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This is VAERS ID 56832

Case Details

VAERS ID: 56832 (history)  
Form: Version 1.0  
Age: 87.0  
Sex: Female  
Location: Michigan  
Vaccinated:1993-10-01
Onset:1993-10-11
   Days after vaccination:10
Submitted: 1993-10-20
   Days after onset:9
Entered: 1993-10-28
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUOGEN) / PARKE-DAVIS 00863P / 1 - / A

Administered by: Private       Purchased by: Private
Symptoms: Apnoea, Guillain-Barre syndrome, Paralysis
SMQs:, Peripheral neuropathy (narrow), Acute central respiratory depression (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Demyelination (narrow), Conditions associated with central nervous system haemorrhages and cerebrovascular accidents (broad), Respiratory failure (narrow), Immune-mediated/autoimmune disorders (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 1993-10-14
   Days after onset: 3
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations: ~ ()~~~In patient
Other Medications: Dyazide-Micro K; Ventolin-Aero Bid uniphyl;
Current Illness: NONE
Preexisting Conditions: bronchial asthma, hypertensive cardio vascular disease;
Allergies:
Diagnostic Lab Data: LP-nl; EMG-nl; consistant w/GBS:
CDC Split Type:

Write-up: ascending paralysis, w/resp failure, consistant w/GBS;


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