"Notes""Symptoms""Symptoms Code""Vaccine""Vaccine Code""VAERS ID""VAERS ID Code"Adverse Event DescriptionAdverse Events After Prior Vaccinations"COVID-19""10084268""COVID19 (COVID19 (JANSSEN))""1203""1111699-1""1111699-1""Patient developed symptomatic COVID infection with symptoms starting 3/13, was admitted to the hospital for respiratory failure on 3/16 and expired on 3/18/21""No prior vaccinations for this event.""COVID-19""10084268""COVID19 (COVID19 (JANSSEN))""1203""1167886-1""1167886-1""Patient vaccinated against COVID-19; received COVID-19 Janssen vaccine on 3/10/2021. Patient developed symptoms last week of March. Called Provider with symptoms and then presented to the hospital (admitted on 4/1/2021). Tested for COVID and found to be positive. 4/1/2021. Patient declined, admitted to ICU on 4/3/2021. Patient died on 4/4/2021. Chief Complaint: HPI: Patient is a 79 y.o. yr. old female who presents today for COUGH (has had cough for a little over a week) and FEVER (on and off for about a week)Patient was seen due to feelingill for over week. Patient states that she was trying to fight it on her own but symptoms have been progressing. Patient has felt feverish no known fevers. Has had a persistent now worsening cough. Patient is feeling very tired and weak due to being sick for over week. Patient does live alone. Patient is coughing which isproductive with sputum. Patient is eating and drinking well. No N/V/d. No loss of taste or smell. No recent ill exposure.; Has had covid vaccine. Patient did get the Johnson and Johnson vaccine over a month ago. Patient is feeling very fatigue; Having feverish/chills. Patient is taking OTC nightquil which is no longer helping. Patient does see oncologist for her CLL. DISCHARGE DIAGNOSIS: 1. Deceased 2. COVID-19 with hypoxia 3. Asthma 4. Anemia DETAILS OF HOSPITAL STAY:PRESENTING PROBLEM: COVID-19 HOSPITAL COURSE: Patient is a 79 year old female whowas admitted on 04/01/2021 for COVID-19 pneumonia with complications of hypoxia. Patient's symptoms of cough and shortness of breath have been present for approximately 2 weeks. It was noted that 1 month ago she did receive the Johnson &Johnson vaccine. Upon admission patient was treated with azithromycin, Rocephin tocover for secondary bacterial infection. She was not a candidate for remdesivir due to the length of her symptoms. She was started on Decadron, as well as gentlefluids due to tachycardia for approximately 12 hours. During the night of 4/2-4/3 patient progressively declined requiring more oxygen she was transferred to the intensive care unit. Patient was a do not resuscitate continued decline and after exacerbating all treatment options patient was switched to comfort care earlier this evening. Pronounced dead at 6:45 a.m.""No prior vaccinations for this event.""COVID-19""10084268""COVID19 (COVID19 (JANSSEN))""1203""1208583-1""1208583-1""Chills, Fever,fatigue. Tested positive for COVID on 3/22 and died on 3/29""No prior vaccinations for this event.""COVID-19""10084268""COVID19 (COVID19 (JANSSEN))""1203""1218602-1""1218602-1""colonic necrosis 62 yo woman history of prior L occipital CVA and DVT on Xarelto presented to Hospital on April 6 with mental status changes. Patient was noted to be in severe metabolic acidosis, renal failure and shock. Chest x-ray showed interstitial infiltrates and she tested positive for SARS-CoV2. She required intubation and mechanical ventilation. CT brain showed encephalomalacia and atrophy, no new changes. She was transferred on April 8. She was given IV bicarb for persistent metabolic acidosis. Initially she was only treated with steroids, then antibiotics were added for fever and persistent hypotension. She started to spike fevers up to 40. Abdominal CXR ordered prior to MRI, showed possible pneumatosis. A follow up CT April 13 abdomen/pelvis was done which shows colonic pneumatosis, with air in the SMV, portal vein, air in the liver. No thrombocytopenia; platelets on April 13 were 310k, as low as 260 on April8.""No prior vaccinations for this event.""COVID-19""10084268""COVID19 (COVID19 (JANSSEN))""1203""1222868-1""1222868-1""According to POC the resident was transferred to the hospital on4/8/2021, due to low pressures, high pulse and cough. They certify death by COVID 19, because it affected the lungs.""No prior vaccinations for this event."

 

"COVID-19""10084268""COVID19 (COVID19 (JANSSEN))""1203""1266936-1""1266936-1""Employee developed a fever and chills on 01-Apr-21 which he managed with Tylenol. Symptoms resolved as per patient who contributed the symptomsas a result of the J&J vaccine. On 10-Apr-21 he developed a cough and requested a day to rest. On 11-Apr-21, he went to Hospital to be evaluated by the physician who ordered some labs which were normal. He was then advised to complete PCR swab and was notified on 12-Apri-21 that his test is positive. As per the protocol, all COVID-19 positive individuals must report to the Health Center within 24 hours of notification and complete 10 days home isolation. During isolation, on 17-Apr-21, patient developed hemoptysis and difficulty breathing a breathing and notified his supervisor who called 112 for an ambulance. He was transferred to Hospital. Evaluated and started treatment for pneumonia and was transferred to Hospital on 18-Apr-21. His condition started declining on 21-Apr-21 as he became hypoxic and tachypneic and was subsequently sedated and intubated. As he became HD unstable, Levophed and Vasopressin were started and reached maxed doses. On 25-Apr-21 Dr. from the hospital called and stated that patient expired at 0830.""No prior vaccinations for this event.""COVID-19""10084268""COVID19 (COVID19 (JANSSEN))""1203""1266953-1""1266953-1""It was reported that patient had been experiencing difficulty breathing, walking and delusions as per his fiancT . Fiance notified Manger that they sought medical attention earlier in the morning on 1-Apr-21 at the Clinic and they refused to evaluate patient beyond performing a PCR swab test so, they went back to their apartment. An SMS notification was sent on 1-Apr-21 indicating that patient was COVID-19 positive which was not seen by patient or fiance who reported the result to Mgmt. on 6-Apr-21. He was contacted by patient's friend and advised him the patient was sick, not able to walk, and having difficulty.""No prior vaccinations for this event.""COVID-19""10084268""COVID19 (COVID19 (JANSSEN))""1203""1267883-1""1267883-1""Cardiac Arrest about an hour after being injected.""No prior vaccinations for this event.""COVID-19""10084268""COVID19 (COVID19 (JANSSEN))""1203""1270605-1""1270605-1""His brother reporting that he got the vaccine, the following dayhe was coughing. The coughing caused him not to be able to sleep and was weak due to that. He could feel his throat closing and he was having a hard time breathing and he called his brother who told him to call 9-1-1. He was taken to Medical Center 4/17/2021, diagnosed with possibly COVID. He was admitted to the COVID ward and he died on 4/26/2021. The doctor that pronounced him was . Cause of death diagnosis. Hypoxic respiratory arrest, COVID 19""No prior vaccinations for this event.""COVID-19""10084268""COVID19 (COVID19 (JANSSEN))""1203""1271243-1""1271243-1""Symptoms of fever, nausea, and weakness started 3 days followingvaccination. Denies any exposure to COVID positive person. Presented to local emergency department on 3/27/21 with nausea, fever, chills, dizziness, and confusion. Due to patient's condition, he was transferred to larger facility for further management. Patient was admitted to hospital and subsequently transferred to ICU on 4/17/21. He was intubated at that time. Patient went into multisystem organ failure and died on 4/18/21.""No prior vaccinations for this event.""COVID-19""10084268""COVID19 (COVID19 (JANSSEN))""1203""1273691-1""1273691-1""Patient tested positive for COVID 19 on 03/21 after a symptom onset of 03/19/21. She was admitted to the hospital on 03/24 and passed away 04/19.Cause of death is listed as multi-organ dysfunction secondary to hemorrhagic shock,other contributing factors: COVID-19 pneumonia.""No prior vaccinations for this event.""COVID-19""10084268""COVID19 (COVID19 (JANSSEN))""1203""1285561-1""1285561-1"""The patient presented with chest pain around 5 pm on 4/4/21. Patient reported ""pain came out of nowhere."" Patient reported pain was non-exertional and non-positional. He described it as ""a constant burning sensation""located in the center of his chest with radiation upwards toward his jaw and shoulders, bilaterally. He was transferred to COVID unit, became hypotensive,

 

hypoxic was seen by house MD. Lung exam crackles bilaterally. IV fluids stopped, patient was given 40 mg Lasix, Morphine 2 mg and started on a small dose nitroglycerine drip. POX 70s, low 80s so Bipap ordered. Patient developed v tach and arrested, resuscitated, defibrillated, received multiple meds, intubated by anesthesia, transferred in ICU on Levophed and Epinephrine. Arrested in ICU. Lines were placed by ICU team, arrested again in ICU. Was maxed out on 4 pressors,despite CPR, pulse could not be obtained, patient was pronounced dead 4/6/21 at 3:31am. 1. Triple vessel CAD 2. Moderately severe LV dysfunction with and EF 30% 3The recent NSTEMI is secondary to the occlusion of the SVG-OM1. There is a large thrombus in the SVG which makes PCI of this vessel unlikely to be successful. 4 The native OM1 is chronically occluded. It may be possible to attempt to open thiswith CTO techniques, however, at this time continued medical treatment. 5. Perclose"""No prior vaccinations for this event.""COVID-19""10084268""COVID19 (COVID19 (JANSSEN))""1203""1295200-1""1295200-1""Pt received Covid-19 vaccine on 3/19 then presented to ED with fever and shortness of breath on 3/23 admitted to the hospital found to be COVID 19+ and requiring 2L oxygen via NC. Treated with dexamethasone, remdesivir and empiric antibiotics. Following admission, O2 requirement increased, received tocilizumab then required transfer to the ICU on 3/29. On 3/31 developed right leg ischemia, underwent thrombectomy and heparin infusion then on 4/1 patient intubated due to increased need for respiratory support and had bilateral chest tubes placed, post-intubation course complicated by shock with AKI requiring pressor support, prolonged encephalolpathy. On 4/24 with worsening shock, hypoxemic resp failure, AKI requiring pressors and CRRT with broad spectrum antibiotics and resumption of stress dose steroids, the family was transitioned to comfort measures and passed away on 4/29.""No prior vaccinations for this event.""COVID-19""10084268""COVID19 (COVID19 (JANSSEN))""1203""1296197-1""1296197-1"""Wife reports patient was vaccinated on 3/30/21. She stated patient only had blurred vision following vaccination which lasted a about 2 days. On 4/4 family members visited and it was noted that 1 member tested positive for Covid on 4/5/21 and her spouse was home sick on 4/4/21 and was later positive on 4/5/21. Around 4/5/21 patient began having more frequent episodes of delusion and confusion. Speech slurred and slouched in chair. Patient would be demanding when asking for water when water was in his hand. Talking to her but looking at the ceiling. She stated she thought he was having ""mini strokes."" Increased weakness with standing. Slid to floor multiple times from chair. She reports lossof appetite and trembling. Saw MD on 4/12. ""Could hardly breathe."" MD ordered doxycycline and an inhaler. Patient to Hospital on 4/13/21. Diagnosed with Covid on 4/13/21 via PCR. Discharged from hospital to Skilled Nursing Facility on 4/16/21. Sent back to Hospital on 4/18/21 and passed away on 5/1/21. Wife states that death certificate indicates ""Utonic Hypercapnic respiratory failure, acute/chronic CHF, hypoxemic respiratory failure and HTN, DM, prostate CA and COVIDPNA. No autopsy performed. Medical PCP."""No prior vaccinations for this event.""COVID-19""10084268""COVID19 (COVID19 (JANSSEN))""1203""1302490-1""1302490-1"""On 4/26/21 The patient presents to our clinic with concerns forback pain, fever, shortness of breath, fatigue and coughing. We performed a covid19antigen test which resulted positive. Based on this and his history and examinationwe recommended he go straight to the hospital for further evaluation and treatment.He was admitted to medical center where a PCR was performed and confirmed positive. He was discharged on 4/29. Per his wife, they felt he was discharged too soon and he went to another hospital. He passed away 5/10/2021. This report is being made in regards to the claim by the CDC that ""no one that has been infected with covid19 4 weeks after having the janssen vaccine has been hospitalized."" Thispatient was not only hospitalized but passed away."""No prior vaccinations for this event.""COVID-19""10084268""COVID19 (COVID19 (JANSSEN))""1203""1306869-1""1306869-1""Brief HPI and Hospital Course: 67 year old male with unknown