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This is VAERS ID 157956

Case Details

VAERS ID: 157956 (history)  
Form: Version 1.0  
Age: 0.6  
Sex: Female  
Location: California  
Vaccinated:2000-07-12
Onset:2000-07-14
   Days after vaccination:2
Submitted: 2000-07-14
   Days after onset:0
Entered: 2000-07-26
   Days after submission:12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 0554K / 1 LL / IM

Administered by: Other       Purchased by: Public
Symptoms: Cardiac arrest, Cerebral palsy, Respiratory arrest
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Congenital, familial and genetic disorders (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2000-07-14
   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: albuterol
Current Illness: Cerebral Palsy, Broncho-pulmonary dysplasia
Preexisting Conditions: 27 week gestation, cerebral palsy
Allergies:
Diagnostic Lab Data: autopsy pending
CDC Split Type:

Write-up: The child was found by the mother in AM, not breathing and without heart rate. Cause of death stated as complications of cerebral palsy. 07/26/2000 12:00 call to MD nurse who read baby''s chart to me. She said she will fax mediccal records to us today. received at 13:00. 07/26/2000 call to coroner''s office. Esitmate of what preliminary COD might be "complication of cerebral palsy". Letter of request for final autopsy report sent.


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