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This is VAERS ID 150185

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 150185
VAERS Form:
Age:51.0
Sex:Female
Location:New York
Vaccinated:1995-03-01
Onset:1995-04-01
Submitted:2000-03-15
Entered:2000-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: UNK. UNCLASSIFIED VACCINE / UNCLASSIFIED - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: ARTHRITIS, APNEA, ARTHRALGIA, CREATINE PK INC, COLLAGEN DIS

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2000-04-29
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Antibiotics
Current Illness: MTI - malignant teratoma intermediate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CPK - severely elevated.
CDC 'Split Type':

Write-up: Pt began suffering pain in her joints shortly after receiving vax. Dx as arthritis, then connective tissue disorder, then auto immune deficiency. She had trouble breathing, can''t walk. The pt died on 4/29/00, no autopsy will be performed. Per the death ce"rtificate the pt''s cause of death was septic shock and respiratory failure.


Changed on 12/30/2006

VAERS ID: 150185 Before After
VAERS Form:
Age:51.0
Sex:Female
Location:New York
Vaccinated:1995-03-01
Onset:1995-04-01
Submitted:2000-03-15
Entered:2000-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: UNK. UNCLASSIFIED VACCINE / UNCLASSIFIED - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: ARTHRITIS, APNEA, ARTHRALGIA, CREATINE PK INC, COLLAGEN DIS

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2000-04-29
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Antibiotics
Current Illness: MTI - malignant teratoma intermediate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CPK - severely elevated.
CDC 'Split Type':

Write-up: Pt began suffering pain in her joints shortly after receiving vax. Dx as arthritis, then connective tissue disorder, then auto immune deficiency. She had trouble breathing, can''t can''''t walk. The pt died on 4/29/00, no autopsy will be performed. Per the death ce"rtificate c"ertificate the pt''s pt''''s cause of death was septic shock and respiratory failure.


Changed on 12/8/2009

VAERS ID: 150185 Before After
VAERS Form:
Age:51.0
Sex:Female
Location:New York
Vaccinated:1995-03-01
Onset:1995-04-01
Submitted:2000-03-15
Entered:2000-03-22 2000-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: UNK. UNCLASSIFIED VACCINE VACCINE NOT SPECIFIED (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -

Administered by: Other (blank)      Purchased by: Unknown (blank)
Symptoms: Arthralgia, Arthritis, Blood creatine phosphokinase increased, Dyspnoea, Respiratory failure, Sepsis, Abasia, Connective tissue disorder, Autoimmune disorder, ARTHRITIS, APNEA, ARTHRALGIA, CREATINE PK INC, COLLAGEN DIS

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2000-04-29
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Antibiotics
Current Illness: MTI - malignant teratoma intermediate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CPK - severely elevated.
CDC 'Split Type':

Write-up: Pt began suffering pain in her joints shortly after receiving vax. Dx as arthritis, then connective tissue disorder, then auto immune deficiency. She had trouble breathing, can''''t can''t walk. The pt died on 4/29/00, no autopsy will be performed. Per the death c"ertificate certificate the pt''''s pt''s cause of death was septic shock and respiratory failure.


Changed on 5/14/2017

VAERS ID: 150185 Before After
VAERS Form:
Age:51.0
Sex:Female
Location:New York
Vaccinated:1995-03-01
Onset:1995-04-01
Submitted:2000-03-15
Entered:2000-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: (blank) Unknown      Purchased by: (blank) Unknown
Symptoms: Arthralgia, Arthritis, Blood creatine phosphokinase increased, Dyspnoea, Respiratory failure, Sepsis, Abasia, Connective tissue disorder, Autoimmune disorder

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2000-04-29
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No Yes
Previous Vaccinations:
Other Medications: Antibiotics
Current Illness: MTI - malignant teratoma intermediate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CPK - severely elevated.
CDC 'Split Type':

Write-up: Pt began suffering pain in her joints shortly after receiving vax. Dx as arthritis, then connective tissue disorder, then auto immune deficiency. She had trouble breathing, can''t walk. The pt died on 4/29/00, no autopsy will be performed. Per the death certificate the pt''s cause of death was septic shock and respiratory failure.


Changed on 9/14/2017

VAERS ID: 150185 Before After
VAERS Form:(blank) 1
Age:51.0
Sex:Female
Location:New York
Vaccinated:1995-03-01
Onset:1995-04-01
Submitted:2000-03-15
Entered:2000-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Blood creatine phosphokinase increased, Dyspnoea, Respiratory failure, Sepsis, Abasia, Connective tissue disorder, Autoimmune disorder

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2000-04-29
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Antibiotics
Current Illness: MTI - malignant teratoma intermediate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CPK - severely elevated.
CDC 'Split Type':

Write-up: Pt began suffering pain in her joints shortly after receiving vax. Dx as arthritis, then connective tissue disorder, then auto immune deficiency. She had trouble breathing, can''t walk. The pt died on 4/29/00, no autopsy will be performed. Per the death certificate the pt''s cause of death was septic shock and respiratory failure.


Changed on 2/14/2018

VAERS ID: 150185 Before After
VAERS Form:1
Age:51.0
Sex:Female
Location:New York
Vaccinated:1995-03-01
Onset:1995-04-01
Submitted:2000-03-15
Entered:2000-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Blood creatine phosphokinase increased, Dyspnoea, Respiratory failure, Sepsis, Abasia, Connective tissue disorder, Autoimmune disorder

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2000-04-29
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Antibiotics
Current Illness: MTI - malignant teratoma intermediate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CPK - severely elevated.
CDC 'Split Type':

Write-up: Pt began suffering pain in her joints shortly after receiving vax. Dx as arthritis, then connective tissue disorder, then auto immune deficiency. She had trouble breathing, can''t walk. The pt died on 4/29/00, no autopsy will be performed. Per the death certificate the pt''s cause of death was septic shock and respiratory failure.


Changed on 6/14/2018

VAERS ID: 150185 Before After
VAERS Form:1
Age:51.0
Sex:Female
Location:New York
Vaccinated:1995-03-01
Onset:1995-04-01
Submitted:2000-03-15
Entered:2000-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Blood creatine phosphokinase increased, Dyspnoea, Respiratory failure, Sepsis, Abasia, Connective tissue disorder, Autoimmune disorder

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2000-04-29
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Antibiotics
Current Illness: MTI - malignant teratoma intermediate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CPK - severely elevated.
CDC 'Split Type':

Write-up: Pt began suffering pain in her joints shortly after receiving vax. Dx as arthritis, then connective tissue disorder, then auto immune deficiency. She had trouble breathing, can''t walk. The pt died on 4/29/00, no autopsy will be performed. Per the death certificate the pt''s cause of death was septic shock and respiratory failure.


Changed on 8/14/2018

VAERS ID: 150185 Before After
VAERS Form:1
Age:51.0
Sex:Female
Location:New York
Vaccinated:1995-03-01
Onset:1995-04-01
Submitted:2000-03-15
Entered:2000-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Blood creatine phosphokinase increased, Dyspnoea, Respiratory failure, Sepsis, Abasia, Connective tissue disorder, Autoimmune disorder

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2000-04-29
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Antibiotics
Current Illness: MTI - malignant teratoma intermediate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CPK - severely elevated.
CDC 'Split Type':

Write-up: Pt began suffering pain in her joints shortly after receiving vax. Dx as arthritis, then connective tissue disorder, then auto immune deficiency. She had trouble breathing, can''t walk. The pt died on 4/29/00, no autopsy will be performed. Per the death certificate the pt''s cause of death was septic shock and respiratory failure.


Changed on 9/14/2018

VAERS ID: 150185 Before After
VAERS Form:1
Age:51.0
Sex:Female
Location:New York
Vaccinated:1995-03-01
Onset:1995-04-01
Submitted:2000-03-15
Entered:2000-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Blood creatine phosphokinase increased, Dyspnoea, Respiratory failure, Sepsis, Abasia, Connective tissue disorder, Autoimmune disorder

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2000-04-29
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Antibiotics
Current Illness: MTI - malignant teratoma intermediate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CPK - severely elevated.
CDC 'Split Type':

Write-up: Pt began suffering pain in her joints shortly after receiving vax. Dx as arthritis, then connective tissue disorder, then auto immune deficiency. She had trouble breathing, can''t walk. The pt died on 4/29/00, no autopsy will be performed. Per the death certificate the pt''s cause of death was septic shock and respiratory failure.


Changed on 10/14/2018

VAERS ID: 150185 Before After
VAERS Form:1
Age:51.0
Sex:Female
Location:New York
Vaccinated:1995-03-01
Onset:1995-04-01
Submitted:2000-03-15
Entered:2000-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthralgia, Arthritis, Blood creatine phosphokinase increased, Dyspnoea, Respiratory failure, Sepsis, Abasia, Connective tissue disorder, Autoimmune disorder

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:2000-04-29
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Antibiotics
Current Illness: MTI - malignant teratoma intermediate
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: CPK - severely elevated.
CDC 'Split Type':

Write-up: Pt began suffering pain in her joints shortly after receiving vax. Dx as arthritis, then connective tissue disorder, then auto immune deficiency. She had trouble breathing, can''t walk. The pt died on 4/29/00, no autopsy will be performed. Per the death certificate the pt''s cause of death was septic shock and respiratory failure.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=150185&WAYBACKHISTORY=ON


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