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This is VAERS ID 150243

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 150243
VAERS Form:
Age:1.0
Sex:Male
Location:Mississippi
Vaccinated:2000-03-07
Onset:2000-03-11
Submitted:2000-03-13
Entered:2000-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA / CONNAUGHT LABS 7388BA / 3 - / IM
HEP: ENGERIX-B / SMITHKLINE ENG314009 / 3 - / IM
HIBV: ACT-HIB / CONNAUGHT LABS N0548AA / 2 - / IM
IPV: POLIOVAX / CONNAUGHT LTD P0473 / 2 - / IM
MMR: MMR II / MSD 0928J / 0 - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: CONVULS, APNEA, EDEMA LUNG, EDEMA BRAIN, ATELECTASIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy to be performed
CDC 'Split Type':

Write-up: No reaction or illness was noted after vaccine until the morning of 3/11/00. The child was playing and then laid down on couch and started shaking and stopped breathing. Autopsy showed cause of death to be consistent with seizure. Other findings of pulmon"ary vascular congestion and edema, atelectasis of the lungs, hepatic congestion, petechiae of the thymus, splenic congestion, reactive lymphoid hyperplasia of the mesenteric lymph nodes, renal congestion, fetal lobulation of the kidneys, cerebal edema.


Changed on 12/8/2009

VAERS ID: 150243 Before After
VAERS Form:
Age:1.0
Sex:Male
Location:Mississippi
Vaccinated:2000-03-07
Onset:2000-03-11
Submitted:2000-03-13
Entered:2000-03-22 2000-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: TRIPEDIA DTAP (TRIPEDIA) / CONNAUGHT LABS CONNAUGHT LABORATORIES 7388BA / 3 - / IM
HEP: ENGERIX-B HEP B (ENGERIX-B) / SMITHKLINE SMITHKLINE BEECHAM ENG314009 / 3 - / IM
HIBV: ACT-HIB HIB (ACTHIB) / CONNAUGHT LABS CONNAUGHT LABORATORIES N0548AA / 2 - / IM
IPV: POLIOVAX POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD CONNAUGHT LTD. P0473 / 2 - / IM
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 0928J / 0 - / SC

Administered by: Private      Purchased by: Unknown Other
Symptoms: Apnoea, Atelectasis, Convulsion, Hyperplasia, Liver disorder, Petechiae, Pulmonary congestion, Pulmonary oedema, Renal disorder, Spleen disorder, Tremor, Brain oedema, Foetal disorder, CONVULS, APNEA, EDEMA LUNG, EDEMA BRAIN, ATELECTASIS

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy to be performed
CDC 'Split Type': (blank) MS00007

Write-up: No reaction or illness was noted after vaccine until the morning of 3/11/00. The child was playing and then laid down on couch and started shaking and stopped breathing. Autopsy showed cause of death to be consistent with seizure. Other findings of pulmon"ary pulmonary vascular congestion and edema, atelectasis of the lungs, hepatic congestion, petechiae of the thymus, splenic congestion, reactive lymphoid hyperplasia of the mesenteric lymph nodes, renal congestion, fetal lobulation of the kidneys, cerebal edema.


Changed on 8/31/2010

VAERS ID: 150243 Before After
VAERS Form:
Age:1.0
Sex:Male
Location:Mississippi
Vaccinated:2000-03-07
Onset:2000-03-11
Submitted:2000-03-13
Entered:2000-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7388BA / 3 - / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM ENG314009 / 3 - / IM
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES N0548AA / 2 - / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. P0473 / 2 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0928J / 0 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Atelectasis, Convulsion, Hyperplasia, Liver disorder, Petechiae, Pulmonary congestion, Pulmonary oedema, Renal disorder, Spleen disorder, Tremor, Brain oedema, Foetal disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy to be performed
CDC 'Split Type': MS00007

Write-up: No reaction or illness was noted after vaccine until the morning of 3/11/00. The child was playing and then laid down on couch and started shaking and stopped breathing. Autopsy showed cause of death to be consistent with seizure. Other findings of pulmonary vascular congestion and edema, atelectasis of the lungs, hepatic congestion, petechiae of the thymus, splenic congestion, reactive lymphoid hyperplasia of the mesenteric lymph nodes, renal congestion, fetal lobulation of the kidneys, cerebal edema.


Changed on 4/13/2011

VAERS ID: 150243 Before After
VAERS Form:
Age:1.0
Sex:Male
Location:Mississippi
Vaccinated:2000-03-07
Onset:2000-03-11
Submitted:2000-03-13
Entered:2000-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7388BA / 3 - / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM ENG314009 / 3 - / IM
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES N0548AA / 2 - / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. P0473 / 2 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0928J / 0 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Atelectasis, Convulsion, Hyperplasia, Liver disorder, Petechiae, Pulmonary congestion, Pulmonary oedema, Renal disorder, Spleen disorder, Tremor, Brain oedema, Foetal disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy to be performed
CDC 'Split Type': MS00007

Write-up: No reaction or illness was noted after vaccine until the morning of 3/11/00. The child was playing and then laid down on couch and started shaking and stopped breathing. Autopsy showed cause of death to be consistent with seizure. Other findings of pulmonary vascular congestion and edema, atelectasis of the lungs, hepatic congestion, petechiae of the thymus, splenic congestion, reactive lymphoid hyperplasia of the mesenteric lymph nodes, renal congestion, fetal lobulation of the kidneys, cerebal edema.


Changed on 5/13/2011

VAERS ID: 150243 Before After
VAERS Form:
Age:1.0
Sex:Male
Location:Mississippi
Vaccinated:2000-03-07
Onset:2000-03-11
Submitted:2000-03-13
Entered:2000-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7388BA / 3 - / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM ENG314009 / 3 - / IM
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES N0548AA / 2 - / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. P0473 / 2 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0928J / 0 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Atelectasis, Convulsion, Hyperplasia, Liver disorder, Petechiae, Pulmonary congestion, Pulmonary oedema, Renal disorder, Spleen disorder, Tremor, Brain oedema, Foetal disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy to be performed
CDC 'Split Type': MS00007

Write-up: No reaction or illness was noted after vaccine until the morning of 3/11/00. The child was playing and then laid down on couch and started shaking and stopped breathing. Autopsy showed cause of death to be consistent with seizure. Other findings of pulmonary vascular congestion and edema, atelectasis of the lungs, hepatic congestion, petechiae of the thymus, splenic congestion, reactive lymphoid hyperplasia of the mesenteric lymph nodes, renal congestion, fetal lobulation of the kidneys, cerebal edema.


Changed on 6/11/2011

VAERS ID: 150243 Before After
VAERS Form:
Age:1.0
Sex:Male
Location:Mississippi
Vaccinated:2000-03-07
Onset:2000-03-11
Submitted:2000-03-13
Entered:2000-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7388BA / 3 - / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM ENG314009 / 3 - / IM
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES N0548AA / 2 - / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. P0473 / 2 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0928J / 0 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Atelectasis, Convulsion, Hyperplasia, Liver disorder, Petechiae, Pulmonary congestion, Pulmonary oedema, Renal disorder, Spleen disorder, Tremor, Brain oedema, Foetal disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy to be performed
CDC 'Split Type': MS00007

Write-up: No reaction or illness was noted after vaccine until the morning of 3/11/00. The child was playing and then laid down on couch and started shaking and stopped breathing. Autopsy showed cause of death to be consistent with seizure. Other findings of pulmonary vascular congestion and edema, atelectasis of the lungs, hepatic congestion, petechiae of the thymus, splenic congestion, reactive lymphoid hyperplasia of the mesenteric lymph nodes, renal congestion, fetal lobulation of the kidneys, cerebal edema.


Changed on 9/14/2017

VAERS ID: 150243 Before After
VAERS Form:(blank) 1
Age:1.0
Sex:Male
Location:Mississippi
Vaccinated:2000-03-07
Onset:2000-03-11
Submitted:2000-03-13
Entered:2000-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7388BA / 3 4 - / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM ENG314009 / 3 4 - / IM
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES N0548AA / 2 3 - / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. P0473 / 2 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0928J / 0 1 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Atelectasis, Convulsion, Hyperplasia, Liver disorder, Petechiae, Pulmonary congestion, Pulmonary oedema, Renal disorder, Spleen disorder, Tremor, Brain oedema, Foetal disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy to be performed
CDC 'Split Type': MS00007

Write-up: No reaction or illness was noted after vaccine until the morning of 3/11/00. The child was playing and then laid down on couch and started shaking and stopped breathing. Autopsy showed cause of death to be consistent with seizure. Other findings of pulmonary vascular congestion and edema, atelectasis of the lungs, hepatic congestion, petechiae of the thymus, splenic congestion, reactive lymphoid hyperplasia of the mesenteric lymph nodes, renal congestion, fetal lobulation of the kidneys, cerebal edema.


Changed on 2/14/2018

VAERS ID: 150243 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Mississippi
Vaccinated:2000-03-07
Onset:2000-03-11
Submitted:2000-03-13
Entered:2000-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7388BA / 4 - / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM ENG314009 / 4 - / IM
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES N0548AA / 3 - / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. P0473 / 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0928J / 1 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Atelectasis, Convulsion, Hyperplasia, Liver disorder, Petechiae, Pulmonary congestion, Pulmonary oedema, Renal disorder, Spleen disorder, Tremor, Brain oedema, Foetal disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy to be performed
CDC 'Split Type': MS00007

Write-up: No reaction or illness was noted after vaccine until the morning of 3/11/00. The child was playing and then laid down on couch and started shaking and stopped breathing. Autopsy showed cause of death to be consistent with seizure. Other findings of pulmonary vascular congestion and edema, atelectasis of the lungs, hepatic congestion, petechiae of the thymus, splenic congestion, reactive lymphoid hyperplasia of the mesenteric lymph nodes, renal congestion, fetal lobulation of the kidneys, cerebal edema.


Changed on 6/14/2018

VAERS ID: 150243 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Mississippi
Vaccinated:2000-03-07
Onset:2000-03-11
Submitted:2000-03-13
Entered:2000-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7388BA / 4 - / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM ENG314009 / 4 - / IM
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES N0548AA / 3 - / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. P0473 / 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0928J / 1 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Atelectasis, Convulsion, Hyperplasia, Liver disorder, Petechiae, Pulmonary congestion, Pulmonary oedema, Renal disorder, Spleen disorder, Tremor, Brain oedema, Foetal disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy to be performed
CDC 'Split Type': MS00007

Write-up: No reaction or illness was noted after vaccine until the morning of 3/11/00. The child was playing and then laid down on couch and started shaking and stopped breathing. Autopsy showed cause of death to be consistent with seizure. Other findings of pulmonary vascular congestion and edema, atelectasis of the lungs, hepatic congestion, petechiae of the thymus, splenic congestion, reactive lymphoid hyperplasia of the mesenteric lymph nodes, renal congestion, fetal lobulation of the kidneys, cerebal edema.


Changed on 8/14/2018

VAERS ID: 150243 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Mississippi
Vaccinated:2000-03-07
Onset:2000-03-11
Submitted:2000-03-13
Entered:2000-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7388BA / 4 - / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM ENG314009 / 4 - / IM
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES N0548AA / 3 - / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. P0473 / 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0928J / 1 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Atelectasis, Convulsion, Hyperplasia, Liver disorder, Petechiae, Pulmonary congestion, Pulmonary oedema, Renal disorder, Spleen disorder, Tremor, Brain oedema, Foetal disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy to be performed
CDC 'Split Type': MS00007

Write-up: No reaction or illness was noted after vaccine until the morning of 3/11/00. The child was playing and then laid down on couch and started shaking and stopped breathing. Autopsy showed cause of death to be consistent with seizure. Other findings of pulmonary vascular congestion and edema, atelectasis of the lungs, hepatic congestion, petechiae of the thymus, splenic congestion, reactive lymphoid hyperplasia of the mesenteric lymph nodes, renal congestion, fetal lobulation of the kidneys, cerebal edema.


Changed on 9/14/2018

VAERS ID: 150243 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Mississippi
Vaccinated:2000-03-07
Onset:2000-03-11
Submitted:2000-03-13
Entered:2000-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7388BA / 4 - / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM ENG314009 / 4 - / IM
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES N0548AA / 3 - / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. P0473 / 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0928J / 1 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Atelectasis, Convulsion, Hyperplasia, Liver disorder, Petechiae, Pulmonary congestion, Pulmonary oedema, Renal disorder, Spleen disorder, Tremor, Brain oedema, Foetal disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy to be performed
CDC 'Split Type': MS00007

Write-up: No reaction or illness was noted after vaccine until the morning of 3/11/00. The child was playing and then laid down on couch and started shaking and stopped breathing. Autopsy showed cause of death to be consistent with seizure. Other findings of pulmonary vascular congestion and edema, atelectasis of the lungs, hepatic congestion, petechiae of the thymus, splenic congestion, reactive lymphoid hyperplasia of the mesenteric lymph nodes, renal congestion, fetal lobulation of the kidneys, cerebal edema.


Changed on 10/14/2018

VAERS ID: 150243 Before After
VAERS Form:1
Age:1.0
Sex:Male
Location:Mississippi
Vaccinated:2000-03-07
Onset:2000-03-11
Submitted:2000-03-13
Entered:2000-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7388BA / 4 - / IM
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM ENG314009 / 4 - / IM
HIBV: HIB (ACTHIB) / CONNAUGHT LABORATORIES N0548AA / 3 - / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. P0473 / 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0928J / 1 - / SC

Administered by: Private      Purchased by: Other
Symptoms: Apnoea, Atelectasis, Convulsion, Hyperplasia, Liver disorder, Petechiae, Pulmonary congestion, Pulmonary oedema, Renal disorder, Spleen disorder, Tremor, Brain oedema, Foetal disorder

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-03-11
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Autopsy to be performed
CDC 'Split Type': MS00007

Write-up: No reaction or illness was noted after vaccine until the morning of 3/11/00. The child was playing and then laid down on couch and started shaking and stopped breathing. Autopsy showed cause of death to be consistent with seizure. Other findings of pulmonary vascular congestion and edema, atelectasis of the lungs, hepatic congestion, petechiae of the thymus, splenic congestion, reactive lymphoid hyperplasia of the mesenteric lymph nodes, renal congestion, fetal lobulation of the kidneys, cerebal edema.

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