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This is VAERS ID 350817

Case Details

VAERS ID: 350817 (history)  
Age: 12.0  
Gender: Female  
Location: New Jersey  
Vaccinated:2008-06-20
Onset:2009-06-20
   Days after vaccination:365
Submitted: 2009-06-23
   Days after onset:3
Entered: 2009-07-06
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0067X / 0 LA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2638AA / 0 UN / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2404AA / 0 UN / UN

Administered by: Private       Purchased by: Private
Symptoms: Blood lactic acid increased, Brain injury, Cardiac operation, Injection site erythema, Injection site induration, Injection site swelling, Metabolic function test abnormal
SMQs:, Lactic acidosis (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Hole in heart
Preexisting Conditions: ASD
Diagnostic Lab Data: Lost all metabolic ability.
CDC Split Type:

Write-up: GARDASIL. Redness, swelling area hard around vaccine. Had open heart surgery 6/27/09. Suffered brain injury. Lactic acids raised to brain, abnormal white matter. 7/13/2009 MR received from PCP 6/20-/2009. In for WCC on 6/20/09. For surgical repair of ASD in 1 week. Impression: Healthy. ASD. Returned 6/23/09 to have throat checked. Impression: Pharyngitis. In for surgury ~6/27/09 with "catastrophic event" intraoperatively with subsequent encephalopathy. ? Mitochondrial defect. Pt currently with L hemiparesis, R dystonia, non-verbal with receptive language intact. S/P pancreatitis with G-tube feeds. Transferred to higher level of care.


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