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This is VAERS ID 58319

(NOTE: This result is from the 9/14/2017 version of the VAERS database)

Case Details

VAERS ID: 58319 (history)  
Form: Version 1.0  
Age: 80.0  
Sex: Female  
Location: Missouri  
Vaccinated:1993-10-22
Onset:1993-11-26
   Days after vaccination:35
Submitted: 1993-12-11
   Days after onset:15
Entered: 1993-12-20
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00863P / UNK RA / -

Administered by: Private       Purchased by: Other
Symptoms: Hepatic failure
SMQs:, Hepatic failure, fibrosis and cirrhosis and other liver damage-related conditions (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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: ~ ()~~~In patient
Other Medications: Capoten, HCTZ, K-tab, Quinine Sulfate;
Current Illness: hypertonia;
Preexisting Conditions: hypertension
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: acute hepatocellular failure;


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20170914&IDNUMBER=58319


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