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This is VAERS ID 184346

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

Case Details

VAERS ID: 184346 (history)  
Form: Version 1.0  
Age: 1.08  
Sex: Female  
Location: California  
Vaccinated:2002-04-04
Onset:2002-04-27
   Days after vaccination:23
Submitted: 2002-05-01
   Days after onset:4
Entered: 2002-05-09
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1379L / 1 RL / SC
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0573L / 1 LL / SC

Administered by: Private       Purchased by: Private
Symptoms: Cardiac arrest, Infection, Multi-organ failure, Respiratory arrest, Shock
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Hypovolaemic shock conditions (narrow), Toxic-septic shock conditions (narrow), Anaphylactic/anaphylactoid shock conditions (narrow), Hypoglycaemic and neurogenic shock conditions (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2002-07-16
   Days after onset: 80
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 44 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: RSV Bronchiolitis and pneumonia
Preexisting Conditions: Congenital ichthyosis, failure to thrive,
Allergies:
Diagnostic Lab Data: VZV-DFA (+)
CDC Split Type:

Write-up: Disseminated VZV with multi-organ failure, shock, CV arrest. Diagnosed with Superficial cellulitis, Otitis externa, hepatomegaly. 3/16/05 Autopsy report received which revealed COD to be respiratory arrest and congenital ichthyosis w/Netherton''s syndrome. Patient arrested in pediatrician''s office & unable to be revived/ss


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170914&IDNUMBER=184346


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