complex regional pain syndrome ("CRPS"); chronic fatigue syndrome ("CFS"); Irlen syndrome; autoimmune disorder; postural orthostatic tachycardia syndrome (POTS), chest and stomach pains, trouble breathing, blood pressure was going up and down, almost fainting, chronic pain, dizziness, lightheadedness, heart rate fluctuations, headaches and extreme brain fog; could not stand at all, struggling to stand, was still unable to stand for longer than a few minutes; could barely walk and had to sit down, could not walk, was struggling to walk from one end of the house to the other, inability to walk; strep throat; Information has been received from a lawyer, regarding a case in litigation and concerning a female patient (pt) of an unknown age. No other information concerning the pt's medical history, concurrent conditions or concomitant medications was provided.  On 08-FEB-2019, at the age of 12 years old, the pt received his 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 preventing cervical cancer. On 09-JAN-2020, the pt returned to the doctor's office because she had previously had strep throat, in December 2019, and her mother wanted to make sure it wasn't coming back. On 09-JAN-2020, during the visit, the pt received his 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). Immediately after receiving the shot, the pt began to feel unwell. She left the office with her mother, and by the time they got to the elevator, the pt could barely walk and had to sit down. Over the next two hours, she started having chest and stomach pains, could not walk or stand at all, and was having trouble breathing. The pt's mother took her to the emergency room, where they ran tests and did bloodwork. The pt was still struggling to breathe, her blood pressure was going up and down, and she was struggling to stand. It was thought that the pt might be dehydrated so she was given intravenous (IV) fluids. After six hours in the ER, the pt was sent home with no answers. A few weeks went by, and the pt was still unable to stand for longer than a few minutes without almost fainting, and she was struggling to walk from one end of the house to the other. On 07-FEB-2020, the pt went to the emergency room for a second opinion and hopefully to get some answers. After extensive testing, it was suggested that pt had postural orthostatic tachycardia syndrome (POTS), and she was referred to a pediatric cardiologist for a tilt table test. On 21-FEB-2020, the pt had a tilt table test which confirmed her POTS diagnosis. As the months progressed, so did the pt's symptoms. She was seen by multiple physicians and specialists for her complaints which now included: chronic pain, dizziness, lightheadedness, heart rate fluctuations, headaches, inability to walk, and extreme brain fog. The pt had at least four Erector Spinal Nerve blocks to try to alleviate her intense pain. As a result of her post-quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) symptoms, the pt was unable to engage in normal activities. 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, complex regional pain syndrome (CRPS), chronic fatigue syndrome (CFS), and Irlen syndrome. The pt contended that her quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) injection(s) caused her to develop serious and debilitating autoimmune, autonomic, and neurological, injuries, including but not limited to POTS, complex regional pain syndrome, chronic fatigue syndrome, and Irlen syndrome, as well as a constellation of adverse symptoms, complications, injuries, and other adverse events, many of which are 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 his autoimmune disease and other 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 POTS, dysstasia, gait inability, pharyngitis streptococcal, CRPS, CFS, Irlen syndrome, and autoimmune disorder was considered to be not recovered. The lawyer considered the events of POTS, dysstasia, gait inability, pharyngitis streptococcal, CRPS, CFS, Irlen syndrome, and autoimmune disorder to be related to quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL).  Upon internal review, the event of autoimmune disorder was determined to be medically significant. The events of POTS, dysstasia, gait inability, pharyngitis streptococcal, CRPS, CFS, Irlen syndrome, and autoimmune disorder was considered to be disabling.