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This is VAERS ID 30232

Case Details

VAERS ID: 30232 (history)  
Form: Version 1.0  
Age: 0.7  
Sex: Male  
Location: Montana  
Vaccinated:1991-02-21
Onset:1991-02-24
   Days after vaccination:3
Submitted: 1991-04-25
   Days after onset:59
Entered: 1991-04-29
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HIBV: HIB (HIBTITER) / PFIZER/WYETH M655FB / 3 LL / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Apnoea, Cardiac failure, Delirium
SMQs:, Cardiac failure (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Noninfectious meningitis (broad), Cardiomyopathy (broad), Respiratory failure (narrow), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1991-02-24
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: NONE~ ()~~~In patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Ammonia 711
CDC Split Type:

Write-up: Death from Reyes synd on 24FEB91 & presented to ER in full arrest & was not resuscitative;


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