National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 40551

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 40551
VAERS Form:
Age:0.2
Sex:Male
Location:California
Vaccinated:1992-03-09
Onset:1992-03-11
Submitted:1992-03-16
Entered:1992-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 1F31022 / 0 LL / IM
HEP: RECOMBIVAX HB / MSD 2013T / 0 RL / IM
HIBV: HIBTITER / LEDERLE(PRAXIS) M135HF / 0 RL / IM
OPV: ORIMUNE / LEDERLE 0646H / 0 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: SIDS, APNEA, NEUROPATHY, HEART ARREST

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-03-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
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;


Changed on 12/8/2009

VAERS ID: 40551 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:California
Vaccinated:1992-03-09
Onset:1992-03-11
Submitted:1992-03-16
Entered:1992-03-27 1992-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 1F31022 / 0 LL / IM
HEP: RECOMBIVAX HB HEP B (RECOMBIVAX HB) / MSD MERCK & CO. INC. 2013T / 0 RL / IM
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M135HF / 0 RL / IM
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0646H / 0 - / PO

Administered by: Public      Purchased by: Unknown Private
Symptoms: Apnoea, Cardiac arrest, Neuropathy, SIDS, Sudden infant death syndrome, APNEA, NEUROPATHY, HEART ARREST

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-03-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
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;


Changed on 5/14/2017

VAERS ID: 40551 Before After
VAERS Form:
Age:0.2
Sex:Male
Location:California
Vaccinated:1992-03-09
Onset:1992-03-11
Submitted:1992-03-16
Entered:1992-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 1F31022 / 0 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 2013T / 0 RL / IM
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M135HF / 0 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0646H / 0 - / PO

Administered by: Public      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest, Neuropathy, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-03-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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;


Changed on 9/14/2017

VAERS ID: 40551 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Male
Location:California
Vaccinated:1992-03-09
Onset:1992-03-11
Submitted:1992-03-16
Entered:1992-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 1F31022 / 0 1 LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 2013T / 0 1 RL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M135HF / 0 1 RL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0646H / 0 1 - MO / PO

Administered by: Public      Purchased by: Private
Symptoms: Apnoea, Cardiac arrest, Neuropathy, Sudden infant death syndrome

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-03-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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;


Changed on 2/14/2018

VAERS ID: 40551 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:California
Vaccinated:1992-03-09
Onset:1992-03-11
Submitted:1992-03-16
Entered:1992-03-24
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-03-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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;


Changed on 6/14/2018

VAERS ID: 40551 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:California
Vaccinated:1992-03-09
Onset:1992-03-11
Submitted:1992-03-16
Entered:1992-03-24
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-03-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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;


Changed on 8/14/2018

VAERS ID: 40551 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:California
Vaccinated:1992-03-09
Onset:1992-03-11
Submitted:1992-03-16
Entered:1992-03-24
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-03-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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;


Changed on 9/14/2018

VAERS ID: 40551 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:California
Vaccinated:1992-03-09
Onset:1992-03-11
Submitted:1992-03-16
Entered:1992-03-24
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-03-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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;


Changed on 10/14/2018

VAERS ID: 40551 Before After
VAERS Form:1
Age:0.2
Sex:Male
Location:California
Vaccinated:1992-03-09
Onset:1992-03-11
Submitted:1992-03-16
Entered:1992-03-24
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-03-14
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     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;

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=40551&WAYBACKHISTORY=ON


Copyright © 2019 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166