tomogram abnormal, 
• Apparent life threatening event, 
• Computerised tomogram intestine

short of breath; O2 was 88%; crepitations in the lungs; vomited; wheezing; This is a spontaneous report received from the regulatory authority (Regulatory authority number AU-TGA-0000521743). A contactable

VACCINE TYPE(S):

• COVID19

VACCINE NAME(S):

• COVID19 (COVID19 (PFIZER-BIONTECH))

SYMPTOM(S):

• Vomiting, 
• Dyspnoea, 
• Wheezing, 
• Rales, 
• Oxygen saturation, 
• Oxygen saturation decreased

deteriorated; shortness of breath; Bronchopneumonia; acute pulmonary oedema; low blood pressure; increased heart rate; pitting peripheral oedema; low oxygen saturations; This is a spontaneous report from

VACCINE TYPE(S):

• COVID19

VACCINE NAME(S):

• COVID19 (COVID19 (PFIZER-BIONTECH))

SYMPTOM(S):

• Hypotension, 
• Dyspnoea, 
• Oedema peripheral, 
• Pneumonia, 
• Heart rate increased, 
• Oxygen saturation decreased, 
• General physical health deterioration, 
• Acute pulmonary oedema

temperatures of 38.4C; dependent on oxygen,adequate level could not be reached with 10 L oxygen suppply; Respiratory insufficiency; Covid-19; severe dyspnoea; productive cough; basilar rales; shivering;

VACCINE TYPE(S):

• COVID19

VACCINE NAME(S):

• COVID19 (COVID19 (MODERNA))

SYMPTOM(S):

• Chills, 
• Pyrexia, 
• Dyspnoea, 
• Sepsis, 
• Productive cough, 
• Polymerase chain reaction, 
• Fatigue, 
• Chest X-ray, 
• Blood culture, 
• Respiratory failure, 
• Rales, 
• Blood gases, 
• Oxygen saturation decreased, 
• Fibrin D dimer, 
• Blood creatinine, 
• Legionella test, 
• SARS-CoV-2 test, 
• COVID-19, 
• Exposure to SARS-CoV-2, 
• Streptococcal urinary tract infection

ED, Discharged , 3/13/2021 (4 hours), Hospital ED, MD Last attending o Treatment team Shortness of breath +1 more Clinical impression Chest Pain o Shortness of Breath o Dizziness Chief complaint, Patient

VACCINE TYPE(S):

• COVID19

VACCINE NAME(S):

• COVID19 (COVID19 (PFIZER-BIONTECH))

SYMPTOM(S):

• Chills, 
• Dizziness, 
• Vomiting, 
• Dyspnoea, 
• Nausea, 
• Pain, 
• Paraesthesia, 
• Tachycardia, 
• Cough, 
• Hypoaesthesia, 
• Pneumonia, 
• Chest pain, 
• Sepsis, 
• Electrocardiogram abnormal, 
• Cholelithiasis, 
• Abdominal distension, 
• Hypoxia, 
• Condition aggravated, 
• Enteritis, 
• Lactic acidosis, 
• Electrocardiogram T wave inversion, 
• Fatigue, 
• Emotional distress, 
• Chest X-ray abnormal, 
• Large intestine perforation, 
• Intensive care, 
• Viral test negative, 
• Breath sounds abnormal, 
• Diverticulitis, 
• Death, 
• Lung infiltration, 
• Abdominal pain lower, 
• Endotracheal intubation, 
• Gastrointestinal tube insertion, 
• Blood gases, 
• Oxygen saturation decreased, 
• Inguinal hernia, 
• Abdominal tenderness, 
• Acute respiratory failure, 
• Dyspnoea exertional, 
• Spinal disorder, 
• Blood lactic acid, 
• Explorative laparotomy, 
• Central venous catheterisation, 
• Colostomy, 
• Respiratory syncytial virus test negative, 
• Abdominal hernia, 
• Colectomy, 
• Colonic fistula, 
• Aortic arteriosclerosis, 
• Intervertebral disc space narrowing, 
• Influenza A virus test negative, 
• Gastrointestinal oedema, 
• Lung consolidation, 
• Use of accessory respiratory muscles, 
• Computerised tomogram thorax, 
• Bladder catheterisation, 
• Computerised tomogram abdomen, 
• Pulmonary mass, 
• Adenovirus test, 
• Enterovirus test negative, 
• Scan with contrast abnormal, 
• Vertebral foraminal stenosis, 
• Influenza virus test negative, 
• Bilevel positive airway pressure, 
• Chlamydia test negative, 
• Renal cyst, 
• Bordetella test negative, 
• Human metapneumovirus test, 
• Arterial catheterisation, 
• Human rhinovirus test, 
• Respiratory viral panel, 
• Mycoplasma test negative, 
• Sedative therapy, 
• Lung opacity, 
• Spinal stenosis, 
• COVID-19, 
• SARS-CoV-2 test positive, 
• COVID-19 pneumonia, 
• Pneumoperitoneum, 
• Colonic abscess, 
• Prone position

On 5/20/21 the patient was at home with his mother when he had acute nausea, light-headedness, and abdominal pain. He presented to the ED by ambulance. Excerpt from ED notes od MD follows: "Initial ED

VACCINE TYPE(S):

• COVID19

VACCINE NAME(S):

• COVID19 (COVID19 (PFIZER-BIONTECH))

SYMPTOM(S):

• Dizziness, 
• Bradycardia, 
• Nausea, 
• Abdominal pain, 
• Hypertonia, 
• Cardiac arrest, 
• Electrocardiogram abnormal, 
• Atelectasis, 
• Anxiety, 
• Pneumothorax, 
• Atrial fibrillation, 
• Dyskinesia, 
• Pulmonary embolism, 
• Chest X-ray normal, 
• Sinus tachycardia, 
• Abnormal behaviour, 
• Heart rate decreased, 
• Death, 
• Pulse absent, 
• Pancreatitis necrotising, 
• Endotracheal intubation, 
• Mechanical ventilation, 
• Resuscitation, 
• Acute coronary syndrome, 
• Pulmonary infarction, 
• Angiogram pulmonary abnormal, 
• Aortic aneurysm, 
• Central venous catheterisation, 
• Bundle branch block left, 
• Right ventricular dysfunction, 
• Lung consolidation, 
• Computerised tomogram abdomen, 
• Scan with contrast abnormal, 
• Pulseless electrical activity, 
• Sedative therapy, 
• COVID-19, 
• SARS-CoV-2 test positive, 
• Aortic dissection, 
• Catheter directed thrombolysis

cardio-respiratory arrest; Acute respiratory failure (interstitial pneumonia); Acute respiratory failure (interstitial pneumonia); acute respiratory distress syndrome; This is a spontaneous report from

VACCINE TYPE(S):

• COVID19

VACCINE NAME(S):

• COVID19 (COVID19 (PFIZER-BIONTECH))

SYMPTOM(S):

• Interstitial lung disease, 
• White blood cell count, 
• Acute respiratory distress syndrome, 
• Cardio-respiratory arrest, 
• Heart rate, 
• Oxygen saturation, 
• Body temperature, 
• C-reactive protein, 
• Acute respiratory failure, 
• Blood creatinine, 
• Blood lactate dehydrogenase, 
• Glomerular filtration rate, 
• Computerised tomogram thorax, 
• Blood pressure measurement, 
• N-terminal prohormone brain natriuretic peptide

Patient expired due to Large Bowel Obstruction. (found to be COVID positive) Attestation signed by MD at 8/7/2021 11:02 PM (Updated) General Surgery Pt seen and examined on 8/6/2021 with the surgery

VACCINE TYPE(S):

• COVID19

VACCINE NAME(S):

• COVID19 (COVID19 (PFIZER-BIONTECH))

SYMPTOM(S):

• Nausea, 
• Abdominal pain, 
• Pain, 
• Abnormal faeces, 
• Cardiac arrest, 
• Sepsis, 
• Coagulopathy, 
• Abdominal distension, 
• Hypoxia, 
• Condition aggravated, 
• Laboratory test, 
• Intensive care, 
• Diverticulitis, 
• Abdominal discomfort, 
• Death, 
• Intestinal ischaemia, 
• Endotracheal intubation, 
• Computerised tomogram abdomen abnormal, 
• Explorative laparotomy, 
• Colectomy, 
• Imaging procedure, 
• Colitis ischaemic, 
• Vasopressive therapy, 
• Large intestinal obstruction, 
• COVID-19, 
• SARS-CoV-2 test positive