This is VAERS ID 151619

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

Case Details

VAERS ID:	151619 (history)
Form:	Version .0
Age:	0.2
Sex:	Male
Location:	California

Vaccinated:	2000-04-10
Onset:	0000-00-00
Submitted:	2000-04-26
Entered:	2000-05-05
Days after submission:	9

Vaccination / Manufacturer	Lot / Dose	Site / Route
DTAP: INFANRIX / SMITHKLINE	DTPA919A2 / 0	RL / IM
HBHEPB: COMVAX / MSD	1975J / 0	LL / IM
IPV: IPV / MERIEUX INST	R02352 / 0	RL / SC

Administered by: Public Purchased by: Unknown
Symptoms: ACIDOSIS, DEHYDRAT, DIARRHEA, EFFUS PLEURAL, FEVER
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
Date died: 2000-04-17
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: pyeloromyotony, pyloric stenosis
Allergies:
Diagnostic Lab Data: CSFCX-neg, BCX-neg
CDC Split Type:

Write-up: Pt experienced vomiting, diarrhea, dehydration. Pt was hospitalized for 20 hours with dehydration. Pt went into cardiac arrest and transferred to ICU where pt continued to arrest and sustained organ failure.Autopsy shows high fever, pleural effusion, acid"osis, hyperkalalemia

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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20031231&IDNUMBER=151619