Adverse Event Report

Field Content
VAERS_ID 1242592
RECVDATE 2021-04-22
STATE RI
AGE_YRS 72
CAGE_YR 72
CAGE_MO
SEX F
RPT_DATE
SYMPTOM_TEXT Presented to the ER on 3/26/21 with complaint of shortness of breath/not being able to take a deep breath. CTA Pulmonary Embolism W IV Contrast at that time revealed an acute PE RIGHT lower lobe without RIGHT heart strain.. Patient was started on heparin drip and transitioned to Eliquis (apixaban). She improved during hospitalization and was discharged on 3/31/21.
DIED
DATEDIED
L_THREAT
ER_VISIT
HOSPITAL Y
HOSPDAYS 6
X_STAY
DISABLE
RECOVD Y
VAX_DATE 2021-03-16
ONSET_DATE 2021-03-26
NUMDAYS 10
LAB_DATA CTA Pulmonary Embolism W IV Contrast 3/26/21: IMPRESSION: 1. Acute PE RIGHT lower lobe, without RIGHT heart strain.. 2. Patchy mosaic groundglass opacities bilaterally nonspecific, differential considerations include atelectasis, inflammatory infectious etiologies, post ischemic changes, and small airways disease. Finding should be correlated clinically. 3. 5 mm nodule inferior lingula LEFT upper lobe. Recommend CT chest follow-up 12 months. SCr 1.34 mg/dl (3/26/21) Troponin 0.03 ng/ml (3/26/21), remained at that level throughout hospitalization BNP 202 pg/ml (3/26/21) CBC with differential (3/26/21) all values within normal limits except for platelets = 90 (baseline 103 to 127) and RDW 16.1. Platelet counts throughout hospitalization: 3/26/21: 90 3/27/21: 88 3/28/21: 76 3/29/21: 74 3/30/21: 78
V_ADMINBY PUB
V_FUNDBY
OTHER_MEDS ? ascorbic acid (VITAMIN C ORAL) ? ascorbic acid/multivit-min (EMERGEN-C ORAL) ? aspirin 81 MG enteric coated tablet ? cetirizine (ZYRTEC) 10 MG tablet ? clopidogreL (PLAVIX) 75 mg tablet ? enalapril (VASOTEC) 20 MG tablet ? famotidine (PEP
CUR_ILL None
HISTORY Liver cirrhosis, HERD, obesity, hyperlipidemia, type 2 diabetes, sleep apnea, hypertension, carotid atherosclerosis, low back pain, tremor, kidney disease, anxiety, depression, TIA, breast cancer, postmenopausal bleeding
PRIOR_VAX
SPLTTYPE
FORM_VERS 2
TODAYS_DATE 2021-04-22
BIRTH_DEFECT
OFC_VISIT
ER_ED_VISIT
ALLERGIES Actos, aloe, benzocaine, gabapentin, lanolin, lidocaine, topiramate, shellfish
SYMPTOMS
  • Angiogram pulmonary abnormal
  • Anticoagulant therapy
  • Atelectasis
  • Blood creatinine increased
  • Brain natriuretic peptide increased
  • Differential white blood cell count
  • Dyspnoea
  • Lung opacity
  • Platelet count decreased
  • Pulmonary embolism
  • Pulmonary mass
  • Red cell distribution width increased
  • Scan with contrast abnormal
  • Small airways disease
  • Troponin

Vaccines

COVID19 (COVID19 (PFIZER-BIONTECH))
Field Content
VAERS_ID 1242592
VAX_TYPE COVID19
VAX_MANU PFIZER\BIONTECH
VAX_LOT
VAX_DOSE_SERIES 2
VAX_ROUTE IM
VAX_SITE AR
VAX_NAME COVID19 (COVID19 (PFIZER-BIONTECH))
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