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This is VAERS ID 300066

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 300066
VAERS Form:
Age:26.0
Sex:Female
Location:Texas
Vaccinated:2007-11-12
Onset:0000-00-00
Submitted:2007-12-14
Entered:2007-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0106U / 1 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Death, Thrombosis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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: Obesity
Preexisting Conditions: Asthma, morbid obesity, smoker, occasional ETOH. OCP unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Information has been received from a physician concerning a large female who received one dose of Gardasil. Subsequently, the patient was found dead in her truck from a blood clot that traveled from her legs to her lungs. The cause of death was reported t"o be a blood clot. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 300066 Before After
VAERS Form:
Age:26.0
Sex:Female
Location:Texas
Vaccinated:2007-11-12
Onset:0000-00-00
Submitted:2007-12-14
Entered:2007-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0106U / 1 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Death, Obesity, Pulmonary embolism, Thrombosis, Deep vein thrombosis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00 2007-11-25
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: Obesity
Preexisting Conditions: Asthma, morbid obesity, smoker, occasional ETOH. OCP unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0712USA02658

Write-up: Information has been received from a physician concerning a large female who received one dose of Gardasil. Subsequently, the patient was found dead in her truck from a blood clot that traveled from her legs to her lungs. The cause of death was reported t"o to be a blood clot. Additional information has been requested. 3/5/08 Autopsy states COD as pulmonary thromboembolus w/deep vein thrombosis of right leg & obesity as contributing factor.


Changed on 4/14/2017

VAERS ID: 300066 Before After
VAERS Form:
Age:26.0
Sex:Female
Location:Texas
Vaccinated:2007-11-12
Onset:0000-00-00
Submitted:2007-12-14
Entered:2007-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0106U / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death, Obesity, Pulmonary embolism, Deep vein thrombosis

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-11-25
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: Obesity
Preexisting Conditions: Asthma, morbid obesity, smoker, occasional ETOH. OCP unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0712USA02658

Write-up: Information has been received from a physician concerning a large female who received one dose of Gardasil. Subsequently, the patient was found dead in her truck from a blood clot that traveled from her legs to her lungs. The cause of death was reported to be a blood clot. Additional information has been requested. 3/5/08 Autopsy states COD as pulmonary thromboembolus w/deep vein thrombosis of right leg & obesity as contributing factor.


Changed on 9/14/2017

VAERS ID: 300066 Before After
VAERS Form:(blank) 1
Age:26.0
Sex:Female
Location:Texas
Vaccinated:2007-11-12
Onset:0000-00-00
Submitted:2007-12-14
Entered:2007-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0106U / 1 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-11-25
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: Obesity
Preexisting Conditions: Asthma, morbid obesity, smoker, occasional ETOH. OCP unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0712USA02658

Write-up: Information has been received from a physician concerning a large female who received one dose of Gardasil. Subsequently, the patient was found dead in her truck from a blood clot that traveled from her legs to her lungs. The cause of death was reported to be a blood clot. Additional information has been requested. 3/5/08 Autopsy states COD as pulmonary thromboembolus w/deep vein thrombosis of right leg & obesity as contributing factor.


Changed on 2/14/2018

VAERS ID: 300066 Before After
VAERS Form:1
Age:26.0
Sex:Female
Location:Texas
Vaccinated:2007-11-12
Onset:0000-00-00
Submitted:2007-12-14
Entered:2007-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0106U / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-11-25
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: Obesity
Preexisting Conditions: Asthma, morbid obesity, smoker, occasional ETOH. OCP unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0712USA02658

Write-up: Information has been received from a physician concerning a large female who received one dose of Gardasil. Subsequently, the patient was found dead in her truck from a blood clot that traveled from her legs to her lungs. The cause of death was reported to be a blood clot. Additional information has been requested. 3/5/08 Autopsy states COD as pulmonary thromboembolus w/deep vein thrombosis of right leg & obesity as contributing factor.


Changed on 6/14/2018

VAERS ID: 300066 Before After
VAERS Form:1
Age:26.0
Sex:Female
Location:Texas
Vaccinated:2007-11-12
Onset:0000-00-00
Submitted:2007-12-14
Entered:2007-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0106U / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-11-25
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: Obesity
Preexisting Conditions: Asthma, morbid obesity, smoker, occasional ETOH. OCP unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0712USA02658

Write-up: Information has been received from a physician concerning a large female who received one dose of Gardasil. Subsequently, the patient was found dead in her truck from a blood clot that traveled from her legs to her lungs. The cause of death was reported to be a blood clot. Additional information has been requested. 3/5/08 Autopsy states COD as pulmonary thromboembolus w/deep vein thrombosis of right leg & obesity as contributing factor.


Changed on 8/14/2018

VAERS ID: 300066 Before After
VAERS Form:1
Age:26.0
Sex:Female
Location:Texas
Vaccinated:2007-11-12
Onset:0000-00-00
Submitted:2007-12-14
Entered:2007-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0106U / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-11-25
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: Obesity
Preexisting Conditions: Asthma, morbid obesity, smoker, occasional ETOH. OCP unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0712USA02658

Write-up: Information has been received from a physician concerning a large female who received one dose of Gardasil. Subsequently, the patient was found dead in her truck from a blood clot that traveled from her legs to her lungs. The cause of death was reported to be a blood clot. Additional information has been requested. 3/5/08 Autopsy states COD as pulmonary thromboembolus w/deep vein thrombosis of right leg & obesity as contributing factor.


Changed on 9/14/2018

VAERS ID: 300066 Before After
VAERS Form:1
Age:26.0
Sex:Female
Location:Texas
Vaccinated:2007-11-12
Onset:0000-00-00
Submitted:2007-12-14
Entered:2007-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0106U / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-11-25
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: Obesity
Preexisting Conditions: Asthma, morbid obesity, smoker, occasional ETOH. OCP unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0712USA02658

Write-up: Information has been received from a physician concerning a large female who received one dose of Gardasil. Subsequently, the patient was found dead in her truck from a blood clot that traveled from her legs to her lungs. The cause of death was reported to be a blood clot. Additional information has been requested. 3/5/08 Autopsy states COD as pulmonary thromboembolus w/deep vein thrombosis of right leg & obesity as contributing factor.


Changed on 10/14/2018

VAERS ID: 300066 Before After
VAERS Form:1
Age:26.0
Sex:Female
Location:Texas
Vaccinated:2007-11-12
Onset:0000-00-00
Submitted:2007-12-14
Entered:2007-12-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0106U / 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-11-25
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: Obesity
Preexisting Conditions: Asthma, morbid obesity, smoker, occasional ETOH. OCP unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0712USA02658

Write-up: Information has been received from a physician concerning a large female who received one dose of Gardasil. Subsequently, the patient was found dead in her truck from a blood clot that traveled from her legs to her lungs. The cause of death was reported to be a blood clot. Additional information has been requested. 3/5/08 Autopsy states COD as pulmonary thromboembolus w/deep vein thrombosis of right leg & obesity as contributing factor.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=300066&WAYBACKHISTORY=ON


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