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This is VAERS ID 47375

Case Details

VAERS ID: 47375 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Tennessee  
Vaccinated:1992-10-29
Onset:1992-10-30
   Days after vaccination:1
Submitted: 1992-11-03
   Days after onset:4
Entered: 1992-11-20
   Days after submission:17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 322914 / 1 RL / IM
HEP: HEP B (FOREIGN) / MERCK & CO. INC. 1158V / 1 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155JA / 1 LL / IM
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0661D / 1 MO / PO

Administered by: Public       Purchased by: Public
Symptoms: Lung disorder, Pulmonary oedema, Sudden infant death syndrome
SMQs:, Cardiac failure (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Neonatal disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1992-10-30
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: NONE
Current Illness: had had MD exam 2 days prior;
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC Split Type: TN92142

Write-up: DTP/OPV/HIB/HBV were given 29OCT92 2PM pt found dead 30OCT92 approx 9AM of apparent crib death;


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