autonomic dysfunction/fatigue, brain for, difficulty focusing, dizziness upon standing; autoimmune encephalitis/autoimmune brain inflammatory process; traumatic brain injury; pediatric acute-onset neuropsychiatric syndrome (PANS)/significant behavioral changes, including becoming defiant and violent, mental health disturbance; polycystic ovary syndrome (PCOS); hyperthyroidism; autoimmune encephalopathy; Information has been received from a lawyer, regarding a case in litigation and concerning a minor (also reported as adult) female patient (pt) of an unknown age. No other information concerning the pt's medical history, concurrent conditions or concomitant medications was provided.  On 30-MAY-2019, at the age of 15 years old, the pt received her first dose of quadrivalent human papillomavirus (HPV) (types 6,11,16,18) recomb. vaccine (GARDASIL) (dose, route of administration, anatomical location, lot # and expiration date were not reported) for prophylaxis. On 07-AUG-2019, the pt received her second dose of quadrivalent human papillomavirus (HPV) (types 6,11,16,18) recomb. vaccine (GARDASIL) (dose, route of administration, anatomical location, lot # and expiration date were not reported). On 07-NOV-2019, the pt received her third dose of quadrivalent human papillomavirus (HPV) (types 6,11,16,18) recomb. vaccine (GARDASIL) (dose, route of administration, anatomical location, lot # and expiration date were not reported). Following her quadrivalent human papillomavirus (HPV) (types 6,11,16,18) recomb. vaccine (GARDASIL) injections, the pt experienced uncharacteristic and significant behavioral changes, including becoming defiant and violent. She was seen by multiple physicians and specialists for her complaints which now included: fatigue, brain fog, difficulty focusing, mental health disturbance, and dizziness upon standing. As a result of her post-quadrivalent human papillomavirus (HPV) (types 6,11,16,18) recomb. vaccine (GARDASIL) symptoms, the pt was unable to engage in activities that a normal young person would enjoy. On unknown dates, based upon her chronic and severe post-quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) symptoms, the pt was diagnosed with various medical conditions, including but not limited to, autonomic dysfunction, autoimmune brain inflammatory process, autoimmune encephalitis, and traumatic brain injury due to inflammation. The pt contended that her quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) injection(s) caused him to develop serious and debilitating autoimmune, autonomic, and neurological injuries, including but not limited to autonomic dysfunction, autoimmune brain inflammatory process, autoimmune encephalopathy, traumatic brain injury caused by inflammation, pediatric acute-onset neuropsychiatric syndrome (PANS), polycystic ovary syndrome (PCOS), hyperthyroidism, as well as a constellation of adverse symptoms, complications, injuries, and other adverse events, many of which were alleged herein and all of which were caused by quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) or otherwise linked to his quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL)-induced autoimmune disorder. The pt had suffered and at the time of report continued to suffer severe and permanent physical injuries, and associated symptomatology and had suffered severe and permanent emotional injuries, including pain and suffering. She also had a substantial fear of suffering additional and ongoing harms, including but not limited to now being at an increased risk of cancer, and future symptoms and harms associated with her injuries caused by quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL). As a direct and proximate result of his quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL)-induced injuries, the pt suffered and at the time of report continued to suffer economic losses, including considerable financial expenses for medical care and treatment, and diminished income capacity, and she would continue to incur these losses and expenses in the future. The outcome of the events of autonomic nervous system imbalance, hyperthyroidism, polycystic ovaries, PANS, craniocerebral injury, encephalitis autoimmune and autoimmune encephalopathy was considered to be not recovered.  The lawyer considered the events of autonomic nervous system imbalance, hyperthyroidism, polycystic ovaries, PANS, craniocerebral injury, encephalitis autoimmune and autoimmune encephalopathy to be related to quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL).  Upon internal review, the events of encephalitis autoimmune, autoimmune encephalopathy, traumatic brain injury, PANS, and hyperthyroidism was determined to be medically significant.   The events of autonomic nervous system imbalance, hyperthyroidism, polycystic ovaries, paediatric acute-onset neuropsychiatric syndrome, craniocerebral injury, encephalitis autoimmune and autoimmune encephalopathy were considered to be disabling.