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This is VAERS ID 187045

Case Details

VAERS ID: 187045 (history)  
Form: Version 1.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2002-07-05
Entered: 2002-07-01
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
TTOX: TETANUS TOXOID (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Coma, Encephalitis
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (narrow), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hospitalization
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES0206USA01625

Write-up: Information has been received from a physician concerning a pt who was vaccinated with a dose of MMR II. The reporter "heard" that the pt "may have had a serious adverse event" and requested information regarding MMR II, encephalitis and coma. Unspecified medical attention was sought; however, the reporting physician noted that the pt was "not his pt." The reporter considered the adverse event to be an other important medical event. Additional info has been requested. Follow-up info was received on 06/27/02. The physician revealed that he is acting as a consutant on a legal case concerning this pt. He reported that she went on to develop encephalitis and later died. The reporter considered the encehalitis to be an other important medical event. Additional info has been requested.


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