![]() |
National Vaccine Information Center Your Health. Your Family. Your Choice. |
MedAlerts Home |
History of Changes from the VAERS Wayback Machine |
VAERS ID: | 324002 |
VAERS Form: | |
Age: | 16.0 |
Sex: | Female |
Location: | Ohio |
Vaccinated: | 2008-02-26 |
Onset: | 2008-03-12 |
Submitted: | 2008-09-03 |
Entered: | 2008-09-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 1266U / 2 | RA / IM |
Administered by: Unknown Purchased by: Unknown
Symptoms: Circulatory collapse, Dehydration, Diabetic ketoacidosis, Laboratory test abnormal, Autopsy
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2008-03-12
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: none
Current Illness: none noted
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Full Autopsy done. Immediate cause of death was massive pulmonary embolus. Secondary was Type 1 Diabetes (previously undiagnosed). Vitreous Humor glucose was 767 9/4/08-records received- Vitreous glucose 767.
CDC 'Split Type':
Write-up: Sudden death occured on 3/12/2008. 9/4/08-records received-Cause of Death:cardiovascular collapse as a consequence of pulmonary emboli, dehydration and diabetic ketacidosis.
Vaccinated: | 2008-02-26 |
Onset: | 2008-03-12 |
Submitted: | 2008-09-03 |
Entered: | 2008-09-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 1266U / 2 | RA / IM |
Administered by: Unknown Purchased by: Unknown
Symptoms: Circulatory collapse, Dehydration, Diabetic ketoacidosis, Laboratory test abnormal, Pulmonary embolism, Sudden death, Autopsy
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2008-03-12
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: none
Current Illness: none noted
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Full Autopsy done. Immediate cause of death was massive pulmonary embolus. Secondary was Type 1 Diabetes (previously undiagnosed). Vitreous Humor glucose was 767 9/4/08-records received- Vitreous glucose 767.
CDC 'Split Type':
Write-up: Sudden death occured on 3/12/2008. 9/4/08-records received-Cause of Death:cardiovascular collapse as a consequence of pulmonary emboli, dehydration and diabetic ketacidosis.
Vaccinated: | 2008-02-26 |
Onset: | 2008-03-12 |
Submitted: | 2008-09-03 |
Entered: | 2008-09-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 1266U / 2 | RA / IM |
Administered by: Unknown Purchased by: Unknown
Symptoms: Circulatory collapse, Dehydration, Diabetic ketoacidosis, Laboratory test abnormal, Pulmonary embolism, Sudden death, Autopsy
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2008-03-12
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: none
Current Illness: none noted
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Full Autopsy done. Immediate cause of death was massive pulmonary embolus. Secondary was Type 1 Diabetes (previously undiagnosed). Vitreous Humor glucose was 767 9/4/08-records received- Vitreous glucose 767.
CDC 'Split Type':
Write-up: Sudden death occured on 3/12/2008. 9/4/08-records received-Cause of Death:cardiovascular collapse as a consequence of pulmonary emboli, dehydration and diabetic ketacidosis.
Vaccinated: | 2008-02-26 |
Onset: | 2008-03-12 |
Submitted: | 2008-09-03 |
Entered: | 2008-09-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 1266U / 2 3 | RA / IM |
Administered by: Unknown Purchased by: Unknown
Symptoms: Sudden death, Autopsy
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2008-03-12
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: none
Current Illness: none noted
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Full Autopsy done. Immediate cause of death was massive pulmonary embolus. Secondary was Type 1 Diabetes (previously undiagnosed). Vitreous Humor glucose was 767 9/4/08-records received- Vitreous glucose 767.
CDC 'Split Type':
Write-up: Sudden death occured on 3/12/2008. 9/4/08-records received-Cause of Death:cardiovascular collapse as a consequence of pulmonary emboli, dehydration and diabetic ketacidosis.
Vaccinated: | 2008-02-26 |
Onset: | 2008-03-12 |
Submitted: | 2008-09-03 |
Entered: | 2008-09-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 1266U / 3 | RA / IM |
Administered by: Unknown Purchased by: Unknown
Symptoms: Sudden death, Autopsy
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2008-03-12
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: none
Current Illness: none noted
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Full Autopsy done. Immediate cause of death was massive pulmonary embolus. Secondary was Type 1 Diabetes (previously undiagnosed). Vitreous Humor glucose was 767 9/4/08-records received- Vitreous glucose 767.
CDC 'Split Type':
Write-up: Sudden death occured on 3/12/2008. 9/4/08-records received-Cause of Death:cardiovascular collapse as a consequence of pulmonary emboli, dehydration and diabetic ketacidosis.
Vaccinated: | 2008-02-26 |
Onset: | 2008-03-12 |
Submitted: | 2008-09-03 |
Entered: | 2008-09-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 1266U / 3 | RA / IM |
Administered by: Unknown Purchased by: Unknown
Symptoms: Sudden death, Autopsy
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2008-03-12
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: none
Current Illness: none noted
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Full Autopsy done. Immediate cause of death was massive pulmonary embolus. Secondary was Type 1 Diabetes (previously undiagnosed). Vitreous Humor glucose was 767 9/4/08-records received- Vitreous glucose 767.
CDC 'Split Type':
Write-up: Sudden death occured on 3/12/2008. 9/4/08-records received-Cause of Death:cardiovascular collapse as a consequence of pulmonary emboli, dehydration and diabetic ketacidosis.
Vaccinated: | 2008-02-26 |
Onset: | 2008-03-12 |
Submitted: | 2008-09-03 |
Entered: | 2008-09-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 1266U / 3 | RA / IM |
Administered by: Unknown Purchased by: Unknown
Symptoms: Sudden death, Autopsy
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2008-03-12
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: none
Current Illness: none noted
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Full Autopsy done. Immediate cause of death was massive pulmonary embolus. Secondary was Type 1 Diabetes (previously undiagnosed). Vitreous Humor glucose was 767 9/4/08-records received- Vitreous glucose 767.
CDC 'Split Type':
Write-up: Sudden death occured on 3/12/2008. 9/4/08-records received-Cause of Death:cardiovascular collapse as a consequence of pulmonary emboli, dehydration and diabetic ketacidosis.
Vaccinated: | 2008-02-26 |
Onset: | 2008-03-12 |
Submitted: | 2008-09-03 |
Entered: | 2008-09-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 1266U / 3 | RA / IM |
Administered by: Unknown Purchased by: Unknown
Symptoms: Sudden death, Autopsy
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2008-03-12
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: none
Current Illness: none noted
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Full Autopsy done. Immediate cause of death was massive pulmonary embolus. Secondary was Type 1 Diabetes (previously undiagnosed). Vitreous Humor glucose was 767 9/4/08-records received- Vitreous glucose 767.
CDC 'Split Type':
Write-up: Sudden death occured on 3/12/2008. 9/4/08-records received-Cause of Death:cardiovascular collapse as a consequence of pulmonary emboli, dehydration and diabetic ketacidosis.
Vaccinated: | 2008-02-26 |
Onset: | 2008-03-12 |
Submitted: | 2008-09-03 |
Entered: | 2008-09-03 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 1266U / 3 | RA / IM |
Administered by: Unknown Purchased by: Unknown
Symptoms: Sudden death, Autopsy
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2008-03-12
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: none
Current Illness: none noted
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Full Autopsy done. Immediate cause of death was massive pulmonary embolus. Secondary was Type 1 Diabetes (previously undiagnosed). Vitreous Humor glucose was 767 9/4/08-records received- Vitreous glucose 767.
CDC 'Split Type':
Write-up: Sudden death occured on 3/12/2008. 9/4/08-records received-Cause of Death:cardiovascular collapse as a consequence of pulmonary emboli, dehydration and diabetic ketacidosis.
Link To This Search Result:
https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=324002&WAYBACKHISTORY=ON
Copyright ©
2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166