Age: 6.0
Sex: F
Vaccine: OPV
Symptoms: Brain neoplasm malignant, Disturbance in attention, Headache, Nausea, Oesophagitis
Clinical narrative: Pt recvd an unspecified number of doses of Orimune from 1992 until 6/13/97. In November, 1998, pt was diagnosed with "medulloblastoma, a tumor of the brain." Following various attempts at treatment, the pt died on 10/7/99. The pt's parents requested testing of the tumor to determine the presence or absence of SV40. As of the date of this report, testing was ongoing. As of the date of this report, no further info was available.  Reported on 02/27/2003: "Follow-up information (medical records) received 02/13/2003 provided dates of vaccination, CT-scan, and MRI results.  Information was received 11/12/2001 from an attorney regarding a 6-year-old female who received three doses of Orimune from 12/1992 until 06/1997.  On 11/16/16988, the patient was hospitalized due to changes in mental status.  Prior to hospitalization the patient had a three week history of vomiting, headache, and malaise.  A CT-scan revealed a posterior fossa tumor and normal ventricular size.  The patient underwent surgery to remove the tumor and pathology revealed medulloblastoma.  On 12/01/1998, a magnetic resonance imaging scan (MRI) of the spine revealed no evidence of metaphysis.  In 03/1999, the patient was admitted for chemotherapy (vincristine and cisplatin), while hospitalized the patient underwent an esophagogastroduodenoscopy which revealed mild to moderate esophagitis. A CT-scan of the abdomen was performed to rule out "mass lesions" and this was found to be within normal limits.  On 08/26/199, the paitent was brought to the emergency room after experiencing nausea, vomiting, headache, and altered mental status with decreased level of conscioiusness.  A MRI of the head showed increased ventricular size, and a craniotomy was performed for revision of her shunt.  Shunt culture and cerebral spinal fluid cultures were negative, but biopsy revealed malignant spread of the medulloblastoma to the leptomeninges.  On 07/27/1999 the patient developed seizures and went into status epilepticus.  Treatment included Ativan and Fosphenytoin, and the patient was subsequently incubated for respiratory failure.  Physician notes stated that the new onset of seizures were likely secondary to the metastasis.  Legal complaint stated that following various attempts at treatment, the patient died on 10/07/1999.  The patient's parents reequested testing of the tumor to determine the presence or absence of SV40; as of the date of this report, testing was ongoing. Follow up on 02/09/04: "Medical records received provided revised dates of vaccination.  Information was received from an attorney regarding a 6 year old female who received four doses of Orimune from December 1992 until June 1997.  On 11/16/1988, the pt was hospitalized due to changes in mental status.  Prior to hospitalization the pt had a three week history of vomiting, headache, and malaise.  A CT-scan revealed a posterior fosma tumor and normal ventricular size.  The pt underwent surgery to remove the tumor and pathology revealed medulloblastoma.  On 12/01/98, a magnetic resonance imaging scan (MRI) of the spine revealed no evidence of metaphysis.  In March 1999, the pt was admitted for chemotherapy (vincristine and cisplatin); while hospitalized the pt underwent an esophagogastroduodenoscopy which revealed mild to moderate esophagitis.  A CT-scan of the abdomen was performed to rule out "mass lesions" and this was found to be within normal limits.  On 08/26/99, the pt was brought to the ER after experiencing nausea, vomiting, headache, and altered mental status with decreased level of consciousness.  A MRI of the head showed increased ventricular size, and a craniotomy was performed for revision of her shunt.  Shunt culture and cerebral spinal fluid cultures were negative, but biopsy revealed malignant spread of the medulloblastoma to the leptomeninges.  On 08/27/99 the pt developed seizures and went into status epilepticus.  Treatment included Ativan and Fosphenytoin, and the pt was subsequently intubated for respiratory failure.  Physician notes stated that the new onset of seizures were likely secondary to the metastasis.  Legan complaint stated that following various attempts at treatment, the pt died on 10/07/99.  The pt's parents requested testing of the tumor to determine the presence or absence of SV40; as of the date of this report, testing was ongoing.  Medical records are on file.