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This is VAERS ID 161719

Case Details

VAERS ID: 161719 (history)  
Form: Version 1.0  
Age: 0.3  
Sex: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:1999-03-26
Submitted: 2000-11-03
   Days after onset:588
Entered: 2000-11-09
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -

Administered by: Unknown       Purchased by: Unknown
Symptoms: Dehydration, Diarrhoea, Gastroenteritis, Viral infection, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Dehydration (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1999-03-26
   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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: The child was reported to be sick with a virus and diarrhea for a couple of weeks. The pt was taken to the ER by EMS after mother found the child unresponsive. The baby was pronounced dead on arrival at the Hospital. The cause of death was dehydration, vomiting, diarrhea, viral gastroenteritis.


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