trouble walking; constant temperature sensitivity; hair loss; Food intolerances; intestinal gas; Dx POTSautoimmune disease,chronicheadache,lightheadedness,difficultysleeping,tachycardia,fatigue,brainfog,inabilitytofocus,abdominalpain,dropbloodpressure,faintedbriefly,feltweak,neckpain,backpain,collapsing episodes,trembling,bloating; fibromyalgia (autonomic dysfunction), depression and anxiety; a feeling that her throat was closing up; she was also experiencing hot flashes in her head; amplification pain syndrome, stabbing pains/pain spread to her elbows, knees and wrists/continued joint pain; Information has been received from a lawyer regarding a case in litigation and refers to 13-year-old female patient (pt). The pt's pertinent medical history included elbow tendinitis, appendectomy and recurrent incidences of dizziness. Her concurrent conditions and concomitant medications were not provided. However, it was reported that prior to receiving vaccination, pt had no autoimmune diseases and no autonomic issues. On 12-AUG-2013, the pt was vaccinated with the first dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) for preventing cervical cancer (strength, dose, route of administration, anatomical location, lot # and expiration date were not reported). Immediately following vaccination, pt fainted briefly, experienced a drop in blood pressure and felt weak. She complained of immediate intense pain in her neck and a feeling that her throat was closing up (thorath tightness). The neck pain continued and the following week after vaccination, on an unspecified date in August 2013, she began to experience pain in her back and in the weeks to follow, the pain spread to her elbows, knees and wrists. She was also experiencing hot flashes (hot flush) in her head for which she continued to seek treatment from her pediatrician. As the months progressed, so did pt's injuries, she was seen by multiple physicians and specialists for her complaints which included: continued joint pain, trouble walking (gait disturbance), chronic headaches, depression, anxiety, difficulty sleeping, lightheadedness, trembling, fatigue, brain fog, abdominal pain, collapsing episodes, constant temperature sensitivity (temperature intolerance), stabbing pains, tachycardia, inability to focus, hair loss (alopecia), food intolerances and intestinal bloating and gas (flatulence). As a result of her post-quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) symptoms, pt was unable to attend school regularly or engage in normal activities that a normal young person would enjoy and was unable to continue her athletic endeavors because simple acts like opening the refrigerator or lifting a book caused her pain. Based upon her chronic and above severe symptoms, pt had been diagnosed with various medical conditions, including but not limited to postural orthostatic tachycardia syndrome (POTS) (Autoimmune disease, chronic headache, lightheadedness, difficulty sleeping, tachycardia, fatigue, brain fog, inability to focus, abdominal pain, drop blood pressure, fainted briefly, felt weak, neck pain, back pain, collapsing episodes, trembling, bloating), fibromyalgia (autonomic dysfunction, depression and anxiety) and amplification pain syndrome (stabbing pains/pain spread to her elbows, knees and wrists/continued joint pain). Quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) and its ingredients caused pt's autoimmune disease and other related serious injuries (autonomic dysfunctions) and had resulted in her suffering from severe, debilitating, disabling and painful chronic injuries. Pt had suffered and continued to suffer severe and permanent physical injuries, and associated symptomology and had suffered severe and permanent emotional injuries, including pain and suffering. Pt 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 quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL). As a direct and proximate result of her Quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL)-induced injuries, pt 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.