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This is VAERS ID 316983

Case Details

VAERS ID: 316983 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: New Hampshire  
Vaccinated:2008-05-28
Onset:2008-06-12
   Days after vaccination:15
Submitted: 2008-06-16
   Days after onset:4
Entered: 2008-06-23
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0928U / 1 LA / UN

Administered by: Private       Purchased by: Other
Symptoms: Death
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-06-12
   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: Seizures PMH: ''problems w/alcohol''.
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Death 9/9/08 Death certificate states COD as idiopathic seizure disorder. 8/5/08 Reviewed ER medical records of 6/12/2008. Records reveal patient found unresponsive, prone on her bed when parent went to awake for school. Last seen at bedtime. Pupils fixed & dilated, cyanotic & pale, incontinent of urine, developed pulmonary edema during resuscitation. Unable to resuscitate.


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