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This is VAERS ID 156370

Case Details

VAERS ID: 156370 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Texas  
Vaccinated:2000-07-06
Onset:2000-07-07
   Days after vaccination:1
Submitted: 2000-07-11
   Days after onset:4
Entered: 2000-07-12
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (TRIPEDIA) / CONNAUGHT LABORATORIES UD173CA / 1 LL / -
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0151K / 2 RL / -

Administered by: Private       Purchased by: Other
Symptoms: Acidosis, Anaemia, Bacterial infection, Blood potassium increased, Cardio-respiratory arrest, Disseminated intravascular coagulation, Encephalopathy, Hypoxia, Pneumonia, Pulse absent, Viral infection
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Haematopoietic erythropenia (broad), Lactic acidosis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, vessel type unspecified and mixed arterial and venous (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (narrow), Eosinophilic pneumonia (broad), Chronic kidney disease (broad), Tumour lysis syndrome (broad), Respiratory failure (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2000-07-07
   Days after onset: 0
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: NONE
Allergies:
Diagnostic Lab Data: Pt in ICU-PH $g212, WBC-nml, initial Hemoglobin-nml, then <5. Initially severe acidosis, never corrected: potassium increased to 8.6
CDC Split Type:

Write-up: Pt found asystolic and pulseless in the field. Received epinephrine X 4 with heart rate obtained. Transferred to ICU, intubated but no respirations, fixed pupils, no corneals. Initial PH=6.5, pt died about 15 hours after arrival with cardiopulmonary arrest. On history, pt had received Hep-B #2, and DTAP at PMD''s office on the day prior to death (<24 hours). Cause of death Hypoxic ischemic encephalopathy with disseminated intravascular coagulopathy, probably due to viral infection. Secondary staphylococcus aureus bronchopneumonia is contributory factor.


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