postural orthostatic tachycardia syndrome (POTS)/ nausea and vomiting, with fatigue and weight loss/heart palpitations and fainting/ serious and debilitating autoimmune, autonomic, and neurological injuries, including but not limited to POTS; severe gastroparesis/ had to have a feeding tube inserted/ nausea and vomiting, weight loss/ severe and permanent physical injuries; serious and debilitating autonomic, and neurological injuries/ serious and debilitating autoimmune injuries/ autoimmune disorder/ severe and permanent physical injuries; depressed; serious and debilitating autoimmune injuries/ autoimmune disorder/ severe and permanent physical injuries; she received her first dosage of Gardasil on March 23, 2018 and 17 years old when she received the second dosage on December 9, 2019.; Information has been received from a lawyer regarding a case in litigation concerning female patient of an unknown age. Prior to receiving her of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) vaccination, the patient was an active teenager. She loved spending time with her friends, traveling with her family, and attending school. She enjoyed swimming and camping and was a big foodie. She always looked at life in a positive light. She was a big dreamer and had her whole life planned out. The patient's concurrent conditions, medical history and concomitant therapies were not provided.   On 23-MAR-2018 (at the age of 15 years old), the patient was vaccinated with the first dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL), and on 09-DEC-2019, with the second dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) (lot #, expiration dates, doses, routes of administration and anatomical locations were not provided for both doses) as prevention of cervical cancer (inappropriate schedule of product administration) as recommended by her physician.   On an unspecified date (reported as shortly following the first quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) vaccination), the patient claimed she began to experience symptoms of nausea and vomiting, with fatigue and weight loss. Even though she was having symptoms, nobody put two and two together that her complaints could be linked back to the vaccination and she was able to cope. After second dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) vaccination her complaints significantly worsened and new symptoms appeared including heart palpitations, nausea, vomiting, and fainting. As the months progressed, so did her injuries. The patient was seen by multiple physicians and specialists for her complaints. She was diagnosed with postural orthostatic tachycardia syndrome (POTS) and had to have a feeding tube inserted due to severe gastroparesis. As a result of her post-quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) symptoms, the patient was unable to engage in activities that a normal young person would enjoy. The patient's life revolved around doctors' visits, tending to her feeding tube, and making sure she did everything she could to keep her body running. As a result of her injuries, the patient was depressed. She claimed, that the quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) injections caused her to develop serious and debilitating autoimmune, autonomic, and neurological injuries, including but not limited to POTS, 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 her quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) -induced autoimmune disorder. As a proximate result of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL), the patient suffered and continued to suffer severe and permanent physical injuries and associated symptomatology, and 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 her quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL)-induced injuries, she 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. The outcome of the events POTS, autoimmune disorder, nervous system disorder, depressed, and gastroparesis was not recovered at the time of the report.  The events were considered to be related to quadrivalent human papillomavirus (types 6,11,16,18) recomb vaccine (GARDASIL).  The events of POTS, gastroparesis, nervous system disorder, depressed, and autoimmune disorder were considered to be disabling events. Upon internal review, the events of gastroparesis and autoimmune disorder were determined to be medically significant events. The event of gastroparesis was considered to be medically significant event due to treatment with feeding tube.