National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 338561

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 338561
VAERS Form:
Age:20.0
Sex:Female
Location:Foreign
Vaccinated:2008-12-27
Onset:2009-01-01
Submitted:2009-01-28
Entered:2009-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arrhythmia, Atrial fibrillation, Blood glucose increased, Body temperature decreased, Body temperature increased, Cyanosis, Death, Dyspnoea, Electrocardiogram abnormal, Hyperthermia, Hypothermia, Intensive care, Leukocytosis, Lung disorder, Malaise, Multi-organ failure, Mydriasis, Tachycardia, Tremor, White blood cell count increased, X-ray abnormal, Autopsy, Ventricular hypokinesia, Drug screen negative, Laboratory test normal

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: BUSPAR; LEXOMIL; hormonal contraceptives (unspecified); magnesium (unspecified) (+) pyridoxine hydrochloride
Current Illness: Asthenia; Anxiety; Overwork; Psychological disorder NOS
Preexisting Conditions: Cardiac Murmur
Allergies:
Diagnostic Lab Data: electrocardiogram, 03Jan09, arrhythmia with atrial fibrillation; X-ray, 03Jan09, pneumopathy of right middle pulmonary lobe and septal hypokinesia; body temp, 01?Jan09, 38 C; WBC count, 03Jan09, 12.4.103/mm3; body temp, 03Jan09, 33.7 C; blo
CDC 'Split Type': WAES0901USA03398

Write-up: Information has been received from a specialist and from the health authority, concerning a 20 year old female with asthenia, anxiety/overwork syndrome and psychologic fragility since May 2008 and a history of cardiac murmur during childhood, who in OCT-2008 was vaccinated with the first dose of GARDASIL. The patient had no adverse effects after this dose. Concomitant therapy included BUSPAR, LEXOMIL, magnesium (unspecified) (+) pyridoxine hydrochloride and hormonal contraceptives (unspecified). On 27-DEC-2008 the patient was vaccinated with the second dose of GARDASIL, batch number not reported. It was reported that 3 days after the second dose of GARDASIL, i.e. in JAN-2009 the patient presented with hyperthermia at 38 C associated with breathlessness. After a malaise during shopping on 01-JAN-2009 the patient consulted her general practitioner; she had tremor and tachycardia. Blood analysis was performed on 03-JAN-2009 and revealed a slight hyperleukocytosis (12.4 103/mm3). By the evening on 03-JAN-2009 the patient presented with a malaise again but with no dyspnea and after taking BUSPAR. 2 hours later the intervention of EMUR (emergency medical mobile unit) could lead to recuperate a sinusal rhythm. Continuous arrhythmia with atrial fibrillation was diagnosed. The patient was transferred to medical intensive care service: she presented with bilateral mydriasis, hypothermia at 33.7 C, the result of measure of sugar in her blood was increased at 3.18 and she had cyanosis of face, ears, and extremities. Radiological examinations revealed a pneumopathy of the right middle pulmonary lobe and septal hypokinesia with paradoxical septal. There was no cocaine and no benzodiazepines. The patient presented with multiorgan failure under high dose of amines and then she dies in spite of the cardiopulmonary by-pass and extra corporeal oxygenation assistance. An autopsy was performed (unspecified date) and found no cause of death, also reported as information on autopsy was still awaited. Other business partner numbers incl


Changed on 4/14/2017

VAERS ID: 338561 Before After
VAERS Form:
Age:20.0
Sex:Female
Location:Foreign
Vaccinated:2008-12-27
Onset:2009-01-01
Submitted:2009-01-28
Entered:2009-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arrhythmia, Atrial fibrillation, Blood glucose increased, Body temperature decreased, Body temperature increased, Cyanosis, Death, Dyspnoea, Electrocardiogram abnormal, Hyperthermia, Hypothermia, Intensive care, Leukocytosis, Lung disorder, Malaise, Multi-organ failure, Mydriasis, Tachycardia, Tremor, White blood cell count increased, X-ray abnormal, Autopsy, Ventricular hypokinesia, Drug screen negative, Laboratory test normal

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: BUSPAR; LEXOMIL; hormonal contraceptives (unspecified); magnesium (unspecified) (+) pyridoxine hydrochloride
Current Illness: Asthenia; Anxiety; Overwork; Psychological disorder NOS
Preexisting Conditions: Cardiac Murmur
Allergies:
Diagnostic Lab Data: electrocardiogram, 03Jan09, arrhythmia with atrial fibrillation; X-ray, 03Jan09, pneumopathy of right middle pulmonary lobe and septal hypokinesia; body temp, 01?Jan09, 38 C; WBC count, 03Jan09, 12.4.103/mm3; body temp, 03Jan09, 33.7 C; blo blood chemistry, no cocaine and no benzodiazepines; blood glucose, 3.18, increased
CDC 'Split Type': WAES0901USA03398

Write-up: Information has been received from a specialist and from the health authority, concerning a 20 year old female with asthenia, anxiety/overwork syndrome and psychologic fragility since May 2008 and a history of cardiac murmur during childhood, who in OCT-2008 was vaccinated with the first dose of GARDASIL. The patient had no adverse effects after this dose. Concomitant therapy included BUSPAR, LEXOMIL, magnesium (unspecified) (+) pyridoxine hydrochloride and hormonal contraceptives (unspecified). On 27-DEC-2008 the patient was vaccinated with the second dose of GARDASIL, batch number not reported. It was reported that 3 days after the second dose of GARDASIL, i.e. in JAN-2009 the patient presented with hyperthermia at 38 C associated with breathlessness. After a malaise during shopping on 01-JAN-2009 the patient consulted her general practitioner; she had tremor and tachycardia. Blood analysis was performed on 03-JAN-2009 and revealed a slight hyperleukocytosis (12.4 103/mm3). By the evening on 03-JAN-2009 the patient presented with a malaise again but with no dyspnea and after taking BUSPAR. 2 hours later the intervention of EMUR (emergency medical mobile unit) could lead to recuperate a sinusal rhythm. Continuous arrhythmia with atrial fibrillation was diagnosed. The patient was transferred to medical intensive care service: she presented with bilateral mydriasis, hypothermia at 33.7 C, the result of measure of sugar in her blood was increased at 3.18 and she had cyanosis of face, ears, and extremities. Radiological examinations revealed a pneumopathy of the right middle pulmonary lobe and septal hypokinesia with paradoxical septal. There was no cocaine and no benzodiazepines. The patient presented with multiorgan failure under high dose of amines and then she dies in spite of the cardiopulmonary by-pass and extra corporeal oxygenation assistance. An autopsy was performed (unspecified date) and found no cause of death, also reported as information on autopsy was still awaited. Other business partner numbers incl include: E2009-00502. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 338561 Before After
VAERS Form:(blank) 1
Age:20.0
Sex:Female
Location:Foreign
Vaccinated:2008-12-27
Onset:2009-01-01
Submitted:2009-01-28
Entered:2009-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 2 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arrhythmia, Atrial fibrillation, Blood glucose increased, Body temperature decreased, Body temperature increased, Cyanosis, Death, Dyspnoea, Electrocardiogram abnormal, Hyperthermia, Hypothermia, Intensive care, Leukocytosis, Lung disorder, Malaise, Multi-organ failure, Mydriasis, Tachycardia, Tremor, White blood cell count increased, X-ray abnormal, Autopsy, Ventricular hypokinesia, Drug screen negative, Laboratory test normal

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: BUSPAR; LEXOMIL; hormonal contraceptives (unspecified); magnesium (unspecified) (+) pyridoxine hydrochloride
Current Illness: Asthenia; Anxiety; Overwork; Psychological disorder NOS
Preexisting Conditions: Cardiac Murmur
Allergies:
Diagnostic Lab Data: electrocardiogram, 03Jan09, arrhythmia with atrial fibrillation; X-ray, 03Jan09, pneumopathy of right middle pulmonary lobe and septal hypokinesia; body temp, 01?Jan09, 38 C; WBC count, 03Jan09, 12.4.103/mm3; body temp, 03Jan09, 33.7 C; blood chemistry, no cocaine and no benzodiazepines; blood glucose, 3.18, increased
CDC 'Split Type': WAES0901USA03398

Write-up: Information has been received from a specialist and from the health authority, concerning a 20 year old female with asthenia, anxiety/overwork syndrome and psychologic fragility since May 2008 and a history of cardiac murmur during childhood, who in OCT-2008 was vaccinated with the first dose of GARDASIL. The patient had no adverse effects after this dose. Concomitant therapy included BUSPAR, LEXOMIL, magnesium (unspecified) (+) pyridoxine hydrochloride and hormonal contraceptives (unspecified). On 27-DEC-2008 the patient was vaccinated with the second dose of GARDASIL, batch number not reported. It was reported that 3 days after the second dose of GARDASIL, i.e. in JAN-2009 the patient presented with hyperthermia at 38 C associated with breathlessness. After a malaise during shopping on 01-JAN-2009 the patient consulted her general practitioner; she had tremor and tachycardia. Blood analysis was performed on 03-JAN-2009 and revealed a slight hyperleukocytosis (12.4 103/mm3). By the evening on 03-JAN-2009 the patient presented with a malaise again but with no dyspnea and after taking BUSPAR. 2 hours later the intervention of EMUR (emergency medical mobile unit) could lead to recuperate a sinusal rhythm. Continuous arrhythmia with atrial fibrillation was diagnosed. The patient was transferred to medical intensive care service: she presented with bilateral mydriasis, hypothermia at 33.7 C, the result of measure of sugar in her blood was increased at 3.18 and she had cyanosis of face, ears, and extremities. Radiological examinations revealed a pneumopathy of the right middle pulmonary lobe and septal hypokinesia with paradoxical septal. There was no cocaine and no benzodiazepines. The patient presented with multiorgan failure under high dose of amines and then she dies in spite of the cardiopulmonary by-pass and extra corporeal oxygenation assistance. An autopsy was performed (unspecified date) and found no cause of death, also reported as information on autopsy was still awaited. Other business partner numbers include: E2009-00502. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 338561 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Foreign
Vaccinated:2008-12-27
Onset:2009-01-01
Submitted:2009-01-28
Entered:2009-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arrhythmia, Atrial fibrillation, Blood glucose increased, Body temperature decreased, Body temperature increased, Cyanosis, Death, Dyspnoea, Electrocardiogram abnormal, Hyperthermia, Hypothermia, Intensive care, Leukocytosis, Lung disorder, Malaise, Multi-organ failure, Mydriasis, Tachycardia, Tremor, White blood cell count increased, X-ray abnormal, Autopsy, Ventricular hypokinesia, Drug screen negative, Laboratory test normal

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: BUSPAR; LEXOMIL; hormonal contraceptives (unspecified); magnesium (unspecified) (+) pyridoxine hydrochloride
Current Illness: Asthenia; Anxiety; Overwork; Psychological disorder NOS
Preexisting Conditions: Cardiac Murmur
Allergies:
Diagnostic Lab Data: electrocardiogram, 03Jan09, arrhythmia with atrial fibrillation; X-ray, 03Jan09, pneumopathy of right middle pulmonary lobe and septal hypokinesia; body temp, 01?Jan09, 38 C; WBC count, 03Jan09, 12.4.103/mm3; body temp, 03Jan09, 33.7 C; blood chemistry, no cocaine and no benzodiazepines; blood glucose, 3.18, increased
CDC 'Split Type': WAES0901USA03398

Write-up: Information has been received from a specialist and from the health authority, concerning a 20 year old female with asthenia, anxiety/overwork syndrome and psychologic fragility since May 2008 and a history of cardiac murmur during childhood, who in OCT-2008 was vaccinated with the first dose of GARDASIL. The patient had no adverse effects after this dose. Concomitant therapy included BUSPAR, LEXOMIL, magnesium (unspecified) (+) pyridoxine hydrochloride and hormonal contraceptives (unspecified). On 27-DEC-2008 the patient was vaccinated with the second dose of GARDASIL, batch number not reported. It was reported that 3 days after the second dose of GARDASIL, i.e. in JAN-2009 the patient presented with hyperthermia at 38 C associated with breathlessness. After a malaise during shopping on 01-JAN-2009 the patient consulted her general practitioner; she had tremor and tachycardia. Blood analysis was performed on 03-JAN-2009 and revealed a slight hyperleukocytosis (12.4 103/mm3). By the evening on 03-JAN-2009 the patient presented with a malaise again but with no dyspnea and after taking BUSPAR. 2 hours later the intervention of EMUR (emergency medical mobile unit) could lead to recuperate a sinusal rhythm. Continuous arrhythmia with atrial fibrillation was diagnosed. The patient was transferred to medical intensive care service: she presented with bilateral mydriasis, hypothermia at 33.7 C, the result of measure of sugar in her blood was increased at 3.18 and she had cyanosis of face, ears, and extremities. Radiological examinations revealed a pneumopathy of the right middle pulmonary lobe and septal hypokinesia with paradoxical septal. There was no cocaine and no benzodiazepines. The patient presented with multiorgan failure under high dose of amines and then she dies in spite of the cardiopulmonary by-pass and extra corporeal oxygenation assistance. An autopsy was performed (unspecified date) and found no cause of death, also reported as information on autopsy was still awaited. Other business partner numbers include: E2009-00502. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 338561 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Foreign
Vaccinated:2008-12-27
Onset:2009-01-01
Submitted:2009-01-28
Entered:2009-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arrhythmia, Atrial fibrillation, Blood glucose increased, Body temperature decreased, Body temperature increased, Cyanosis, Death, Dyspnoea, Electrocardiogram abnormal, Hyperthermia, Hypothermia, Intensive care, Leukocytosis, Lung disorder, Malaise, Multi-organ failure, Mydriasis, Tachycardia, Tremor, White blood cell count increased, X-ray abnormal, Autopsy, Ventricular hypokinesia, Drug screen negative, Laboratory test normal

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: BUSPAR; LEXOMIL; hormonal contraceptives (unspecified); magnesium (unspecified) (+) pyridoxine hydrochloride
Current Illness: Asthenia; Anxiety; Overwork; Psychological disorder NOS
Preexisting Conditions: Cardiac Murmur
Allergies:
Diagnostic Lab Data: electrocardiogram, 03Jan09, arrhythmia with atrial fibrillation; X-ray, 03Jan09, pneumopathy of right middle pulmonary lobe and septal hypokinesia; body temp, 01?Jan09, 38 C; WBC count, 03Jan09, 12.4.103/mm3; body temp, 03Jan09, 33.7 C; blood chemistry, no cocaine and no benzodiazepines; blood glucose, 3.18, increased
CDC 'Split Type': WAES0901USA03398

Write-up: Information has been received from a specialist and from the health authority, concerning a 20 year old female with asthenia, anxiety/overwork syndrome and psychologic fragility since May 2008 and a history of cardiac murmur during childhood, who in OCT-2008 was vaccinated with the first dose of GARDASIL. The patient had no adverse effects after this dose. Concomitant therapy included BUSPAR, LEXOMIL, magnesium (unspecified) (+) pyridoxine hydrochloride and hormonal contraceptives (unspecified). On 27-DEC-2008 the patient was vaccinated with the second dose of GARDASIL, batch number not reported. It was reported that 3 days after the second dose of GARDASIL, i.e. in JAN-2009 the patient presented with hyperthermia at 38 C associated with breathlessness. After a malaise during shopping on 01-JAN-2009 the patient consulted her general practitioner; she had tremor and tachycardia. Blood analysis was performed on 03-JAN-2009 and revealed a slight hyperleukocytosis (12.4 103/mm3). By the evening on 03-JAN-2009 the patient presented with a malaise again but with no dyspnea and after taking BUSPAR. 2 hours later the intervention of EMUR (emergency medical mobile unit) could lead to recuperate a sinusal rhythm. Continuous arrhythmia with atrial fibrillation was diagnosed. The patient was transferred to medical intensive care service: she presented with bilateral mydriasis, hypothermia at 33.7 C, the result of measure of sugar in her blood was increased at 3.18 and she had cyanosis of face, ears, and extremities. Radiological examinations revealed a pneumopathy of the right middle pulmonary lobe and septal hypokinesia with paradoxical septal. There was no cocaine and no benzodiazepines. The patient presented with multiorgan failure under high dose of amines and then she dies in spite of the cardiopulmonary by-pass and extra corporeal oxygenation assistance. An autopsy was performed (unspecified date) and found no cause of death, also reported as information on autopsy was still awaited. Other business partner numbers include: E2009-00502. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 338561 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Foreign
Vaccinated:2008-12-27
Onset:2009-01-01
Submitted:2009-01-28
Entered:2009-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arrhythmia, Atrial fibrillation, Blood glucose increased, Body temperature decreased, Body temperature increased, Cyanosis, Death, Dyspnoea, Electrocardiogram abnormal, Hyperthermia, Hypothermia, Intensive care, Leukocytosis, Lung disorder, Malaise, Multi-organ failure, Mydriasis, Tachycardia, Tremor, White blood cell count increased, X-ray abnormal, Autopsy, Ventricular hypokinesia, Drug screen negative, Laboratory test normal

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: BUSPAR; LEXOMIL; hormonal contraceptives (unspecified); magnesium (unspecified) (+) pyridoxine hydrochloride
Current Illness: Asthenia; Anxiety; Overwork; Psychological disorder NOS
Preexisting Conditions: Cardiac Murmur
Allergies:
Diagnostic Lab Data: electrocardiogram, 03Jan09, arrhythmia with atrial fibrillation; X-ray, 03Jan09, pneumopathy of right middle pulmonary lobe and septal hypokinesia; body temp, 01?Jan09, 38 C; WBC count, 03Jan09, 12.4.103/mm3; body temp, 03Jan09, 33.7 C; blood chemistry, no cocaine and no benzodiazepines; blood glucose, 3.18, increased
CDC 'Split Type': WAES0901USA03398

Write-up: Information has been received from a specialist and from the health authority, concerning a 20 year old female with asthenia, anxiety/overwork syndrome and psychologic fragility since May 2008 and a history of cardiac murmur during childhood, who in OCT-2008 was vaccinated with the first dose of GARDASIL. The patient had no adverse effects after this dose. Concomitant therapy included BUSPAR, LEXOMIL, magnesium (unspecified) (+) pyridoxine hydrochloride and hormonal contraceptives (unspecified). On 27-DEC-2008 the patient was vaccinated with the second dose of GARDASIL, batch number not reported. It was reported that 3 days after the second dose of GARDASIL, i.e. in JAN-2009 the patient presented with hyperthermia at 38 C associated with breathlessness. After a malaise during shopping on 01-JAN-2009 the patient consulted her general practitioner; she had tremor and tachycardia. Blood analysis was performed on 03-JAN-2009 and revealed a slight hyperleukocytosis (12.4 103/mm3). By the evening on 03-JAN-2009 the patient presented with a malaise again but with no dyspnea and after taking BUSPAR. 2 hours later the intervention of EMUR (emergency medical mobile unit) could lead to recuperate a sinusal rhythm. Continuous arrhythmia with atrial fibrillation was diagnosed. The patient was transferred to medical intensive care service: she presented with bilateral mydriasis, hypothermia at 33.7 C, the result of measure of sugar in her blood was increased at 3.18 and she had cyanosis of face, ears, and extremities. Radiological examinations revealed a pneumopathy of the right middle pulmonary lobe and septal hypokinesia with paradoxical septal. There was no cocaine and no benzodiazepines. The patient presented with multiorgan failure under high dose of amines and then she dies in spite of the cardiopulmonary by-pass and extra corporeal oxygenation assistance. An autopsy was performed (unspecified date) and found no cause of death, also reported as information on autopsy was still awaited. Other business partner numbers include: E2009-00502. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 338561 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Foreign
Vaccinated:2008-12-27
Onset:2009-01-01
Submitted:2009-01-28
Entered:2009-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arrhythmia, Atrial fibrillation, Blood glucose increased, Body temperature decreased, Body temperature increased, Cyanosis, Death, Dyspnoea, Electrocardiogram abnormal, Hyperthermia, Hypothermia, Intensive care, Leukocytosis, Lung disorder, Malaise, Multi-organ failure, Mydriasis, Tachycardia, Tremor, White blood cell count increased, X-ray abnormal, Autopsy, Ventricular hypokinesia, Drug screen negative, Laboratory test normal

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: BUSPAR; LEXOMIL; hormonal contraceptives (unspecified); magnesium (unspecified) (+) pyridoxine hydrochloride
Current Illness: Asthenia; Anxiety; Overwork; Psychological disorder NOS
Preexisting Conditions: Cardiac Murmur
Allergies:
Diagnostic Lab Data: electrocardiogram, 03Jan09, arrhythmia with atrial fibrillation; X-ray, 03Jan09, pneumopathy of right middle pulmonary lobe and septal hypokinesia; body temp, 01?Jan09, 38 C; WBC count, 03Jan09, 12.4.103/mm3; body temp, 03Jan09, 33.7 C; blood chemistry, no cocaine and no benzodiazepines; blood glucose, 3.18, increased
CDC 'Split Type': WAES0901USA03398

Write-up: Information has been received from a specialist and from the health authority, concerning a 20 year old female with asthenia, anxiety/overwork syndrome and psychologic fragility since May 2008 and a history of cardiac murmur during childhood, who in OCT-2008 was vaccinated with the first dose of GARDASIL. The patient had no adverse effects after this dose. Concomitant therapy included BUSPAR, LEXOMIL, magnesium (unspecified) (+) pyridoxine hydrochloride and hormonal contraceptives (unspecified). On 27-DEC-2008 the patient was vaccinated with the second dose of GARDASIL, batch number not reported. It was reported that 3 days after the second dose of GARDASIL, i.e. in JAN-2009 the patient presented with hyperthermia at 38 C associated with breathlessness. After a malaise during shopping on 01-JAN-2009 the patient consulted her general practitioner; she had tremor and tachycardia. Blood analysis was performed on 03-JAN-2009 and revealed a slight hyperleukocytosis (12.4 103/mm3). By the evening on 03-JAN-2009 the patient presented with a malaise again but with no dyspnea and after taking BUSPAR. 2 hours later the intervention of EMUR (emergency medical mobile unit) could lead to recuperate a sinusal rhythm. Continuous arrhythmia with atrial fibrillation was diagnosed. The patient was transferred to medical intensive care service: she presented with bilateral mydriasis, hypothermia at 33.7 C, the result of measure of sugar in her blood was increased at 3.18 and she had cyanosis of face, ears, and extremities. Radiological examinations revealed a pneumopathy of the right middle pulmonary lobe and septal hypokinesia with paradoxical septal. There was no cocaine and no benzodiazepines. The patient presented with multiorgan failure under high dose of amines and then she dies in spite of the cardiopulmonary by-pass and extra corporeal oxygenation assistance. An autopsy was performed (unspecified date) and found no cause of death, also reported as information on autopsy was still awaited. Other business partner numbers include: E2009-00502. Additional information has been requested.


Changed on 10/14/2018

VAERS ID: 338561 Before After
VAERS Form:1
Age:20.0
Sex:Female
Location:Foreign
Vaccinated:2008-12-27
Onset:2009-01-01
Submitted:2009-01-28
Entered:2009-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arrhythmia, Atrial fibrillation, Blood glucose increased, Body temperature decreased, Body temperature increased, Cyanosis, Death, Dyspnoea, Electrocardiogram abnormal, Hyperthermia, Hypothermia, Intensive care, Leukocytosis, Lung disorder, Malaise, Multi-organ failure, Mydriasis, Tachycardia, Tremor, White blood cell count increased, X-ray abnormal, Autopsy, Ventricular hypokinesia, Drug screen negative, Laboratory test normal

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: BUSPAR; LEXOMIL; hormonal contraceptives (unspecified); magnesium (unspecified) (+) pyridoxine hydrochloride
Current Illness: Asthenia; Anxiety; Overwork; Psychological disorder NOS
Preexisting Conditions: Cardiac Murmur
Allergies:
Diagnostic Lab Data: electrocardiogram, 03Jan09, arrhythmia with atrial fibrillation; X-ray, 03Jan09, pneumopathy of right middle pulmonary lobe and septal hypokinesia; body temp, 01?Jan09, 38 C; WBC count, 03Jan09, 12.4.103/mm3; body temp, 03Jan09, 33.7 C; blood chemistry, no cocaine and no benzodiazepines; blood glucose, 3.18, increased
CDC 'Split Type': WAES0901USA03398

Write-up: Information has been received from a specialist and from the health authority, concerning a 20 year old female with asthenia, anxiety/overwork syndrome and psychologic fragility since May 2008 and a history of cardiac murmur during childhood, who in OCT-2008 was vaccinated with the first dose of GARDASIL. The patient had no adverse effects after this dose. Concomitant therapy included BUSPAR, LEXOMIL, magnesium (unspecified) (+) pyridoxine hydrochloride and hormonal contraceptives (unspecified). On 27-DEC-2008 the patient was vaccinated with the second dose of GARDASIL, batch number not reported. It was reported that 3 days after the second dose of GARDASIL, i.e. in JAN-2009 the patient presented with hyperthermia at 38 C associated with breathlessness. After a malaise during shopping on 01-JAN-2009 the patient consulted her general practitioner; she had tremor and tachycardia. Blood analysis was performed on 03-JAN-2009 and revealed a slight hyperleukocytosis (12.4 103/mm3). By the evening on 03-JAN-2009 the patient presented with a malaise again but with no dyspnea and after taking BUSPAR. 2 hours later the intervention of EMUR (emergency medical mobile unit) could lead to recuperate a sinusal rhythm. Continuous arrhythmia with atrial fibrillation was diagnosed. The patient was transferred to medical intensive care service: she presented with bilateral mydriasis, hypothermia at 33.7 C, the result of measure of sugar in her blood was increased at 3.18 and she had cyanosis of face, ears, and extremities. Radiological examinations revealed a pneumopathy of the right middle pulmonary lobe and septal hypokinesia with paradoxical septal. There was no cocaine and no benzodiazepines. The patient presented with multiorgan failure under high dose of amines and then she dies in spite of the cardiopulmonary by-pass and extra corporeal oxygenation assistance. An autopsy was performed (unspecified date) and found no cause of death, also reported as information on autopsy was still awaited. Other business partner numbers include: E2009-00502. Additional information has been requested.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=338561&WAYBACKHISTORY=ON


Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166