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This is VAERS ID 192483

(NOTE: This result is from the 12/8/2009 version of the VAERS database)

Case Details

VAERS ID: 192483 (history)  
Form: Version .0  
Age: 1.0  
Sex: Male  
Location: Foreign  
Submitted: 2002-10-30
Entered: 2002-11-05
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Unknown       Purchased by: Unknown
Symptoms: Autism, Gastrointestinal disorder, Hydroureter, Psychomotor hyperactivity
SMQs:, Retroperitoneal fibrosis (narrow), Akathisia (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0210USA02146

Write-up: Information has been received regarding a case in litigation concerning a male child who on 10/13/94, at the age of 12 months was vaccinated with a dose of MMR II (lot 609861/1037W; batch 850672). It is alleged that following the vaccination the pt developed Asperger''s syndrome and bowel problems. Upon internal review the pt''s Asperger''s syndrome and bowel problems were considered to be other important medical events (OMIC). No further info is available. A 15-day follow up report received 3/10/2003 adds: Information has been received concerning a 13 month old male child with mild asthma, mild hydroureteronephrosis and a medical history of clicking hips, bilateral ureteric reflux, and meconium staining of the liquor during during, who on 10/13/1994 was vaccinated with a dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation) (Lot #609861/1037W: Batch #950672 (diluent)). It is alleged that following the vaccination the pt developed Asperger''s syndrome, Attention Deficit Disorder with Hyperactivity, and Lymphoid Nodular Hyperplasia in the terminal ileum. Additional info was received and indicted that the pt was crying, screaming and writhing about on one afternoon during the week post vaccination. This was unusual, as the pt never behaved like this before. Within 6 weeks post vaccination, the pt began to pick up his toys one after the other, look at them and then throw them away. He was no longer playing appropriately with them. Also the pt was extremely restless. He was not seeking out the company of adults as he had done before. He started to throw heavy objects around the house. Also within 8 weeks, his speech patterns had changed and from conversational cadences to being less talkative and expressing himself in a kind of gibberish that did not sound like conversational attempts. Within 3 to 4 months, his sleep patterns completely changed. He now needed little sleep, during which he was restless and twitchy. Within approximately 6 months, the pt had de

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