Worker’s death linked to Covid-19 vaccine: Ruling was by default

SINGAPORE - Was

Mr Rajib’s death

really caused by the Covid-19 vaccine he had received 21 days prior to his death?

Officially, yes, and his family will receive $225,000, the highest amount that can be awarded under the Vaccine Injury Financial Assistance Programme.

But State Coroner Adam Nakhoda came to that decision not because the autopsy showed that was the cause of his death, but rather because no other causes were found.

Hence, “on the balance of probabilities, (his death is) likely to be related to the Covid-19 vaccination”, said the coroner last Wednesday in ruling the death as a medical misadventure.

Mr Rajib, 28, a worker from Bangladesh who went by only one name, had appeared perfectly fine until he fell and died on July 9, 2021.

He had been working here since February 2013 and a fellow worker, Mr Sarker Juran, said he had “never complained of being unwell”.

He had no known chronic ailments. But a year before his death, he was infected with Covid-19 and recovered fully.

On June 18, 2021, he received his first dose of the Moderna mRNA vaccine. He was fine and returned to work the next day.

On July 9, 2021, the day he died, Mr Rajib was supervising welding work on a tank by four other workers at Sembawang Shipyard. The tank was 20m deep and accessed through a 1m-wide manhole.

Mr Rajib did not enter the tank, as he was also supervising welding work at other locations.

The four workers finished at around 4pm and left. At about 5.45pm, Mr Rajib asked Mr Sarker to help him wrap the newly welded points in the tank with aluminium foil.

After Mr Sarker checked to ensure there were no toxic fumes, the two men climbed down to the bottom of the tank. They finished the work at around 6.30pm.

Mr Sarker started up the ladder first, followed by Mr Rajib, who fell backwards onto the metal floor after climbing 60cm. When Mr Sarker went down to check, Mr Rajib was unconscious but did not have any obvious injuries. Mr Sarker then called for help.

The company’s emergency response team arrived at 7.25pm with cardiopulmonary resuscitation equipment. The resuscitation efforts continued as an ambulance took Mr Rajib to Ng Teng Fong General Hospital at 8.25pm.

Mr Rajib was unconscious and had no pulse when he arrived at the emergency department at 9.05pm. Doctors worked on him till 9.22pm, when they decided to stop as there was no response. He was pronounced dead at 9.27pm.

The hospital made a police report and his body was taken to the Health Sciences Authority (HSA) mortuary.

An autopsy, carried out the next day by Associate Professor Teo Eng Swee of the HSA’s Forensic Medicine Division, found no obvious cause of death.

Microscopic examination of heart tissue revealed myocarditis, or inflammation of the heart muscle, though earlier examination had found “the heart was normal-sized and the chambers did not appear dilated”.

Prof Teo certified the cause of death as myocarditis. As Mr Rajib had taken the vaccine 21 days earlier, he said there was a possibility the myocarditis was an adverse reaction to the Covid-19 vaccine. However, he emphasised that this could not be definitely proven by autopsy.

The more usual causes of myocarditis – such as viral or other infection, substance abuse and autoimmune diseases – were all eliminated in this case.

While Covid-19 infection can cause myocarditis, Prof Teo said this was unlikely in Mr Rajib’s case, as there were no signs of scarring or fibrosis that would have indicated a chronic condition.

The autopsy found Mr Rajib had a mutation in a gene that is known to cause abnormal heart rhythms and sudden deaths. But his mutation was a “variant of unknown significance”, meaning it was not one of the mutations known to cause abnormal heart rhythms.

This left the vaccine as a possible cause as the police had ruled out foul play.

State Coroner Nakhoda said: “As the myocarditis was, on the balance of probabilities, likely to be related to the Covid-19 vaccination Mr Rajib had received on June 18, 2021, I found that his death was not due to a natural disease process.”

The Ministry of Health said last Friday that Mr Rajib’s death was the first in Singapore related to Covid-19 vaccination.