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This is VAERS ID 161098

Case Details

VAERS ID: 161098 (history)  
Form: Version 1.0  
Age: 0.2  
Sex: Male  
Location: Illinois  
Vaccinated:2000-10-25
Onset:2000-10-26
   Days after vaccination:1
Submitted: 0000-00-00
Entered: 2000-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / SMITHKLINE BEECHAM 941A2 / 1 LL / IM
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. 1945J / 1 LL / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PASTEUR MERIEUX INST. R1433 / 1 RL / IM

Administered by: Private       Purchased by: Public
Symptoms: Apnoea, Asphyxia, Cardiac arrest, Coma, Pulmonary congestion, Renal disorder, Suffocation feeling
SMQs:, Torsade de pointes/QT prolongation (broad), Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Acute central respiratory depression (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hostility/aggression (broad), Cardiomyopathy (broad), Hypersensitivity (broad), Respiratory failure (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2000-10-26
   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: Tylenol for fever
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Chest X-ray in ER-no cardiopulmonary process
CDC Split Type:

Write-up: Pt received vaccines on 10/25/00 and on 10/26/00, infant asleep with 16 year old sibling. Mother found arm of sibling across baby''s face and baby was not breathing. CPR was administered and intubation to no avail. Autopsy shows found unresponsive, congestion of lungs, kidneys congested. Final cause of death stated as suffocation by mechanical asphyxia.


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