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This is VAERS ID 160203

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 160203
VAERS Form:
Age:0.3
Sex:Female
Location:Illinois
Vaccinated:2000-08-31
Onset:2000-09-01
Submitted:2000-09-01
Entered:2000-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
IPV: POLIOVAX / CONNAUGHT LTD R1489 / 0 RL / SC

Administered by: Private      Purchased by: Unknown
Symptoms: APNEA, HEART ARREST, HYPERNATREM

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The pt was brought into the ER in full cardio respiratory arrest. Autopsy states cause of death as hypernatremia.


Changed on 12/8/2009

VAERS ID: 160203 Before After
VAERS Form:
Age:0.3
Sex:Female
Location:Illinois
Vaccinated:2000-08-31
Onset:2000-09-01
Submitted:2000-09-01
Entered:2000-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
IPV: POLIOVAX POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD CONNAUGHT LTD. R1489 / 0 RL / SC

Administered by: Private      Purchased by: Unknown Private
Symptoms: Cardiac arrest, Hypernatraemia, Respiratory arrest, APNEA, HEART ARREST, HYPERNATREM

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The pt was brought into the ER in full cardio respiratory arrest. Autopsy states cause of death as hypernatremia. .


Changed on 8/31/2010

VAERS ID: 160203 Before After
VAERS Form:
Age:0.3
Sex:Female
Location:Illinois
Vaccinated:2000-08-31
Onset:2000-09-01
Submitted:2000-09-01
Entered:2000-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R1489 / 0 RL / SC

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Hypernatraemia, Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The pt was brought into the ER in full cardio respiratory arrest. Autopsy states cause of death as hypernatremia. .


Changed on 4/13/2011

VAERS ID: 160203 Before After
VAERS Form:
Age:0.3
Sex:Female
Location:Illinois
Vaccinated:2000-08-31
Onset:2000-09-01
Submitted:2000-09-01
Entered:2000-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R1489 / 0 RL / SC

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Hypernatraemia, Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The pt was brought into the ER in full cardio respiratory arrest. Autopsy states cause of death as hypernatremia. .


Changed on 5/13/2011

VAERS ID: 160203 Before After
VAERS Form:
Age:0.3
Sex:Female
Location:Illinois
Vaccinated:2000-08-31
Onset:2000-09-01
Submitted:2000-09-01
Entered:2000-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R1489 / 0 RL / SC

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Hypernatraemia, Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The pt was brought into the ER in full cardio respiratory arrest. Autopsy states cause of death as hypernatremia. .


Changed on 6/11/2011

VAERS ID: 160203 Before After
VAERS Form:
Age:0.3
Sex:Female
Location:Illinois
Vaccinated:2000-08-31
Onset:2000-09-01
Submitted:2000-09-01
Entered:2000-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R1489 / 0 RL / SC

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Hypernatraemia, Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The pt was brought into the ER in full cardio respiratory arrest. Autopsy states cause of death as hypernatremia. .


Changed on 2/14/2017

VAERS ID: 160203 Before After
VAERS Form:
Age:0.3 0.25
Sex:Female
Location:Illinois
Vaccinated:2000-08-31
Onset:2000-09-01
Submitted:2000-09-01
Entered:2000-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R1489 / 0 RL / SC

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Hypernatraemia, Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The pt was brought into the ER in full cardio respiratory arrest. Autopsy states cause of death as hypernatremia. .


Changed on 5/14/2017

VAERS ID: 160203 Before After
VAERS Form:
Age:0.25
Sex:Female
Location:Illinois
Vaccinated:2000-08-31
Onset:2000-09-01
Submitted:2000-09-01
Entered:2000-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R1489 / 0 RL / SC

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Hypernatraemia, Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The pt was brought into the ER in full cardio respiratory arrest. Autopsy states cause of death as hypernatremia. .


Changed on 9/14/2017

VAERS ID: 160203 Before After
VAERS Form:(blank) 1
Age:0.25
Sex:Female
Location:Illinois
Vaccinated:2000-08-31
Onset:2000-09-01
Submitted:2000-09-01
Entered:2000-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R1489 / 0 1 RL / SC

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Hypernatraemia, Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The pt was brought into the ER in full cardio respiratory arrest. Autopsy states cause of death as hypernatremia.


Changed on 2/14/2018

VAERS ID: 160203 Before After
VAERS Form:1
Age:0.25
Sex:Female
Location:Illinois
Vaccinated:2000-08-31
Onset:2000-09-01
Submitted:2000-09-01
Entered:2000-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R1489 / 1 RL / SC

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Hypernatraemia, Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The pt was brought into the ER in full cardio respiratory arrest. Autopsy states cause of death as hypernatremia.


Changed on 6/14/2018

VAERS ID: 160203 Before After
VAERS Form:1
Age:0.25
Sex:Female
Location:Illinois
Vaccinated:2000-08-31
Onset:2000-09-01
Submitted:2000-09-01
Entered:2000-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R1489 / 1 RL / SC

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Hypernatraemia, Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The pt was brought into the ER in full cardio respiratory arrest. Autopsy states cause of death as hypernatremia.


Changed on 8/14/2018

VAERS ID: 160203 Before After
VAERS Form:1
Age:0.25
Sex:Female
Location:Illinois
Vaccinated:2000-08-31
Onset:2000-09-01
Submitted:2000-09-01
Entered:2000-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R1489 / 1 RL / SC

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Hypernatraemia, Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The pt was brought into the ER in full cardio respiratory arrest. Autopsy states cause of death as hypernatremia.


Changed on 9/14/2018

VAERS ID: 160203 Before After
VAERS Form:1
Age:0.25
Sex:Female
Location:Illinois
Vaccinated:2000-08-31
Onset:2000-09-01
Submitted:2000-09-01
Entered:2000-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R1489 / 1 RL / SC

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Hypernatraemia, Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The pt was brought into the ER in full cardio respiratory arrest. Autopsy states cause of death as hypernatremia.


Changed on 10/14/2018

VAERS ID: 160203 Before After
VAERS Form:1
Age:0.25
Sex:Female
Location:Illinois
Vaccinated:2000-08-31
Onset:2000-09-01
Submitted:2000-09-01
Entered:2000-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
IPV: POLIO VIRUS, INACT. (POLIOVAX) / CONNAUGHT LTD. R1489 / 1 RL / SC

Administered by: Private      Purchased by: Private
Symptoms: Cardiac arrest, Hypernatraemia, Respiratory arrest

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2000-09-01
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: The pt was brought into the ER in full cardio respiratory arrest. Autopsy states cause of death as hypernatremia.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=160203&WAYBACKHISTORY=ON


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