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This is VAERS ID 40551

Case Details

VAERS ID: 40551 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: California  
Vaccinated:1992-03-09
Onset:1992-03-11
   Days after vaccination:2
Submitted: 1992-03-16
   Days after onset:5
Entered: 1992-03-24
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 1F31022 / 1 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 2013T / 1 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M135HF / 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0646H / 1 MO / PO

Administered by: Public       Purchased by: Private
Symptoms: Apnoea, Cardiac arrest, Neuropathy, Sudden infant death syndrome
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Peripheral neuropathy (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Neonatal disorders (narrow), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1992-03-14
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Hydorcortisone, Nystatin ointment;
Current Illness: candida diaper derm-oral candiasis
Preexisting Conditions: probable milk allergy 4FEB92; otitis-cleared, thrush 18FEB92;
Allergies:
Diagnostic Lab Data: CT of head, abdomen; autopsy;
CDC Split Type:

Write-up: After being cllinically well, pt was found asystolic w/o respiration; this was felt to be SIDS; resusitation was begun & pt brough to ER; over next 2-3 days pt showed evidence of severe neuro damage & multiple organ failure;


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