This is VAERS ID 183160

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID:	183160 (history)
Form:	Version 1.0
Age:	32.0
Sex:	Female
Location:	California

Vaccinated:	2002-03-21
Onset:	2002-03-22
Days after vaccination:	1
Submitted:	2002-03-30
Days after onset:	8
Entered:	2002-04-04
Days after submission:	5

Vaccination / Manufacturer	Lot / Dose	Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC.	13844 / UNK	- / SC
TD: TD ADSORBED (NO BRAND NAME) / SANOFI PASTEUR	U0519AA / UNK	- / IM

Administered by: Private Purchased by: Private
Symptoms: Respiratory disorder
SMQs:, Acute central respiratory depression (broad), Respiratory failure (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2002-05-01
   Days after onset: 39
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: At 17:00 on 3/21/02, she received MMR and Tetanus vaccination. About 12 hours later (05:00 on 3/22/02), she died and was brought back. 05/01/2002 patient expired after being transferred to hospital in Budapest. Records from San Clemente Hospital: Diagnosed with severe anoxic brain injury, probably alpha coma, seizure disorder, staphylococcus aureus bronchitis, ventricular fibrillation arrest, tachycardia, elevated liver enzymes.

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