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This is VAERS ID 321696

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

VAERS ID: 321696
VAERS Form:
Age:16.0
Sex:Female
Location:Missouri
Vaccinated:2008-03-31
Onset:2008-04-03
Submitted:2008-08-08
Entered:2008-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1487U / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Arrhythmia, Cardiac arrest, Computerised tomogram, Convulsion, Brain oedema

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-04-07
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: 3/31 ROCEPHIN; 3/31 ZITHROMAX
Current Illness: Sore throat
Preexisting Conditions: Hx of pharyngitis; Bacterial Meningitis at 17 mons
Allergies:
Diagnostic Lab Data: lab work, Cat scans, X-rays
CDC 'Split Type':

Write-up: To Whom It May Concern: My daughter went to our nurse practitioner at Health Care Center on March 31, 2008 for a sore throat. She complained of her throat for about two days prior. Pt would get pharyngitis and strep about twice a year since she was 13. Sh"e received a shot of ROCEPHIN in the office on March 31st as well she was given a prescription for ZITHROMAX (Z-PAK) at the same time. I''''m not sure exactly what time her appointment was it was around 11:00 am. that day. She dropped off her prescription a


Changed on 12/8/2009

VAERS ID: 321696 Before After
VAERS Form:
Age:16.0
Sex:Female
Location:Missouri
Vaccinated:2008-03-31
Onset:2008-04-03
Submitted:2008-08-08
Entered:2008-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1487U / 1 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Arrhythmia, Cardiac arrest, Computerised tomogram, Convulsion, Cough, Death, Dyspnoea, Fall, Headache, Hypotonia, Lobar pneumonia, Loss of consciousness, Syncope, Tremor, X-ray, Brain oedema, Tongue biting, Respiratory tract congestion, Upper respiratory tract congestion, Haemorrhage, Organ donor, Laboratory test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-04-07
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: 3/31 ROCEPHIN; 3/31 ZITHROMAX
Current Illness: Sore throat
Preexisting Conditions: Hx of pharyngitis; Bacterial Meningitis at 17 mons
Allergies:
Diagnostic Lab Data: lab work, Cat scans, X-rays
CDC 'Split Type':

Write-up: To Whom It May Concern: My daughter went to our nurse practitioner at Health Care Center on March 31, 2008 for a sore throat. She complained of her throat for about two days prior. Pt would get pharyngitis and strep about twice a year since she was 13. Sh"e She received a shot of ROCEPHIN in the office on March 31st as well she was given a prescription for ZITHROMAX (Z-PAK) at the same time. I''''m I''m not sure exactly what time her appointment was it was around 11:00 am. that day. She dropped off her prescription at the pharmacy and I picked up on my way home. She took her first dose of ZITHROMAX on the 31st. She stayed home from school the next two days. She slept late both days which is not abnormal for her. In the evenings we played rummy, she was congested and coughing a little. She complained of a headache the next night and I gave her some ibuprofen. On Wednesday April 3rd she went to school, (school gets out at 3:05 p.m.) after school she went to tract practice. Her tract practice was a short one, I know she ran but I''m not sure how much. She stopped at a convenience store on the way home from school and got a Red Bull. She went home and changed clothes for work. She called me between 4:30 and 5:00 p.m. on her way to work to tell me about the road being blocked due to rain where we live. She parked her car and was walking the short distance into where she works she collapsed and started seizing. A lady in the drive through told the owner that she had fallen and he went out immediately. He said she was shaking, the employees inside called 911 and then me. The owner told me she stopped shaking and took a few strained breaths and then went limp. The police officer arrive within three minutes, he was a first responder. He did not check for a pulse or attempt CPR (I am in the process of getting a police report as well). Just as I got there an off duty paramedic arrived and started CPR. It took quite awhile before the ambulance arrived; she had been down too long. I later learned that they did not get her heart started unt


Changed on 4/14/2017

VAERS ID: 321696 Before After
VAERS Form:
Age:16.0
Sex:Female
Location:Missouri
Vaccinated:2008-03-31
Onset:2008-04-03
Submitted:2008-08-08
Entered:2008-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1487U / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Arrhythmia, Cardiac arrest, Computerised tomogram, Convulsion, Cough, Death, Dyspnoea, Fall, Headache, Hypotonia, Lobar pneumonia, Loss of consciousness, Syncope, Tremor, X-ray, Brain oedema, Tongue biting, Respiratory tract congestion, Upper respiratory tract congestion, Haemorrhage, Organ donor, Laboratory test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-04-07
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: 3/31 ROCEPHIN; 3/31 ZITHROMAX
Current Illness: Sore throat
Preexisting Conditions: Hx of pharyngitis; Bacterial Meningitis at 17 mons
Allergies:
Diagnostic Lab Data: lab work, Cat scans, X-rays
CDC 'Split Type':

Write-up: To Whom It May Concern: My daughter went to our nurse practitioner at Health Care Center on March 31, 2008 for a sore throat. She complained of her throat for about two days prior. Pt would get pharyngitis and strep about twice a year since she was 13. She received a shot of ROCEPHIN in the office on March 31st as well she was given a prescription for ZITHROMAX (Z-PAK) at the same time. I''m not sure exactly what time her appointment was it was around 11:00 am. that day. She dropped off her prescription at the pharmacy and I picked up on my way home. She took her first dose of ZITHROMAX on the 31st. She stayed home from school the next two days. She slept late both days which is not abnormal for her. In the evenings we played rummy, she was congested and coughing a little. She complained of a headache the next night and I gave her some ibuprofen. On Wednesday April 3rd she went to school, (school gets out at 3:05 p.m.) after school she went to tract practice. Her tract practice was a short one, I know she ran but I''m not sure how much. She stopped at a convenience store on the way home from school and got a Red Bull. She went home and changed clothes for work. She called me between 4:30 and 5:00 p.m. on her way to work to tell me about the road being blocked due to rain where we live. She parked her car and was walking the short distance into where she works she collapsed and started seizing. A lady in the drive through told the owner that she had fallen and he went out immediately. He said she was shaking, the employees inside called 911 and then me. The owner told me she stopped shaking and took a few strained breaths and then went limp. The police officer arrive within three minutes, he was a first responder. He did not check for a pulse or attempt CPR (I am in the process of getting a police report as well). Just as I got there an off duty paramedic arrived and started CPR. It took quite awhile before the ambulance arrived; she had been down too long. I later learned that they did not get her heart started unt until just before the ambulance arrived at the hospital. Pt officially died on April 7th, the decision was made on April 6th that she become an organ donor. My daughter was a very healthy, vibrant, and beautiful person! Any other information you need I will do my best to provide. I STILL have not received the autopsy report. I did talk to them Friday and they said it would be within the next two weeks. Sincerely, pt''s mother 9/19/08 Autopsy report states COD as apparent cardiac rhythm disturbance of undetermined etiology. Report states pathologic findings of: hx of sudden fall & cardiac arrest; subgaleal hemorrhage, fontoparietal scalp; tongue abrasions c/w tooth marks; hx of recent illness; agonal seizures; bilateral cerebral edema; catecholamine induced myotoxicity; bilatreral lobar pneumonia; organ & tissue harvesting.


Changed on 9/14/2017

VAERS ID: 321696 Before After
VAERS Form:(blank) 1
Age:16.0
Sex:Female
Location:Missouri
Vaccinated:2008-03-31
Onset:2008-04-03
Submitted:2008-08-08
Entered:2008-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1487U / 1 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Computerised tomogram, Convulsion, Cough, Death, Dyspnoea, Fall, Headache, Hypotonia, Loss of consciousness, Syncope, Tremor, X-ray, Respiratory tract congestion, Upper respiratory tract congestion, Laboratory test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-04-07
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: 3/31 ROCEPHIN; 3/31 ZITHROMAX
Current Illness: Sore throat
Preexisting Conditions: Hx of pharyngitis; Bacterial Meningitis at 17 mons
Allergies:
Diagnostic Lab Data: lab work, Cat scans, X-rays
CDC 'Split Type':

Write-up: To Whom It May Concern: My daughter went to our nurse practitioner at Health Care Center on March 31, 2008 for a sore throat. She complained of her throat for about two days prior. Pt would get pharyngitis and strep about twice a year since she was 13. She received a shot of ROCEPHIN in the office on March 31st as well she was given a prescription for ZITHROMAX (Z-PAK) at the same time. I''m not sure exactly what time her appointment was it was around 11:00 am. that day. She dropped off her prescription at the pharmacy and I picked up on my way home. She took her first dose of ZITHROMAX on the 31st. She stayed home from school the next two days. She slept late both days which is not abnormal for her. In the evenings we played rummy, she was congested and coughing a little. She complained of a headache the next night and I gave her some ibuprofen. On Wednesday April 3rd she went to school, (school gets out at 3:05 p.m.) after school she went to tract practice. Her tract practice was a short one, I know she ran but I''m not sure how much. She stopped at a convenience store on the way home from school and got a Red Bull. She went home and changed clothes for work. She called me between 4:30 and 5:00 p.m. on her way to work to tell me about the road being blocked due to rain where we live. She parked her car and was walking the short distance into where she works she collapsed and started seizing. A lady in the drive through told the owner that she had fallen and he went out immediately. He said she was shaking, the employees inside called 911 and then me. The owner told me she stopped shaking and took a few strained breaths and then went limp. The police officer arrive within three minutes, he was a first responder. He did not check for a pulse or attempt CPR (I am in the process of getting a police report as well). Just as I got there an off duty paramedic arrived and started CPR. It took quite awhile before the ambulance arrived; she had been down too long. I later learned that they did not get her heart started until just before the ambulance arrived at the hospital. Pt officially died on April 7th, the decision was made on April 6th that she become an organ donor. My daughter was a very healthy, vibrant, and beautiful person! Any other information you need I will do my best to provide. I STILL have not received the autopsy report. I did talk to them Friday and they said it would be within the next two weeks. Sincerely, pt''s mother 9/19/08 Autopsy report states COD as apparent cardiac rhythm disturbance of undetermined etiology. Report states pathologic findings of: hx of sudden fall & cardiac arrest; subgaleal hemorrhage, fontoparietal scalp; tongue abrasions c/w tooth marks; hx of recent illness; agonal seizures; bilateral cerebral edema; catecholamine induced myotoxicity; bilatreral lobar pneumonia; organ & tissue harvesting.


Changed on 2/14/2018

VAERS ID: 321696 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:Missouri
Vaccinated:2008-03-31
Onset:2008-04-03
Submitted:2008-08-08
Entered:2008-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1487U / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Computerised tomogram, Convulsion, Cough, Death, Dyspnoea, Fall, Headache, Hypotonia, Loss of consciousness, Syncope, Tremor, X-ray, Respiratory tract congestion, Upper respiratory tract congestion, Laboratory test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-04-07
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: 3/31 ROCEPHIN; 3/31 ZITHROMAX
Current Illness: Sore throat
Preexisting Conditions: Hx of pharyngitis; Bacterial Meningitis at 17 mons
Allergies:
Diagnostic Lab Data: lab work, Cat scans, X-rays
CDC 'Split Type':

Write-up: To Whom It May Concern: My daughter went to our nurse practitioner at Health Care Center on March 31, 2008 for a sore throat. She complained of her throat for about two days prior. Pt would get pharyngitis and strep about twice a year since she was 13. She received a shot of ROCEPHIN in the office on March 31st as well she was given a prescription for ZITHROMAX (Z-PAK) at the same time. I''m not sure exactly what time her appointment was it was around 11:00 am. that day. She dropped off her prescription at the pharmacy and I picked up on my way home. She took her first dose of ZITHROMAX on the 31st. She stayed home from school the next two days. She slept late both days which is not abnormal for her. In the evenings we played rummy, she was congested and coughing a little. She complained of a headache the next night and I gave her some ibuprofen. On Wednesday April 3rd she went to school, (school gets out at 3:05 p.m.) after school she went to tract practice. Her tract practice was a short one, I know she ran but I''m not sure how much. She stopped at a convenience store on the way home from school and got a Red Bull. She went home and changed clothes for work. She called me between 4:30 and 5:00 p.m. on her way to work to tell me about the road being blocked due to rain where we live. She parked her car and was walking the short distance into where she works she collapsed and started seizing. A lady in the drive through told the owner that she had fallen and he went out immediately. He said she was shaking, the employees inside called 911 and then me. The owner told me she stopped shaking and took a few strained breaths and then went limp. The police officer arrive within three minutes, he was a first responder. He did not check for a pulse or attempt CPR (I am in the process of getting a police report as well). Just as I got there an off duty paramedic arrived and started CPR. It took quite awhile before the ambulance arrived; she had been down too long. I later learned that they did not get her heart started until just before the ambulance arrived at the hospital. Pt officially died on April 7th, the decision was made on April 6th that she become an organ donor. My daughter was a very healthy, vibrant, and beautiful person! Any other information you need I will do my best to provide. I STILL have not received the autopsy report. I did talk to them Friday and they said it would be within the next two weeks. Sincerely, pt''s mother 9/19/08 Autopsy report states COD as apparent cardiac rhythm disturbance of undetermined etiology. Report states pathologic findings of: hx of sudden fall & cardiac arrest; subgaleal hemorrhage, fontoparietal scalp; tongue abrasions c/w tooth marks; hx of recent illness; agonal seizures; bilateral cerebral edema; catecholamine induced myotoxicity; bilatreral lobar pneumonia; organ & tissue harvesting.


Changed on 6/14/2018

VAERS ID: 321696 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:Missouri
Vaccinated:2008-03-31
Onset:2008-04-03
Submitted:2008-08-08
Entered:2008-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1487U / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Computerised tomogram, Convulsion, Cough, Death, Dyspnoea, Fall, Headache, Hypotonia, Loss of consciousness, Syncope, Tremor, X-ray, Respiratory tract congestion, Upper respiratory tract congestion, Laboratory test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-04-07
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: 3/31 ROCEPHIN; 3/31 ZITHROMAX
Current Illness: Sore throat
Preexisting Conditions: Hx of pharyngitis; Bacterial Meningitis at 17 mons
Allergies:
Diagnostic Lab Data: lab work, Cat scans, X-rays
CDC 'Split Type':

Write-up: To Whom It May Concern: My daughter went to our nurse practitioner at Health Care Center on March 31, 2008 for a sore throat. She complained of her throat for about two days prior. Pt would get pharyngitis and strep about twice a year since she was 13. She received a shot of ROCEPHIN in the office on March 31st as well she was given a prescription for ZITHROMAX (Z-PAK) at the same time. I''m not sure exactly what time her appointment was it was around 11:00 am. that day. She dropped off her prescription at the pharmacy and I picked up on my way home. She took her first dose of ZITHROMAX on the 31st. She stayed home from school the next two days. She slept late both days which is not abnormal for her. In the evenings we played rummy, she was congested and coughing a little. She complained of a headache the next night and I gave her some ibuprofen. On Wednesday April 3rd she went to school, (school gets out at 3:05 p.m.) after school she went to tract practice. Her tract practice was a short one, I know she ran but I''m not sure how much. She stopped at a convenience store on the way home from school and got a Red Bull. She went home and changed clothes for work. She called me between 4:30 and 5:00 p.m. on her way to work to tell me about the road being blocked due to rain where we live. She parked her car and was walking the short distance into where she works she collapsed and started seizing. A lady in the drive through told the owner that she had fallen and he went out immediately. He said she was shaking, the employees inside called 911 and then me. The owner told me she stopped shaking and took a few strained breaths and then went limp. The police officer arrive within three minutes, he was a first responder. He did not check for a pulse or attempt CPR (I am in the process of getting a police report as well). Just as I got there an off duty paramedic arrived and started CPR. It took quite awhile before the ambulance arrived; she had been down too long. I later learned that they did not get her heart started until just before the ambulance arrived at the hospital. Pt officially died on April 7th, the decision was made on April 6th that she become an organ donor. My daughter was a very healthy, vibrant, and beautiful person! Any other information you need I will do my best to provide. I STILL have not received the autopsy report. I did talk to them Friday and they said it would be within the next two weeks. Sincerely, pt''s mother 9/19/08 Autopsy report states COD as apparent cardiac rhythm disturbance of undetermined etiology. Report states pathologic findings of: hx of sudden fall & cardiac arrest; subgaleal hemorrhage, fontoparietal scalp; tongue abrasions c/w tooth marks; hx of recent illness; agonal seizures; bilateral cerebral edema; catecholamine induced myotoxicity; bilatreral lobar pneumonia; organ & tissue harvesting.


Changed on 8/14/2018

VAERS ID: 321696 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:Missouri
Vaccinated:2008-03-31
Onset:2008-04-03
Submitted:2008-08-08
Entered:2008-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1487U / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Computerised tomogram, Convulsion, Cough, Death, Dyspnoea, Fall, Headache, Hypotonia, Loss of consciousness, Syncope, Tremor, X-ray, Respiratory tract congestion, Upper respiratory tract congestion, Laboratory test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-04-07
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: 3/31 ROCEPHIN; 3/31 ZITHROMAX
Current Illness: Sore throat
Preexisting Conditions: Hx of pharyngitis; Bacterial Meningitis at 17 mons
Allergies:
Diagnostic Lab Data: lab work, Cat scans, X-rays
CDC 'Split Type':

Write-up: To Whom It May Concern: My daughter went to our nurse practitioner at Health Care Center on March 31, 2008 for a sore throat. She complained of her throat for about two days prior. Pt would get pharyngitis and strep about twice a year since she was 13. She received a shot of ROCEPHIN in the office on March 31st as well she was given a prescription for ZITHROMAX (Z-PAK) at the same time. I''m not sure exactly what time her appointment was it was around 11:00 am. that day. She dropped off her prescription at the pharmacy and I picked up on my way home. She took her first dose of ZITHROMAX on the 31st. She stayed home from school the next two days. She slept late both days which is not abnormal for her. In the evenings we played rummy, she was congested and coughing a little. She complained of a headache the next night and I gave her some ibuprofen. On Wednesday April 3rd she went to school, (school gets out at 3:05 p.m.) after school she went to tract practice. Her tract practice was a short one, I know she ran but I''m not sure how much. She stopped at a convenience store on the way home from school and got a Red Bull. She went home and changed clothes for work. She called me between 4:30 and 5:00 p.m. on her way to work to tell me about the road being blocked due to rain where we live. She parked her car and was walking the short distance into where she works she collapsed and started seizing. A lady in the drive through told the owner that she had fallen and he went out immediately. He said she was shaking, the employees inside called 911 and then me. The owner told me she stopped shaking and took a few strained breaths and then went limp. The police officer arrive within three minutes, he was a first responder. He did not check for a pulse or attempt CPR (I am in the process of getting a police report as well). Just as I got there an off duty paramedic arrived and started CPR. It took quite awhile before the ambulance arrived; she had been down too long. I later learned that they did not get her heart started until just before the ambulance arrived at the hospital. Pt officially died on April 7th, the decision was made on April 6th that she become an organ donor. My daughter was a very healthy, vibrant, and beautiful person! Any other information you need I will do my best to provide. I STILL have not received the autopsy report. I did talk to them Friday and they said it would be within the next two weeks. Sincerely, pt''s mother 9/19/08 Autopsy report states COD as apparent cardiac rhythm disturbance of undetermined etiology. Report states pathologic findings of: hx of sudden fall & cardiac arrest; subgaleal hemorrhage, fontoparietal scalp; tongue abrasions c/w tooth marks; hx of recent illness; agonal seizures; bilateral cerebral edema; catecholamine induced myotoxicity; bilatreral lobar pneumonia; organ & tissue harvesting.


Changed on 9/14/2018

VAERS ID: 321696 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:Missouri
Vaccinated:2008-03-31
Onset:2008-04-03
Submitted:2008-08-08
Entered:2008-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1487U / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Computerised tomogram, Convulsion, Cough, Death, Dyspnoea, Fall, Headache, Hypotonia, Loss of consciousness, Syncope, Tremor, X-ray, Respiratory tract congestion, Upper respiratory tract congestion, Laboratory test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-04-07
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: 3/31 ROCEPHIN; 3/31 ZITHROMAX
Current Illness: Sore throat
Preexisting Conditions: Hx of pharyngitis; Bacterial Meningitis at 17 mons
Allergies:
Diagnostic Lab Data: lab work, Cat scans, X-rays
CDC 'Split Type':

Write-up: To Whom It May Concern: My daughter went to our nurse practitioner at Health Care Center on March 31, 2008 for a sore throat. She complained of her throat for about two days prior. Pt would get pharyngitis and strep about twice a year since she was 13. She received a shot of ROCEPHIN in the office on March 31st as well she was given a prescription for ZITHROMAX (Z-PAK) at the same time. I''m not sure exactly what time her appointment was it was around 11:00 am. that day. She dropped off her prescription at the pharmacy and I picked up on my way home. She took her first dose of ZITHROMAX on the 31st. She stayed home from school the next two days. She slept late both days which is not abnormal for her. In the evenings we played rummy, she was congested and coughing a little. She complained of a headache the next night and I gave her some ibuprofen. On Wednesday April 3rd she went to school, (school gets out at 3:05 p.m.) after school she went to tract practice. Her tract practice was a short one, I know she ran but I''m not sure how much. She stopped at a convenience store on the way home from school and got a Red Bull. She went home and changed clothes for work. She called me between 4:30 and 5:00 p.m. on her way to work to tell me about the road being blocked due to rain where we live. She parked her car and was walking the short distance into where she works she collapsed and started seizing. A lady in the drive through told the owner that she had fallen and he went out immediately. He said she was shaking, the employees inside called 911 and then me. The owner told me she stopped shaking and took a few strained breaths and then went limp. The police officer arrive within three minutes, he was a first responder. He did not check for a pulse or attempt CPR (I am in the process of getting a police report as well). Just as I got there an off duty paramedic arrived and started CPR. It took quite awhile before the ambulance arrived; she had been down too long. I later learned that they did not get her heart started until just before the ambulance arrived at the hospital. Pt officially died on April 7th, the decision was made on April 6th that she become an organ donor. My daughter was a very healthy, vibrant, and beautiful person! Any other information you need I will do my best to provide. I STILL have not received the autopsy report. I did talk to them Friday and they said it would be within the next two weeks. Sincerely, pt''s mother 9/19/08 Autopsy report states COD as apparent cardiac rhythm disturbance of undetermined etiology. Report states pathologic findings of: hx of sudden fall & cardiac arrest; subgaleal hemorrhage, fontoparietal scalp; tongue abrasions c/w tooth marks; hx of recent illness; agonal seizures; bilateral cerebral edema; catecholamine induced myotoxicity; bilatreral lobar pneumonia; organ & tissue harvesting.


Changed on 10/14/2018

VAERS ID: 321696 Before After
VAERS Form:1
Age:16.0
Sex:Female
Location:Missouri
Vaccinated:2008-03-31
Onset:2008-04-03
Submitted:2008-08-08
Entered:2008-08-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1487U / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Computerised tomogram, Convulsion, Cough, Death, Dyspnoea, Fall, Headache, Hypotonia, Loss of consciousness, Syncope, Tremor, X-ray, Respiratory tract congestion, Upper respiratory tract congestion, Laboratory test

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-04-07
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: 3/31 ROCEPHIN; 3/31 ZITHROMAX
Current Illness: Sore throat
Preexisting Conditions: Hx of pharyngitis; Bacterial Meningitis at 17 mons
Allergies:
Diagnostic Lab Data: lab work, Cat scans, X-rays
CDC 'Split Type':

Write-up: To Whom It May Concern: My daughter went to our nurse practitioner at Health Care Center on March 31, 2008 for a sore throat. She complained of her throat for about two days prior. Pt would get pharyngitis and strep about twice a year since she was 13. She received a shot of ROCEPHIN in the office on March 31st as well she was given a prescription for ZITHROMAX (Z-PAK) at the same time. I''m not sure exactly what time her appointment was it was around 11:00 am. that day. She dropped off her prescription at the pharmacy and I picked up on my way home. She took her first dose of ZITHROMAX on the 31st. She stayed home from school the next two days. She slept late both days which is not abnormal for her. In the evenings we played rummy, she was congested and coughing a little. She complained of a headache the next night and I gave her some ibuprofen. On Wednesday April 3rd she went to school, (school gets out at 3:05 p.m.) after school she went to tract practice. Her tract practice was a short one, I know she ran but I''m not sure how much. She stopped at a convenience store on the way home from school and got a Red Bull. She went home and changed clothes for work. She called me between 4:30 and 5:00 p.m. on her way to work to tell me about the road being blocked due to rain where we live. She parked her car and was walking the short distance into where she works she collapsed and started seizing. A lady in the drive through told the owner that she had fallen and he went out immediately. He said she was shaking, the employees inside called 911 and then me. The owner told me she stopped shaking and took a few strained breaths and then went limp. The police officer arrive within three minutes, he was a first responder. He did not check for a pulse or attempt CPR (I am in the process of getting a police report as well). Just as I got there an off duty paramedic arrived and started CPR. It took quite awhile before the ambulance arrived; she had been down too long. I later learned that they did not get her heart started until just before the ambulance arrived at the hospital. Pt officially died on April 7th, the decision was made on April 6th that she become an organ donor. My daughter was a very healthy, vibrant, and beautiful person! Any other information you need I will do my best to provide. I STILL have not received the autopsy report. I did talk to them Friday and they said it would be within the next two weeks. Sincerely, pt''s mother 9/19/08 Autopsy report states COD as apparent cardiac rhythm disturbance of undetermined etiology. Report states pathologic findings of: hx of sudden fall & cardiac arrest; subgaleal hemorrhage, fontoparietal scalp; tongue abrasions c/w tooth marks; hx of recent illness; agonal seizures; bilateral cerebral edema; catecholamine induced myotoxicity; bilatreral lobar pneumonia; organ & tissue harvesting.

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