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This is VAERS ID 162588

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 162588
VAERS Form:
Age:39.0
Sex:Male
Location:California
Vaccinated:1996-07-09
Onset:1996-10-01
Submitted:2000-11-14
Entered:2000-11-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: UNK. PNEUMOCOCCAL POLYVALENT / UNCLASSIFIED - / - - / IM
TTOX: UNK. TETANUS TOX / UNCLASSIFIED - / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: INJURY ACCID, DRUG INTERACTION

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1997-03-26
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
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.


Changed on 12/8/2009

VAERS ID: 162588 Before After
VAERS Form:
Age:39.0
Sex:Male
Location:California
Vaccinated:1996-07-09
Onset:1996-10-01
Submitted:2000-11-14
Entered:2000-11-28 2000-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: UNK. PNEUMOCOCCAL POLYVALENT PNEUMO (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / IM
TTOX: UNK. TETANUS TOX TETANUS TOXOID (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Drug interaction, Injury, INJURY ACCID, DRUG INTERACTION

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1997-03-26
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No
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. 3


Changed on 5/14/2017

VAERS ID: 162588 Before After
VAERS Form:
Age:39.0
Sex:Male
Location:California
Vaccinated:1996-07-09
Onset:1996-10-01
Submitted:2000-11-14
Entered:2000-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
PPV: PNEUMO (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / IM

Administered by: Private      Purchased by: Other
Symptoms: Drug interaction, Injury

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1997-03-26
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days:     Extended hospital stay? No 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. 3


Changed on 9/14/2017

VAERS ID: 162588 Before After
VAERS Form:(blank) 1
Age:39.0
Sex:Male
Location:California
Vaccinated:1996-07-09
Onset:1996-10-01
Submitted:2000-11-14
Entered:2000-11-27
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

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1997-03-26
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 2/14/2018

VAERS ID: 162588 Before After
VAERS Form:1
Age:39.0
Sex:Male
Location:California
Vaccinated:1996-07-09
Onset:1996-10-01
Submitted:2000-11-14
Entered:2000-11-27
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

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1997-03-26
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 6/14/2018

VAERS ID: 162588 Before After
VAERS Form:1
Age:39.0
Sex:Male
Location:California
Vaccinated:1996-07-09
Onset:1996-10-01
Submitted:2000-11-14
Entered:2000-11-27
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

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1997-03-26
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 8/14/2018

VAERS ID: 162588 Before After
VAERS Form:1
Age:39.0
Sex:Male
Location:California
Vaccinated:1996-07-09
Onset:1996-10-01
Submitted:2000-11-14
Entered:2000-11-27
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

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1997-03-26
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 9/14/2018

VAERS ID: 162588 Before After
VAERS Form:1
Age:39.0
Sex:Male
Location:California
Vaccinated:1996-07-09
Onset:1996-10-01
Submitted:2000-11-14
Entered:2000-11-27
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

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1997-03-26
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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.


Changed on 10/14/2018

VAERS ID: 162588 Before After
VAERS Form:1
Age:39.0
Sex:Male
Location:California
Vaccinated:1996-07-09
Onset:1996-10-01
Submitted:2000-11-14
Entered:2000-11-27
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

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died:1997-03-26
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? 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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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=162588&WAYBACKHISTORY=ON


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