Age: 53.0
Sex: F
Vaccine: FLU3, PPV
Symptoms: Local swelling, Musculoskeletal pain, Pain in extremity, Radial nerve palsy
Clinical narrative: Information had been received from a lawyer regarding a case in litigation. It was alleged in litigation that a female was administered two vaccines, PNEUMOVAX23 and AFLURIA on 15-APR-2013 at a pharmacy. The patient sustained severe side effects including shoulder, chest and headache. The pain radiated to her fingers and she was referred to a physiatrist. Information had been received from a claims representative of the pharmacy where the patient had been vaccinated. It was alleged that the patient was administered two vaccines in the same right arm, PNEUMOVAX23 and AFLURIA and sustained severe side effects such as: inflammation, severe pain in the shoulder, chest and headache. It was alleged that pain radiated to her fingers and she was referred to a physiatrist. Information had been received from a lawyer and claims service representative for a pharmacy regarding a 53 year old female non-smoker with asthma and diabetes. On 15-APR-2013, the patient visited a pharmacy to buy some medicine and was offered vaccination services. The patient was administered PNEUMOVAX23 (lot# H015749, expiration date 08-JUN-2014) and AFLURIA (lot# reported as 08149211A, expiration date 30-JUN-2013). Both were injected simultaneously on the right arm, intramuscularly. Both the lawyer and claims representative noted that this was an incorrect determination as they should not have been injected on the same arm. A previous interview was not completed either. As a consequence, the patient developed a strong discomfort on her right side, inflammation swelling on her arm, strong pain on her shoulder, chest and head, and pain that reached to the fingers of her right hand. Days after, her arm condition worsened as it turned red all over and also got swelled. The patient called the pharmacy on 17-APR-2013 and was attended by a pharmacist who indicated that the administration of both vaccines on the same arm was not an appropriate one. The pharmacist oriented the patient to go to her physician so that he could call the pharmacy and have the patient's diabetes drugs to be dispatched for free. On 18-APR-2013, the patient visited her physician who in turn called the pharmacy. The physician concluded that indeed, the patient should have not received both vaccines simultaneously on the same arm since among other things a proper determination of its reaction was not possible. Physician prescribed CIPRO 500mg and nabumetone 750mg. Physician recommended that the patient rest from 18-APR-2013 during which time the patient was absent from her job. On 22-APR-2013, physician reevaluated the patient who authorized her to return to work on 23-APR-2013 and to continue with her medications. Once back at her job, the patient started to feel discomfort when she tried to grab using her thumb, index and middle hand fingers, and this discomfort continued intermittently. On 01-JUN-2013, the patient was examined again by her physician and referred to a physiotherapist for evaluation. The diagnosis was "right radial nerve palsy". Upon internal review, right radial nerve palsy was considered to be medically significant. Additional information has been requested.