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This is VAERS ID 406289

Case Details

VAERS ID: 406289 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: Michigan  
Vaccinated:2010-08-06
Onset:2010-08-19
   Days after vaccination:13
Submitted: 2010-11-02
   Days after onset:75
Entered: 2010-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0640Z / 2 LA / IM

Administered by: Unknown       Purchased by: Private
Symptoms: Grand mal convulsion, Sudden death
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2010-08-19
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: seizure~HPV (Gardasil)~1~19.42~Patient
Other Medications:
Current Illness:
Preexisting Conditions: Autism
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient had her first Gardasil shot on 02/15/2010. On 02/19/2010, she had a Grand Mal seizure. She had her 2nd shot on 08/06/2010. She died on 08/19/2010. Medical Examiner listed cause of death as Sudden unexpected death associated with Seizure Disorder.


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