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This is VAERS ID 309233

(NOTE: This result is from the 12/31/2008 version of the VAERS database)

Case Details

VAERS ID: 309233 (history)  
Form: Version .0  
Age: 12.0  
Sex: Female  
Location: Unknown  
Vaccinated:2007-04-27
Onset:2007-06-22
   Days after vaccination:56
Submitted: 2008-04-09
   Days after onset:292
Entered: 2008-04-10
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0250U / 1 LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 LA / UN

Administered by: Other       Purchased by: Unknown
Symptoms: Arrhythmia, Brain death, Brugada syndrome, Convulsion, Death
SMQs:, Systemic lupus erythematosus (broad), Congenital and neonatal arrhythmias (narrow), Conduction defects (narrow), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2007-06-29
   Days after onset: 7
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: LAMICTAL; KEPPRA; vitamins (unspecified)
Current Illness:
Preexisting Conditions: Convulsion; Arrhythmia
Allergies:
Diagnostic Lab Data: electrocardiogram
CDC Split Type:

Write-up: Information has been received from a consumer concerning her 12 year old daughter with a history of seizures and heart arrhythmias, who on 25-JAN-2007 was vaccinated with a first dose of Gardasil. On 27-APRIL-2007 the patient was vaccinated with a second"dose of Gardasil. Concomitant therapy included LAMICTAL, vitamins (unspecified) and KEPPRA. Subsequently, the patient began to have seizures, developed a rash on her arm, and was complaining about headaches. On 22-JUN-2007 the patient experienced a heart


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20081231&IDNUMBER=309233


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