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This is VAERS ID 324002

Case Details

VAERS ID: 324002 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Ohio  
Vaccinated:2008-02-26
Onset:2008-03-12
   Days after vaccination:15
Submitted: 2008-09-03
   Days after onset:175
Entered: 2008-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1266U / 3 RA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Autopsy, Sudden death
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-03-12
   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: none
Current Illness: none noted
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Full Autopsy done. Immediate cause of death was massive pulmonary embolus. Secondary was Type 1 Diabetes (previously undiagnosed). Vitreous Humor glucose was 767 9/4/08-records received- Vitreous glucose 767.
CDC Split Type:

Write-up: Sudden death occured on 3/12/2008. 9/4/08-records received-Cause of Death:cardiovascular collapse as a consequence of pulmonary emboli, dehydration and diabetic ketacidosis.


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