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This is VAERS ID 48672

Case Details

VAERS ID: 48672 (history)  
Form: Version 1.0  
Age: 82.0  
Sex: Female  
Location: West Virginia  
Vaccinated:1992-10-29
Onset:1992-11-22
   Days after vaccination:24
Submitted: 1992-11-30
   Days after onset:8
Entered: 1993-01-04
   Days after submission:35
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / PFIZER/WYETH 4928217 / 2 RA / IM

Administered by: Public       Purchased by: Public
Symptoms: Anxiety, Cardiac arrest, Condition aggravated, Dyspnoea, Hypertension, Hyperventilation, Myocardial infarction, Paraesthesia
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (narrow), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Embolic and thrombotic events, arterial (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Hypertension (narrow), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Respiratory failure (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1992-11-22
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Lasix, Lanoxin, Calan SR, Humulin, Axid, Nitrobid, Elavil, Nifedipineoth
Current Illness: NONE
Preexisting Conditions: CAD, IDDM, Hypertension, chronic CHF, cardiomegaly;
Allergies:
Diagnostic Lab Data: unk
CDC Split Type: WV9242

Write-up: dyspnea, anxiety, P56, R36, BP 200/90, 02 on transferred to hosp; causes of death-cardiac failure, CHF, Ischemic cardiomyopathy, COPD; also exp discomfort & tingling in arms; R36 shallow & labored;


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