SINGAPORE, July 30 — A Coroner’s Inquiry into the death of a 72-year-old woman who died a day after taking her first Pfizer Covid-19 vaccination shot has concluded that her death was the result of coronary heart failure and not the vaccine.

The findings into Chan Yoke Chew’s death were presented by Coroner Christopher Goh on July 25.

Chan’s family were understandably concerned that the administration of the vaccine somehow caused her death, but the medical reports indicated this was not the case, he said.

Took first Covid-19 vaccination shot

Sometime after 2pm on June 3, 2021, Chan took her first Pfizer Covid-19 vaccination shot.

The court heard that she was observed to be well, and did not complain of any pain that day.

The next day, however, Chan complained of a slight pain and soreness on her arm where she had been injected.

She did not complain of having fever or any other illness, and was otherwise observed to be well for the rest of the afternoon.

At about 7.45pm on June 4, her husband called out to her after noticing that she had been in the toilet for 15 minutes, but he did not get a response.

He then opened the toilet door and found her lying motionless on the floor.

Unable to rouse her, he called for an ambulance.

Paramedics from the Singapore Civil Defence Force arrived at about 8.03pm.

The paramedics observed that Chan had no pulse and was not breathing, though no visible injuries were noted.

They then carried out manual cardiopulmonary resuscitation (CPR) and administered three shots of intravenous adrenaline.

At about 8.20pm, Chan was taken by ambulance to Sengkang General Hospital.

Chan was attended to by medical staff upon arrival at the hospital’s department of emergency medicine where staff made futile attempts to resuscitate her.

At 8.52pm, the hospital team made a decision to terminate their resuscitative efforts due to “futility and prolonged downtime”.

Chan was pronounced dead at 9pm on June 4.

Autopsy certified coronary heart disease to be cause of death

On June 5, Dr Audrey Yeo, a medical officer with the Health Sciences Authority’s (HSA) forensic medicine division, conducted an autopsy.

The autopsy certified that the cause of death was ischaemic heart disease, or coronary heart disease.

On June 7, Chan’s peripheral blood and urine samples were also submitted to HSA for analysis.

The coroner’s report stated that nothing unusual was detected from the analysis.

Though certain drugs were detected, Dr Yeo clarified that these drugs had been used for the treatment of — among other things — abnormal heart rhythms, hypertension and ischaemic heart disease.

Dr Yeo opined that the drug concentrations in the post-mortem blood sample were within their respective expected ranges and did not cause or contribute to Chan’s death.

Medical reports were also obtained from Tan Tock Seng Hospital (TTSH) and independent medical experts.

The TTSH medical report stated that Chan was first seen as an outpatient at the hospital’s cardiology clinic on May 18, 2015.

It stated that she had a past medical history of diabetes mellitus, hypertension, dyslipidaemia and stable ischemic heart disease.

Separately, Dr Lim Xin Rong from TTSH’s department of rheumatology, allergy and immunology was appointed by the Academy of Medicine to be the independent medical expert.

In her report, Dr Lim concurred with the finding of ischaemic heart disease as Chan’s cause of death.

Dr Lim said that the diagnosis of vaccine-induced immune thrombotic thrombocytopenia was “unlikely” as there were “no demonstrable thrombi or clots”.

Dr Lim was asked to comment on a document furnished by Chan’s next-of-kin, which included a section stating that acute coronary syndrome and coronary artery disease were known to be adverse effects of the vaccine.

However, she concluded that the document did not show these to be the vaccine’s adverse effects.

On December 13, 2022, Dr Lim was provided with additional post-mortem ancillary investigation reports, and asked to provide her views on whether there were any links between the vaccination and Chan’s cause of death.

Dr Lim concluded that there was no such evidence.

In his report, Coroner Goh noted that Chan had a known history of diabetes mellitus, hypertension, hyperlipidaemia and ischaemic heart disease.

As she had died shortly after she had taken a Covid-19 vaccine shot, “her family understandably has expressed concerns as to whether the Covid-19 vaccine had caused her death”.

The coroner, however, said that the medical reports concluded that the vaccine did not cause her death.

“Whilst the family has provided medical literature to show a possible link between the Covid-19 vaccine shot and Madam Chan’s death, in my view, this literature was inconclusive and insufficient for this inquiry to reach the conclusion that the Covid-19 vaccine caused or contributed to Madam Chan’s death.

“Further, the evidence before the court is that the body’s reaction to, in this case, a vaccine, would occur almost immediately after a vaccine is administered.

“This was not the case here.” — TODAY