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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 293334 |
VAERS Form: | |
Age: | 0.5 |
Sex: | Female |
Location: | Alabama |
Vaccinated: | 2007-09-19 |
Onset: | 2007-09-28 |
Submitted: | 2007-10-09 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B097AB / 1 | LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF117AA / 2 | RL / IM |
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC | B08690K / 2 | RL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 1032F / 2 | - / PO |
Administered by: Public Purchased by: Unknown
Symptoms: Abdominal pain, Constipation, Clostridium difficile toxin test, Abdominal hernia, Abdominal X-ray
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omnicef
Current Illness: Ear infection
Preexisting Conditions: Ventral hernia
Allergies:
Diagnostic Lab Data: Abd sonar
CDC 'Split Type':
Write-up: Severe intestinal irritability with U/S documented small bowel intussusception.
Vaccinated: | 2007-09-19 |
Onset: | 2007-09-28 |
Submitted: | 2007-10-09 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B097AB / 1 | LL / IM |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B097AB / 1 | LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF117AA / 2 | RL / IM |
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC | B08690K / 2 | RL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 1032F / 2 | - / PO |
Administered by: Public Purchased by: Unknown Public
Symptoms: Abdominal pain, Constipation, Diarrhoea, Haematochezia, Intussusception, Irritability, Irritable bowel syndrome, Milk allergy, Clostridium difficile toxin test, Ultrasound abdomen, Ultrasound abdomen abnormal, Abdominal hernia, Intestinal functional disorder, Abdominal X-ray, Disbacteriosis
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omnicef
Current Illness: Ear infection
Preexisting Conditions: Ventral hernia hernia. PMH: multiple ear infections.
Allergies:
Diagnostic Lab Data: Abd sonar sonar. Labs and diagnostics: US abd (10/3/07) shows a transient small bowel intussusception which resolved during the course of the study. US abd (10/5/07) again showed a transient small bowel intussusception in the RUQ. Abd X-ray 10
CDC 'Split Type':
Write-up: Severe intestinal irritability with U/S documented small bowel intussusception. 11/26/2007 MR received for several OV with ped surgeon and ped gastroenterology beginning 10/03/2007 to 11/08/07 operative report for ventral hernia repair. Child presented to ped surgeon on 10/03/2007 with c/o significant diarrhea as well as blood in stool. Seen again 10/5/07 for irritability and abdominal pain. DX: irritable bowel 2'' disrupted bowel flora. GI visit 10/18/07 with assessment: Constipation. Milk Allergy. Diarrhea. Abdominal pain. Ventral hernia. Ventral hernia repair on 11/08/07. 12/10/2007 Vaqx record received from PCP. Corresponds with VAERS report.
Vaccinated: | 2007-09-19 |
Onset: | 2007-09-28 |
Submitted: | 2007-10-09 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B097AB / 1 | LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF117AA / 2 | RL / IM |
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC | B08690K / 2 | RL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 1032F / 2 | - / PO |
Administered by: Public Purchased by: Public
Symptoms: Abdominal pain, Constipation, Diarrhoea, Haematochezia, Intussusception, Irritability, Irritable bowel syndrome, Milk allergy, Clostridium difficile toxin test, Ultrasound abdomen, Ultrasound abdomen abnormal, Abdominal hernia, Intestinal functional disorder, Abdominal X-ray, Disbacteriosis
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omnicef
Current Illness: Ear infection
Preexisting Conditions: Ventral hernia. PMH: multiple ear infections.
Allergies:
Diagnostic Lab Data: Abd sonar. Labs and diagnostics: US abd (10/3/07) shows a transient small bowel intussusception which resolved during the course of the study. US abd (10/5/07) again showed a transient small bowel intussusception in the RUQ. Abd X-ray 10
CDC 'Split Type':
Write-up: Severe intestinal irritability with U/S documented small bowel intussusception. 11/26/2007 MR received for several OV with ped surgeon and ped gastroenterology beginning 10/03/2007 to 11/08/07 operative report for ventral hernia repair. Child presented to ped surgeon on 10/03/2007 with c/o significant diarrhea as well as blood in stool. Seen again 10/5/07 for irritability and abdominal pain. DX: irritable bowel 2'' disrupted bowel flora. GI visit 10/18/07 with assessment: Constipation. Milk Allergy. Diarrhea. Abdominal pain. Ventral hernia. Ventral hernia repair on 11/08/07. 12/10/2007 Vaqx record received from PCP. Corresponds with VAERS report.
Vaccinated: | 2007-09-19 |
Onset: | 2007-09-28 |
Submitted: | 2007-10-09 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B097AB / 1 | LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF117AA / 2 | RL / IM |
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC | B08690K / 2 | RL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 1032F / 2 | - / PO |
Administered by: Public Purchased by: Public
Symptoms: Abdominal pain, Constipation, Diarrhoea, Haematochezia, Intussusception, Irritability, Irritable bowel syndrome, Milk allergy, Clostridium difficile toxin test, Ultrasound abdomen, Ultrasound abdomen abnormal, Abdominal hernia, Intestinal functional disorder, Abdominal X-ray, Disbacteriosis
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omnicef
Current Illness: Ear infection
Preexisting Conditions: Ventral hernia. PMH: multiple ear infections.
Allergies:
Diagnostic Lab Data: Abd sonar. Labs and diagnostics: US abd (10/3/07) shows a transient small bowel intussusception which resolved during the course of the study. US abd (10/5/07) again showed a transient small bowel intussusception in the RUQ. Abd X-ray 10
CDC 'Split Type':
Write-up: Severe intestinal irritability with U/S documented small bowel intussusception. 11/26/2007 MR received for several OV with ped surgeon and ped gastroenterology beginning 10/03/2007 to 11/08/07 operative report for ventral hernia repair. Child presented to ped surgeon on 10/03/2007 with c/o significant diarrhea as well as blood in stool. Seen again 10/5/07 for irritability and abdominal pain. DX: irritable bowel 2'' disrupted bowel flora. GI visit 10/18/07 with assessment: Constipation. Milk Allergy. Diarrhea. Abdominal pain. Ventral hernia. Ventral hernia repair on 11/08/07. 12/10/2007 Vaqx record received from PCP. Corresponds with VAERS report.
Vaccinated: | 2007-09-19 |
Onset: | 2007-09-28 |
Submitted: | 2007-10-09 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B097AB / 1 | LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF117AA / 2 | RL / IM |
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH | B08690K / 2 | RL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 1032F / 2 | - / PO |
Administered by: Public Purchased by: Public
Symptoms: Abdominal pain, Constipation, Diarrhoea, Haematochezia, Intussusception, Irritability, Irritable bowel syndrome, Milk allergy, Clostridium difficile toxin test, Ultrasound abdomen, Ultrasound abdomen abnormal, Abdominal hernia, Intestinal functional disorder, Abdominal X-ray, Disbacteriosis
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omnicef
Current Illness: Ear infection
Preexisting Conditions: Ventral hernia. PMH: multiple ear infections.
Allergies:
Diagnostic Lab Data: Abd sonar. Labs and diagnostics: US abd (10/3/07) shows a transient small bowel intussusception which resolved during the course of the study. US abd (10/5/07) again showed a transient small bowel intussusception in the RUQ. Abd X-ray 10
CDC 'Split Type':
Write-up: Severe intestinal irritability with U/S documented small bowel intussusception. 11/26/2007 MR received for several OV with ped surgeon and ped gastroenterology beginning 10/03/2007 to 11/08/07 operative report for ventral hernia repair. Child presented to ped surgeon on 10/03/2007 with c/o significant diarrhea as well as blood in stool. Seen again 10/5/07 for irritability and abdominal pain. DX: irritable bowel 2'' disrupted bowel flora. GI visit 10/18/07 with assessment: Constipation. Milk Allergy. Diarrhea. Abdominal pain. Ventral hernia. Ventral hernia repair on 11/08/07. 12/10/2007 Vaqx record received from PCP. Corresponds with VAERS report.
Vaccinated: | 2007-09-19 |
Onset: | 2007-09-28 |
Submitted: | 2007-10-09 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B097AB / 1 | LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF117AA / 2 | RL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B08690K / 2 | RL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 1032F / 2 | - / PO |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 1032F / 2 | - / PO |
Administered by: Public Purchased by: Public
Symptoms: Abdominal pain, Constipation, Diarrhoea, Haematochezia, Intussusception, Irritability, Irritable bowel syndrome, Milk allergy, Clostridium difficile toxin test, Ultrasound abdomen, Ultrasound abdomen abnormal, Abdominal hernia, Intestinal functional disorder, Abdominal X-ray, Disbacteriosis
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omnicef
Current Illness: Ear infection
Preexisting Conditions: Ventral hernia. PMH: multiple ear infections.
Allergies:
Diagnostic Lab Data: Abd sonar. Labs and diagnostics: US abd (10/3/07) shows a transient small bowel intussusception which resolved during the course of the study. US abd (10/5/07) again showed a transient small bowel intussusception in the RUQ. Abd X-ray 10
CDC 'Split Type':
Write-up: Severe intestinal irritability with U/S documented small bowel intussusception. 11/26/2007 MR received for several OV with ped surgeon and ped gastroenterology beginning 10/03/2007 to 11/08/07 operative report for ventral hernia repair. Child presented to ped surgeon on 10/03/2007 with c/o significant diarrhea as well as blood in stool. Seen again 10/5/07 for irritability and abdominal pain. DX: irritable bowel 2'' disrupted bowel flora. GI visit 10/18/07 with assessment: Constipation. Milk Allergy. Diarrhea. Abdominal pain. Ventral hernia. Ventral hernia repair on 11/08/07. 12/10/2007 Vaqx record received from PCP. Corresponds with VAERS report.
Vaccinated: | 2007-09-19 |
Onset: | 2007-09-28 |
Submitted: | 2007-10-09 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B097AB / 1 | LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF117AA / 2 | RL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B08690K / 2 | RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 1032F / 2 | - / PO |
Administered by: Public Purchased by: Public
Symptoms: Abdominal pain, Constipation, Diarrhoea, Haematochezia, Intussusception, Irritability, Irritable bowel syndrome, Milk allergy, Clostridium difficile toxin test, Ultrasound abdomen, Ultrasound abdomen abnormal, Abdominal hernia, Intestinal functional disorder, Abdominal X-ray, Disbacteriosis
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omnicef
Current Illness: Ear infection
Preexisting Conditions: Ventral hernia. PMH: multiple ear infections.
Allergies:
Diagnostic Lab Data: Abd sonar. Labs and diagnostics: US abd (10/3/07) shows a transient small bowel intussusception which resolved during the course of the study. US abd (10/5/07) again showed a transient small bowel intussusception in the RUQ. Abd X-ray 10 10/11/07 with a non-obstructive gas pattern. US abd (10/11/07) no IS. C-diff toxin (-).
CDC 'Split Type':
Write-up: Severe intestinal irritability with U/S documented small bowel intussusception. 11/26/2007 MR received for several OV with ped surgeon and ped gastroenterology beginning 10/03/2007 to 11/08/07 operative report for ventral hernia repair. Child presented to ped surgeon on 10/03/2007 with c/o significant diarrhea as well as blood in stool. Seen again 10/5/07 for irritability and abdominal pain. DX: irritable bowel 2'' disrupted bowel flora. GI visit 10/18/07 with assessment: Constipation. Milk Allergy. Diarrhea. Abdominal pain. Ventral hernia. Ventral hernia repair on 11/08/07. 12/10/2007 Vaqx record received from PCP. Corresponds with VAERS report.
Vaccinated: | 2007-09-19 |
Onset: | 2007-09-28 |
Submitted: | 2007-10-09 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B097AB / 1 2 | LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF117AA / 2 3 | RL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B08690K / 2 3 | RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 1032F / 2 3 | - MO / PO |
Administered by: Public Purchased by: Public
Symptoms: Intussusception, Ultrasound abdomen, Intestinal functional disorder
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omnicef
Current Illness: Ear infection
Preexisting Conditions: Ventral hernia. PMH: multiple ear infections.
Allergies:
Diagnostic Lab Data: Abd sonar. Labs and diagnostics: US abd (10/3/07) shows a transient small bowel intussusception which resolved during the course of the study. US abd (10/5/07) again showed a transient small bowel intussusception in the RUQ. Abd X-ray 10/11/07 with a non-obstructive gas pattern. US abd (10/11/07) no IS. C-diff toxin (-).
CDC 'Split Type':
Write-up: Severe intestinal irritability with U/S documented small bowel intussusception. 11/26/2007 MR received for several OV with ped surgeon and ped gastroenterology beginning 10/03/2007 to 11/08/07 operative report for ventral hernia repair. Child presented to ped surgeon on 10/03/2007 with c/o significant diarrhea as well as blood in stool. Seen again 10/5/07 for irritability and abdominal pain. DX: irritable bowel 2'' disrupted bowel flora. GI visit 10/18/07 with assessment: Constipation. Milk Allergy. Diarrhea. Abdominal pain. Ventral hernia. Ventral hernia repair on 11/08/07. 12/10/2007 Vaqx record received from PCP. Corresponds with VAERS report.
Vaccinated: | 2007-09-19 |
Onset: | 2007-09-28 |
Submitted: | 2007-10-09 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B097AB / 2 | LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF117AA / 3 | RL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B08690K / 3 | RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 1032F / 3 | MO / PO |
Administered by: Public Purchased by: Public
Symptoms: Intussusception, Ultrasound abdomen, Intestinal functional disorder
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omnicef
Current Illness: Ear infection
Preexisting Conditions: Ventral hernia. PMH: multiple ear infections.
Allergies:
Diagnostic Lab Data: Abd sonar. Labs and diagnostics: US abd (10/3/07) shows a transient small bowel intussusception which resolved during the course of the study. US abd (10/5/07) again showed a transient small bowel intussusception in the RUQ. Abd X-ray 10/11/07 with a non-obstructive gas pattern. US abd (10/11/07) no IS. C-diff toxin (-).
CDC 'Split Type':
Write-up: Severe intestinal irritability with U/S documented small bowel intussusception. 11/26/2007 MR received for several OV with ped surgeon and ped gastroenterology beginning 10/03/2007 to 11/08/07 operative report for ventral hernia repair. Child presented to ped surgeon on 10/03/2007 with c/o significant diarrhea as well as blood in stool. Seen again 10/5/07 for irritability and abdominal pain. DX: irritable bowel 2'' disrupted bowel flora. GI visit 10/18/07 with assessment: Constipation. Milk Allergy. Diarrhea. Abdominal pain. Ventral hernia. Ventral hernia repair on 11/08/07. 12/10/2007 Vaqx record received from PCP. Corresponds with VAERS report.
Vaccinated: | 2007-09-19 |
Onset: | 2007-09-28 |
Submitted: | 2007-10-09 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B097AB / 2 | LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF117AA / 3 | RL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B08690K / 3 | RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 1032F / 3 | MO / PO |
Administered by: Public Purchased by: Public
Symptoms: Intussusception, Ultrasound abdomen, Intestinal functional disorder
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omnicef
Current Illness: Ear infection
Preexisting Conditions: Ventral hernia. PMH: multiple ear infections.
Allergies:
Diagnostic Lab Data: Abd sonar. Labs and diagnostics: US abd (10/3/07) shows a transient small bowel intussusception which resolved during the course of the study. US abd (10/5/07) again showed a transient small bowel intussusception in the RUQ. Abd X-ray 10/11/07 with a non-obstructive gas pattern. US abd (10/11/07) no IS. C-diff toxin (-).
CDC 'Split Type':
Write-up: Severe intestinal irritability with U/S documented small bowel intussusception. 11/26/2007 MR received for several OV with ped surgeon and ped gastroenterology beginning 10/03/2007 to 11/08/07 operative report for ventral hernia repair. Child presented to ped surgeon on 10/03/2007 with c/o significant diarrhea as well as blood in stool. Seen again 10/5/07 for irritability and abdominal pain. DX: irritable bowel 2'' disrupted bowel flora. GI visit 10/18/07 with assessment: Constipation. Milk Allergy. Diarrhea. Abdominal pain. Ventral hernia. Ventral hernia repair on 11/08/07. 12/10/2007 Vaqx record received from PCP. Corresponds with VAERS report.
Vaccinated: | 2007-09-19 |
Onset: | 2007-09-28 |
Submitted: | 2007-10-09 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B097AB / 2 | LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF117AA / 3 | RL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B08690K / 3 | RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 1032F / 3 | MO / PO |
Administered by: Public Purchased by: Public
Symptoms: Intussusception, Ultrasound abdomen, Intestinal functional disorder
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omnicef
Current Illness: Ear infection
Preexisting Conditions: Ventral hernia. PMH: multiple ear infections.
Allergies:
Diagnostic Lab Data: Abd sonar. Labs and diagnostics: US abd (10/3/07) shows a transient small bowel intussusception which resolved during the course of the study. US abd (10/5/07) again showed a transient small bowel intussusception in the RUQ. Abd X-ray 10/11/07 with a non-obstructive gas pattern. US abd (10/11/07) no IS. C-diff toxin (-).
CDC 'Split Type':
Write-up: Severe intestinal irritability with U/S documented small bowel intussusception. 11/26/2007 MR received for several OV with ped surgeon and ped gastroenterology beginning 10/03/2007 to 11/08/07 operative report for ventral hernia repair. Child presented to ped surgeon on 10/03/2007 with c/o significant diarrhea as well as blood in stool. Seen again 10/5/07 for irritability and abdominal pain. DX: irritable bowel 2'' disrupted bowel flora. GI visit 10/18/07 with assessment: Constipation. Milk Allergy. Diarrhea. Abdominal pain. Ventral hernia. Ventral hernia repair on 11/08/07. 12/10/2007 Vaqx record received from PCP. Corresponds with VAERS report.
Vaccinated: | 2007-09-19 |
Onset: | 2007-09-28 |
Submitted: | 2007-10-09 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B097AB / 2 | LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF117AA / 3 | RL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B08690K / 3 | RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 1032F / 3 | MO / PO |
Administered by: Public Purchased by: Public
Symptoms: Intussusception, Ultrasound abdomen, Intestinal functional disorder
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omnicef
Current Illness: Ear infection
Preexisting Conditions: Ventral hernia. PMH: multiple ear infections.
Allergies:
Diagnostic Lab Data: Abd sonar. Labs and diagnostics: US abd (10/3/07) shows a transient small bowel intussusception which resolved during the course of the study. US abd (10/5/07) again showed a transient small bowel intussusception in the RUQ. Abd X-ray 10/11/07 with a non-obstructive gas pattern. US abd (10/11/07) no IS. C-diff toxin (-).
CDC 'Split Type':
Write-up: Severe intestinal irritability with U/S documented small bowel intussusception. 11/26/2007 MR received for several OV with ped surgeon and ped gastroenterology beginning 10/03/2007 to 11/08/07 operative report for ventral hernia repair. Child presented to ped surgeon on 10/03/2007 with c/o significant diarrhea as well as blood in stool. Seen again 10/5/07 for irritability and abdominal pain. DX: irritable bowel 2'' disrupted bowel flora. GI visit 10/18/07 with assessment: Constipation. Milk Allergy. Diarrhea. Abdominal pain. Ventral hernia. Ventral hernia repair on 11/08/07. 12/10/2007 Vaqx record received from PCP. Corresponds with VAERS report.
Vaccinated: | 2007-09-19 |
Onset: | 2007-09-28 |
Submitted: | 2007-10-09 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B097AB / 2 | LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF117AA / 3 | RL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B08690K / 3 | RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 1032F / 3 | MO / PO |
Administered by: Public Purchased by: Public
Symptoms: Intussusception, Ultrasound abdomen, Intestinal functional disorder
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omnicef
Current Illness: Ear infection
Preexisting Conditions: Ventral hernia. PMH: multiple ear infections.
Allergies:
Diagnostic Lab Data: Abd sonar. Labs and diagnostics: US abd (10/3/07) shows a transient small bowel intussusception which resolved during the course of the study. US abd (10/5/07) again showed a transient small bowel intussusception in the RUQ. Abd X-ray 10/11/07 with a non-obstructive gas pattern. US abd (10/11/07) no IS. C-diff toxin (-).
CDC 'Split Type':
Write-up: Severe intestinal irritability with U/S documented small bowel intussusception. 11/26/2007 MR received for several OV with ped surgeon and ped gastroenterology beginning 10/03/2007 to 11/08/07 operative report for ventral hernia repair. Child presented to ped surgeon on 10/03/2007 with c/o significant diarrhea as well as blood in stool. Seen again 10/5/07 for irritability and abdominal pain. DX: irritable bowel 2'' disrupted bowel flora. GI visit 10/18/07 with assessment: Constipation. Milk Allergy. Diarrhea. Abdominal pain. Ventral hernia. Ventral hernia repair on 11/08/07. 12/10/2007 Vaqx record received from PCP. Corresponds with VAERS report.
Vaccinated: | 2007-09-19 |
Onset: | 2007-09-28 |
Submitted: | 2007-10-09 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B097AB / 2 | LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF117AA / 3 | RL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B08690K / 3 | RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 1032F / 3 | MO / PO |
Administered by: Public Purchased by: Public
Symptoms: Intussusception, Ultrasound abdomen, Intestinal functional disorder
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omnicef
Current Illness: Ear infection
Preexisting Conditions: Ventral hernia. PMH: multiple ear infections.
Allergies:
Diagnostic Lab Data: Abd sonar. Labs and diagnostics: US abd (10/3/07) shows a transient small bowel intussusception which resolved during the course of the study. US abd (10/5/07) again showed a transient small bowel intussusception in the RUQ. Abd X-ray 10/11/07 with a non-obstructive gas pattern. US abd (10/11/07) no IS. C-diff toxin (-).
CDC 'Split Type':
Write-up: Severe intestinal irritability with U/S documented small bowel intussusception. 11/26/2007 MR received for several OV with ped surgeon and ped gastroenterology beginning 10/03/2007 to 11/08/07 operative report for ventral hernia repair. Child presented to ped surgeon on 10/03/2007 with c/o significant diarrhea as well as blood in stool. Seen again 10/5/07 for irritability and abdominal pain. DX: irritable bowel 2'' disrupted bowel flora. GI visit 10/18/07 with assessment: Constipation. Milk Allergy. Diarrhea. Abdominal pain. Ventral hernia. Ventral hernia repair on 11/08/07. 12/10/2007 Vaqx record received from PCP. Corresponds with VAERS report.
Vaccinated: | 2007-09-19 |
Onset: | 2007-09-28 |
Submitted: | 2007-10-09 |
Entered: | 2007-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B097AB / 2 | LL / IM |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF117AA / 3 | RL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B08690K / 3 | RL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 1032F / 3 | MO / PO |
Administered by: Public Purchased by: Public
Symptoms: Intussusception, Ultrasound abdomen, Intestinal functional disorder
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Omnicef
Current Illness: Ear infection
Preexisting Conditions: Ventral hernia. PMH: multiple ear infections.
Allergies:
Diagnostic Lab Data: Abd sonar. Labs and diagnostics: US abd (10/3/07) shows a transient small bowel intussusception which resolved during the course of the study. US abd (10/5/07) again showed a transient small bowel intussusception in the RUQ. Abd X-ray 10/11/07 with a non-obstructive gas pattern. US abd (10/11/07) no IS. C-diff toxin (-).
CDC 'Split Type':
Write-up: Severe intestinal irritability with U/S documented small bowel intussusception. 11/26/2007 MR received for several OV with ped surgeon and ped gastroenterology beginning 10/03/2007 to 11/08/07 operative report for ventral hernia repair. Child presented to ped surgeon on 10/03/2007 with c/o significant diarrhea as well as blood in stool. Seen again 10/5/07 for irritability and abdominal pain. DX: irritable bowel 2'' disrupted bowel flora. GI visit 10/18/07 with assessment: Constipation. Milk Allergy. Diarrhea. Abdominal pain. Ventral hernia. Ventral hernia repair on 11/08/07. 12/10/2007 Vaqx record received from PCP. Corresponds with VAERS report.
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