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This is VAERS ID 291804

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 291804
VAERS Form:
Age:17.0
Sex:Female
Location:Ohio
Vaccinated:2007-07-13
Onset:2007-09-01
Submitted:2007-10-01
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 LA / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Blood glucose increased, Death, Diabetic ketoacidosis, Pulse absent

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-09-19
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: Unknown
Current Illness: IDDM, uncontrolled. Smoker. anemia.
Preexisting Conditions: Unknown PMH: IDDM, uncontrolled. Smoker. Right buttock abscess 8/31/07. Anemia. Father w/diabetes. ALLERGIES: PCN, cipro, ultram (hives).
Allergies:
Diagnostic Lab Data: Unknown Vitreous glucose 667 (H).
CDC 'Split Type':

Write-up: Information has been received from a physician concerning a female who on an unknown date was vaccinated with the first dose of Gardasil (yeast, unknown lot number) and in July 2007, was vaccinated with the second dose of Gardasil. In September 2007, the"patient died. No further details or symptoms were known regarding the patient''''s death. The physician mentioned that an autopsy would be done however, had not received the results yet. The reporting physician felt that the patient''''s death was not related


Changed on 12/8/2009

VAERS ID: 291804 Before After
VAERS Form:
Age:17.0
Sex:Female
Location:Ohio
Vaccinated:2007-07-13
Onset:2007-09-01
Submitted:2007-10-01
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 LA / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Blood glucose increased, Death, Diabetic ketoacidosis, Pulse absent, Resuscitation, Unresponsive to stimuli, Vomiting

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-09-19
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: Unknown
Current Illness: IDDM, uncontrolled. Smoker. anemia.
Preexisting Conditions: Unknown PMH: IDDM, uncontrolled. Smoker. Right buttock abscess 8/31/07. Anemia. Father w/diabetes. ALLERGIES: PCN, cipro, ultram (hives).
Allergies:
Diagnostic Lab Data: Unknown Vitreous glucose 667 (H).
CDC 'Split Type': (blank) WAES0709USA04400

Write-up: Information has been received from a physician concerning a female who on an unknown date was vaccinated with the first dose of Gardasil (yeast, unknown lot number) and in July 2007, was vaccinated with the second dose of Gardasil. In September 2007, the"patient the patient died. No further details or symptoms were known regarding the patient''''s patient''s death. The physician mentioned that an autopsy would be done however, had not received the results yet. The reporting physician felt that the patient''''s patient''s death was not related to therapy with Gardasil. Additional information has been requested. 10/11/2007 Patient demographics provided by CDC. 10/15/07 Received vax record from pcp. VAERS database updated w/same. 10/15/07 Received pcp & hospital medical records from CDC which reveal patient experienced vomiting with elevated blood sugars who became unresponsive & pulseless. CPR started & taken to ER on 9/19/07. Resuscitation was unsuccessful & patient pronounced 9/19/07. 10/26/07 Reviewed autopsy report which reveals COD as diabetic ketoacidosis & manner of death as natural. Patient had been found by parent unresponsive at home. History of severe diabetes mellitus. Vitreous glucose 667 (H).


Changed on 10/11/2011

VAERS ID: 291804 Before After
VAERS Form:
Age:17.0
Sex:Female
Location:Ohio
Vaccinated:2007-07-13
Onset:2007-09-01
Submitted:2007-10-01
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 LA / UN

Administered by: Other      Purchased by: Other
Symptoms: Abscess drainage, Anaemia, Blood calcium decreased, Blood glucose increased, Blood sodium decreased, Blood urea decreased, Death, Diabetes mellitus inadequate control, Diabetic ketoacidosis, Erythema, Glycosylated haemoglobin increased, Gram stain positive, Haematocrit decreased, Haemoglobin decreased, Pulse absent, Resuscitation, Subcutaneous abscess, Unresponsive to stimuli, Vomiting, Incisional drainage, Perirectal abscess, Bacterial test positive, Induration, Lactobacillus test positive, Staphylococcus test positive, Aspergillus test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-09-19
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: Unknown
Current Illness: IDDM, uncontrolled. Smoker. anemia.
Preexisting Conditions: Unknown PMH: IDDM, uncontrolled. Smoker. Right buttock abscess 8/31/07. Anemia. Father w/diabetes. ALLERGIES: PCN, cipro, ultram (hives).
Allergies:
Diagnostic Lab Data: Unknown Vitreous glucose 667 (H).
CDC 'Split Type': WAES0709USA04400

Write-up: Information has been received from a physician concerning a female who on an unknown date was vaccinated with the first dose of Gardasil (yeast, unknown lot number) and in July 2007, was vaccinated with the second dose of Gardasil. In September 2007, the patient died. No further details or symptoms were known regarding the patient''s death. The physician mentioned that an autopsy would be done however, had not received the results yet. The reporting physician felt that the patient''s death was not related to therapy with Gardasil. Additional information has been requested. 10/11/2007 Patient demographics provided by CDC. 10/15/07 Received vax record from pcp. VAERS database updated w/same. 10/15/07 Received pcp & hospital medical records from CDC which reveal patient experienced vomiting with elevated blood sugars who became unresponsive & pulseless. CPR started & taken to ER on 9/19/07. Resuscitation was unsuccessful & patient pronounced 9/19/07. 10/26/07 Reviewed autopsy report which reveals COD as diabetic ketoacidosis & manner of death as natural. Patient had been found by parent unresponsive at home. History of severe diabetes mellitus. Vitreous glucose 667 (H).


Changed on 6/14/2014

VAERS ID: 291804 Before After
VAERS Form:
Age:17.0
Sex:Female
Location:Ohio
Vaccinated:2007-07-13
Onset:2007-09-01
Submitted:2007-10-01
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 LA / UN

Administered by: Other      Purchased by: Other
Symptoms: Abscess drainage, Anaemia, Blood calcium decreased, Blood glucose increased, Blood sodium decreased, Blood urea decreased, Death, Diabetes mellitus inadequate control, Diabetic ketoacidosis, Erythema, Glycosylated haemoglobin increased, Gram stain positive, Haematocrit decreased, Haemoglobin decreased, Pulse absent, Resuscitation, Subcutaneous abscess, Unresponsive to stimuli, Vomiting, Incisional drainage, Perirectal abscess, Bacterial test positive, Induration, Lactobacillus test positive, Staphylococcus test positive, Aspergillus test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-09-19
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: Unknown
Current Illness: IDDM, uncontrolled. Smoker. anemia.
Preexisting Conditions: Unknown PMH: IDDM, uncontrolled. Smoker. Right buttock abscess 8/31/07. Anemia. Father w/diabetes. ALLERGIES: PCN, cipro, ultram (hives).
Allergies:
Diagnostic Lab Data: Unknown Vitreous glucose 667 (H).
CDC 'Split Type': WAES0709USA04400

Write-up: Information has been received from a physician concerning a female who on an unknown date was vaccinated with the first dose of Gardasil (yeast, unknown lot number) and in July 2007, was vaccinated with the second dose of Gardasil. In September 2007, the patient died. No further details or symptoms were known regarding the patient''s death. The physician mentioned that an autopsy would be done however, had not received the results yet. The reporting physician felt that the patient''s death was not related to therapy with Gardasil. Additional information has been requested. 10/11/2007 Patient demographics provided by CDC. 10/15/07 Received vax record from pcp. VAERS database updated w/same. 10/15/07 Received pcp & hospital medical records from CDC which reveal patient experienced vomiting with elevated blood sugars who became unresponsive & pulseless. CPR started & taken to ER on 9/19/07. Resuscitation was unsuccessful & patient pronounced 9/19/07. 10/26/07 Reviewed autopsy report which reveals COD as diabetic ketoacidosis & manner of death as natural. Patient had been found by parent unresponsive at home. History of severe diabetes mellitus. Vitreous glucose 667 (H).


Changed on 2/14/2017

VAERS ID: 291804 Before After
VAERS Form:
Age:17.0
Sex:Female
Location:Ohio
Vaccinated:2007-07-13
Onset:2007-09-01
Submitted:2007-10-01
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 LA / UN

Administered by: Other      Purchased by: Other
Symptoms: Abscess drainage, Anaemia, Blood calcium decreased, Blood glucose increased, Blood sodium decreased, Blood urea decreased, Death, Diabetes mellitus inadequate control, Diabetic ketoacidosis, Erythema, Glycosylated haemoglobin increased, Gram stain positive, Haematocrit decreased, Haemoglobin decreased, Pulse absent, Resuscitation, Subcutaneous abscess, Unresponsive to stimuli, Vomiting, Incisional drainage, Perirectal abscess, Bacterial test positive, Induration, Lactobacillus test positive, Staphylococcus test positive, Aspergillus test positive

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-09-19
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: Unknown
Current Illness: IDDM, uncontrolled. Smoker. anemia.
Preexisting Conditions: Unknown PMH: IDDM, uncontrolled. Smoker. Right buttock abscess 8/31/07. Anemia. Father w/diabetes. ALLERGIES: PCN, cipro, ultram (hives).
Allergies:
Diagnostic Lab Data: Unknown Vitreous glucose 667 (H).
CDC 'Split Type': WAES0709USA04400

Write-up: Information has been received from a physician concerning a female who on an unknown date was vaccinated with the first dose of Gardasil (yeast, unknown lot number) and in July 2007, was vaccinated with the second dose of Gardasil. In September 2007, the patient died. No further details or symptoms were known regarding the patient''s death. The physician mentioned that an autopsy would be done however, had not received the results yet. The reporting physician felt that the patient''s death was not related to therapy with Gardasil. Additional information has been requested. 10/11/2007 Patient demographics provided by CDC. 10/15/07 Received vax record from pcp. VAERS database updated w/same. 10/15/07 Received pcp & hospital medical records from CDC which reveal patient experienced vomiting with elevated blood sugars who became unresponsive & pulseless. CPR started & taken to ER on 9/19/07. Resuscitation was unsuccessful & patient pronounced 9/19/07. 10/26/07 Reviewed autopsy report which reveals COD as diabetic ketoacidosis & manner of death as natural. Patient had been found by parent unresponsive at home. History of severe diabetes mellitus. Vitreous glucose 667 (H).


Changed on 9/14/2017

VAERS ID: 291804 Before After
VAERS Form:(blank) 1
Age:17.0
Sex:Female
Location:Ohio
Vaccinated:2007-07-13
Onset:2007-09-01
Submitted:2007-10-01
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 2 LA / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-09-19
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: Unknown
Current Illness: IDDM, uncontrolled. Smoker. anemia.
Preexisting Conditions: Unknown PMH: IDDM, uncontrolled. Smoker. Right buttock abscess 8/31/07. Anemia. Father w/diabetes. ALLERGIES: PCN, cipro, ultram (hives).
Allergies:
Diagnostic Lab Data: Unknown Vitreous glucose 667 (H).
CDC 'Split Type': WAES0709USA04400

Write-up: Information has been received from a physician concerning a female who on an unknown date was vaccinated with the first dose of Gardasil (yeast, unknown lot number) and in July 2007, was vaccinated with the second dose of Gardasil. In September 2007, the patient died. No further details or symptoms were known regarding the patient''s death. The physician mentioned that an autopsy would be done however, had not received the results yet. The reporting physician felt that the patient''s death was not related to therapy with Gardasil. Additional information has been requested. 10/11/2007 Patient demographics provided by CDC. 10/15/07 Received vax record from pcp. VAERS database updated w/same. 10/15/07 Received pcp & hospital medical records from CDC which reveal patient experienced vomiting with elevated blood sugars who became unresponsive & pulseless. CPR started & taken to ER on 9/19/07. Resuscitation was unsuccessful & patient pronounced 9/19/07. 10/26/07 Reviewed autopsy report which reveals COD as diabetic ketoacidosis & manner of death as natural. Patient had been found by parent unresponsive at home. History of severe diabetes mellitus. Vitreous glucose 667 (H).


Changed on 2/14/2018

VAERS ID: 291804 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Ohio
Vaccinated:2007-07-13
Onset:2007-09-01
Submitted:2007-10-01
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 2 LA / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-09-19
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: Unknown
Current Illness: IDDM, uncontrolled. Smoker. anemia.
Preexisting Conditions: Unknown PMH: IDDM, uncontrolled. Smoker. Right buttock abscess 8/31/07. Anemia. Father w/diabetes. ALLERGIES: PCN, cipro, ultram (hives).
Allergies:
Diagnostic Lab Data: Unknown Vitreous glucose 667 (H).
CDC 'Split Type': WAES0709USA04400

Write-up: Information has been received from a physician concerning a female who on an unknown date was vaccinated with the first dose of Gardasil (yeast, unknown lot number) and in July 2007, was vaccinated with the second dose of Gardasil. In September 2007, the patient died. No further details or symptoms were known regarding the patient''s death. The physician mentioned that an autopsy would be done however, had not received the results yet. The reporting physician felt that the patient''s death was not related to therapy with Gardasil. Additional information has been requested. 10/11/2007 Patient demographics provided by CDC. 10/15/07 Received vax record from pcp. VAERS database updated w/same. 10/15/07 Received pcp & hospital medical records from CDC which reveal patient experienced vomiting with elevated blood sugars who became unresponsive & pulseless. CPR started & taken to ER on 9/19/07. Resuscitation was unsuccessful & patient pronounced 9/19/07. 10/26/07 Reviewed autopsy report which reveals COD as diabetic ketoacidosis & manner of death as natural. Patient had been found by parent unresponsive at home. History of severe diabetes mellitus. Vitreous glucose 667 (H).


Changed on 6/14/2018

VAERS ID: 291804 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Ohio
Vaccinated:2007-07-13
Onset:2007-09-01
Submitted:2007-10-01
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 2 LA / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-09-19
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: Unknown
Current Illness: IDDM, uncontrolled. Smoker. anemia.
Preexisting Conditions: Unknown PMH: IDDM, uncontrolled. Smoker. Right buttock abscess 8/31/07. Anemia. Father w/diabetes. ALLERGIES: PCN, cipro, ultram (hives).
Allergies:
Diagnostic Lab Data: Unknown Vitreous glucose 667 (H).
CDC 'Split Type': WAES0709USA04400

Write-up: Information has been received from a physician concerning a female who on an unknown date was vaccinated with the first dose of Gardasil (yeast, unknown lot number) and in July 2007, was vaccinated with the second dose of Gardasil. In September 2007, the patient died. No further details or symptoms were known regarding the patient''s death. The physician mentioned that an autopsy would be done however, had not received the results yet. The reporting physician felt that the patient''s death was not related to therapy with Gardasil. Additional information has been requested. 10/11/2007 Patient demographics provided by CDC. 10/15/07 Received vax record from pcp. VAERS database updated w/same. 10/15/07 Received pcp & hospital medical records from CDC which reveal patient experienced vomiting with elevated blood sugars who became unresponsive & pulseless. CPR started & taken to ER on 9/19/07. Resuscitation was unsuccessful & patient pronounced 9/19/07. 10/26/07 Reviewed autopsy report which reveals COD as diabetic ketoacidosis & manner of death as natural. Patient had been found by parent unresponsive at home. History of severe diabetes mellitus. Vitreous glucose 667 (H).


Changed on 8/14/2018

VAERS ID: 291804 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Ohio
Vaccinated:2007-07-13
Onset:2007-09-01
Submitted:2007-10-01
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 2 LA / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-09-19
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: Unknown
Current Illness: IDDM, uncontrolled. Smoker. anemia.
Preexisting Conditions: Unknown PMH: IDDM, uncontrolled. Smoker. Right buttock abscess 8/31/07. Anemia. Father w/diabetes. ALLERGIES: PCN, cipro, ultram (hives).
Allergies:
Diagnostic Lab Data: Unknown Vitreous glucose 667 (H).
CDC 'Split Type': WAES0709USA04400

Write-up: Information has been received from a physician concerning a female who on an unknown date was vaccinated with the first dose of Gardasil (yeast, unknown lot number) and in July 2007, was vaccinated with the second dose of Gardasil. In September 2007, the patient died. No further details or symptoms were known regarding the patient''s death. The physician mentioned that an autopsy would be done however, had not received the results yet. The reporting physician felt that the patient''s death was not related to therapy with Gardasil. Additional information has been requested. 10/11/2007 Patient demographics provided by CDC. 10/15/07 Received vax record from pcp. VAERS database updated w/same. 10/15/07 Received pcp & hospital medical records from CDC which reveal patient experienced vomiting with elevated blood sugars who became unresponsive & pulseless. CPR started & taken to ER on 9/19/07. Resuscitation was unsuccessful & patient pronounced 9/19/07. 10/26/07 Reviewed autopsy report which reveals COD as diabetic ketoacidosis & manner of death as natural. Patient had been found by parent unresponsive at home. History of severe diabetes mellitus. Vitreous glucose 667 (H).


Changed on 9/14/2018

VAERS ID: 291804 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Ohio
Vaccinated:2007-07-13
Onset:2007-09-01
Submitted:2007-10-01
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 2 LA / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-09-19
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: Unknown
Current Illness: IDDM, uncontrolled. Smoker. anemia.
Preexisting Conditions: Unknown PMH: IDDM, uncontrolled. Smoker. Right buttock abscess 8/31/07. Anemia. Father w/diabetes. ALLERGIES: PCN, cipro, ultram (hives).
Allergies:
Diagnostic Lab Data: Unknown Vitreous glucose 667 (H).
CDC 'Split Type': WAES0709USA04400

Write-up: Information has been received from a physician concerning a female who on an unknown date was vaccinated with the first dose of Gardasil (yeast, unknown lot number) and in July 2007, was vaccinated with the second dose of Gardasil. In September 2007, the patient died. No further details or symptoms were known regarding the patient''s death. The physician mentioned that an autopsy would be done however, had not received the results yet. The reporting physician felt that the patient''s death was not related to therapy with Gardasil. Additional information has been requested. 10/11/2007 Patient demographics provided by CDC. 10/15/07 Received vax record from pcp. VAERS database updated w/same. 10/15/07 Received pcp & hospital medical records from CDC which reveal patient experienced vomiting with elevated blood sugars who became unresponsive & pulseless. CPR started & taken to ER on 9/19/07. Resuscitation was unsuccessful & patient pronounced 9/19/07. 10/26/07 Reviewed autopsy report which reveals COD as diabetic ketoacidosis & manner of death as natural. Patient had been found by parent unresponsive at home. History of severe diabetes mellitus. Vitreous glucose 667 (H).


Changed on 10/14/2018

VAERS ID: 291804 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Ohio
Vaccinated:2007-07-13
Onset:2007-09-01
Submitted:2007-10-01
Entered:2007-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 2 LA / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-09-19
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: Unknown
Current Illness: IDDM, uncontrolled. Smoker. anemia.
Preexisting Conditions: Unknown PMH: IDDM, uncontrolled. Smoker. Right buttock abscess 8/31/07. Anemia. Father w/diabetes. ALLERGIES: PCN, cipro, ultram (hives).
Allergies:
Diagnostic Lab Data: Unknown Vitreous glucose 667 (H).
CDC 'Split Type': WAES0709USA04400

Write-up: Information has been received from a physician concerning a female who on an unknown date was vaccinated with the first dose of Gardasil (yeast, unknown lot number) and in July 2007, was vaccinated with the second dose of Gardasil. In September 2007, the patient died. No further details or symptoms were known regarding the patient''s death. The physician mentioned that an autopsy would be done however, had not received the results yet. The reporting physician felt that the patient''s death was not related to therapy with Gardasil. Additional information has been requested. 10/11/2007 Patient demographics provided by CDC. 10/15/07 Received vax record from pcp. VAERS database updated w/same. 10/15/07 Received pcp & hospital medical records from CDC which reveal patient experienced vomiting with elevated blood sugars who became unresponsive & pulseless. CPR started & taken to ER on 9/19/07. Resuscitation was unsuccessful & patient pronounced 9/19/07. 10/26/07 Reviewed autopsy report which reveals COD as diabetic ketoacidosis & manner of death as natural. Patient had been found by parent unresponsive at home. History of severe diabetes mellitus. Vitreous glucose 667 (H).

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