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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 287888 |
VAERS Form: | |
Age: | 22.0 |
Sex: | Female |
Location: | Unknown |
Vaccinated: | 2007-05-21 |
Onset: | 2007-05-23 |
Submitted: | 2007-08-10 |
Entered: | 2007-08-13 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0389U / - | UN / IM |
Administered by: Other Purchased by: Unknown
Symptoms: Death, Autopsy
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2007-05-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: autopsy - no findings
CDC 'Split Type':
Write-up: Information has been received from a nurse practitioner concerning a 22 year old female patient with no pertinent medical history or drug allergies who on 21-MAY-2007, was vaccinated IM with a 0.5ml dose of Gardasil (Lot# 657736/0389U). Concomitant therap"y included hormonal contraceptives (unspecified) (/"MERCET/"). On 23-MAY-2007, the patient died suddenly. The cause of death was unknown. Unspecified medical attention was sought. Laboratory diagnostic studies included an autopsy which showed no findings.
Vaccinated: | 2007-05-21 |
Onset: | 2007-05-23 |
Submitted: | 2007-08-10 |
Entered: | 2007-08-13 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0389U / - | UN / IM |
Administered by: Other Purchased by: Unknown Other
Symptoms: Death, Drug screen positive, Autopsy, Adverse drug reaction
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2007-05-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: None 7/2/08-records received-HX of heroin and prescription drug abuse.
Allergies:
Diagnostic Lab Data: autopsy - no findings
CDC 'Split Type': (blank) WAES0708USA00407
Write-up: Information has been received from a nurse practitioner concerning a 22 year old female patient with no pertinent medical history or drug allergies who on 21-MAY-2007, was vaccinated IM with a 0.5ml dose of Gardasil (Lot# 657736/0389U). Concomitant therap"y therapy included hormonal contraceptives (unspecified) (/"MERCET/"). ("MERCET"). On 23-MAY-2007, the patient died suddenly. The cause of death was unknown. Unspecified medical attention was sought. Laboratory diagnostic studies included an autopsy which showed no findings. No product quality complaint was involved. The reporter stated that Gardasil did not cause the patient''s death. Additional information is not expected. 7/2/08-records received-Adverse effect of drugs.Toxicology survey findings:urine positive for methadone, benzodiazepines, benzoylecgonine (from cocaine), cannabinoids, nicotine, diphenhydramine and naproxen.
Vaccinated: | 2007-05-21 |
Onset: | 2007-05-23 |
Submitted: | 2007-08-10 |
Entered: | 2007-08-13 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0389U / - | UN / IM |
Administered by: Other Purchased by: Other
Symptoms: Death, Drug screen positive, Autopsy, Adverse drug reaction
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2007-05-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: None 7/2/08-records received-HX of heroin and prescription drug abuse.
Allergies:
Diagnostic Lab Data: autopsy - no findings
CDC 'Split Type': WAES0708USA00407
Write-up: Information has been received from a nurse practitioner concerning a 22 year old female patient with no pertinent medical history or drug allergies who on 21-MAY-2007, was vaccinated IM with a 0.5ml dose of Gardasil (Lot# 657736/0389U). Concomitant therapy included hormonal contraceptives (unspecified) ("MERCET"). On 23-MAY-2007, the patient died suddenly. The cause of death was unknown. Unspecified medical attention was sought. Laboratory diagnostic studies included an autopsy which showed no findings. No product quality complaint was involved. The reporter stated that Gardasil did not cause the patient''s death. Additional information is not expected. 7/2/08-records received-Adverse effect of drugs.Toxicology survey findings:urine positive for methadone, benzodiazepines, benzoylecgonine (from cocaine), cannabinoids, nicotine, diphenhydramine and naproxen.
Vaccinated: | 2007-05-21 |
Onset: | 2007-05-23 |
Submitted: | 2007-08-10 |
Entered: | 2007-08-13 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0389U / - UNK | UN / IM |
Administered by: Other Purchased by: Other
Symptoms: Death, Autopsy
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2007-05-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: None 7/2/08-records received-HX of heroin and prescription drug abuse.
Allergies:
Diagnostic Lab Data: autopsy - no findings
CDC 'Split Type': WAES0708USA00407
Write-up: Information has been received from a nurse practitioner concerning a 22 year old female patient with no pertinent medical history or drug allergies who on 21-MAY-2007, was vaccinated IM with a 0.5ml dose of Gardasil (Lot# 657736/0389U). Concomitant therapy included hormonal contraceptives (unspecified) ("MERCET"). On 23-MAY-2007, the patient died suddenly. The cause of death was unknown. Unspecified medical attention was sought. Laboratory diagnostic studies included an autopsy which showed no findings. No product quality complaint was involved. The reporter stated that Gardasil did not cause the patient''s death. Additional information is not expected. 7/2/08-records received-Adverse effect of drugs.Toxicology survey findings:urine positive for methadone, benzodiazepines, benzoylecgonine (from cocaine), cannabinoids, nicotine, diphenhydramine and naproxen.
Vaccinated: | 2007-05-21 |
Onset: | 2007-05-23 |
Submitted: | 2007-08-10 |
Entered: | 2007-08-13 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0389U / UNK | UN / IM |
Administered by: Other Purchased by: Other
Symptoms: Death, Autopsy
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2007-05-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: None 7/2/08-records received-HX of heroin and prescription drug abuse.
Allergies:
Diagnostic Lab Data: autopsy - no findings
CDC 'Split Type': WAES0708USA00407
Write-up: Information has been received from a nurse practitioner concerning a 22 year old female patient with no pertinent medical history or drug allergies who on 21-MAY-2007, was vaccinated IM with a 0.5ml dose of Gardasil (Lot# 657736/0389U). Concomitant therapy included hormonal contraceptives (unspecified) ("MERCET"). On 23-MAY-2007, the patient died suddenly. The cause of death was unknown. Unspecified medical attention was sought. Laboratory diagnostic studies included an autopsy which showed no findings. No product quality complaint was involved. The reporter stated that Gardasil did not cause the patient''s death. Additional information is not expected. 7/2/08-records received-Adverse effect of drugs.Toxicology survey findings:urine positive for methadone, benzodiazepines, benzoylecgonine (from cocaine), cannabinoids, nicotine, diphenhydramine and naproxen.
Vaccinated: | 2007-05-21 |
Onset: | 2007-05-23 |
Submitted: | 2007-08-10 |
Entered: | 2007-08-13 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0389U / UNK | UN / IM |
Administered by: Other Purchased by: Other
Symptoms: Death, Autopsy
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2007-05-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: None 7/2/08-records received-HX of heroin and prescription drug abuse.
Allergies:
Diagnostic Lab Data: autopsy - no findings
CDC 'Split Type': WAES0708USA00407
Write-up: Information has been received from a nurse practitioner concerning a 22 year old female patient with no pertinent medical history or drug allergies who on 21-MAY-2007, was vaccinated IM with a 0.5ml dose of Gardasil (Lot# 657736/0389U). Concomitant therapy included hormonal contraceptives (unspecified) ("MERCET"). On 23-MAY-2007, the patient died suddenly. The cause of death was unknown. Unspecified medical attention was sought. Laboratory diagnostic studies included an autopsy which showed no findings. No product quality complaint was involved. The reporter stated that Gardasil did not cause the patient''s death. Additional information is not expected. 7/2/08-records received-Adverse effect of drugs.Toxicology survey findings:urine positive for methadone, benzodiazepines, benzoylecgonine (from cocaine), cannabinoids, nicotine, diphenhydramine and naproxen.
Vaccinated: | 2007-05-21 |
Onset: | 2007-05-23 |
Submitted: | 2007-08-10 |
Entered: | 2007-08-13 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0389U / UNK | UN / IM |
Administered by: Other Purchased by: Other
Symptoms: Death, Autopsy
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2007-05-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: None 7/2/08-records received-HX of heroin and prescription drug abuse.
Allergies:
Diagnostic Lab Data: autopsy - no findings
CDC 'Split Type': WAES0708USA00407
Write-up: Information has been received from a nurse practitioner concerning a 22 year old female patient with no pertinent medical history or drug allergies who on 21-MAY-2007, was vaccinated IM with a 0.5ml dose of Gardasil (Lot# 657736/0389U). Concomitant therapy included hormonal contraceptives (unspecified) ("MERCET"). On 23-MAY-2007, the patient died suddenly. The cause of death was unknown. Unspecified medical attention was sought. Laboratory diagnostic studies included an autopsy which showed no findings. No product quality complaint was involved. The reporter stated that Gardasil did not cause the patient''s death. Additional information is not expected. 7/2/08-records received-Adverse effect of drugs.Toxicology survey findings:urine positive for methadone, benzodiazepines, benzoylecgonine (from cocaine), cannabinoids, nicotine, diphenhydramine and naproxen.
Vaccinated: | 2007-05-21 |
Onset: | 2007-05-23 |
Submitted: | 2007-08-10 |
Entered: | 2007-08-13 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0389U / UNK | UN / IM |
Administered by: Other Purchased by: Other
Symptoms: Death, Autopsy
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2007-05-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: None 7/2/08-records received-HX of heroin and prescription drug abuse.
Allergies:
Diagnostic Lab Data: autopsy - no findings
CDC 'Split Type': WAES0708USA00407
Write-up: Information has been received from a nurse practitioner concerning a 22 year old female patient with no pertinent medical history or drug allergies who on 21-MAY-2007, was vaccinated IM with a 0.5ml dose of Gardasil (Lot# 657736/0389U). Concomitant therapy included hormonal contraceptives (unspecified) ("MERCET"). On 23-MAY-2007, the patient died suddenly. The cause of death was unknown. Unspecified medical attention was sought. Laboratory diagnostic studies included an autopsy which showed no findings. No product quality complaint was involved. The reporter stated that Gardasil did not cause the patient''s death. Additional information is not expected. 7/2/08-records received-Adverse effect of drugs.Toxicology survey findings:urine positive for methadone, benzodiazepines, benzoylecgonine (from cocaine), cannabinoids, nicotine, diphenhydramine and naproxen.
Vaccinated: | 2007-05-21 |
Onset: | 2007-05-23 |
Submitted: | 2007-08-10 |
Entered: | 2007-08-13 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0389U / UNK | UN / IM |
Administered by: Other Purchased by: Other
Symptoms: Death, Autopsy
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2007-05-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: None 7/2/08-records received-HX of heroin and prescription drug abuse.
Allergies:
Diagnostic Lab Data: autopsy - no findings
CDC 'Split Type': WAES0708USA00407
Write-up: Information has been received from a nurse practitioner concerning a 22 year old female patient with no pertinent medical history or drug allergies who on 21-MAY-2007, was vaccinated IM with a 0.5ml dose of Gardasil (Lot# 657736/0389U). Concomitant therapy included hormonal contraceptives (unspecified) ("MERCET"). On 23-MAY-2007, the patient died suddenly. The cause of death was unknown. Unspecified medical attention was sought. Laboratory diagnostic studies included an autopsy which showed no findings. No product quality complaint was involved. The reporter stated that Gardasil did not cause the patient''s death. Additional information is not expected. 7/2/08-records received-Adverse effect of drugs.Toxicology survey findings:urine positive for methadone, benzodiazepines, benzoylecgonine (from cocaine), cannabinoids, nicotine, diphenhydramine and naproxen.
Vaccinated: | 2007-05-21 |
Onset: | 2007-05-23 |
Submitted: | 2007-08-10 |
Entered: | 2007-08-13 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0389U / UNK | UN / IM |
Administered by: Other Purchased by: Other
Symptoms: Death, Autopsy
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2007-05-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: None 7/2/08-records received-HX of heroin and prescription drug abuse.
Allergies:
Diagnostic Lab Data: autopsy - no findings
CDC 'Split Type': WAES0708USA00407
Write-up: Information has been received from a nurse practitioner concerning a 22 year old female patient with no pertinent medical history or drug allergies who on 21-MAY-2007, was vaccinated IM with a 0.5ml dose of Gardasil (Lot# 657736/0389U). Concomitant therapy included hormonal contraceptives (unspecified) ("MERCET"). On 23-MAY-2007, the patient died suddenly. The cause of death was unknown. Unspecified medical attention was sought. Laboratory diagnostic studies included an autopsy which showed no findings. No product quality complaint was involved. The reporter stated that Gardasil did not cause the patient''s death. Additional information is not expected. 7/2/08-records received-Adverse effect of drugs.Toxicology survey findings:urine positive for methadone, benzodiazepines, benzoylecgonine (from cocaine), cannabinoids, nicotine, diphenhydramine and naproxen.
Vaccinated: | 2007-05-21 |
Onset: | 2007-05-23 |
Submitted: | 2007-08-10 |
Entered: | 2007-08-13 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0389U / UNK | UN / IM |
Administered by: Other Purchased by: Other
Symptoms: Death, Autopsy
Life Threatening? No
Birth Defect? No
Died? Yes
Date died:2007-05-23
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: None 7/2/08-records received-HX of heroin and prescription drug abuse.
Allergies:
Diagnostic Lab Data: autopsy - no findings
CDC 'Split Type': WAES0708USA00407
Write-up: Information has been received from a nurse practitioner concerning a 22 year old female patient with no pertinent medical history or drug allergies who on 21-MAY-2007, was vaccinated IM with a 0.5ml dose of Gardasil (Lot# 657736/0389U). Concomitant therapy included hormonal contraceptives (unspecified) ("MERCET"). On 23-MAY-2007, the patient died suddenly. The cause of death was unknown. Unspecified medical attention was sought. Laboratory diagnostic studies included an autopsy which showed no findings. No product quality complaint was involved. The reporter stated that Gardasil did not cause the patient''s death. Additional information is not expected. 7/2/08-records received-Adverse effect of drugs.Toxicology survey findings:urine positive for methadone, benzodiazepines, benzoylecgonine (from cocaine), cannabinoids, nicotine, diphenhydramine and naproxen.
Link To This Search Result:
https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=287888&WAYBACKHISTORY=ON
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