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This is VAERS ID 291804

(NOTE: This result is from the 12/31/2007 version of the VAERS database)

Case Details

VAERS ID: 291804 (history)  
Form: Version .0  
Age: 17.0  
Sex: Female  
Location: Ohio  
Vaccinated:2007-07-13
Onset:2007-09-01
   Days after vaccination:50
Submitted: 2007-10-01
   Days after onset:30
Entered: 2007-10-02
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 LA / UN

Administered by: Other       Purchased by: Unknown
Symptoms: Blood glucose increased, Death, Diabetic ketoacidosis, Pulse absent
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-09-19
   Days after onset: 18
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: IDDM, uncontrolled. Smoker. anemia.
Preexisting Conditions: Unknown PMH: IDDM, uncontrolled. Smoker. Right buttock abscess 8/31/07. Anemia. Father w/diabetes. ALLERGIES: PCN, cipro, ultram (hives).
Allergies:
Diagnostic Lab Data: Unknown Vitreous glucose 667 (H).
CDC Split Type:

Write-up: Information has been received from a physician concerning a female who on an unknown date was vaccinated with the first dose of Gardasil (yeast, unknown lot number) and in July 2007, was vaccinated with the second dose of Gardasil. In September 2007, the"patient died. No further details or symptoms were known regarding the patient''''s death. The physician mentioned that an autopsy would be done however, had not received the results yet. The reporting physician felt that the patient''''s death was not related


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20071231&IDNUMBER=291804


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