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This is VAERS ID 811493

Case Details

VAERS ID: 811493 (history)  
Form: Version 2.0  
Sex: Female  
Location: Unknown  
Submitted: 0000-00-00
Entered: 2019-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: ?
Symptoms: Anxiety, Arthralgia, Back pain, Brain oedema, Hypokinesia, Nausea, Pain, Paraesthesia, Sudden death
SMQs:, Torsade de pointes/QT prolongation (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Retroperitoneal fibrosis (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hyponatraemia/SIADH (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Arthritis (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2013-10-12
   Days after onset: 0
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:
Diagnostic Lab Data:
CDC Split Type: US0095075131904USA009465

Write-up: This spontaneous report was received from social media "Revolution For Choice", via a vendor regarding a 16 year old female patient. The patient''s medical history, concurrent condition and concomitant medications were not reported. On an unknown date, the patient was vaccinated with GARDASIL (dose, frequency, route of administration, lot # and date of expiry were unknown) for prophylaxis. On an unknown date, the patient experienced swollen brain (brain oedema), anxiety, no movement (hypokinesia), tingliness (paraesthesia), pain/extreme pain/body pain, constant nausea, worst start to hurt her knees and back (back pain and arthralgia. The outcome of anxiety, back pain, body pain, arthralgia, nausea, pain, paraesthesia, hypokinesia and brain oedema was unknown. On 12-OCT-2013, the patient had died suddenly on bed. The cause of death was not reported. It was not reported if autopsy was performed. The causality assessment was not reported. Upon internal review, event of brain oedema was considered to be medically significant. This is one of the several reports.; Reported Cause(s) of Death: sudden death.

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