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This is VAERS ID 43712

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 43712
VAERS Form:
Age:1.4
Sex:Male
Location:Oregon
Vaccinated:1992-05-19
Onset:1992-06-10
Submitted:1992-06-16
Entered:1992-07-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD 1712S / 0 - / SC

Administered by: Other      Purchased by: Unknown
Symptoms: FEVER, CYANOSIS, APNEA, DYSPNEA, HEART ARREST

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-10
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: pt exp elevated temp @ 16 1/2 mos w/DTP/OPV/HIB/PPD #1 dose;
Other Medications: PPD by Connaught lot# 233121 29APR91; polyviflor; tums;
Current Illness: afebrile, chronic vegetative state
Preexisting Conditions: abruptio placenta-birth asphyxia-persistent vegetative state microcephaly, temp instability, acute renal tubular necrosis;
Allergies:
Diagnostic Lab Data: G-tube culture/purulent dr/gm stain no bacteria; prelim results WBC''s +1 gm neg bacilli +1; gm pos cocci +1;
CDC 'Split Type': abruptio placenta-birth asphyxia-persistent vegetative state microcephaly, temp instability, acute renal tubular necrosis;

Write-up: 10JUN92 230PM resp distress, color bluish, temp elevated; 02 placed, resp tx given, suctioned, APAP given for temp sudafed given no effect; 730PM resp & cardiac arrest, no code;


Changed on 12/8/2009

VAERS ID: 43712 Before After
VAERS Form:
Age:1.4
Sex:Male
Location:Oregon
Vaccinated:1992-05-19
Onset:1992-06-10
Submitted:1992-06-16
Entered:1992-07-28 1992-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. 1712S / 0 - / SC

Administered by: Other      Purchased by: Unknown Public
Symptoms: Apnoea, Cardiac arrest, Cyanosis, Dyspnoea, Infection, Pyrexia, FEVER, CYANOSIS, APNEA, DYSPNEA, HEART ARREST

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-10
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: pt exp elevated temp @ 16 1/2 mos w/DTP/OPV/HIB/PPD #1 dose;
Other Medications: PPD by Connaught lot# 233121 29APR91; polyviflor; tums;
Current Illness: afebrile, chronic vegetative state
Preexisting Conditions: abruptio placenta-birth asphyxia-persistent vegetative state microcephaly, temp instability, acute renal tubular necrosis;
Allergies:
Diagnostic Lab Data: G-tube culture/purulent dr/gm stain no bacteria; prelim results WBC''s +1 gm neg bacilli +1; gm pos cocci +1;
CDC 'Split Type': abruptio placenta-birth asphyxia-persistent vegetative state microcephaly, temp instability, acute renal tubular necrosis; OR9238

Write-up: 10JUN92 230PM resp distress, color bluish, temp elevated; 02 placed, resp tx given, suctioned, APAP given for temp sudafed given no effect; 730PM resp & cardiac arrest, no code;


Changed on 5/14/2017

VAERS ID: 43712 Before After
VAERS Form:
Age:1.4
Sex:Male
Location:Oregon
Vaccinated:1992-05-19
Onset:1992-06-10
Submitted:1992-06-16
Entered:1992-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1712S / 0 - / SC

Administered by: Other      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Cyanosis, Dyspnoea, Infection, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-10
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: pt exp elevated temp @ 16 1/2 mos w/DTP/OPV/HIB/PPD #1 dose; dose;~ ()~~~In patient
Other Medications: PPD by Connaught lot# 233121 29APR91; polyviflor; tums;
Current Illness: afebrile, chronic vegetative state
Preexisting Conditions: abruptio placenta-birth asphyxia-persistent vegetative state microcephaly, temp instability, acute renal tubular necrosis;
Allergies:
Diagnostic Lab Data: G-tube culture/purulent dr/gm stain no bacteria; prelim results WBC''s +1 gm neg bacilli +1; gm pos cocci +1;
CDC 'Split Type': OR9238

Write-up: 10JUN92 230PM resp distress, color bluish, temp elevated; 02 placed, resp tx given, suctioned, APAP given for temp sudafed given no effect; 730PM resp & cardiac arrest, no code;


Changed on 9/14/2017

VAERS ID: 43712 Before After
VAERS Form:(blank) 1
Age:1.4
Sex:Male
Location:Oregon
Vaccinated:1992-05-19
Onset:1992-06-10
Submitted:1992-06-16
Entered:1992-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1712S / 0 1 - / SC

Administered by: Other      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Cyanosis, Dyspnoea, Infection, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-10
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: pt exp elevated temp @ 16 1/2 mos w/DTP/OPV/HIB/PPD #1 dose;~ ()~~~In patient
Other Medications: PPD by Connaught lot# 233121 29APR91; polyviflor; tums;
Current Illness: afebrile, chronic vegetative state
Preexisting Conditions: abruptio placenta-birth asphyxia-persistent vegetative state microcephaly, temp instability, acute renal tubular necrosis;
Allergies:
Diagnostic Lab Data: G-tube culture/purulent dr/gm stain no bacteria; prelim results WBC''s +1 gm neg bacilli +1; gm pos cocci +1;
CDC 'Split Type': OR9238

Write-up: 10JUN92 230PM resp distress, color bluish, temp elevated; 02 placed, resp tx given, suctioned, APAP given for temp sudafed given no effect; 730PM resp & cardiac arrest, no code;


Changed on 2/14/2018

VAERS ID: 43712 Before After
VAERS Form:1
Age:1.4
Sex:Male
Location:Oregon
Vaccinated:1992-05-19
Onset:1992-06-10
Submitted:1992-06-16
Entered:1992-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1712S / 1 - / SC

Administered by: Other      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Cyanosis, Dyspnoea, Infection, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-10
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: pt exp elevated temp @ 16 1/2 mos w/DTP/OPV/HIB/PPD #1 dose;~ ()~~~In patient
Other Medications: PPD by Connaught lot# 233121 29APR91; polyviflor; tums;
Current Illness: afebrile, chronic vegetative state
Preexisting Conditions: abruptio placenta-birth asphyxia-persistent vegetative state microcephaly, temp instability, acute renal tubular necrosis;
Allergies:
Diagnostic Lab Data: G-tube culture/purulent dr/gm stain no bacteria; prelim results WBC''s +1 gm neg bacilli +1; gm pos cocci +1;
CDC 'Split Type': OR9238

Write-up: 10JUN92 230PM resp distress, color bluish, temp elevated; 02 placed, resp tx given, suctioned, APAP given for temp sudafed given no effect; 730PM resp & cardiac arrest, no code;


Changed on 6/14/2018

VAERS ID: 43712 Before After
VAERS Form:1
Age:1.4
Sex:Male
Location:Oregon
Vaccinated:1992-05-19
Onset:1992-06-10
Submitted:1992-06-16
Entered:1992-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1712S / 1 - / SC

Administered by: Other      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Cyanosis, Dyspnoea, Infection, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-10
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: pt exp elevated temp @ 16 1/2 mos w/DTP/OPV/HIB/PPD #1 dose;~ ()~~~In patient
Other Medications: PPD by Connaught lot# 233121 29APR91; polyviflor; tums;
Current Illness: afebrile, chronic vegetative state
Preexisting Conditions: abruptio placenta-birth asphyxia-persistent vegetative state microcephaly, temp instability, acute renal tubular necrosis;
Allergies:
Diagnostic Lab Data: G-tube culture/purulent dr/gm stain no bacteria; prelim results WBC''s +1 gm neg bacilli +1; gm pos cocci +1;
CDC 'Split Type': OR9238

Write-up: 10JUN92 230PM resp distress, color bluish, temp elevated; 02 placed, resp tx given, suctioned, APAP given for temp sudafed given no effect; 730PM resp & cardiac arrest, no code;


Changed on 8/14/2018

VAERS ID: 43712 Before After
VAERS Form:1
Age:1.4
Sex:Male
Location:Oregon
Vaccinated:1992-05-19
Onset:1992-06-10
Submitted:1992-06-16
Entered:1992-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1712S / 1 - / SC

Administered by: Other      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Cyanosis, Dyspnoea, Infection, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-10
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: pt exp elevated temp @ 16 1/2 mos w/DTP/OPV/HIB/PPD #1 dose;~ ()~~~In patient
Other Medications: PPD by Connaught lot# 233121 29APR91; polyviflor; tums;
Current Illness: afebrile, chronic vegetative state
Preexisting Conditions: abruptio placenta-birth asphyxia-persistent vegetative state microcephaly, temp instability, acute renal tubular necrosis;
Allergies:
Diagnostic Lab Data: G-tube culture/purulent dr/gm stain no bacteria; prelim results WBC''s +1 gm neg bacilli +1; gm pos cocci +1;
CDC 'Split Type': OR9238

Write-up: 10JUN92 230PM resp distress, color bluish, temp elevated; 02 placed, resp tx given, suctioned, APAP given for temp sudafed given no effect; 730PM resp & cardiac arrest, no code;


Changed on 9/14/2018

VAERS ID: 43712 Before After
VAERS Form:1
Age:1.4
Sex:Male
Location:Oregon
Vaccinated:1992-05-19
Onset:1992-06-10
Submitted:1992-06-16
Entered:1992-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1712S / 1 - / SC

Administered by: Other      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Cyanosis, Dyspnoea, Infection, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-10
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: pt exp elevated temp @ 16 1/2 mos w/DTP/OPV/HIB/PPD #1 dose;~ ()~~~In patient
Other Medications: PPD by Connaught lot# 233121 29APR91; polyviflor; tums;
Current Illness: afebrile, chronic vegetative state
Preexisting Conditions: abruptio placenta-birth asphyxia-persistent vegetative state microcephaly, temp instability, acute renal tubular necrosis;
Allergies:
Diagnostic Lab Data: G-tube culture/purulent dr/gm stain no bacteria; prelim results WBC''s +1 gm neg bacilli +1; gm pos cocci +1;
CDC 'Split Type': OR9238

Write-up: 10JUN92 230PM resp distress, color bluish, temp elevated; 02 placed, resp tx given, suctioned, APAP given for temp sudafed given no effect; 730PM resp & cardiac arrest, no code;


Changed on 10/14/2018

VAERS ID: 43712 Before After
VAERS Form:1
Age:1.4
Sex:Male
Location:Oregon
Vaccinated:1992-05-19
Onset:1992-06-10
Submitted:1992-06-16
Entered:1992-07-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1712S / 1 - / SC

Administered by: Other      Purchased by: Public
Symptoms: Apnoea, Cardiac arrest, Cyanosis, Dyspnoea, Infection, Pyrexia

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1992-06-10
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: pt exp elevated temp @ 16 1/2 mos w/DTP/OPV/HIB/PPD #1 dose;~ ()~~~In patient
Other Medications: PPD by Connaught lot# 233121 29APR91; polyviflor; tums;
Current Illness: afebrile, chronic vegetative state
Preexisting Conditions: abruptio placenta-birth asphyxia-persistent vegetative state microcephaly, temp instability, acute renal tubular necrosis;
Allergies:
Diagnostic Lab Data: G-tube culture/purulent dr/gm stain no bacteria; prelim results WBC''s +1 gm neg bacilli +1; gm pos cocci +1;
CDC 'Split Type': OR9238

Write-up: 10JUN92 230PM resp distress, color bluish, temp elevated; 02 placed, resp tx given, suctioned, APAP given for temp sudafed given no effect; 730PM resp & cardiac arrest, no code;

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