heart arrhythmia/heart palpitations while resting, dizziness upon standing, feeling faint/fatigue; arthritis/excruciating sharp piercing knee pain that radiated to her ankles and toes/burning in elbows; autoimmune, autonomic, and neurological, injuries; autoimmune, autonomic, and neurological, injuries/fatigue; autoimmune, autonomic, and neurological, injuries; generalized pain/body aches; edema/body swelling; nausea; burning, and tingling in elbow, hands, and fingers; burning, and tingling in elbow, hands, and fingers; a constellation of adverse symptoms, complications, injuries, and other adverse events; a constellation of adverse symptoms, complications, injuries, and other adverse events; pt was 28-year-old when she received 2 doses of the vaccine; Information has been received from a lawyer regarding a case in litigation and referred to an adult female patient (pt). No information was provided regarding medical history, concurrent conditions, or concomitant medications. On an unknown date, pt was vaccinated with the first, second and third dose of Quadrivalent Human Papillomavirus (Types 6,11,16,18) Recomb. Vaccine (GARDASIL) (pt was 28-year-old when she received 2 doses of the vaccine, product administered to patient of inappropriate age) for preventing cervical cancer. Following her second vaccine dose, pt experienced disabling excruciating sharp piercing knee pain that radiated to her ankles and toes, burning, and tingling in elbow, hands, and fingers, joint pain, body swelling, body aches, fatigue, heart palpitations while resting, dizziness upon standing, feeling faint, and nausea. Based upon her chronic and severe post-vaccine symptoms, pt has been diagnosed with various medical conditions, including but not limited to arthritis and heart arrhythmia. Pt had serious debilitating injuries, including but not limited to autonomic, autoimmune, neurological injuries including but not limited to generalized pain, edema, arthritis, and heart arrhythmia, 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 the vaccine or otherwise linked to her vaccine-induced autoimmune disorder. As a result of her post-vaccine symptoms, she had been unable to engage in activities that a young person would normally enjoy. As a direct and proximate result of her vaccine-induced injuries, she had suffered and 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. She had suffered and continued to suffer severe and permanent physical injuries, and associated symptomology and has 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 autoimmune disease and other injuries caused by the vaccine. The outcome of events was not resolved.    All the events were considered to be disabling by the lawyer. Upon on internal review, the events arrhythmia and autoimmune disorder were considered to be medically significant.