Age: 71.0
Sex: M
Vaccine: COVID19
Symptoms: Loss of consciousness, Skin discolouration
Clinical narrative: Passed away/ Doctors couldn't revive him; passed out; gasping for air/couldn't breathe/tried to breathe for him and do CPR, but it wasn't working; He was sweating/chest was wet; looked a little ashy; his legs went limb and relaxed; "His eyes were, like, not right"; This spontaneous case was reported by a consumer and describes the occurrence of DEATH (Passed away/ Doctors couldn't revive him), LOSS OF CONSCIOUSNESS (passed out), DYSPNOEA (gasping for air/couldn't breathe/tried to breathe for him and do CPR, but it wasn't working), HYPERHIDROSIS (He was sweating/chest was wet), SKIN DISCOLOURATION (looked a little ashy), LIMB DISCOMFORT (his legs went limb and relaxed) and EYE DISORDER ("His eyes were, like, not right") in a 71-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 076C21A, 039*K20A and 038K20A) for COVID-19 vaccination.     The patient's past medical history included Heart disease, unspecified and Heart valve replacement (three years ago he had a heart valve replacement surgery, but he had been fine since.) in 2018. Concurrent medical conditions included Diabetes (had diabetes (but under control).), Blood pressure high (had high blood pressure (but under control).) and Overweight.   On 05-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On 09-Feb-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Nov-2021, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 15-Nov-2021, the patient experienced LOSS OF CONSCIOUSNESS (passed out) (seriousness criteria death and medically significant), DYSPNOEA (gasping for air/couldn't breathe/tried to breathe for him and do CPR, but it wasn't working) (seriousness criterion death), HYPERHIDROSIS (He was sweating/chest was wet) (seriousness criterion death), SKIN DISCOLOURATION (looked a little ashy) (seriousness criterion death), LIMB DISCOMFORT (his legs went limb and relaxed) (seriousness criterion death) and EYE DISORDER ("His eyes were, like, not right") (seriousness criterion death). The patient died on 15-Nov-2021. The cause of death was not reported. An autopsy was performed, but no results were provided.            Patient was sitting on the couch, gasping for air, and told reporter  to hurry and call 911 since he couldn't breathe.The ambulance people tried to revive him, they put him on the floor, and they took his pulse. They asked for his medications and took him into the ambulance.  When they arrived at the hospital, it took a while for any doctor to come and talk to her, so she thought they could revive him and was expecting some damage, like slow speech or paralysis. But when the doctor came in, he told her that they couldn't revive him, and he had passed. When she got in to see him, he had a tube on his mouth and his body temperature was fine, but he wasn't there anymore.  No concomitant medication information were given. No treatment information were given.  Company comment: This case concerns a 71-year-old, male patient, with medical history of diabetes, heart disease, and heart valve replacement surgery, who experienced the serious, unexpected events of death, loss of consciousness, dyspnea, hyperhidrosis, skin discoloration, limb discomfort and eye disorder. One day after receiving the booster dose of mRNA 1273 vaccine, patient called out for his wife as he was gasping for air and couldn't breathe, he was sweating and looked a little ashy. Patient passed out before ambulance arrived, CPR was done but patient was not revived. Wife requested for an autopsy by private individual, result not yet provided. The patient's co-morbidities of diabetes, heart disease, and heart valve replacement remains as a confounder to the events. The benefit risk relationship of vaccine is not affected by this report.; Sender's Comments: This case concerns a 71-year-old, male patient, with medical history of diabetes, heart disease, and heart valve replacement surgery, who experienced the serious, unexpected events of death, loss of consciousness, dyspnea, hyperhidrosis, skin discoloration, limb discomfort and eye disorder. One day after receiving the booster dose of mRNA 1273 vaccine, patient called out for his wife as he was gasping for air and couldn't breathe, he was sweating and looked a little ashy. Patient passed out before ambulance arrived, CPR was done but patient was not revived. Wife requested for an autopsy by private individual, result not yet provided. The patient's co-morbidities of diabetes, heart disease, and heart valve replacement remains as a confounder to the events. The benefit risk relationship of vaccine is not affected by this report.; Reported Cause(s) of Death: Unknown cause of death