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This is VAERS ID 806343

Case Details

VAERS ID: 806343 (history)  
Form: Version 2.0  
Age:   
Sex: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2019-03-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Unknown       Purchased by: ?
Symptoms: Arrhythmia, Death
SMQs:, Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)

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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: US0095075131903USA007463

Write-up: This spontaneous report was received from a pharmacist via company representative concerning to a 21-year-old female patient. The patient''s concurrent conditions, medical history, drug reaction or allergies and concomitant medications were not reported. On an unspecified day in 2007 (reported as 12 years ago), the patient received a dose of GARDASIL (dose number, route of administration, lot# and expiration date were not reported). The pharmacist stated that he heard about a court case where the female patient died from arrhythmia after the administration of GARDASIL. It was unknown if an autopsy was performed. No additional information was provided. The causal relationship between de patient''s death and GARDASIL was unknown.; Reported Cause(s) of Death: developed a heart arrhythmia that caused death.


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