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This is VAERS ID 58232

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 58232
VAERS Form:
Age:2.7
Sex:Female
Location:Illinois
Vaccinated:0000-00-00
Onset:1991-01-01
Submitted:1993-12-10
Entered:1993-12-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II / MSD - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: DYSPNEA, HEART FAIL, ECG ABNORM, EFFUS PLEURAL, CARDIOMYOPATHY

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1991-10-10
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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: medical hx: imperforate anus;
Allergies:
Diagnostic Lab Data: Chest x-ray JAN91: cardiomegaly/pleural effusion; ECG JAN91: cardiomegaly; ECG 18JAN91: voltage & T wave improvement; 13FEB91 ECG: extremely low voltage;
CDC 'Split Type':

Write-up: Pt recvd vax in FEB91 & devel cardiomyopathy & myocarditis; pt underwent a heart transplant; however, it was unsuccessful; 10OCT91 pt died;


Changed on 12/8/2009

VAERS ID: 58232 Before After
VAERS Form:
Age:2.7
Sex:Female
Location:Illinois
Vaccinated:0000-00-00
Onset:1991-01-01
Submitted:1993-12-10
Entered:1993-12-22 1993-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Cardiac failure, Cardiomyopathy, Dyspnoea, Electrocardiogram abnormal, Hyperventilation, Infection, Myocarditis, Pleural effusion, DYSPNEA, HEART FAIL, ECG ABNORM, EFFUS PLEURAL, CARDIOMYOPATHY

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1991-10-10
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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: medical hx: imperforate anus;
Allergies:
Diagnostic Lab Data: Chest x-ray JAN91: cardiomegaly/pleural effusion; ECG JAN91: cardiomegaly; ECG 18JAN91: voltage & T wave improvement; 13FEB91 ECG: extremely low voltage;
CDC 'Split Type': (blank) WAES93111107

Write-up: Pt recvd vax in FEB91 & devel cardiomyopathy & myocarditis; pt underwent a heart transplant; however, it was unsuccessful; 10OCT91 pt died;


Changed on 2/14/2017

VAERS ID: 58232 Before After
VAERS Form:
Age:2.7 2.0
Sex:Female
Location:Illinois
Vaccinated:0000-00-00
Onset:1991-01-01
Submitted:1993-12-10
Entered:1993-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiac failure, Cardiomyopathy, Dyspnoea, Electrocardiogram abnormal, Hyperventilation, Infection, Myocarditis, Pleural effusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1991-10-10
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: 9     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: medical hx: imperforate anus;
Allergies:
Diagnostic Lab Data: Chest x-ray JAN91: cardiomegaly/pleural effusion; ECG JAN91: cardiomegaly; ECG 18JAN91: voltage & T wave improvement; 13FEB91 ECG: extremely low voltage;
CDC 'Split Type': WAES93111107

Write-up: Pt recvd vax in FEB91 & devel cardiomyopathy & myocarditis; pt underwent a heart transplant; however, it was unsuccessful; 10OCT91 pt died;


Changed on 5/14/2017

VAERS ID: 58232 Before After
VAERS Form:
Age:2.0
Sex:Female
Location:Illinois
Vaccinated:0000-00-00
Onset:1991-01-01
Submitted:1993-12-10
Entered:1993-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiac failure, Cardiomyopathy, Dyspnoea, Electrocardiogram abnormal, Hyperventilation, Infection, Myocarditis, Pleural effusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1991-10-10
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: 9     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: medical hx: imperforate anus;
Allergies:
Diagnostic Lab Data: Chest x-ray JAN91: cardiomegaly/pleural effusion; ECG JAN91: cardiomegaly; ECG 18JAN91: voltage & T wave improvement; 13FEB91 ECG: extremely low voltage;
CDC 'Split Type': WAES93111107

Write-up: Pt recvd vax in FEB91 & devel cardiomyopathy & myocarditis; pt underwent a heart transplant; however, it was unsuccessful; 10OCT91 pt died;


Changed on 9/14/2017

VAERS ID: 58232 Before After
VAERS Form:(blank) 1
Age:2.0
Sex:Female
Location:Illinois
Vaccinated:0000-00-00
Onset:1991-01-01
Submitted:1993-12-10
Entered:1993-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiac failure, Cardiomyopathy, Dyspnoea, Electrocardiogram abnormal, Hyperventilation, Infection, Myocarditis, Pleural effusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1991-10-10
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: 9     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: medical hx: imperforate anus;
Allergies:
Diagnostic Lab Data: Chest x-ray JAN91: cardiomegaly/pleural effusion; ECG JAN91: cardiomegaly; ECG 18JAN91: voltage & T wave improvement; 13FEB91 ECG: extremely low voltage;
CDC 'Split Type': WAES93111107

Write-up: Pt recvd vax in FEB91 & devel cardiomyopathy & myocarditis; pt underwent a heart transplant; however, it was unsuccessful; 10OCT91 pt died;


Changed on 2/14/2018

VAERS ID: 58232 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Illinois
Vaccinated:0000-00-00
Onset:1991-01-01
Submitted:1993-12-10
Entered:1993-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiac failure, Cardiomyopathy, Dyspnoea, Electrocardiogram abnormal, Hyperventilation, Infection, Myocarditis, Pleural effusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1991-10-10
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: 9     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: medical hx: imperforate anus;
Allergies:
Diagnostic Lab Data: Chest x-ray JAN91: cardiomegaly/pleural effusion; ECG JAN91: cardiomegaly; ECG 18JAN91: voltage & T wave improvement; 13FEB91 ECG: extremely low voltage;
CDC 'Split Type': WAES93111107

Write-up: Pt recvd vax in FEB91 & devel cardiomyopathy & myocarditis; pt underwent a heart transplant; however, it was unsuccessful; 10OCT91 pt died;


Changed on 6/14/2018

VAERS ID: 58232 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Illinois
Vaccinated:0000-00-00
Onset:1991-01-01
Submitted:1993-12-10
Entered:1993-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiac failure, Cardiomyopathy, Dyspnoea, Electrocardiogram abnormal, Hyperventilation, Infection, Myocarditis, Pleural effusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1991-10-10
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: 9     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: medical hx: imperforate anus;
Allergies:
Diagnostic Lab Data: Chest x-ray JAN91: cardiomegaly/pleural effusion; ECG JAN91: cardiomegaly; ECG 18JAN91: voltage & T wave improvement; 13FEB91 ECG: extremely low voltage;
CDC 'Split Type': WAES93111107

Write-up: Pt recvd vax in FEB91 & devel cardiomyopathy & myocarditis; pt underwent a heart transplant; however, it was unsuccessful; 10OCT91 pt died;


Changed on 8/14/2018

VAERS ID: 58232 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Illinois
Vaccinated:0000-00-00
Onset:1991-01-01
Submitted:1993-12-10
Entered:1993-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiac failure, Cardiomyopathy, Dyspnoea, Electrocardiogram abnormal, Hyperventilation, Infection, Myocarditis, Pleural effusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1991-10-10
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: 9     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: medical hx: imperforate anus;
Allergies:
Diagnostic Lab Data: Chest x-ray JAN91: cardiomegaly/pleural effusion; ECG JAN91: cardiomegaly; ECG 18JAN91: voltage & T wave improvement; 13FEB91 ECG: extremely low voltage;
CDC 'Split Type': WAES93111107

Write-up: Pt recvd vax in FEB91 & devel cardiomyopathy & myocarditis; pt underwent a heart transplant; however, it was unsuccessful; 10OCT91 pt died;


Changed on 9/14/2018

VAERS ID: 58232 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Illinois
Vaccinated:0000-00-00
Onset:1991-01-01
Submitted:1993-12-10
Entered:1993-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiac failure, Cardiomyopathy, Dyspnoea, Electrocardiogram abnormal, Hyperventilation, Infection, Myocarditis, Pleural effusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1991-10-10
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: 9     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: medical hx: imperforate anus;
Allergies:
Diagnostic Lab Data: Chest x-ray JAN91: cardiomegaly/pleural effusion; ECG JAN91: cardiomegaly; ECG 18JAN91: voltage & T wave improvement; 13FEB91 ECG: extremely low voltage;
CDC 'Split Type': WAES93111107

Write-up: Pt recvd vax in FEB91 & devel cardiomyopathy & myocarditis; pt underwent a heart transplant; however, it was unsuccessful; 10OCT91 pt died;


Changed on 10/14/2018

VAERS ID: 58232 Before After
VAERS Form:1
Age:2.0
Sex:Female
Location:Illinois
Vaccinated:0000-00-00
Onset:1991-01-01
Submitted:1993-12-10
Entered:1993-12-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Cardiac failure, Cardiomyopathy, Dyspnoea, Electrocardiogram abnormal, Hyperventilation, Infection, Myocarditis, Pleural effusion

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1991-10-10
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: 9     Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: medical hx: imperforate anus;
Allergies:
Diagnostic Lab Data: Chest x-ray JAN91: cardiomegaly/pleural effusion; ECG JAN91: cardiomegaly; ECG 18JAN91: voltage & T wave improvement; 13FEB91 ECG: extremely low voltage;
CDC 'Split Type': WAES93111107

Write-up: Pt recvd vax in FEB91 & devel cardiomyopathy & myocarditis; pt underwent a heart transplant; however, it was unsuccessful; 10OCT91 pt died;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=58232&WAYBACKHISTORY=ON


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