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This is VAERS ID 319533

Case Details

VAERS ID: 319533 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: Maryland  
Vaccinated:2008-06-03
Onset:2008-06-20
   Days after vaccination:17
Submitted: 2008-07-17
   Days after onset:27
Entered: 2008-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0053X / 3 LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Autopsy, Death, Spleen disorder
SMQs:

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-06-20
   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: None
Current Illness: None
Preexisting Conditions: Reported allergy to penicillin and cephid 3/5/09-records received-Allergic to penicillin.
Allergies:
Diagnostic Lab Data: None - apparently healthy young woman 8/22/08-records received-cardiac blood neg for ethanol; urine (+) for ethanol=16 mg/dl; liver (+) for acetaldehyde (incidental finding). 3/5/09-records received-pap smear normal. 2/4/09-records received-CBC WNL, chemistry WNL. 2/12/08 ECG abnormal mild tricuspid regurgitation, 2D Doppler frequent premature ventricular contractions. 4/30/09-records received-lung specimen showed diffuse edema and intraalveolar hemorrhages. Staphylococcus aureus negative.
CDC Split Type:

Write-up: Pt received her 3rd and final dose of HPV vaccine on 6/3/08. Per mother patient was found dead, in bed on 6/22/08, in her dorm room at an out-of-state college. According to the autopsy the patient had been dead for about 48 hours. According to mother autopsy was negative except for splenic inflammation. 8/22/08 Autopsy report also states Final Diagnoses: Cardiac arrest, cause undetermined w/recent history of PAC w/otherwise normal EKG; normal echocardiogram 2/08; no evidence of myocarditis; acute pulmonary edema; slight splenomegaly; cardiac blood neg for ethanol; urine (+) for ethanol=16 mg/dl; liver (+) for acetaldehyde (incidental finding). 3/5/09-records received for DOS 8/22/07-seen for routine visit and first annual pap test..PE normal. First HPV vaccine administered. 2/4/09-records received for DOS 11/20/07-C/O chronic PAC and irregular heart beat.


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