Détails du rapport Vaer
Âge: N/A
Genre: Female
Région : Outside US
- Patient décédé?
- Oui
- Renseignements sur les vaccins
-
Nom: COVID19 (COVID19 (PFIZER-BIONTECH))
Type : Coronavirus 2019 vaccine
Fabricant: PFIZER
Lot: ex0893
- Date de réception du rapport
- 2022-03-04
- Date à laquelle le formulaire est complèté
- Date de vaccination
- 2021-04-17
- Date d’apparition
- 1
- Nombre de jours (date d’apparition – date de vaccination)
- 1
- Description de l’événement indésirable
-
heart failure in hypertensive patient.; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority. regulatory number: it-minisal02-843200. a 84 year-old female patient received bnt162b2 (comirnaty), intramuscular, administered in arm left, administration date 17apr2021 (lot number: ex0893) as dose 2, single for covid-19 immunisation. relevant medical history included: "chronic renal insufficiency" (unknown if ongoing), notes: stage iii; "hypertension arterial" (unknown if ongoing). the patient's concomitant medications were not reported. vaccination history included: comirnaty (dose 1, lot er9470, time 14:46, left deltoid), administration date: 27mar2021, for covid-19 immunization. the following information was reported: cardiac failure (death, medically significant) with onset 18apr2021, outcome "fatal", described as "heart failure in hypertensive patient.". the patient date of death was 18apr2021. the reported cause of death was cardiac failure. autopsy result 15feb2021, death following adverse effect induced by comirnaty vaccine (pfizer) second dose given less than 24 hours earlier. no follow-up attempts are possible. no further information is expected.; reported cause(s) of death: cardiac failure
- Données de laboratoire
-
na
- Liste des symptômes
-
cardiac failure
- Patient décédé?
- Oui
- Date de décès
- 2021-04-18
- Anomalie congénitale
- false
- Vaccin administré par :
- Other
- Vaccin acheté par :
- Inconnu
- Visite d’un patient à l’urgence?
- Non
- Patient hospitalisé?
- Non
- Séjour à l’hôpital
- Non
- Nombre de jours à l’hôpital
- Non spécifié
- Invalidité permanente?
- Non
- Allergies:
-
na
- Maladie actuelle
-
na