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This is VAERS ID 50420

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History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 50420
VAERS Form:
Age:0.2
Sex:Female
Location:Kansas
Vaccinated:1993-02-02
Onset:1993-02-04
Submitted:1993-02-09
Entered:1993-03-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL / LEDERLE 331913 / 0 LL / -
HIBV: HIBTITER / LEDERLE(PRAXIS) M155JA / 0 RL / -
OPV: ORIMUNE / LEDERLE 0670B / 0 - / PO

Administered by: Public      Purchased by: Unknown
Symptoms: AGITATION, EDEMA LUNG, PETECHIA, NERVOUSNESS, HEM

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-02-04
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: Rondec drops
Current Illness: 2FEB93 pt mom siad pt had cold & take AP
Preexisting Conditions: last seen by MD 12JAN93; potential apneic condition; prev suspicious apneic episode described by mom to MD;
Allergies:
Diagnostic Lab Data: MD said a pneumogram had been ordered but not done adequately because the apnea monitor was not on long enough;
CDC 'Split Type':

Write-up: pt MD said pt discovered dead by parents on 4FEB93 & that apparently is a SIDS death; MD said that the parents had an apnea monitor @ home but it was not used;


Changed on 12/8/2009

VAERS ID: 50420 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Kansas
Vaccinated:1993-02-02
Onset:1993-02-04
Submitted:1993-02-09
Entered:1993-03-03 1993-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: TRI-IMMUNOL DTP (TRI-IMMUNOL) / LEDERLE LEDERLE LABORATORIES 331913 / 0 LL / -
HIBV: HIBTITER HIB (HIBTITER) / LEDERLE(PRAXIS) LEDERLE PRAXSIS M155JA / 0 RL / -
OPV: ORIMUNE POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LEDERLE LABORATORIES 0670B / 0 - / PO

Administered by: Public      Purchased by: Unknown Public
Symptoms: Agitation, Nervousness, Petechiae, Pulmonary oedema, Sudden infant death syndrome, Haemorrhage, AGITATION, EDEMA LUNG, PETECHIA, NERVOUSNESS, HEM

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-02-04
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: Rondec drops
Current Illness: 2FEB93 pt mom siad pt had cold & take AP
Preexisting Conditions: last seen by MD 12JAN93; potential apneic condition; prev suspicious apneic episode described by mom to MD;
Allergies:
Diagnostic Lab Data: MD said a pneumogram had been ordered but not done adequately because the apnea monitor was not on long enough;
CDC 'Split Type': (blank) KS93003

Write-up: pt MD said pt discovered dead by parents on 4FEB93 & that apparently is a SIDS death; MD said that the parents had an apnea monitor @ home but it was not used;


Changed on 5/14/2017

VAERS ID: 50420 Before After
VAERS Form:
Age:0.2
Sex:Female
Location:Kansas
Vaccinated:1993-02-02
Onset:1993-02-04
Submitted:1993-02-09
Entered:1993-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 331913 / 0 LL / -
HIBV: HIB (HIBTITER) / LEDERLE PRAXSIS PFIZER/WYETH M155JA / 0 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / LEDERLE LABORATORIES PFIZER/WYETH 0670B / 0 - / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Nervousness, Petechiae, Pulmonary oedema, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-02-04
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: Rondec drops
Current Illness: 2FEB93 pt mom siad pt had cold & take AP
Preexisting Conditions: last seen by MD 12JAN93; potential apneic condition; prev suspicious apneic episode described by mom to MD;
Allergies:
Diagnostic Lab Data: MD said a pneumogram had been ordered but not done adequately because the apnea monitor was not on long enough;
CDC 'Split Type': KS93003

Write-up: pt MD said pt discovered dead by parents on 4FEB93 & that apparently is a SIDS death; MD said that the parents had an apnea monitor @ home but it was not used;


Changed on 9/14/2017

VAERS ID: 50420 Before After
VAERS Form:(blank) 1
Age:0.2
Sex:Female
Location:Kansas
Vaccinated:1993-02-02
Onset:1993-02-04
Submitted:1993-02-09
Entered:1993-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 331913 / 0 1 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155JA / 0 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670B / 0 1 - MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Nervousness, Petechiae, Pulmonary oedema, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-02-04
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: Rondec drops
Current Illness: 2FEB93 pt mom siad pt had cold & take AP
Preexisting Conditions: last seen by MD 12JAN93; potential apneic condition; prev suspicious apneic episode described by mom to MD;
Allergies:
Diagnostic Lab Data: MD said a pneumogram had been ordered but not done adequately because the apnea monitor was not on long enough;
CDC 'Split Type': KS93003

Write-up: pt MD said pt discovered dead by parents on 4FEB93 & that apparently is a SIDS death; MD said that the parents had an apnea monitor @ home but it was not used;


Changed on 2/14/2018

VAERS ID: 50420 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Kansas
Vaccinated:1993-02-02
Onset:1993-02-04
Submitted:1993-02-09
Entered:1993-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 331913 / 1 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155JA / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670B / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Nervousness, Petechiae, Pulmonary oedema, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-02-04
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: Rondec drops
Current Illness: 2FEB93 pt mom siad pt had cold & take AP
Preexisting Conditions: last seen by MD 12JAN93; potential apneic condition; prev suspicious apneic episode described by mom to MD;
Allergies:
Diagnostic Lab Data: MD said a pneumogram had been ordered but not done adequately because the apnea monitor was not on long enough;
CDC 'Split Type': KS93003

Write-up: pt MD said pt discovered dead by parents on 4FEB93 & that apparently is a SIDS death; MD said that the parents had an apnea monitor @ home but it was not used;


Changed on 6/14/2018

VAERS ID: 50420 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Kansas
Vaccinated:1993-02-02
Onset:1993-02-04
Submitted:1993-02-09
Entered:1993-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 331913 / 1 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155JA / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670B / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Nervousness, Petechiae, Pulmonary oedema, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-02-04
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: Rondec drops
Current Illness: 2FEB93 pt mom siad pt had cold & take AP
Preexisting Conditions: last seen by MD 12JAN93; potential apneic condition; prev suspicious apneic episode described by mom to MD;
Allergies:
Diagnostic Lab Data: MD said a pneumogram had been ordered but not done adequately because the apnea monitor was not on long enough;
CDC 'Split Type': KS93003

Write-up: pt MD said pt discovered dead by parents on 4FEB93 & that apparently is a SIDS death; MD said that the parents had an apnea monitor @ home but it was not used;


Changed on 8/14/2018

VAERS ID: 50420 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Kansas
Vaccinated:1993-02-02
Onset:1993-02-04
Submitted:1993-02-09
Entered:1993-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 331913 / 1 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155JA / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670B / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Nervousness, Petechiae, Pulmonary oedema, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-02-04
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: Rondec drops
Current Illness: 2FEB93 pt mom siad pt had cold & take AP
Preexisting Conditions: last seen by MD 12JAN93; potential apneic condition; prev suspicious apneic episode described by mom to MD;
Allergies:
Diagnostic Lab Data: MD said a pneumogram had been ordered but not done adequately because the apnea monitor was not on long enough;
CDC 'Split Type': KS93003

Write-up: pt MD said pt discovered dead by parents on 4FEB93 & that apparently is a SIDS death; MD said that the parents had an apnea monitor @ home but it was not used;


Changed on 9/14/2018

VAERS ID: 50420 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Kansas
Vaccinated:1993-02-02
Onset:1993-02-04
Submitted:1993-02-09
Entered:1993-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 331913 / 1 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155JA / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670B / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Nervousness, Petechiae, Pulmonary oedema, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-02-04
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: Rondec drops
Current Illness: 2FEB93 pt mom siad pt had cold & take AP
Preexisting Conditions: last seen by MD 12JAN93; potential apneic condition; prev suspicious apneic episode described by mom to MD;
Allergies:
Diagnostic Lab Data: MD said a pneumogram had been ordered but not done adequately because the apnea monitor was not on long enough;
CDC 'Split Type': KS93003

Write-up: pt MD said pt discovered dead by parents on 4FEB93 & that apparently is a SIDS death; MD said that the parents had an apnea monitor @ home but it was not used;


Changed on 10/14/2018

VAERS ID: 50420 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Kansas
Vaccinated:1993-02-02
Onset:1993-02-04
Submitted:1993-02-09
Entered:1993-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 331913 / 1 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155JA / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670B / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Nervousness, Petechiae, Pulmonary oedema, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-02-04
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: Rondec drops
Current Illness: 2FEB93 pt mom siad pt had cold & take AP
Preexisting Conditions: last seen by MD 12JAN93; potential apneic condition; prev suspicious apneic episode described by mom to MD;
Allergies:
Diagnostic Lab Data: MD said a pneumogram had been ordered but not done adequately because the apnea monitor was not on long enough;
CDC 'Split Type': KS93003

Write-up: pt MD said pt discovered dead by parents on 4FEB93 & that apparently is a SIDS death; MD said that the parents had an apnea monitor @ home but it was not used;


Changed on 12/24/2020

VAERS ID: 50420 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Kansas
Vaccinated:1993-02-02
Onset:1993-02-04
Submitted:1993-02-09
Entered:1993-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 331913 / 1 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155JA / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670B / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Nervousness, Petechiae, Pulmonary oedema, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-02-04
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: Rondec drops
Current Illness: 2FEB93 pt mom siad pt had cold & take AP
Preexisting Conditions: last seen by MD 12JAN93; potential apneic condition; prev suspicious apneic episode described by mom to MD;
Allergies:
Diagnostic Lab Data: MD said a pneumogram had been ordered but not done adequately because the apnea monitor was not on long enough;
CDC 'Split Type': KS93003

Write-up: pt MD said pt discovered dead by parents on 4FEB93 & that apparently is a SIDS death; MD said that the parents had an apnea monitor @ home but it was not used;


Changed on 12/30/2020

VAERS ID: 50420 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Kansas
Vaccinated:1993-02-02
Onset:1993-02-04
Submitted:1993-02-09
Entered:1993-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 331913 / 1 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155JA / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670B / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Nervousness, Petechiae, Pulmonary oedema, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-02-04
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: Rondec drops
Current Illness: 2FEB93 pt mom siad pt had cold & take AP
Preexisting Conditions: last seen by MD 12JAN93; potential apneic condition; prev suspicious apneic episode described by mom to MD;
Allergies:
Diagnostic Lab Data: MD said a pneumogram had been ordered but not done adequately because the apnea monitor was not on long enough;
CDC 'Split Type': KS93003

Write-up: pt MD said pt discovered dead by parents on 4FEB93 & that apparently is a SIDS death; MD said that the parents had an apnea monitor @ home but it was not used;


Changed on 5/7/2021

VAERS ID: 50420 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Kansas
Vaccinated:1993-02-02
Onset:1993-02-04
Submitted:1993-02-09
Entered:1993-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 331913 / 1 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155JA / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670B / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Nervousness, Petechiae, Pulmonary oedema, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-02-04
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: Rondec drops
Current Illness: 2FEB93 pt mom siad pt had cold & take AP
Preexisting Conditions: last seen by MD 12JAN93; potential apneic condition; prev suspicious apneic episode described by mom to MD;
Allergies:
Diagnostic Lab Data: MD said a pneumogram had been ordered but not done adequately because the apnea monitor was not on long enough;
CDC 'Split Type': KS93003

Write-up: pt MD said pt discovered dead by parents on 4FEB93 & that apparently is a SIDS death; MD said that the parents had an apnea monitor @ home but it was not used;


Changed on 5/21/2021

VAERS ID: 50420 Before After
VAERS Form:1
Age:0.2
Sex:Female
Location:Kansas
Vaccinated:1993-02-02
Onset:1993-02-04
Submitted:1993-02-09
Entered:1993-03-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTP: DTP (TRI-IMMUNOL) / LEDERLE LABORATORIES 331913 / 1 LL / -
HIBV: HIB (HIBTITER) / PFIZER/WYETH M155JA / 1 RL / -
OPV: POLIO VIRUS, ORAL (ORIMUNE) / PFIZER/WYETH 0670B / 1 MO / PO

Administered by: Public      Purchased by: Public
Symptoms: Agitation, Nervousness, Petechiae, Pulmonary oedema, Sudden infant death syndrome, Haemorrhage

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:1993-02-04
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: Rondec drops
Current Illness: 2FEB93 pt mom siad pt had cold & take AP
Preexisting Conditions: last seen by MD 12JAN93; potential apneic condition; prev suspicious apneic episode described by mom to MD;
Allergies:
Diagnostic Lab Data: MD said a pneumogram had been ordered but not done adequately because the apnea monitor was not on long enough;
CDC 'Split Type': KS93003

Write-up: pt MD said pt discovered dead by parents on 4FEB93 & that apparently is a SIDS death; MD said that the parents had an apnea monitor @ home but it was not used;

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