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This is VAERS ID 28812

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 28812
VAERS Form:
Age:0.7
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-18
Onset:1990-12-18
Submitted:1991-01-02
Entered:1991-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIBTITER / LEDERLE(PRAXIS) M195FD / 0 RL / IM
M: ATTENUVAX / MSD 1464S / 0 LL / -

Administered by: Private      Purchased by: Unknown
Symptoms: APNEA, HEART ARREST, HEART FAIL

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
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: Ferinsol, Diuril until 17DEC; Nebs: Ventolin/Mucomyst
Current Illness: BPD, S/P G-Tube placement
Preexisting Conditions: 25 wk premie w/h/o BPD, Cardiorespiratory arrest; S/P tracheostomy, sepsis, blood trnafusions, subglottis stenosis.
Allergies:
Diagnostic Lab Data: ABG=6.8; PCO2=30; PO2=185; base excess of 25.8; saturated of 97.8%. Lytes p/med NA=141, K=3.1, CO2=2.4, cl=111; Glucose=486; temp 95.4; HR-166
CDC 'Split Type':

Write-up: @ 1030PM, monitor went off for heart & respirations; no palpable pulse; appeared to be in asystole. Rec''d Atropine & Epinephrine, bicarb; a second dose of epi & bicarb were also administered @ 10:39, faint fem pulse present; 1 BrS @ 1041


Changed on 12/8/2009

VAERS ID: 28812 Before After
VAERS Form:
Age:0.7
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-18
Onset:1990-12-18
Submitted:1991-01-02
Entered:1991-03-08 1991-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M195FD / 0 RL / IM
M: ATTENUVAX / MSD 1464S / 0 LL / -
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1464S / 0 LL / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Apnoea, Cardiac arrest, Cardiac failure, APNEA, HEART ARREST, HEART FAIL

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
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: Ferinsol, Diuril until 17DEC; Nebs: Ventolin/Mucomyst
Current Illness: BPD, S/P G-Tube placement
Preexisting Conditions: 25 wk premie w/h/o BPD, Cardiorespiratory arrest; S/P tracheostomy, sepsis, blood trnafusions, subglottis stenosis.
Allergies:
Diagnostic Lab Data: ABG=6.8; PCO2=30; PO2=185; base excess of 25.8; saturated of 97.8%. Lytes p/med NA=141, K=3.1, CO2=2.4, cl=111; Glucose=486; temp 95.4; HR-166
CDC 'Split Type':

Write-up: @ 1030PM, monitor went off for heart & respirations; no palpable pulse; appeared to be in asystole. Rec''d Atropine & Epinephrine, bicarb; a second dose of epi & bicarb were also administered @ 10:39, faint fem pulse present; 1 BrS @ 1041


Changed on 5/14/2017

VAERS ID: 28812 Before After
VAERS Form:
Age:0.7
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-18
Onset:1990-12-18
Submitted:1991-01-02
Entered:1991-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M195FD / 0 RL / IM
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1464S / 0 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest, Cardiac failure

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ferinsol, Diuril until 17DEC; Nebs: Ventolin/Mucomyst
Current Illness: BPD, S/P G-Tube placement
Preexisting Conditions: 25 wk premie w/h/o BPD, Cardiorespiratory arrest; S/P tracheostomy, sepsis, blood trnafusions, subglottis stenosis.
Allergies:
Diagnostic Lab Data: ABG=6.8; PCO2=30; PO2=185; base excess of 25.8; saturated of 97.8%. Lytes p/med NA=141, K=3.1, CO2=2.4, cl=111; Glucose=486; temp 95.4; HR-166
CDC 'Split Type':

Write-up: @ 1030PM, monitor went off for heart & respirations; no palpable pulse; appeared to be in asystole. Rec''d Atropine & Epinephrine, bicarb; a second dose of epi & bicarb were also administered @ 10:39, faint fem pulse present; 1 BrS @ 1041


Changed on 9/14/2017

VAERS ID: 28812 Before After
VAERS Form:(blank) 1
Age:0.7
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-18
Onset:1990-12-18
Submitted:1991-01-02
Entered:1991-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M195FD / 0 1 RL / IM
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1464S / 0 1 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest, Cardiac failure

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ferinsol, Diuril until 17DEC; Nebs: Ventolin/Mucomyst
Current Illness: BPD, S/P G-Tube placement
Preexisting Conditions: 25 wk premie w/h/o BPD, Cardiorespiratory arrest; S/P tracheostomy, sepsis, blood trnafusions, subglottis stenosis.
Allergies:
Diagnostic Lab Data: ABG=6.8; PCO2=30; PO2=185; base excess of 25.8; saturated of 97.8%. Lytes p/med NA=141, K=3.1, CO2=2.4, cl=111; Glucose=486; temp 95.4; HR-166
CDC 'Split Type':

Write-up: @ 1030PM, monitor went off for heart & respirations; no palpable pulse; appeared to be in asystole. Rec''d Atropine & Epinephrine, bicarb; a second dose of epi & bicarb were also administered @ 10:39, faint fem pulse present; 1 BrS @ 1041


Changed on 2/14/2018

VAERS ID: 28812 Before After
VAERS Form:1
Age:0.7
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-18
Onset:1990-12-18
Submitted:1991-01-02
Entered:1991-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M195FD / 1 RL / IM
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1464S / 1 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest, Cardiac failure

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ferinsol, Diuril until 17DEC; Nebs: Ventolin/Mucomyst
Current Illness: BPD, S/P G-Tube placement
Preexisting Conditions: 25 wk premie w/h/o BPD, Cardiorespiratory arrest; S/P tracheostomy, sepsis, blood trnafusions, subglottis stenosis.
Allergies:
Diagnostic Lab Data: ABG=6.8; PCO2=30; PO2=185; base excess of 25.8; saturated of 97.8%. Lytes p/med NA=141, K=3.1, CO2=2.4, cl=111; Glucose=486; temp 95.4; HR-166
CDC 'Split Type':

Write-up: @ 1030PM, monitor went off for heart & respirations; no palpable pulse; appeared to be in asystole. Rec''d Atropine & Epinephrine, bicarb; a second dose of epi & bicarb were also administered @ 10:39, faint fem pulse present; 1 BrS @ 1041


Changed on 6/14/2018

VAERS ID: 28812 Before After
VAERS Form:1
Age:0.7
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-18
Onset:1990-12-18
Submitted:1991-01-02
Entered:1991-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M195FD / 1 RL / IM
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1464S / 1 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest, Cardiac failure

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ferinsol, Diuril until 17DEC; Nebs: Ventolin/Mucomyst
Current Illness: BPD, S/P G-Tube placement
Preexisting Conditions: 25 wk premie w/h/o BPD, Cardiorespiratory arrest; S/P tracheostomy, sepsis, blood trnafusions, subglottis stenosis.
Allergies:
Diagnostic Lab Data: ABG=6.8; PCO2=30; PO2=185; base excess of 25.8; saturated of 97.8%. Lytes p/med NA=141, K=3.1, CO2=2.4, cl=111; Glucose=486; temp 95.4; HR-166
CDC 'Split Type':

Write-up: @ 1030PM, monitor went off for heart & respirations; no palpable pulse; appeared to be in asystole. Rec''d Atropine & Epinephrine, bicarb; a second dose of epi & bicarb were also administered @ 10:39, faint fem pulse present; 1 BrS @ 1041


Changed on 8/14/2018

VAERS ID: 28812 Before After
VAERS Form:1
Age:0.7
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-18
Onset:1990-12-18
Submitted:1991-01-02
Entered:1991-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M195FD / 1 RL / IM
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1464S / 1 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest, Cardiac failure

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ferinsol, Diuril until 17DEC; Nebs: Ventolin/Mucomyst
Current Illness: BPD, S/P G-Tube placement
Preexisting Conditions: 25 wk premie w/h/o BPD, Cardiorespiratory arrest; S/P tracheostomy, sepsis, blood trnafusions, subglottis stenosis.
Allergies:
Diagnostic Lab Data: ABG=6.8; PCO2=30; PO2=185; base excess of 25.8; saturated of 97.8%. Lytes p/med NA=141, K=3.1, CO2=2.4, cl=111; Glucose=486; temp 95.4; HR-166
CDC 'Split Type':

Write-up: @ 1030PM, monitor went off for heart & respirations; no palpable pulse; appeared to be in asystole. Rec''d Atropine & Epinephrine, bicarb; a second dose of epi & bicarb were also administered @ 10:39, faint fem pulse present; 1 BrS @ 1041


Changed on 9/14/2018

VAERS ID: 28812 Before After
VAERS Form:1
Age:0.7
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-18
Onset:1990-12-18
Submitted:1991-01-02
Entered:1991-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M195FD / 1 RL / IM
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1464S / 1 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest, Cardiac failure

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ferinsol, Diuril until 17DEC; Nebs: Ventolin/Mucomyst
Current Illness: BPD, S/P G-Tube placement
Preexisting Conditions: 25 wk premie w/h/o BPD, Cardiorespiratory arrest; S/P tracheostomy, sepsis, blood trnafusions, subglottis stenosis.
Allergies:
Diagnostic Lab Data: ABG=6.8; PCO2=30; PO2=185; base excess of 25.8; saturated of 97.8%. Lytes p/med NA=141, K=3.1, CO2=2.4, cl=111; Glucose=486; temp 95.4; HR-166
CDC 'Split Type':

Write-up: @ 1030PM, monitor went off for heart & respirations; no palpable pulse; appeared to be in asystole. Rec''d Atropine & Epinephrine, bicarb; a second dose of epi & bicarb were also administered @ 10:39, faint fem pulse present; 1 BrS @ 1041


Changed on 10/14/2018

VAERS ID: 28812 Before After
VAERS Form:1
Age:0.7
Sex:Female
Location:Pennsylvania
Vaccinated:1990-12-18
Onset:1990-12-18
Submitted:1991-01-02
Entered:1991-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M195FD / 1 RL / IM
MEA: MEASLES (ATTENUVAX) / MERCK & CO. INC. 1464S / 1 LL / -

Administered by: Private      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest, Cardiac failure

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Ferinsol, Diuril until 17DEC; Nebs: Ventolin/Mucomyst
Current Illness: BPD, S/P G-Tube placement
Preexisting Conditions: 25 wk premie w/h/o BPD, Cardiorespiratory arrest; S/P tracheostomy, sepsis, blood trnafusions, subglottis stenosis.
Allergies:
Diagnostic Lab Data: ABG=6.8; PCO2=30; PO2=185; base excess of 25.8; saturated of 97.8%. Lytes p/med NA=141, K=3.1, CO2=2.4, cl=111; Glucose=486; temp 95.4; HR-166
CDC 'Split Type':

Write-up: @ 1030PM, monitor went off for heart & respirations; no palpable pulse; appeared to be in asystole. Rec''d Atropine & Epinephrine, bicarb; a second dose of epi & bicarb were also administered @ 10:39, faint fem pulse present; 1 BrS @ 1041

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