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This is VAERS ID 317695

Case Details

VAERS ID: 317695 (history)  
Form: Version 1.0  
Age: 42.0  
Gender: Female  
Location: Foreign  
Vaccinated:2008-04-12
Onset:2008-04-14
   Days after vaccination:2
Submitted: 2008-06-26
   Days after onset:73
Entered: 2008-06-27
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal pain, Death, Haemorrhage, Inappropriate schedule of drug administration
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0806MYS00011

Write-up: Information has been received from a health professional concerning a 42 year old female who on 12 Apr 2008 was vaccinated with GARDASIL. Prior to the vaccination, the patient was reported looking weak and lost weight. On 14 Apr 2008, the patient returned to the clinic and complained of abdominal pain and bleeding. The patient was treated with painkillers for abdominal pain and advised to return if pain persists. The patient never came back. The second dose was due on 12 Jun 2008 but the patient did not turn up. On 14 Jun 2008, the clinic was informed that the patient had died. The cause of death was unknown. The reporter felt that abdominal pain, bleeding and death were not related to therapy with GARDASIL. No further information is available.


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