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This is VAERS ID 69684

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

Case Details

VAERS ID: 69684 (history)  
Form: Version .0  
Age: 73.8  
Sex: Male  
Location: Pennsylvania  
Vaccinated:1994-10-12
Onset:1994-10-30
   Days after vaccination:18
Submitted: 1994-12-09
   Days after onset:40
Entered: 1994-12-23
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: FLUOGEN 1994-1995 / PARKE-DAVIS 00374P / - LA / -

Administered by: Private       Purchased by: Unknown
Symptoms: CEREBROVASC ACCID, DYSPHAGIA, HEMIPLEGIA, INFARCT CEREBR, LAB TEST ABNORM
SMQs:

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 14 days
   Extended hospital stay? No
Previous Vaccinations: pt exp rt hemiparesis @A 72 y/o flu shot;
Other Medications: Micconas; Procardia
Current Illness: HBP type II Dm (old, no new disease)
Preexisting Conditions: HBP-CVA rt hemiparesis; type II DM
Allergies:
Diagnostic Lab Data: MRI: multifocal ischaemic disease involving matter basal ganglia;
CDC Split Type: HBP-CVA rt hemiparesis; type II DM

Write-up: acute CVA, lt hemiparesis; dysphagia post; pt had flu vax 12OCT94; CVA-30OCT94; pt has hx of CVA w/ rt hemiparesis on 13OCT93; 2 wkd prior to CVA in 1993 pt had a flu shot;


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