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This is VAERS ID 607675

Case Details

VAERS ID: 607675 (history)  
Form: Version 1.0  
Age:   
Sex: Unknown  
Location: Foreign  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2015-08-21
Entered: 2015-08-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Death, Sudden death
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES1508NZL009159

Write-up: The spontaneous report was received from Regulatory Authority regarding a patient of unknown age and gender. The patient''s medical history and concurrent conditions were not reported. On an unknown date the patient was vaccinated with GARDASIL dose, route unknown. Concomitant medications were not reported. On an unknown date the patient died due to sudden death. The pathologist was investigating the possibility of a heridatory cardiac conduction problem. The reporter considered sudden death to be not related to GARDASIL. This is one of several reports received from the same reporter. Additional information is not expected from the Agency as follow up information cannot be obtained.


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