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This is VAERS ID 162588

Case Details

VAERS ID: 162588 (history)  
Form: Version 1.0  
Age: 39.0  
Sex: Male  
Location: California  
Vaccinated:1996-07-09
Onset:1996-10-01
   Days after vaccination:84
Submitted: 2000-11-14
   Days after onset:1505
Entered: 2000-11-27
   Days after submission:13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Private       Purchased by: Other
Symptoms: Drug interaction, Injury
SMQs:, Accidents and injuries (narrow), Hostility/aggression (broad)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 1997-03-26
   Days after onset: 176
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: PPD/4 previously, Aldactone, methadone, vitamin K, spironolactone, penicillin V
Current Illness: leg abscess, hepatitis
Preexisting Conditions: Allergies to ampicillin/penicillin
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: January through February of 1997, in jail. He almost died from adverse reactions to medication given to him by doctors. He was falsely arrested for not completing program/he was injured and no one would help him. I seen when they overdosed him with drugs.


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