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Found 753 cases where Vaccine is RV5 and Symptom is Intussusception and Appearance Date on/before '2012-04-30'

Case Details

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VAERS ID: 277955 (history)  
Form: Version 1.0  
Age: 0.4  
Gender: Male  
Location: Montana  
Vaccinated:2006-11-29
Onset:2007-04-21
   Days after vaccination:143
Submitted: 2007-05-04
   Days after onset:13
Entered: 2007-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B074AA / 2 UN / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR 0278F / 2 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08683D / 2 UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0278F / 1 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abnormal behaviour, Diarrhoea, Fatigue, Intussusception, Irritability, Nasopharyngitis, Otitis media acute, Pallor, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: unknown
Preexisting Conditions: extensive port wine stain on lower extremities with resultant leg assymetry PMH: Klippel-Trenaunay syndrome. Fever & otitis media dx 6 days prior & on antibiotics. Extensive port wine stain over lower back down to feet.
Allergies:
Diagnostic Lab Data: LABS: WBC low at 5.2, neutros elevated at 38, bandss elevated at 15, lymphs low at 39 w/markedly reactive lymphs noted. Creatinine low at 0.33. Na elevated at 145.
CDC Split Type:

Write-up: Patient received rotavirus vaccines on 11/29/2006 and 1/22/2007. Patient presented on 4/21/07 with a 1 day h/o episodic fussyness, vomiting a few times, clingy, tired between episodes, pale. Seen in clinic 5 days prior with cold symptoms and fever and diagnosed with an AOM and placed on amoxicillin. Had a few day h/o diarrhea without blood a few days ago which resolved. Cold symptoms improving. Barium enema revealed intussusception from ileocecal area completely through ascending colon which reduced 1/3 of the way. Life flight to hospital where peds surgeon reduced with air enema. 6/12/07 Received medical records from PCP which also included ER records & vax records. Patient experienced abdominal pain, nausea/vomiting & diarrhea & was not acting himself since awakening from nap on 4/21/07. Insoncolable crying & decreased activity. Parent reported fever approx 3 days prior & was on antibiotic since 4/16 when dx w/acute otitis media. Exam revealed slight eye discharge. Abdominal x-ray revealed IS. Patient transferred via helicopter to higher level of care for probable surgery. PCP records indicate IS was reduced w/air enema. VAX record: Does not include vax lot numbers. Vax received at Health Department. Will request from them. PCP Records: Patient had extensive port wine stain over lower back down to feet & had US of lower spine to eval which was reported as WNL. Had normal newborn labs. Experienced dry skin, viral URI, fussiness, keratosis pilaris w/mild atopic dermatitis, diaper rash, bronchiolitis, bilateral otitis media, heart murmur. Leg length & circumference was unequal & referred to ortho specialist. On 4/16 dx w/left acute otitis media & started on antibiotics. 06/13/07-vac rec received. VAERS updated with information and record faxed to CDC. 6/19/07 Received hospital medical records which reveal patient was transferred from outlying ER for incompletely reduced IS. Patient had become very lethargic after vomiting. Mass was still palpable in RUQ & air contrast enema was repeated successfully. Had a bloody stool & vomiting s/p enema. Kept overnight for observation & d/c home next am. FINAL DX: ileocolonic intussusception, reduced by air enema.


VAERS ID: 278006 (history)  
Form: Version 1.0  
Age: 0.5  
Gender: Female  
Location: California  
Vaccinated:2006-12-29
Onset:2007-04-26
   Days after vaccination:118
Submitted: 2007-05-02
   Days after onset:6
Entered: 2007-05-07
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR U1965AB / UNK LL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. 0032F / 3 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF018AD / 3 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Y10312 / 3 RL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08646C / 3 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1110F / 3 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Inappropriate schedule of drug administration, Intussusception
SMQs:, Gastrointestinal obstruction (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Hospitalized Abdominal US abnormal, barium enema cbc & chemistry both WNL.
CDC Split Type:

Write-up: Intussusception 5/15/07 Received vax records from reporter. Lot numbers corrected in VAERS database. RO lot number & dose confirmed by vax records. 5/25/07 Received medical records from hospital which reveal patient experienced emesis, bloody stools, abdominal pain & lethargy. IS at right hepatic flexure diagnosed by abd US & reduced by barium enema. Admitted 4/27 & d/c later same day after observation s/p IS reduction. Consult by peds surgery done. FINAL DX: Intussusception.


VAERS ID: 278136 (history)  
Form: Version 1.0  
Age: 0.2  
Gender: Female  
Location: New Mexico  
Vaccinated:2007-04-18
Onset:2007-04-21
   Days after vaccination:3
Submitted: 2007-05-07
   Days after onset:16
Entered: 2007-05-08
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0026U / UNK MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Barium enema, Intussusception, Surgery, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None. PMH: none. NKDA.
Allergies:
Diagnostic Lab Data: Unknown. Labs and Diagnostics: Abd X-ray revealed multiple dilated loops of bowel in mid-abdomen. ? Volvulus vs. intussusception. Barium enema (+) for intussusception.
CDC Split Type: WAES0704USA05355

Write-up: Information has been received from a registered nurse concerning a 10 week old formula fed female with no medical history or allergies who on 18-APR-2007 was vaccinated with a 2 ml oral dose of Rotateq (lot # 656196/0026U). There was no concomitant medication. On 21-APR-2007 the patient developed vomiting. She was seen in the ER that day. She was admitted to the hospital with intussusception. Barium procedure to open the bowel was unsuccessful. Surgery was required. On 23-APR-2007 the baby was discharged from the hospital. At the time of the report the patient was recovering. There was no product quality complaint involved. The patient''s intussusception was considered to be life threatening and an other important medical event. Additional information has been requested. 05/29/2007 MR received for 2 night ER admit for c/o abdominal pain, vomiting and bloody diarrhea. Hx of diarrhea x 5 days prior to emesis and bloody diarrhea. PE: Irritable infant in moderate distress. Abdomen distended, tender to palpation. Unable to reduce with BE so pt. had surgical reduction of ileocolic intussusception and appendectomy. Final DX: Intussusception.


VAERS ID: 278155 (history)  
Form: Version 1.0  
Age: 0.6  
Gender: Male  
Location: Tennessee  
Vaccinated:2006-12-13
Onset:2007-04-15
   Days after vaccination:123
Submitted: 2007-05-03
   Days after onset:18
Entered: 2007-05-08
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR 42174RA / 2 LA / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1034F / 3 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Abdominal X-ray, Abdominal pain upper, Barium enema, Blood chloride, Blood creatinine, Blood glucose, Blood potassium, Blood urea, C-reactive protein increased, Carbon dioxide normal, Diarrhoea, Ileus paralytic, Intussusception, Laboratory test, Liver function test, Platelet count, Pyrexia, Screaming, Vomiting, White blood cell count
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: none
Preexisting Conditions: none. PMH: none. NKDA.
Allergies:
Diagnostic Lab Data: WBC - 11.45, Hem - 11.5, HCT:34.2, and Platelets 431, CRP - 1.0, NA - 138, K+ - 4.4, chloride - 99, CO2 - 18, Glucose - 91, Bun - 10, creatinine - 04, LFTs - normal ABD. Films, KUB, Barium Enema. Labs and Diagnostics: Abdominal X-rays x 3-normal. Barium enema which showed a filling defect at hepatic flexure c/w intussusception.
CDC Split Type:

Write-up: 4/16/07 acute vomiting, stomach pains - screaming seen in ER and fever and Diarrhea ? Paralytic Ileus GI consult - Bilious Emesis and concern for intussusception and flims/KUB normal s/p enema with good results. 07/02/2007 MR received for hospital stay 4/19-21/2007. Infant developed intermittant, severe abdominal pain (evidenced by back arching and screaming) and emesis 5 days prior to admission. Seen in ER x 2 for above and progression to bilious vomiting and acting "lifeless". 2nd ER visit with DX of constipation and enema given with improvement initially. Symptoms reoccured and child was admitted. Barium enema succesfully reduced intussusception. Feeding, stooling, and voiding well post procedure. DX: c/w Intussusception.


VAERS ID: 278302 (history)  
Form: Version 1.0  
Age: 0.6  
Gender: Male  
Location: Texas  
Vaccinated:2007-03-24
Onset:2007-04-30
   Days after vaccination:37
Submitted: 2007-05-10
   Days after onset:10
Entered: 2007-05-12
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C249U0A / 2 - / -
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0240 / 2 - / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH 808672E / 2 - / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1109F / 3 - / -

Administered by: Private       Purchased by: Other
Symptoms: Intussusception
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: PMH: otitis media 8 days prior to admit
Allergies:
Diagnostic Lab Data: None LABS: initial Na 130, K 3.8, Cl 98, CO2 22. Guaiac + stools. KUB & air contrast enema revealed +IS which was successfully reduced by air contrast enema. Stool & urine c/s were neg.
CDC Split Type:

Write-up: Intussusception 37 days later (reduced successfully). 5/11/07 Received vax records from reporter which indicate RO received on 3/24/07 was 3rd dose & lot number correct as reported. 5/29/07 Received hospital medical records which reveal patient experienced vomiting, decreased oral intake, abdominal pain & intermittent lethargy. Admitted 4/30-5/3/07. Tx w/IVF for dehydration. Surg consult done. Observed s/p reduction & progressed well. FINAL DX: vomiting, resolved; Intussusception s/p reduction w/air contrast enema.


VAERS ID: 278389 (history)  
Form: Version 1.0  
Age: 0.4  
Gender: Female  
Location: Arkansas  
Vaccinated:2007-04-13
Onset:2007-05-01
   Days after vaccination:18
Submitted: 2007-05-11
   Days after onset:10
Entered: 2007-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2553AA / 2 LL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 1014F / 2 RL / IM
IPV: POLIO VIRUS, INACT. (POLIOVAX) / SANOFI PASTEUR Z0306-2 / 2 LL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH BO8691 / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1365F / 2 MO / PO

Administered by: Private       Purchased by: Unknown
Symptoms: Intussusception, Surgery
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: LABS: abdominal x-ray revealed SBO. Contrast study revealed mid transverse IS which reduced s/p several attempts.
CDC Split Type:

Write-up: Two weeks after receiving Rotateq - 05/03/07 dx with intussusception - requiring surgical intervention. 5/22/07 Received vax records & operative note from PCP which reveals patient experienced intussusception which was initially reduced by contrast. However, symptoms persisted & contrast study was repeated which revealed recurence of IS right at ileocecal valve & patient taken to OR. Findings at surgery were ileoileal IS successfully reduced w/o difficulty, Peyer patch & incidental appendectomy was done. Vax record corrects lot numbers, VAERS database updated. 7/17/07 Received hospital medical records which reveal patient experienced vomiting, bloody stool, lethargy, dehydration & decreased appetite. FINAL DX: Intussusception.


VAERS ID: 278583 (history)  
Form: Version 1.0  
Age: 0.83  
Gender: Male  
Location: Colorado  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-05-07
Entered: 2007-05-15
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B079BA / 3 - / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF011AA / 3 - / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08670E / 3 - / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1082F / 3 MO / PO

Administered by: Private       Purchased by: Other
Symptoms: Barium double contrast, Dehydration, Intussusception, Vomiting
SMQs:, Acute pancreatitis (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Air enema diagnosed and reduced obstruction records received 6/20/07-air enema reduction
CDC Split Type:

Write-up: Vomiting, dehydration, had intussusception reduced with air enema. 06/20/07-records received for DOS 4/28-4/29/07-Impression:Ileocolic Intussusception status post air enema reduction. Complaint of vomiting for 7 hours and has vomited 4 times day of admission. No diarrhea. No abdominal pain. Returned to ER with 2 days of vomiting and decreased PO intake. Sleepy, decreased response level.


VAERS ID: 278694 (history)  
Form: Version 1.0  
Age: 0.4  
Gender: Female  
Location: Michigan  
Vaccinated:2007-03-22
Onset:2007-05-06
   Days after vaccination:45
Submitted: 2007-05-08
   Days after onset:2
Entered: 2007-05-16
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B084CA / 2 RL / -
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0062U / 2 LL / -
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08646C / 2 LL / -
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1235F / 3 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Barium enema, Haematochezia, Intussusception, Pain
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Ischaemic colitis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Tobrex eye drops 11/15
Current Illness: Only dacryostenosis
Preexisting Conditions: Neonatal jaundice, dacryostenosis, cystitis, umbilical hernia
Allergies:
Diagnostic Lab Data: Barium enema
CDC Split Type:

Write-up: Patient was hospitalized for two days for bowel intussusception and pain (proven by barium enema). Patient had bloody bowel movement and pain. 06/12/07-DC Summary received for DOS 5/6-5/7/07-DC DX:Ileocolic Intussusception. S/P Barium Enema Reduction. Two day history vomiting and subsequent bloody stools


VAERS ID: 278716 (history)  
Form: Version 1.0  
Age: 0.6  
Gender: Male  
Location: Oklahoma  
Vaccinated:2007-05-14
Onset:2007-05-15
   Days after vaccination:1
Submitted: 2007-05-16
   Days after onset:1
Entered: 2007-05-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B090BA / 4 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08690B / 4 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1232F / 4 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal X-ray, Diarrhoea, Enema administration, Intussusception, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Abdominal X-ray, air insufflation enema. LABS: Blood c/s neg. Renal US was WNL. WBC WNL, segs elevated at 43, bands elevated at 27 & lymphs low at 24. CO2 low at 17 on admit
CDC Split Type:

Write-up: Fever, diarrhea, diagnosis of intussusception. 6/1/07 Received vax record from CDC. VAERS database updated. 8/7/07 Received hospital medical records which reveal patient experienced fever, vomiting & bloody stools. Abdominal x-ray in ER revealed IS. Admitted 5/15-5/18/07 & IS reduced by gastrograffin enema. Also diagnosed w/UTI. Progressed well & d/c to home on oral antibiotics for UTI. FINAL DX: Intussusception, s/p reduction by enema; fever; & UTI.


VAERS ID: 278725 (history)  
Form: Version 1.0  
Age: 0.5  
Gender: Male  
Location: California  
Vaccinated:2007-03-15
Onset:2007-04-11
   Days after vaccination:27
Submitted: 2007-05-16
   Days after onset:35
Entered: 2007-05-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B092AA / 4 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B08657B / 4 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1238F / 4 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Intussusception, Medication error, Wrong drug administered
SMQs:, Gastrointestinal obstruction (narrow), Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: See the vaccine history attached. 8 month old baby diagnosed with intussuscetion on April 11, 2007 had third rotavirus vax on March 15. DTaP-HBV-POL (Diphtheria, Tetanus, acellular Pertussis, Hepatitis B, Polio) 3/15/2007, 1/2/2007, 10/31/2006 HBV adult (Hepatitis B) 9/1/2006 HIB PRP-OMP (Haemophilus influenzae b) 1/2/2007, 10/31/2006 PNUcn (Pneumococcal conjugate, pneumonia) 3/15/2007, 1/2/2007, 10/31/2006 ROT5 (Rotavirus live, pentavalent) 3/15/2007, 1/2/2007, 10/31/2006 6/26/07 Received hosp med recs which reveal on 4/10/07 pt experienced abdominal pain & wretching & seen in peds clinic. Referred to ER for w/u. Surg consult done. Pt d/c to home to be eval by PCP next day. FINAL DX: None provided, surgeon did not feel probable IS. 6/29/07 Received additional hospital medical records which reveal patient admitted 4/11-4/12/07 for continued fever, vomiting, irritability & abdominal pain. Found to have heme (+) stool in ER. Per MD notes, IS was reduced by barium enema but no radiology report included. FINAL DX: Intussusception, reduced by barium enema. 7/31/07 Received vax record from reporter. VAERS database updated w/same.


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