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This is VAERS ID 29488

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 29488
VAERS Form:
Age:0.2
Sex:Female
Location:Pennsylvania
Vaccinated:1991-03-25
Onset:1991-03-26
Submitted:1991-03-29
Entered:1991-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP / CONNAUGHT LABS 0C21000 / 0 LL / -
HIBV: HIBTITER / LEDERLE(PRAXIS) M560FP / 0 RL / -

Administered by: Private      Purchased by: Unknown
Symptoms: HEART ARREST

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Cardiac Arrest noted 26MAR @ approx 7PM; Brought to ER-Resuscitation efforts did not help;


Changed on 12/8/2009

VAERS ID: 29488 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Pennsylvania
Vaccinated:1991-03-25
Onset:1991-03-26
Submitted:1991-03-29
Entered:1991-04-04 1991-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP DTP (NO BRAND NAME) / CONNAUGHT LABS CONNAUGHT LABORATORIES 0C21000 / 0 LL / -
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M560FP / 0 RL / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Cardiac arrest, HEART ARREST

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Cardiac Arrest noted 26MAR @ approx 7PM; Brought to ER-Resuscitation efforts did not help;


Changed on 5/14/2017

VAERS ID: 29488 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Pennsylvania
Vaccinated:1991-03-25
Onset:1991-03-26
Submitted:1991-03-29
Entered:1991-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0C21000 / 0 LL / -
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M560FP / 0 RL / -

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Cardiac Arrest noted 26MAR @ approx 7PM; Brought to ER-Resuscitation efforts did not help;


Changed on 9/14/2017

VAERS ID: 29488 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Female
Location:Pennsylvania
Vaccinated:1991-03-25
Onset:1991-03-26
Submitted:1991-03-29
Entered:1991-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0C21000 / 0 1 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M560FP / 0 1 RL / -

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Cardiac Arrest noted 26MAR @ approx 7PM; Brought to ER-Resuscitation efforts did not help;


Changed on 2/14/2018

VAERS ID: 29488 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Pennsylvania
Vaccinated:1991-03-25
Onset:1991-03-26
Submitted:1991-03-29
Entered:1991-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0C21000 / 1 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M560FP / 1 RL / -

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Cardiac Arrest noted 26MAR @ approx 7PM; Brought to ER-Resuscitation efforts did not help;


Changed on 6/14/2018

VAERS ID: 29488 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Pennsylvania
Vaccinated:1991-03-25
Onset:1991-03-26
Submitted:1991-03-29
Entered:1991-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0C21000 / 1 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M560FP / 1 RL / -

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Cardiac Arrest noted 26MAR @ approx 7PM; Brought to ER-Resuscitation efforts did not help;


Changed on 8/14/2018

VAERS ID: 29488 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Pennsylvania
Vaccinated:1991-03-25
Onset:1991-03-26
Submitted:1991-03-29
Entered:1991-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0C21000 / 1 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M560FP / 1 RL / -

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Cardiac Arrest noted 26MAR @ approx 7PM; Brought to ER-Resuscitation efforts did not help;


Changed on 9/14/2018

VAERS ID: 29488 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Pennsylvania
Vaccinated:1991-03-25
Onset:1991-03-26
Submitted:1991-03-29
Entered:1991-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0C21000 / 1 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M560FP / 1 RL / -

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Cardiac Arrest noted 26MAR @ approx 7PM; Brought to ER-Resuscitation efforts did not help;


Changed on 10/14/2018

VAERS ID: 29488 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Pennsylvania
Vaccinated:1991-03-25
Onset:1991-03-26
Submitted:1991-03-29
Entered:1991-04-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (NO BRAND NAME) / CONNAUGHT LABORATORIES 0C21000 / 1 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M560FP / 1 RL / -

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1991-03-26
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Cardiac Arrest noted 26MAR @ approx 7PM; Brought to ER-Resuscitation efforts did not help;

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=29488&WAYBACKHISTORY=ON


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