Received Apr 21, 2025
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| HPV9 | HPV (GARDASIL 9) | MERCK & CO. INC. | 1 | Y007197 | IM / LA |
| MNQ | MENINGOCOCCAL CONJUGATE (MENQUADFI) | SANOFI PASTEUR | 1 | U8375AA | IM / RA |
| TDAP | TDAP (ADACEL) | SANOFI PASTEUR | 1 | U8252AA | IM / RA |
Patient received immunization, all questions were answered. Patient was assisted to a chair by her mom to wait the suggested 15 minutes in the clinic immediately following the shots. She requested water and the nurse stepped out of the room to get the water. Within 5 seconds patients mom yelled for help. Nurse returned to the room immediately and found patient unconscious, pale, entire body rigid, hands clenched into fists and not breathing. Nurse yelled patients name, shook her head and shoulders and lightly tapped cheeks for response. Patient did not respond and nurse yelled for the CSR at the front desk to call "Dr." over the intercom (page for medical emergency). 6-7 personnel responded from within the building to the call and by this time patient was awake and responsive. Patient was unresponsive for approximately a total of 15-20 seconds. Patient was helped to the exam table. Patient was able to confirm, date, place and her name; her color returned, and she was given orange juice. Vital signs were 76/43, pulse 44, respirations 12 at 10:16am. Provider,FNP-BC, APRN, came into the room to assess patient and obtain hx from patient's mom. After the visit, patient and mom were given the following instructions: Do not leave patient unattended, especially in places like the shower, for the next 48 hours and to seek medical attention for headache or another episode and to report this event to her pediatrician. Mom stated she understood. Vital Signs at 10:23 99/64, pulse 56 and respirations 12. Patient left with her mom at 10:42. Nurse left a message on phone number listed on the consent Friday 4/18/25 and Monday 4/21/25 to have mom call back to give update on her daughter. No returned phone call has been received.
Unsure, not feeling sick the day of vaccination
None listed on consent
Unsure
None listed on consent
none