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This is VAERS ID 150618

Case Details

VAERS ID: 150618 (history)  
Form: Version 1.0  
Age: 0.6  
Sex: Female  
Location: Arizona  
Vaccinated:2000-03-15
Onset:0000-00-00
Submitted: 2000-03-29
Entered: 2000-03-31
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES 7316BB / 3 LL / IM
HIBV: HIB (HIBTITER) / PFIZER/WYETH 530453A / 3 LL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R0444 / 3 - / SC

Administered by: Private       Purchased by: Other
Symptoms: Coma, Pneumonia, Pulmonary congestion, Pulmonary oedema, Unevaluable event
SMQs:, Cardiac failure (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Eosinophilic pneumonia (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2000-03-27
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: Exposure to Hep B at birth
Allergies:
Diagnostic Lab Data: autopsy-pending
CDC Split Type:

Write-up: No adverse reaction to immunizations. Unknown states "as far as we know, pt did not have reaction (fever etc). Infant given a bottle and put down for nap. Later the babysitter found the baby unresponsive. Autospy states cause of death as pneumonia. Autopsy also shows pulmonary edema and congestion.


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