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This is VAERS ID 113717

(NOTE: This result is from the 12/31/2003 version of the VAERS database)

Case Details

VAERS ID: 113717 (history)  
Form: Version .0  
Age: 53.6  
Sex: Male  
Location: Tennessee  
Vaccinated:1998-05-20
Onset:1998-05-26
   Days after vaccination:6
Submitted: 1998-06-02
   Days after onset:7
Entered: 1998-09-01
   Days after submission:91
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: ENGERIX-B / SMITHKLINE 2186A4 / 1 RA / IM

Administered by: Public       Purchased by: Unknown
Symptoms: LIVER FAIL
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1998-05-26
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NA
Other Medications: Hep B vax dose 1;
Current Illness: liver failure
Preexisting Conditions: NKA, liver failure
Allergies:
Diagnostic Lab Data: liver failure
CDC Split Type: NKA, liver failure

Write-up: liver failure


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=113717


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