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This is VAERS ID 806343

History of Changes from the VAERS Wayback Machine

First Appeared on 4/14/2019

VAERS ID: 806343
VAERS Form:2
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:0000-00-00
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:
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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