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This is VAERS ID 406289

History of Changes from the VAERS Wayback Machine

First Appeared on 11/3/2010

VAERS ID: 406289
VAERS Form:
Age:19.0
Sex:Female
Location:Michigan
Vaccinated:2010-08-06
Onset:2010-08-19
Submitted:2010-11-02
Entered:2010-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0640Z / 1 LA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Grand mal convulsion, Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-08-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 4/13/2011

VAERS ID: 406289 Before After
VAERS Form:
Age:19.0
Sex:Female
Location:Michigan
Vaccinated:2010-08-06
Onset:2010-08-19
Submitted:2010-11-02
Entered:2010-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0640Z / 1 LA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Condition aggravated, Grand mal convulsion, Pulmonary congestion, Pulmonary oedema, Sudden death, Contusion

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-08-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 5/13/2011

VAERS ID: 406289 Before After
VAERS Form:
Age:19.0
Sex:Female
Location:Michigan
Vaccinated:2010-08-06
Onset:2010-08-19
Submitted:2010-11-02
Entered:2010-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0640Z / 1 LA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Condition aggravated, Grand mal convulsion, Pulmonary congestion, Pulmonary oedema, Sudden death, Contusion

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-08-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 6/14/2014

VAERS ID: 406289 Before After
VAERS Form:
Age:19.0
Sex:Female
Location:Michigan
Vaccinated:2010-08-06
Onset:2010-08-19
Submitted:2010-11-02
Entered:2010-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0640Z / 1 LA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Grand mal convulsion, Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-08-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 2/14/2017

VAERS ID: 406289 Before After
VAERS Form:
Age:19.0
Sex:Female
Location:Michigan
Vaccinated:2010-08-06
Onset:2010-08-19
Submitted:2010-11-02
Entered:2010-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0640Z / 1 LA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Grand mal convulsion, Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-08-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 9/14/2017

VAERS ID: 406289 Before After
VAERS Form:(blank) 1
Age:19.0
Sex:Female
Location:Michigan
Vaccinated:2010-08-06
Onset:2010-08-19
Submitted:2010-11-02
Entered:2010-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0640Z / 1 2 LA / IM

Administered by: Unknown      Purchased by: Private
Symptoms: Grand mal convulsion, Sudden death

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-08-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 2/14/2018

VAERS ID: 406289 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Michigan
Vaccinated:2010-08-06
Onset:2010-08-19
Submitted:2010-11-02
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-08-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 6/14/2018

VAERS ID: 406289 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Michigan
Vaccinated:2010-08-06
Onset:2010-08-19
Submitted:2010-11-02
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-08-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 8/14/2018

VAERS ID: 406289 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Michigan
Vaccinated:2010-08-06
Onset:2010-08-19
Submitted:2010-11-02
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-08-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 9/14/2018

VAERS ID: 406289 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Michigan
Vaccinated:2010-08-06
Onset:2010-08-19
Submitted:2010-11-02
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-08-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 10/14/2018

VAERS ID: 406289 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Michigan
Vaccinated:2010-08-06
Onset:2010-08-19
Submitted:2010-11-02
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-08-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 12/24/2020

VAERS ID: 406289 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Michigan
Vaccinated:2010-08-06
Onset:2010-08-19
Submitted:2010-11-02
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-08-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 12/30/2020

VAERS ID: 406289 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Michigan
Vaccinated:2010-08-06
Onset:2010-08-19
Submitted:2010-11-02
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-08-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 5/7/2021

VAERS ID: 406289 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Michigan
Vaccinated:2010-08-06
Onset:2010-08-19
Submitted:2010-11-02
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-08-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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.


Changed on 5/14/2021

VAERS ID: 406289 Before After
VAERS Form:1
Age:19.0
Sex:Female
Location:Michigan
Vaccinated:2010-08-06
Onset:2010-08-19
Submitted:2010-11-02
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

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2010-08-19
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? 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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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=406289&WAYBACKHISTORY=ON


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