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This is VAERS ID 487759

History of Changes from the VAERS Wayback Machine

First Appeared on 4/13/2013

VAERS ID: 487759
VAERS Form:
Age:75.0
Sex:Male
Location:New Jersey
Vaccinated:2013-03-08
Onset:2013-03-12
Submitted:2013-03-25
Entered:2013-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
YF: YELLOW FEVER (YF-VAX) / SANOFI PASTEUR UH588AA / 0 UN / UN

Administered by: Private      Purchased by: Other
Symptoms: Abdominal distension, Choking sensation, Death, Dyspnoea, Ear infection, Gastric perforation, Gastrointestinal gangrene, Guillain-Barre syndrome, Haemodialysis, Plasmapheresis, Pyrexia, Renal failure, Respiratory failure, Surgery, Upper gastrointestinal haemorrhage, General physical health deterioration, Computerised tomogram abdomen abnormal, Post procedural complication, Gastrectomy, Mechanical ventilation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-03-21
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levofloxacin
Current Illness: No
Preexisting Conditions: Allergy to Sulfa drugs
Allergies:
Diagnostic Lab Data: As above
CDC 'Split Type':

Write-up: He started having high grade fever on 3/12, reaching up to 102.9. I asked him to go to his primary care physician who thought he had ear infection and prescribed Levofloxacin. He called me on 3/16/13 complaining of severe shortness of breath and choking sensation in the neck. He deteriorated over the next few days with worsening shortness of breath, persistent fever, renal and respiratory failure requiring hemodialysis and ventilator support. He also underwent a single course of plasmapharesis with presumed diagnosis of Guillain Barre Syndrome but did not respond. He had upper GI bleed and subsequent CT scan showed free air in the abdomen. He underwent emergency surgery that showed gastric gangrene and perforation. Total gastrectomy was performed. He had increasing abdominal distention post-surgically and passed away approximately 5 am on 3/21/2013.


Changed on 9/17/2013

VAERS ID: 487759 Before After
VAERS Form:
Age:75.0
Sex:Male
Location:New Jersey
Vaccinated:2013-03-08
Onset:2013-03-12
Submitted:2013-03-25
Entered:2013-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
YF: YELLOW FEVER (YF-VAX) / SANOFI PASTEUR UH588AA / 0 UN / UN

Administered by: Private      Purchased by: Other
Symptoms: Abdominal distension, Acidosis, Activated partial thromboplastin time prolonged, Alanine aminotransferase increased, Areflexia, Aspartate aminotransferase increased, Asthenia, Atrial fibrillation, Bladder catheterisation, Blood albumin decreased, Blood bicarbonate decreased, Blood bilirubin increased, Blood calcium decreased, Blood creatinine increased, Blood fibrinogen increased, Blood gases abnormal, Blood glucose increased, Blood lactic acid increased, Blood magnesium increased, Blood potassium increased, Blood urea increased, Bradycardia, Carbon dioxide decreased, Cardiac murmur, Cardiomegaly, Chest X-ray abnormal, Chills, Choking sensation, Death, Dysphagia, Dyspnoea, Ear infection, Electrocardiogram abnormal, Fatigue, Fibrin D dimer increased, Gastric perforation, Gastrointestinal gangrene, Glomerular filtration rate decreased, Guillain-Barre syndrome, Haematocrit decreased, Haemodialysis, Haemoglobin decreased, Heart rate irregular, Hepatitis A antibody negative, Hyperglycaemia, Hypertension, Hypocalcaemia, Hyporeflexia, Hypotension, Intensive care, International normalised ratio increased, Intestinal ischaemia, Leukocytosis, Malaise, Multi-organ failure, Oxygen saturation decreased, Palpitations, Plasmapheresis, Platelet count decreased, Protein total decreased, Prothrombin time prolonged, Pulmonary congestion, Pyrexia, Rales, Red blood cell count decreased, Renal failure, Respiratory failure, Resuscitation, Septic shock, Sinus tachycardia, Surgery, Tachycardia, Tachypnoea, Thrombocytopenia, Upper gastrointestinal haemorrhage, Urinary system X-ray, Urine abnormality, Ventilation/perfusion scan normal, Ventricular extrasystoles, Wheezing, White blood cell count increased, X-ray abnormal, General physical health deterioration, Blood phosphorus increased, Specific gravity urine increased, Facial paresis, Neutrophil percentage increased, Lymphocyte percentage decreased, Bilirubin urine, Central venous catheterisation, Red cell distribution width increased, Allergy to vaccine, Cardiac stress test normal, Urine ketone body present, Computerised tomogram abdomen abnormal, Post procedural complication, Pulseless electrical activity, Bacterial test positive, Calcium ionised decreased, Gastrectomy, Hepatitis C test negative, Hepatitis B test negative, Mechanical ventilation, Endotracheal intubation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-03-21
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levofloxacin
Current Illness: No
Preexisting Conditions: Allergy to Sulfa drugs The following information was obtained through follow-up and/or provided by the government. PMH: HTN, DM, possiblity of TIA, chronic kidney disease, arthritis. Allergy: hydrochlorothiazide, sulfa, levaquin. Former smoker.
Allergies:
Diagnostic Lab Data: As above The following information was obtained through follow-up and/or provided by the government. 3/27 & 28/2013 lab/diagnostic records received for DOS 3/6-21/2013. ECG: sinus tach (initial), A fib w/ PVCs (repeat). Cardiac stress test, ventilation lung scan WNL. CXR: pulmonary vascular congestion, cardiomegaly. Blood: WBC 26.8 K/uL (H), neutros 76% (H), lymphs 5% (L), RBC 3.21 M/uL (L), Hgb 9.2 g/dL (L), Hct 27.8% (L), RDW 16.1% (H), Plt 105 K/uL (L), BUN 110 mg/dL (H), creatinine 7.3 mg/dL (H), GFR 9 (L), PT 18.1 sec (H), INR 1.69 (H), PTT 51 (H), HCO3 18 mmol/L (L), D-dimer 2880 ng/mL (H), fibrinogen 409 mg/dL (H), glucose 450 mg/dL (H), Ca 5.6 mg/dL (L), ionized Ca 2.78 mg/dL (L), K 6 mEq/L (H), Mg 2.6 mg/dL (H), PO4 12.7 mg/dL (H
CDC 'Split Type':

Write-up: He started having high grade fever on 3/12, reaching up to 102.9. I asked him to go to his primary care physician who thought he had ear infection and prescribed Levofloxacin. He called me on 3/16/13 complaining of severe shortness of breath and choking sensation in the neck. He deteriorated over the next few days with worsening shortness of breath, persistent fever, renal and respiratory failure requiring hemodialysis and ventilator support. He also underwent a single course of plasmapharesis with presumed diagnosis of Guillain Barre Syndrome but did not respond. He had upper GI bleed and subsequent CT scan showed free air in the abdomen. He underwent emergency surgery that showed gastric gangrene and perforation. Total gastrectomy was performed. He had increasing abdominal distention post-surgically and passed away approximately 5 am on 3/21/2013. The following information was obtained through follow-up and/or provided by the government. 3/27 & 28/2013 hospital records received for DOS 3/16-21/2013. Impression: 1) GBS; 2) HTN, respiratory failure, renal failure; 3) leukocytosis, thrombocytopenia, prolonged PTT; 4) allergic reaction to YF vaccine. 3 days s/p vaccination pt c/o generalized malaise, fatigue, chills, fevers, progressive weakness from LE to UE to entire body. Progressed to difficulty swallowing. PCP gave ABX for possible URI, no improvement noted. Developed tachycardia, dyspnea, wheezing, palpitations - presented to ER. PE: tachycardia, HR irregularly irregular, holosystolic murmur, tachypnea, decreased O2 saturation, rales bilat lung bases, weakness of LE. Tx''t: steroids, ABX. Admitted to telemetry. Progressed to diffuse weakness UE/LE, facial weakness, hyporeflexia of UE, areflexia in LE, severe hypotension, A fib. Transferred to ICU. Developed respiratory failure, acute renal failure, possible acute exacerbation of GBS. Tx''t: intubation, mechanical ventilation, PICC, pressor support, plasmapheresis, foley. Progressed to multi-organ failure, ischemic bowel, acidosis, hyperglycemia, hypocalcemia, septic shock. Tx''t: laparotomy, gastrectomy. Post-op: abdominal distension, bradycardia, developed PEA, CPR/ACLS initiated but unsuccessful. 4/8/2013 death certificate received for DOD 3/21/2013. COD: multisystem organ failure due to septic shock. Other contributing conditions: gastric ischemia, GBS.


Changed on 3/14/2015

VAERS ID: 487759 Before After
VAERS Form:
Age:75.0
Sex:Male
Location:New Jersey
Vaccinated:2013-03-08
Onset:2013-03-12
Submitted:2013-03-25
Entered:2013-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
YF: YELLOW FEVER (YF-VAX) / SANOFI PASTEUR UH588AA / 0 UN / UN

Administered by: Private      Purchased by: Other
Symptoms: Abdominal distension, Acidosis, Activated partial thromboplastin time prolonged, Alanine aminotransferase increased, Areflexia, Aspartate aminotransferase increased, Asthenia, Atrial fibrillation, Bladder catheterisation, Blood albumin decreased, Blood bicarbonate decreased, Blood bilirubin increased, Blood calcium decreased, Blood creatinine increased, Blood fibrinogen increased, Blood gases abnormal, Blood glucose increased, Blood lactic acid increased, Blood magnesium increased, Blood potassium increased, Blood urea increased, Bradycardia, Carbon dioxide decreased, Cardiac murmur, Cardiomegaly, Chest X-ray abnormal, Chills, Choking sensation, Death, Dysphagia, Dyspnoea, Ear infection, Electrocardiogram abnormal, Fatigue, Fibrin D dimer increased, Gastric perforation, Gastrointestinal gangrene, Glomerular filtration rate decreased, Guillain-Barre syndrome, Haematocrit decreased, Haemodialysis, Haemoglobin decreased, Heart rate irregular, Hepatitis A antibody negative, Hyperglycaemia, Hypertension, Hypocalcaemia, Hyporeflexia, Hypotension, Intensive care, International normalised ratio increased, Intestinal ischaemia, Leukocytosis, Malaise, Multi-organ failure, Oxygen saturation decreased, Palpitations, Plasmapheresis, Platelet count decreased, Protein total decreased, Prothrombin time prolonged, Pulmonary congestion, Pyrexia, Rales, Red blood cell count decreased, Renal failure, Respiratory failure, Resuscitation, Septic shock, Sinus tachycardia, Surgery, Tachycardia, Tachypnoea, Thrombocytopenia, Upper gastrointestinal haemorrhage, Urinary system X-ray, Urine abnormality, Ventilation/perfusion scan normal, Ventricular extrasystoles, Wheezing, White blood cell count increased, X-ray abnormal, General physical health deterioration, Blood phosphorus increased, Specific gravity urine increased, Facial paresis, Neutrophil percentage increased, Lymphocyte percentage decreased, Bilirubin urine, Central venous catheterisation, Red cell distribution width increased, Allergy to vaccine, Cardiac stress test normal, Urine ketone body present, Computerised tomogram abdomen abnormal, Post procedural complication, Pulseless electrical activity, Bacterial test positive, Calcium ionised decreased, Gastrectomy, Hepatitis C test negative, Hepatitis B test negative, Mechanical ventilation, Endotracheal intubation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-03-21
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levofloxacin
Current Illness: No
Preexisting Conditions: Allergy to Sulfa drugs The following information was obtained through follow-up and/or provided by the government. PMH: HTN, DM, possiblity of TIA, chronic kidney disease, arthritis. Allergy: hydrochlorothiazide, sulfa, levaquin. Former smoker.
Allergies:
Diagnostic Lab Data: As above The following information was obtained through follow-up and/or provided by the government. 3/27 & 28/2013 lab/diagnostic records received for DOS 3/6-21/2013. ECG: sinus tach (initial), A fib w/ PVCs (repeat). Cardiac stress test, ventilation lung scan WNL. CXR: pulmonary vascular congestion, cardiomegaly. Blood: WBC 26.8 K/uL (H), neutros 76% (H), lymphs 5% (L), RBC 3.21 M/uL (L), Hgb 9.2 g/dL (L), Hct 27.8% (L), RDW 16.1% (H), Plt 105 K/uL (L), BUN 110 mg/dL (H), creatinine 7.3 mg/dL (H), GFR 9 (L), PT 18.1 sec (H), INR 1.69 (H), PTT 51 (H), HCO3 18 mmol/L (L), D-dimer 2880 ng/mL (H), fibrinogen 409 mg/dL (H), glucose 450 mg/dL (H), Ca 5.6 mg/dL (L), ionized Ca 2.78 mg/dL (L), K 6 mEq/L (H), Mg 2.6 mg/dL (H), PO4 12.7 mg/dL (H
CDC 'Split Type':

Write-up: He started having high grade fever on 3/12, reaching up to 102.9. I asked him to go to his primary care physician who thought he had ear infection and prescribed Levofloxacin. He called me on 3/16/13 complaining of severe shortness of breath and choking sensation in the neck. He deteriorated over the next few days with worsening shortness of breath, persistent fever, renal and respiratory failure requiring hemodialysis and ventilator support. He also underwent a single course of plasmapharesis with presumed diagnosis of Guillain Barre Syndrome but did not respond. He had upper GI bleed and subsequent CT scan showed free air in the abdomen. He underwent emergency surgery that showed gastric gangrene and perforation. Total gastrectomy was performed. He had increasing abdominal distention post-surgically and passed away approximately 5 am on 3/21/2013. The following information was obtained through follow-up and/or provided by the government. 3/27 & 28/2013 hospital records received for DOS 3/16-21/2013. Impression: 1) GBS; 2) HTN, respiratory failure, renal failure; 3) leukocytosis, thrombocytopenia, prolonged PTT; 4) allergic reaction to YF vaccine. 3 days s/p vaccination pt c/o generalized malaise, fatigue, chills, fevers, progressive weakness from LE to UE to entire body. Progressed to difficulty swallowing. PCP gave ABX for possible URI, no improvement noted. Developed tachycardia, dyspnea, wheezing, palpitations - presented to ER. PE: tachycardia, HR irregularly irregular, holosystolic murmur, tachypnea, decreased O2 saturation, rales bilat lung bases, weakness of LE. Tx''t: steroids, ABX. Admitted to telemetry. Progressed to diffuse weakness UE/LE, facial weakness, hyporeflexia of UE, areflexia in LE, severe hypotension, A fib. Transferred to ICU. Developed respiratory failure, acute renal failure, possible acute exacerbation of GBS. Tx''t: intubation, mechanical ventilation, PICC, pressor support, plasmapheresis, foley. Progressed to multi-organ failure, ischemic bowel, acidosis, hyperglycemia, hypocalcemia, septic shock. Tx''t: laparotomy, gastrectomy. Post-op: abdominal distension, bradycardia, developed PEA, CPR/ACLS initiated but unsuccessful. 4/8/2013 death certificate received for DOD 3/21/2013. COD: multisystem organ failure due to septic shock. Other contributing conditions: gastric ischemia, GBS.


Changed on 9/14/2017

VAERS ID: 487759 Before After
VAERS Form:(blank) 1
Age:75.0
Sex:Male
Location:New Jersey
Vaccinated:2013-03-08
Onset:2013-03-12
Submitted:2013-03-25
Entered:2013-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
YF: YELLOW FEVER (YF-VAX) / SANOFI PASTEUR UH588AA / 0 1 UN / UN

Administered by: Private      Purchased by: Other
Symptoms: Abdominal distension, Choking sensation, Death, Dyspnoea, Ear infection, Gastric perforation, Gastrointestinal gangrene, Guillain-Barre syndrome, Haemodialysis, Plasmapheresis, Pyrexia, Renal failure, Respiratory failure, Surgery, Upper gastrointestinal haemorrhage, General physical health deterioration, Computerised tomogram abdomen abnormal, Post procedural complication, Gastrectomy, Mechanical ventilation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-03-21
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levofloxacin
Current Illness: No
Preexisting Conditions: Allergy to Sulfa drugs
Allergies:
Diagnostic Lab Data: As above
CDC 'Split Type':

Write-up: He started having high grade fever on 3/12, reaching up to 102.9. I asked him to go to his primary care physician who thought he had ear infection and prescribed Levofloxacin. He called me on 3/16/13 complaining of severe shortness of breath and choking sensation in the neck. He deteriorated over the next few days with worsening shortness of breath, persistent fever, renal and respiratory failure requiring hemodialysis and ventilator support. He also underwent a single course of plasmapharesis with presumed diagnosis of Guillain Barre Syndrome but did not respond. He had upper GI bleed and subsequent CT scan showed free air in the abdomen. He underwent emergency surgery that showed gastric gangrene and perforation. Total gastrectomy was performed. He had increasing abdominal distention post-surgically and passed away approximately 5 am on 3/21/2013.


Changed on 2/14/2018

VAERS ID: 487759 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:New Jersey
Vaccinated:2013-03-08
Onset:2013-03-12
Submitted:2013-03-25
Entered:2013-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
YF: YELLOW FEVER (YF-VAX) / SANOFI PASTEUR UH588AA / 1 UN / UN

Administered by: Private      Purchased by: Other
Symptoms: Abdominal distension, Choking sensation, Death, Dyspnoea, Ear infection, Gastric perforation, Gastrointestinal gangrene, Guillain-Barre syndrome, Haemodialysis, Plasmapheresis, Pyrexia, Renal failure, Respiratory failure, Surgery, Upper gastrointestinal haemorrhage, General physical health deterioration, Computerised tomogram abdomen abnormal, Post procedural complication, Gastrectomy, Mechanical ventilation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-03-21
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levofloxacin
Current Illness: No
Preexisting Conditions: Allergy to Sulfa drugs
Allergies:
Diagnostic Lab Data: As above
CDC 'Split Type':

Write-up: He started having high grade fever on 3/12, reaching up to 102.9. I asked him to go to his primary care physician who thought he had ear infection and prescribed Levofloxacin. He called me on 3/16/13 complaining of severe shortness of breath and choking sensation in the neck. He deteriorated over the next few days with worsening shortness of breath, persistent fever, renal and respiratory failure requiring hemodialysis and ventilator support. He also underwent a single course of plasmapharesis with presumed diagnosis of Guillain Barre Syndrome but did not respond. He had upper GI bleed and subsequent CT scan showed free air in the abdomen. He underwent emergency surgery that showed gastric gangrene and perforation. Total gastrectomy was performed. He had increasing abdominal distention post-surgically and passed away approximately 5 am on 3/21/2013.


Changed on 6/14/2018

VAERS ID: 487759 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:New Jersey
Vaccinated:2013-03-08
Onset:2013-03-12
Submitted:2013-03-25
Entered:2013-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
YF: YELLOW FEVER (YF-VAX) / SANOFI PASTEUR UH588AA / 1 UN / UN

Administered by: Private      Purchased by: Other
Symptoms: Abdominal distension, Choking sensation, Death, Dyspnoea, Ear infection, Gastric perforation, Gastrointestinal gangrene, Guillain-Barre syndrome, Haemodialysis, Plasmapheresis, Pyrexia, Renal failure, Respiratory failure, Surgery, Upper gastrointestinal haemorrhage, General physical health deterioration, Computerised tomogram abdomen abnormal, Post procedural complication, Gastrectomy, Mechanical ventilation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-03-21
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levofloxacin
Current Illness: No
Preexisting Conditions: Allergy to Sulfa drugs
Allergies:
Diagnostic Lab Data: As above
CDC 'Split Type':

Write-up: He started having high grade fever on 3/12, reaching up to 102.9. I asked him to go to his primary care physician who thought he had ear infection and prescribed Levofloxacin. He called me on 3/16/13 complaining of severe shortness of breath and choking sensation in the neck. He deteriorated over the next few days with worsening shortness of breath, persistent fever, renal and respiratory failure requiring hemodialysis and ventilator support. He also underwent a single course of plasmapharesis with presumed diagnosis of Guillain Barre Syndrome but did not respond. He had upper GI bleed and subsequent CT scan showed free air in the abdomen. He underwent emergency surgery that showed gastric gangrene and perforation. Total gastrectomy was performed. He had increasing abdominal distention post-surgically and passed away approximately 5 am on 3/21/2013.


Changed on 8/14/2018

VAERS ID: 487759 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:New Jersey
Vaccinated:2013-03-08
Onset:2013-03-12
Submitted:2013-03-25
Entered:2013-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
YF: YELLOW FEVER (YF-VAX) / SANOFI PASTEUR UH588AA / 1 UN / UN

Administered by: Private      Purchased by: Other
Symptoms: Abdominal distension, Choking sensation, Death, Dyspnoea, Ear infection, Gastric perforation, Gastrointestinal gangrene, Guillain-Barre syndrome, Haemodialysis, Plasmapheresis, Pyrexia, Renal failure, Respiratory failure, Surgery, Upper gastrointestinal haemorrhage, General physical health deterioration, Computerised tomogram abdomen abnormal, Post procedural complication, Gastrectomy, Mechanical ventilation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-03-21
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levofloxacin
Current Illness: No
Preexisting Conditions: Allergy to Sulfa drugs
Allergies:
Diagnostic Lab Data: As above
CDC 'Split Type':

Write-up: He started having high grade fever on 3/12, reaching up to 102.9. I asked him to go to his primary care physician who thought he had ear infection and prescribed Levofloxacin. He called me on 3/16/13 complaining of severe shortness of breath and choking sensation in the neck. He deteriorated over the next few days with worsening shortness of breath, persistent fever, renal and respiratory failure requiring hemodialysis and ventilator support. He also underwent a single course of plasmapharesis with presumed diagnosis of Guillain Barre Syndrome but did not respond. He had upper GI bleed and subsequent CT scan showed free air in the abdomen. He underwent emergency surgery that showed gastric gangrene and perforation. Total gastrectomy was performed. He had increasing abdominal distention post-surgically and passed away approximately 5 am on 3/21/2013.


Changed on 9/14/2018

VAERS ID: 487759 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:New Jersey
Vaccinated:2013-03-08
Onset:2013-03-12
Submitted:2013-03-25
Entered:2013-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
YF: YELLOW FEVER (YF-VAX) / SANOFI PASTEUR UH588AA / 1 UN / UN

Administered by: Private      Purchased by: Other
Symptoms: Abdominal distension, Choking sensation, Death, Dyspnoea, Ear infection, Gastric perforation, Gastrointestinal gangrene, Guillain-Barre syndrome, Haemodialysis, Plasmapheresis, Pyrexia, Renal failure, Respiratory failure, Surgery, Upper gastrointestinal haemorrhage, General physical health deterioration, Computerised tomogram abdomen abnormal, Post procedural complication, Gastrectomy, Mechanical ventilation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-03-21
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levofloxacin
Current Illness: No
Preexisting Conditions: Allergy to Sulfa drugs
Allergies:
Diagnostic Lab Data: As above
CDC 'Split Type':

Write-up: He started having high grade fever on 3/12, reaching up to 102.9. I asked him to go to his primary care physician who thought he had ear infection and prescribed Levofloxacin. He called me on 3/16/13 complaining of severe shortness of breath and choking sensation in the neck. He deteriorated over the next few days with worsening shortness of breath, persistent fever, renal and respiratory failure requiring hemodialysis and ventilator support. He also underwent a single course of plasmapharesis with presumed diagnosis of Guillain Barre Syndrome but did not respond. He had upper GI bleed and subsequent CT scan showed free air in the abdomen. He underwent emergency surgery that showed gastric gangrene and perforation. Total gastrectomy was performed. He had increasing abdominal distention post-surgically and passed away approximately 5 am on 3/21/2013.


Changed on 10/14/2018

VAERS ID: 487759 Before After
VAERS Form:1
Age:75.0
Sex:Male
Location:New Jersey
Vaccinated:2013-03-08
Onset:2013-03-12
Submitted:2013-03-25
Entered:2013-03-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
YF: YELLOW FEVER (YF-VAX) / SANOFI PASTEUR UH588AA / 1 UN / UN

Administered by: Private      Purchased by: Other
Symptoms: Abdominal distension, Choking sensation, Death, Dyspnoea, Ear infection, Gastric perforation, Gastrointestinal gangrene, Guillain-Barre syndrome, Haemodialysis, Plasmapheresis, Pyrexia, Renal failure, Respiratory failure, Surgery, Upper gastrointestinal haemorrhage, General physical health deterioration, Computerised tomogram abdomen abnormal, Post procedural complication, Gastrectomy, Mechanical ventilation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2013-03-21
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? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Levofloxacin
Current Illness: No
Preexisting Conditions: Allergy to Sulfa drugs
Allergies:
Diagnostic Lab Data: As above
CDC 'Split Type':

Write-up: He started having high grade fever on 3/12, reaching up to 102.9. I asked him to go to his primary care physician who thought he had ear infection and prescribed Levofloxacin. He called me on 3/16/13 complaining of severe shortness of breath and choking sensation in the neck. He deteriorated over the next few days with worsening shortness of breath, persistent fever, renal and respiratory failure requiring hemodialysis and ventilator support. He also underwent a single course of plasmapharesis with presumed diagnosis of Guillain Barre Syndrome but did not respond. He had upper GI bleed and subsequent CT scan showed free air in the abdomen. He underwent emergency surgery that showed gastric gangrene and perforation. Total gastrectomy was performed. He had increasing abdominal distention post-surgically and passed away approximately 5 am on 3/21/2013.

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