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This is VAERS ID 58319

(NOTE: This result is from the 12/31/2003 version of the VAERS database)

Case Details

VAERS ID: 58319 (history)  
Form: Version .0  
Age: 80.1  
Sex: Female  
Location: Missouri  
   Days after vaccination:35
Submitted: 1993-12-11
   Days after onset:15
Entered: 1993-12-23
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1993-1994 / PARKE-DAVIS 00863P / - RA / -

Administered by: Private       Purchased by: Unknown
Symptoms: LIVER FAIL

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
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: Capoten, HCTZ, K-tab, Quinine Sulfate;
Current Illness: hypertonia;
Preexisting Conditions: hypertension
Diagnostic Lab Data:
CDC Split Type:

Write-up: acute hepatocellular failure;

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