이상반응 보고

VAERS ID	2586956
성별	남성
나이	73세
주 코드	MI
제약회사	PFIZER\BIONTECH
로트 번호	649693
예방접종 횟수	3
접종일	2022-12-13
발병일	2023-01-26
상태	입원 사망

증상

이환 중 질병

Hospital 11/04/2022 - 12/13/2022 Septic shock (CMS/HCC) (Primary Dx); Cerebrovascular accident (CVA), unspecified mechanism (CMS/HCC); Pneumonia of left lower lobe due to infectious organism; Urinary tract infection in male; Seizure-like activity (CMS/HCC)

지병

Atrial fibrillation (HCC) Hypertension, benign Diabetes (HCC) Chronic kidney disease, stage I Adjustment reaction Abnormal urine color Anxiety Arthritis of both hips Cardiomyopathy (HCC) Chronic diastolic heart failure (HCC) Chronic obstructive pulmonary disease (HCC) Homeless single person Gout Glaucoma Depressive disorder Morbid obesity (HCC) Multiple nodules of lung Stage 3a chronic kidney disease (HCC) Wheezing Hyperlipidemia Hypogonadism in male Feeding tube dysfunction Pneumonia due to infectious organism Airway compromise Osteophyte of cervical spine Encephalopathy Multiple renal cysts Thickening of wall of gallbladder Sacral wound Type 2 diabetes mellitus with hyperglycemia, with long-term current use of insulin (HCC) Seizures (HCC) Dysphagia Pulmonary infiltrate ACP (advance care planning) Sacral osteomyelitis (HCC) Tracheostomy in place (HCC) Chronic respiratory failure with hypoxia (HCC) AKI (acute kidney injury) (HCC) Recent hx of Pseudomonas pneumonia (HCC) COVID-19 Acute respiratory failure with hypoxia (HCC) Anemia Hypokalemia Stage III pressure ulcer of left heel (HCC) Stage IV pressure ulcer of sacral region (HCC) Enterococcus faecalis infection Multiple comorbid conditions Comfort measures only status End of life care

기타 의료

acetaminophen (TYLENOL) 325 MG tablet albuterol HFA (PROVENTIL HFA, VENTOLIN HFA, PROAIR HFA) 108 (90 Base) MCG/ACT inhaler bisacodyl (DULCOLAX) 10 MG suppository dexamethasone (DECADRON) 2 MG tablet guaifenesin (ROBITUSSIN) 100 MG/5ML liqu

이전 예방접종

알레르기

Bee VenomAnaphylaxis Povidone-iodineAnaphylaxis, Swelling Shellfish AllergyAnaphylaxis, Swelling Bee Pollen

임상 검사

증상 상세

Discharge Provider: MD Primary Care Physician at Discharge: MD Admission Date: 1/26/2023 PRESENTING PROBLEM: Shock (HCC) [R57.
9] Encephalopathy [G93.
40] Acute on chronic respiratory failure, unspecified whether with hypoxia or hypercapnia (HCC) [J96.
20] Acute on chronic anemia [D64.
9] Pressure injury of sacral region, stage 4 (HCC) [L89.
154] Septic shock (HCC) [A41.
9, R65.
21] Enterococcus faecalis infection [B95.
2] HOSPITAL COURSE: 73yo M with hx multiple CVAs, chronic trach/PEG (not vent dependant), DMII, non-verbal, diastolic heart failure, Afib (Xarelto), resident who was admitted 1/26 with acute hypoxic respiratory failure and shock.
COVID +, suspected bacterial sepsis, RIGHT sided PNA (recently PSA PNA).
Placed on ventilator, given 3 L IVF with ongoing hypotension needing norepinephrine.
Empiric Vanco and Cefepime were started.
NE off 1/27.
Enterobacter 1/2 BC, unclear if true bacteremia.
Palliative care c/s 1/27.
Hemoptysis 1/27, bronch without source, TXA Nebs x24hrs, resolved.
Heparin gtt started 1/29 for afib while holding Xarelto.
Limited ECHO NEG vegetation but tricuspid and pulmonic valves not seen, considering TEE.
Worsening AKI, Renal US NEG, renal consulted.
T-piece since 1/28.
Stento growing in sputum felt to be colonizer.
Renal function continued to worsening with decreasing urine output.
Case conference with family (son, daughter), guardian, hospitalist, Palliative Care Dr.
on 1/30.
Hospice informational meeting was arranged and family and guardian decided to make patient comfort measures.
Guarding decided initially to continue tube feeds as family was requesting.
Patient with large episode emesis with aspiration 2/10.
Tube feeds discontinued.
Patient with seizure life activity switched to versed and fentanyl.
However, did not require boluses and placement being sough however suctioning needs to high.
He was transitioned to humidified air by flow meter.
Patient noted to be hypothermic and bradycardic on 2/20 while seeking placement at facility switched to prn pushes.
Death Pronouncement: Called to patient's bedside to pronounce that patient has died.
Patient was DNR/DNI/Comfort care.
On bedside exam no spontaneous movements were present.
There was not response to verbal or tactile stimuli.
Pupils were mid-dilated and fixed.
No breath sounds were appreciated over either lung field.
No carotid pulses were palpable.
No heart sounds appreciated.
Patient pronounced deceased 2/22/2023 at 05:09