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This is VAERS ID 308429

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

308429
VAERS Form:
Age:15.0
Gender:Female
Location:Kansas
Vaccinated:2007-10-17
Onset:2007-10-17
Submitted:2008-03-27
Entered:2008-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1265U / 1 GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Biopsy heart, Blood creatine phosphokinase increased, Cardiac arrest, Abasia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 34     Extended hospital stay? Yes
Previous Vaccinations: headache and dizziness~HPV (Gardasil)~1~16~In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: list is too extensive, will need to send separetly. 4/24/08-records received-CT negative. Drug screen positive for benzoidiazepines and phencyclidine. EKG inversion T waves, QTc prolongation. Premature ventricular contraction. CPK elevatio
CDC 'Split Type': NONE

Write-up:Cardiac arrest, no pulse, clinically dead, fro several minutes until EMT arrived and used defibrillator paddles to re start heart. Ambulance to Hospital for about 4 to 5 hours. Transported by ambulance to facility. Unconscious for 2 days sedated. Afte"r she awoke she was unresponsive to family and friends, impaired speech, memory loss and no ability to walk for about 10 days. The first night the many test were run and continued through 29 day stay at the hospital. Treatment included pills, physical t


Changed on 12/8/2009

308429 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Kansas
Vaccinated:2007-10-17
Onset:2007-10-17
Submitted:2008-03-27
Entered:2008-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1265U / 1 GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Biopsy heart, Blood creatine phosphokinase increased, Cardiac arrest, Cardioversion, Catheterisation cardiac normal, Echocardiogram normal, Electrocardiogram, Electrocardiogram QT prolonged, Extubation, Intensive care, Loss of consciousness, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging brain, Pulse absent, Respiratory failure, Speech disorder, Unresponsive to stimuli, Ventricular extrasystoles, Ventricular fibrillation, Drug screen positive, Implantable defibrillator insertion, Abasia, Cardiac stress test normal, Hepatic enzyme abnormal, Endotracheal intubation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 34     Extended hospital stay? Yes
Previous Vaccinations: headache and dizziness~HPV (Gardasil)~1~16~In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: list is too extensive, will need to send separetly. 4/24/08-records received-CT negative. Drug screen positive for benzoidiazepines and phencyclidine. EKG inversion T waves, QTc prolongation. Premature ventricular contraction. CPK elevatio
CDC 'Split Type': NONE (blank)

Write-up:Cardiac arrest, no pulse, clinically dead, fro several minutes until EMT arrived and used defibrillator paddles to re start heart. Ambulance to Hospital for about 4 to 5 hours. Transported by ambulance to facility. Unconscious for 2 days sedated. Afte"r After she awoke she was unresponsive to family and friends, impaired speech, memory loss and no ability to walk for about 10 days. The first night the many test were run and continued through 29 day stay at the hospital. Treatment included pills, physical t therapy, strees testing, 24 hour monitoring of heart and atendent care. EKG, Biopsey of heart, injection of dye to heart, MRI of Brain and Heart. A permanent defibrillator connecting to the heart. 05/05/08-DC summary received for DOS 10/18/11/13/07-DC DX: Ventricular fibrillation, cardiac Arrest. Placement of cardiac defibrillator (internal), pacemaker generator and lead system. 4/24/08-records received-10/18/07-presented to ED with cardiac arrest, ventricular fibrillation. Playing basketball, suddenly had shaking of right arm and deep breaths. Fell down. CPR began, cardioversion successful. Never fully regained consciousness. Respiratory failure. Intubated on ventilator. Extubated. Fentanyl drip. Hypertension since arrival.


Changed on 2/5/2010

308429 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Kansas
Vaccinated:2007-10-17
Onset:2007-10-17
Submitted:2008-03-27
Entered:2008-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1265U / 1 GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Biopsy heart, Blood creatine phosphokinase increased, Cardiac arrest, Cardioversion, Catheterisation cardiac normal, Echocardiogram normal, Electrocardiogram, Electrocardiogram QT prolonged, Extubation, Intensive care, Loss of consciousness, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging brain, Pulse absent, Respiratory failure, Speech disorder, Unresponsive to stimuli, Ventricular extrasystoles, Ventricular fibrillation, Drug screen positive, Implantable defibrillator insertion, Abasia, Cardiac stress test normal, Hepatic enzyme abnormal, Endotracheal intubation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 34     Extended hospital stay? Yes
Previous Vaccinations: headache and dizziness~HPV (Gardasil)~1~16~In Patient (Gardasil)~1~15.70~Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: list is too extensive, will need to send separetly. 4/24/08-records received-CT negative. Drug screen positive for benzoidiazepines and phencyclidine. EKG inversion T waves, QTc prolongation. Premature ventricular contraction. CPK elevatio
CDC 'Split Type':

Write-up:Cardiac arrest, no pulse, clinically dead, fro several minutes until EMT arrived and used defibrillator paddles to re start heart. Ambulance to Hospital for about 4 to 5 hours. Transported by ambulance to facility. Unconscious for 2 days sedated. After she awoke she was unresponsive to family and friends, impaired speech, memory loss and no ability to walk for about 10 days. The first night the many test were run and continued through 29 day stay at the hospital. Treatment included pills, physical therapy, strees testing, 24 hour monitoring of heart and atendent care. EKG, Biopsey of heart, injection of dye to heart, MRI of Brain and Heart. A permanent defibrillator connecting to the heart. 05/05/08-DC summary received for DOS 10/18/11/13/07-DC DX: Ventricular fibrillation, cardiac Arrest. Placement of cardiac defibrillator (internal), pacemaker generator and lead system. 4/24/08-records received-10/18/07-presented to ED with cardiac arrest, ventricular fibrillation. Playing basketball, suddenly had shaking of right arm and deep breaths. Fell down. CPR began, cardioversion successful. Never fully regained consciousness. Respiratory failure. Intubated on ventilator. Extubated. Fentanyl drip. Hypertension since arrival.


Changed on 8/31/2010

308429 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Kansas
Vaccinated:2007-10-17
Onset:2007-10-17
Submitted:2008-03-27
Entered:2008-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1265U / 1 GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Biopsy heart, Cardiac arrest, Electrocardiogram, Electrocardiogram QT prolonged, Loss of consciousness, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging brain, Pulse absent, Speech disorder, Unresponsive to stimuli, Implantable defibrillator insertion, Abasia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 34     Extended hospital stay? Yes
Previous Vaccinations: headache and dizziness~HPV (Gardasil)~1~15.70~Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: list is too extensive, will need to send separetly. 4/24/08-records received-CT negative. Drug screen positive for benzoidiazepines and phencyclidine. EKG inversion T waves, QTc prolongation. Premature ventricular contraction. CPK elevatio
CDC 'Split Type':

Write-up:Cardiac arrest, no pulse, clinically dead, fro several minutes until EMT arrived and used defibrillator paddles to re start heart. Ambulance to Hospital for about 4 to 5 hours. Transported by ambulance to facility. Unconscious for 2 days sedated. After she awoke she was unresponsive to family and friends, impaired speech, memory loss and no ability to walk for about 10 days. The first night the many test were run and continued through 29 day stay at the hospital. Treatment included pills, physical therapy, strees testing, 24 hour monitoring of heart and atendent care. EKG, Biopsey of heart, injection of dye to heart, MRI of Brain and Heart. A permanent defibrillator connecting to the heart. 05/05/08-DC summary received for DOS 10/18/11/13/07-DC DX: Ventricular fibrillation, cardiac Arrest. Placement of cardiac defibrillator (internal), pacemaker generator and lead system. 4/24/08-records received-10/18/07-presented to ED with cardiac arrest, ventricular fibrillation. Playing basketball, suddenly had shaking of right arm and deep breaths. Fell down. CPR began, cardioversion successful. Never fully regained consciousness. Respiratory failure. Intubated on ventilator. Extubated. Fentanyl drip. Hypertension since arrival.


Changed on 1/4/2011

308429 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Kansas
Vaccinated:2007-10-17
Onset:2007-10-17
Submitted:2008-03-27
Entered:2008-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1265U / 1 GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Biopsy heart, Cardiac arrest, Electrocardiogram, Electrocardiogram QT prolonged, Loss of consciousness, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging brain, Pulse absent, Speech disorder, Unresponsive to stimuli, Implantable defibrillator insertion, Abasia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 34     Extended hospital stay? Yes
Previous Vaccinations: headache and dizziness~HPV (Gardasil)~1~15.70~Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: list is too extensive, will need to send separetly. 4/24/08-records received-CT negative. Drug screen positive for benzoidiazepines and phencyclidine. EKG inversion T waves, QTc prolongation. Premature ventricular contraction. CPK elevatio elevation 566 with elevated MR fraction of 6.9. Liver enzymes elevated. Echo, exercise stress test and cardiac cath all negative.
CDC 'Split Type':

Write-up:Cardiac arrest, no pulse, clinically dead, fro several minutes until EMT arrived and used defibrillator paddles to re start heart. Ambulance to Hospital for about 4 to 5 hours. Transported by ambulance to facility. Unconscious for 2 days sedated. After she awoke she was unresponsive to family and friends, impaired speech, memory loss and no ability to walk for about 10 days. The first night the many test were run and continued through 29 day stay at the hospital. Treatment included pills, physical therapy, strees testing, 24 hour monitoring of heart and atendent care. EKG, Biopsey of heart, injection of dye to heart, MRI of Brain and Heart. A permanent defibrillator connecting to the heart. 05/05/08-DC summary received for DOS 10/18/11/13/07-DC DX: Ventricular fibrillation, cardiac Arrest. Placement of cardiac defibrillator (internal), pacemaker generator and lead system. 4/24/08-records received-10/18/07-presented to ED with cardiac arrest, ventricular fibrillation. Playing basketball, suddenly had shaking of right arm and deep breaths. Fell down. CPR began, cardioversion successful. Never fully regained consciousness. Respiratory failure. Intubated on ventilator. Extubated. Fentanyl drip. Hypertension since arrival.


Changed on 4/13/2011

308429 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Kansas
Vaccinated:2007-10-17
Onset:2007-10-17
Submitted:2008-03-27
Entered:2008-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1265U / 1 GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Biopsy heart, Blood creatine phosphokinase increased, Cardiac arrest, Cardioversion, Catheterisation cardiac normal, Echocardiogram normal, Electrocardiogram, Electrocardiogram QT prolonged, Extubation, Intensive care, Loss of consciousness, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging brain, Pulse absent, Respiratory failure, Speech disorder, Unresponsive to stimuli, Ventricular extrasystoles, Ventricular fibrillation, Drug screen positive, Implantable defibrillator insertion, Abasia, Cardiac stress test normal, Hepatic enzyme abnormal, Endotracheal intubation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 34     Extended hospital stay? Yes
Previous Vaccinations: headache and dizziness~HPV (Gardasil)~1~15.70~Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: list is too extensive, will need to send separetly. 4/24/08-records received-CT negative. Drug screen positive for benzoidiazepines and phencyclidine. EKG inversion T waves, QTc prolongation. Premature ventricular contraction. CPK elevation 566 with elevated MR fraction of 6.9. Liver enzymes elevated. Echo, exercise stress test and cardiac cath all negative.
CDC 'Split Type':

Write-up:Cardiac arrest, no pulse, clinically dead, fro several minutes until EMT arrived and used defibrillator paddles to re start heart. Ambulance to Hospital for about 4 to 5 hours. Transported by ambulance to facility. Unconscious for 2 days sedated. After she awoke she was unresponsive to family and friends, impaired speech, memory loss and no ability to walk for about 10 days. The first night the many test were run and continued through 29 day stay at the hospital. Treatment included pills, physical therapy, strees testing, 24 hour monitoring of heart and atendent care. EKG, Biopsey of heart, injection of dye to heart, MRI of Brain and Heart. A permanent defibrillator connecting to the heart. 05/05/08-DC summary received for DOS 10/18/11/13/07-DC DX: Ventricular fibrillation, cardiac Arrest. Placement of cardiac defibrillator (internal), pacemaker generator and lead system. 4/24/08-records received-10/18/07-presented to ED with cardiac arrest, ventricular fibrillation. Playing basketball, suddenly had shaking of right arm and deep breaths. Fell down. CPR began, cardioversion successful. Never fully regained consciousness. Respiratory failure. Intubated on ventilator. Extubated. Fentanyl drip. Hypertension since arrival.


Changed on 5/13/2011

308429 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Kansas
Vaccinated:2007-10-17
Onset:2007-10-17
Submitted:2008-03-27
Entered:2008-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1265U / 1 GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Biopsy heart, Blood creatine phosphokinase increased, Cardiac arrest, Cardioversion, Catheterisation cardiac normal, Echocardiogram normal, Electrocardiogram, Electrocardiogram QT prolonged, Extubation, Intensive care, Loss of consciousness, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging brain, Pulse absent, Respiratory failure, Speech disorder, Unresponsive to stimuli, Ventricular extrasystoles, Ventricular fibrillation, Drug screen positive, Implantable defibrillator insertion, Abasia, Cardiac stress test normal, Hepatic enzyme abnormal, Endotracheal intubation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 34     Extended hospital stay? Yes
Previous Vaccinations: headache and dizziness~HPV (Gardasil)~1~15.70~Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: list is too extensive, will need to send separetly. 4/24/08-records received-CT negative. Drug screen positive for benzoidiazepines and phencyclidine. EKG inversion T waves, QTc prolongation. Premature ventricular contraction. CPK elevation 566 with elevated MR fraction of 6.9. Liver enzymes elevated. Echo, exercise stress test and cardiac cath all negative.
CDC 'Split Type':

Write-up:Cardiac arrest, no pulse, clinically dead, fro several minutes until EMT arrived and used defibrillator paddles to re start heart. Ambulance to Hospital for about 4 to 5 hours. Transported by ambulance to facility. Unconscious for 2 days sedated. After she awoke she was unresponsive to family and friends, impaired speech, memory loss and no ability to walk for about 10 days. The first night the many test were run and continued through 29 day stay at the hospital. Treatment included pills, physical therapy, strees testing, 24 hour monitoring of heart and atendent care. EKG, Biopsey of heart, injection of dye to heart, MRI of Brain and Heart. A permanent defibrillator connecting to the heart. 05/05/08-DC summary received for DOS 10/18/11/13/07-DC DX: Ventricular fibrillation, cardiac Arrest. Placement of cardiac defibrillator (internal), pacemaker generator and lead system. 4/24/08-records received-10/18/07-presented to ED with cardiac arrest, ventricular fibrillation. Playing basketball, suddenly had shaking of right arm and deep breaths. Fell down. CPR began, cardioversion successful. Never fully regained consciousness. Respiratory failure. Intubated on ventilator. Extubated. Fentanyl drip. Hypertension since arrival.


Changed on 6/11/2011

308429 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Kansas
Vaccinated:2007-10-17
Onset:2007-10-17
Submitted:2008-03-27
Entered:2008-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1265U / 1 GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Biopsy heart, Blood creatine phosphokinase increased, Cardiac arrest, Cardioversion, Catheterisation cardiac normal, Echocardiogram normal, Electrocardiogram, Electrocardiogram QT prolonged, Extubation, Intensive care, Loss of consciousness, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging brain, Pulse absent, Respiratory failure, Speech disorder, Unresponsive to stimuli, Ventricular extrasystoles, Ventricular fibrillation, Drug screen positive, Implantable defibrillator insertion, Abasia, Cardiac stress test normal, Hepatic enzyme abnormal, Endotracheal intubation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 34     Extended hospital stay? Yes
Previous Vaccinations: headache and dizziness~HPV (Gardasil)~1~15.70~Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: list is too extensive, will need to send separetly. 4/24/08-records received-CT negative. Drug screen positive for benzoidiazepines and phencyclidine. EKG inversion T waves, QTc prolongation. Premature ventricular contraction. CPK elevation 566 with elevated MR fraction of 6.9. Liver enzymes elevated. Echo, exercise stress test and cardiac cath all negative.
CDC 'Split Type':

Write-up:Cardiac arrest, no pulse, clinically dead, fro several minutes until EMT arrived and used defibrillator paddles to re start heart. Ambulance to Hospital for about 4 to 5 hours. Transported by ambulance to facility. Unconscious for 2 days sedated. After she awoke she was unresponsive to family and friends, impaired speech, memory loss and no ability to walk for about 10 days. The first night the many test were run and continued through 29 day stay at the hospital. Treatment included pills, physical therapy, strees testing, 24 hour monitoring of heart and atendent care. EKG, Biopsey of heart, injection of dye to heart, MRI of Brain and Heart. A permanent defibrillator connecting to the heart. 05/05/08-DC summary received for DOS 10/18/11/13/07-DC DX: Ventricular fibrillation, cardiac Arrest. Placement of cardiac defibrillator (internal), pacemaker generator and lead system. 4/24/08-records received-10/18/07-presented to ED with cardiac arrest, ventricular fibrillation. Playing basketball, suddenly had shaking of right arm and deep breaths. Fell down. CPR began, cardioversion successful. Never fully regained consciousness. Respiratory failure. Intubated on ventilator. Extubated. Fentanyl drip. Hypertension since arrival.


Changed on 7/13/2012

308429 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Kansas
Vaccinated:2007-10-17
Onset:2007-10-17
Submitted:2008-03-27
Entered:2008-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1265U / 1 GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Biopsy heart, Blood creatine phosphokinase increased, Cardiac arrest, Cardioversion, Catheterisation cardiac normal, Echocardiogram normal, Electrocardiogram, Electrocardiogram QT prolonged, Extubation, Intensive care, Loss of consciousness, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging brain, Pulse absent, Respiratory failure, Speech disorder, Unresponsive to stimuli, Ventricular extrasystoles, Ventricular fibrillation, Drug screen positive, Implantable defibrillator insertion, Abasia, Cardiac stress test normal, Hepatic enzyme abnormal, Endotracheal intubation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 34     Extended hospital stay? Yes
Previous Vaccinations: headache and dizziness~HPV (Gardasil)~1~15.70~Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: list is too extensive, will need to send separetly. separately. 4/24/08-records received-CT negative. Drug screen positive for benzoidiazepines and phencyclidine. EKG inversion T waves, QTc prolongation. Premature ventricular contraction. CPK elevation 566 with elevated MR fraction of 6.9. Liver enzymes elevated. Echo, exercise stress test and cardiac cath all negative.
CDC 'Split Type':

Write-up:Cardiac arrest, no pulse, clinically dead, fro for several minutes until EMT arrived and used defibrillator paddles to re start heart. Ambulance to Hospital for about 4 to 5 hours. Transported by ambulance to facility. Unconscious for 2 days sedated. After she awoke she was unresponsive to family and friends, impaired speech, memory loss and no ability to walk for about 10 days. The first night the many test were run and continued through 29 day stay at the hospital. Treatment included pills, physical therapy, strees stress testing, 24 hour monitoring of heart and atendent attendant care. EKG, Biopsey Biopsy of heart, injection of dye to heart, MRI of Brain and Heart. A permanent defibrillator connecting to the heart. 05/05/08-DC summary received for DOS 10/18/11/13/07-DC DX: Ventricular fibrillation, cardiac Arrest. Placement of cardiac defibrillator (internal), pacemaker generator and lead system. 4/24/08-records received-10/18/07-presented to ED with cardiac arrest, ventricular fibrillation. Playing basketball, suddenly had shaking of right arm and deep breaths. Fell down. CPR began, cardioversion successful. Never fully regained consciousness. Respiratory failure. Intubated on ventilator. Extubated. Fentanyl drip. Hypertension since arrival.


Changed on 6/14/2014

308429 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Kansas
Vaccinated:2007-10-17
Onset:2007-10-17
Submitted:2008-03-27
Entered:2008-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1265U / 1 GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Biopsy heart, Blood creatine phosphokinase increased, Cardiac arrest, Cardioversion, Catheterisation cardiac normal, Echocardiogram normal, Electrocardiogram, Electrocardiogram QT prolonged, Extubation, Intensive care, Loss of consciousness, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging brain, Pulse absent, Respiratory failure, Speech disorder, Unresponsive to stimuli, Ventricular extrasystoles, Ventricular fibrillation, Drug screen positive, Implantable defibrillator insertion, Abasia, Cardiac stress test normal, Hepatic enzyme abnormal, Endotracheal intubation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 34     Extended hospital stay? Yes
Previous Vaccinations: headache and dizziness~HPV (Gardasil)~1~15.70~Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: list is too extensive, will need to send separately. 4/24/08-records received-CT negative. Drug screen positive for benzoidiazepines and phencyclidine. EKG inversion T waves, QTc prolongation. Premature ventricular contraction. CPK elevation 566 with elevated MR fraction of 6.9. Liver enzymes elevated. Echo, exercise stress test and cardiac cath all negative.
CDC 'Split Type':

Write-up:Cardiac arrest, no pulse, clinically dead, for several minutes until EMT arrived and used defibrillator paddles to re start heart. Ambulance to Hospital for about 4 to 5 hours. Transported by ambulance to facility. Unconscious for 2 days sedated. After she awoke she was unresponsive to family and friends, impaired speech, memory loss and no ability to walk for about 10 days. The first night the many test were run and continued through 29 day stay at the hospital. Treatment included pills, physical therapy, stress testing, 24 hour monitoring of heart and attendant care. EKG, Biopsy of heart, injection of dye to heart, MRI of Brain and Heart. A permanent defibrillator connecting to the heart. 05/05/08-DC summary received for DOS 10/18/11/13/07-DC DX: Ventricular fibrillation, cardiac Arrest. Placement of cardiac defibrillator (internal), pacemaker generator and lead system. 4/24/08-records received-10/18/07-presented to ED with cardiac arrest, ventricular fibrillation. Playing basketball, suddenly had shaking of right arm and deep breaths. Fell down. CPR began, cardioversion successful. Never fully regained consciousness. Respiratory failure. Intubated on ventilator. Extubated. Fentanyl drip. Hypertension since arrival.


Changed on 2/14/2017

308429 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Kansas
Vaccinated:2007-10-17
Onset:2007-10-17
Submitted:2008-03-27
Entered:2008-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1265U / 1 GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Biopsy heart, Blood creatine phosphokinase increased, Cardiac arrest, Cardioversion, Catheterisation cardiac normal, Echocardiogram normal, Electrocardiogram, Electrocardiogram QT prolonged, Extubation, Intensive care, Loss of consciousness, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging brain, Pulse absent, Respiratory failure, Speech disorder, Unresponsive to stimuli, Ventricular extrasystoles, Ventricular fibrillation, Drug screen positive, Implantable defibrillator insertion, Abasia, Cardiac stress test normal, Hepatic enzyme abnormal, Endotracheal intubation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 34     Extended hospital stay? Yes
Previous Vaccinations: headache and dizziness~HPV (Gardasil)~1~15.70~Patient
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: list is too extensive, will need to send separately. 4/24/08-records received-CT negative. Drug screen positive for benzoidiazepines and phencyclidine. EKG inversion T waves, QTc prolongation. Premature ventricular contraction. CPK elevation 566 with elevated MR fraction of 6.9. Liver enzymes elevated. Echo, exercise stress test and cardiac cath all negative.
CDC 'Split Type':

Write-up:Cardiac arrest, no pulse, clinically dead, for several minutes until EMT arrived and used defibrillator paddles to re start heart. Ambulance to Hospital for about 4 to 5 hours. Transported by ambulance to facility. Unconscious for 2 days sedated. After she awoke she was unresponsive to family and friends, impaired speech, memory loss and no ability to walk for about 10 days. The first night the many test were run and continued through 29 day stay at the hospital. Treatment included pills, physical therapy, stress testing, 24 hour monitoring of heart and attendant care. EKG, Biopsy of heart, injection of dye to heart, MRI of Brain and Heart. A permanent defibrillator connecting to the heart. 05/05/08-DC summary received for DOS 10/18/11/13/07-DC DX: Ventricular fibrillation, cardiac Arrest. Placement of cardiac defibrillator (internal), pacemaker generator and lead system. 4/24/08-records received-10/18/07-presented to ED with cardiac arrest, ventricular fibrillation. Playing basketball, suddenly had shaking of right arm and deep breaths. Fell down. CPR began, cardioversion successful. Never fully regained consciousness. Respiratory failure. Intubated on ventilator. Extubated. Fentanyl drip. Hypertension since arrival.


Changed on 4/14/2017

308429 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Kansas
Vaccinated:2007-10-17
Onset:2007-10-17
Submitted:2008-03-27
Entered:2008-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1265U / 1 GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Biopsy heart, Blood creatine phosphokinase increased, Cardiac arrest, Cardioversion, Catheterisation cardiac normal, Echocardiogram normal, Electrocardiogram, Electrocardiogram QT prolonged, Extubation, Intensive care, Loss of consciousness, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging brain, Pulse absent, Respiratory failure, Speech disorder, Unresponsive to stimuli, Ventricular extrasystoles, Ventricular fibrillation, Drug screen positive, Implantable defibrillator insertion, Abasia, Cardiac stress test normal, Hepatic enzyme abnormal, Endotracheal intubation

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 34     Extended hospital stay? Yes
Previous Vaccinations: headache and dizziness~HPV (Gardasil)~1~15.70~Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: list is too extensive, will need to send separately. 4/24/08-records received-CT negative. Drug screen positive for benzoidiazepines and phencyclidine. EKG inversion T waves, QTc prolongation. Premature ventricular contraction. CPK elevation 566 with elevated MR fraction of 6.9. Liver enzymes elevated. Echo, exercise stress test and cardiac cath all negative.
CDC 'Split Type':

Write-up:Cardiac arrest, no pulse, clinically dead, for several minutes until EMT arrived and used defibrillator paddles to re start heart. Ambulance to Hospital for about 4 to 5 hours. Transported by ambulance to facility. Unconscious for 2 days sedated. After she awoke she was unresponsive to family and friends, impaired speech, memory loss and no ability to walk for about 10 days. The first night the many test were run and continued through 29 day stay at the hospital. Treatment included pills, physical therapy, stress testing, 24 hour monitoring of heart and attendant care. EKG, Biopsy of heart, injection of dye to heart, MRI of Brain and Heart. A permanent defibrillator connecting to the heart. 05/05/08-DC summary received for DOS 10/18/11/13/07-DC DX: Ventricular fibrillation, cardiac Arrest. Placement of cardiac defibrillator (internal), pacemaker generator and lead system. 4/24/08-records received-10/18/07-presented to ED with cardiac arrest, ventricular fibrillation. Playing basketball, suddenly had shaking of right arm and deep breaths. Fell down. CPR began, cardioversion successful. Never fully regained consciousness. Respiratory failure. Intubated on ventilator. Extubated. Fentanyl drip. Hypertension since arrival.


Changed on 9/14/2017

308429 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Kansas
Vaccinated:2007-10-17
Onset:2007-10-17
Submitted:2008-03-27
Entered:2008-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1265U / 1 2 GM / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Amnesia, Biopsy heart, Cardiac arrest, Electrocardiogram, Loss of consciousness, Nuclear magnetic resonance imaging, Nuclear magnetic resonance imaging brain, Pulse absent, Speech disorder, Unresponsive to stimuli, Implantable defibrillator insertion, Abasia

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 34     Extended hospital stay? Yes
Previous Vaccinations: headache and dizziness~HPV (Gardasil)~1~15.70~Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: list is too extensive, will need to send separately. 4/24/08-records received-CT negative. Drug screen positive for benzoidiazepines and phencyclidine. EKG inversion T waves, QTc prolongation. Premature ventricular contraction. CPK elevation 566 with elevated MR fraction of 6.9. Liver enzymes elevated. Echo, exercise stress test and cardiac cath all negative.
CDC 'Split Type':

Write-up:Cardiac arrest, no pulse, clinically dead, for several minutes until EMT arrived and used defibrillator paddles to re start heart. Ambulance to Hospital for about 4 to 5 hours. Transported by ambulance to facility. Unconscious for 2 days sedated. After she awoke she was unresponsive to family and friends, impaired speech, memory loss and no ability to walk for about 10 days. The first night the many test were run and continued through 29 day stay at the hospital. Treatment included pills, physical therapy, stress testing, 24 hour monitoring of heart and attendant care. EKG, Biopsy of heart, injection of dye to heart, MRI of Brain and Heart. A permanent defibrillator connecting to the heart. 05/05/08-DC summary received for DOS 10/18/11/13/07-DC DX: Ventricular fibrillation, cardiac Arrest. Placement of cardiac defibrillator (internal), pacemaker generator and lead system. 4/24/08-records received-10/18/07-presented to ED with cardiac arrest, ventricular fibrillation. Playing basketball, suddenly had shaking of right arm and deep breaths. Fell down. CPR began, cardioversion successful. Never fully regained consciousness. Respiratory failure. Intubated on ventilator. Extubated. Fentanyl drip. Hypertension since arrival.


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