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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 294236 |
VAERS Form: | |
Age: | 0.5 |
Sex: | Male |
Location: | Massachusetts |
Vaccinated: | 2007-10-17 |
Onset: | 2007-10-17 |
Submitted: | 2007-10-22 |
Entered: | 2007-10-24 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B127AA / 2 | RL / UN |
FLU: INFLUENZA (FLUZONE) / SANOFI PASTEUR | U245BA / 0 | RL / UN |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF192AA / 2 | LL / UN |
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC | B47300F / 2 | RL / UN |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0408U / 2 | - / PO |
Administered by: Private Purchased by: Unknown
Symptoms: Abdominal pain, Barium enema, Dehydration, Blood alkaline phosphatase increased, Abdominal X-ray
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Intussusception
Vaccinated: | 2007-10-17 |
Onset: | 2007-10-17 |
Submitted: | 2007-10-22 |
Entered: | 2007-10-24 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B127AA / 2 | RL / UN |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B127AA / 2 | RL / UN |
FLU: INFLUENZA (FLUZONE) INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U245BA / 0 | RL / UN |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF192AA / 2 | LL / UN |
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC | B47300F / 2 | RL / UN |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0408U / 2 | - / PO |
Administered by: Private Purchased by: Unknown Public
Symptoms: Abdominal pain, Barium enema, Dehydration, Diarrhoea, Intussusception, Irritability, Lymphocyte count decreased, Protein total normal, Pyrexia, Retching, Sleep disorder, Urinary system X-ray, Vomiting, Platelet count increased, Neutrophil percentage increased, Monocyte percentage increased, Blood alkaline phosphatase increased, Urine analysis normal, Abdominal X-ray, Oral intake reduced
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Intussusception Intussusception. 11/02/07 Reviewed medical records from 2nd ER of 10/19/07 which reveal patient experienced pulling up of legs, vomiting & apparent abdominal pain. Seen in outlying ER & admitted overnight. Tx w/IVF & serial abdominal exams. D/c to home & had continued gagging, reduced oral intake, irritability, decreased sleep & uncomfortable abdomen. BE reduced IS & admitted overnight for observation s/p reduction. FINAL DX: Intussusception, enema reduced. Records faxed to CDC. 11/13/07 Reviewed hospital medical records which reveal patient experienced vomiting, fever & abdominal pain. Admitted 10/18-10/19/2007. Abdomen was diffusely tender. Tx w/IVF, antipyretic & antinausea meds. Improved & d/c to home. ER Diagnosis: dehydration, vomiting & abdominal pain. Seen at outlying hospital for persistent vomiting where IS was dx & reduced by BE. Admitted overnight for observation & d/c to home. Continued to run fever & had diarrhea & returned to ER. Temp 103 in ER. Tx w/antipyretic & d/c to home. Final ER dx: fever secondary to vaccines. Records faxed to CDC. 11/16/07 Received vax record from pcp which confirms RO dose & lot as reported. Record faxed to CDC.
Vaccinated: | 2007-10-17 |
Onset: | 2007-10-17 |
Submitted: | 2007-10-22 |
Entered: | 2007-10-24 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B127AA / 2 | RL / UN |
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U245BA / 0 | RL / UN |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF192AA / 2 | LL / UN |
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC | B47300F / 2 | RL / UN |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0408U / 2 | - / PO |
Administered by: Private Purchased by: Public
Symptoms: Abdominal pain, Barium enema, Dehydration, Diarrhoea, Intussusception, Irritability, Lymphocyte count decreased, Protein total normal, Pyrexia, Retching, Sleep disorder, Urinary system X-ray, Vomiting, Platelet count increased, Neutrophil percentage increased, Monocyte percentage increased, Blood alkaline phosphatase increased, Urine analysis normal, Abdominal X-ray, Oral intake reduced
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Intussusception. 11/02/07 Reviewed medical records from 2nd ER of 10/19/07 which reveal patient experienced pulling up of legs, vomiting & apparent abdominal pain. Seen in outlying ER & admitted overnight. Tx w/IVF & serial abdominal exams. D/c to home & had continued gagging, reduced oral intake, irritability, decreased sleep & uncomfortable abdomen. BE reduced IS & admitted overnight for observation s/p reduction. FINAL DX: Intussusception, enema reduced. Records faxed to CDC. 11/13/07 Reviewed hospital medical records which reveal patient experienced vomiting, fever & abdominal pain. Admitted 10/18-10/19/2007. Abdomen was diffusely tender. Tx w/IVF, antipyretic & antinausea meds. Improved & d/c to home. ER Diagnosis: dehydration, vomiting & abdominal pain. Seen at outlying hospital for persistent vomiting where IS was dx & reduced by BE. Admitted overnight for observation & d/c to home. Continued to run fever & had diarrhea & returned to ER. Temp 103 in ER. Tx w/antipyretic & d/c to home. Final ER dx: fever secondary to vaccines. Records faxed to CDC. 11/16/07 Received vax record from pcp which confirms RO dose & lot as reported. Record faxed to CDC.
Vaccinated: | 2007-10-17 |
Onset: | 2007-10-17 |
Submitted: | 2007-10-22 |
Entered: | 2007-10-24 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B127AA / 2 | RL / UN |
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U245BA / 0 | RL / UN |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF192AA / 2 | LL / UN |
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC | B47300F / 2 | RL / UN |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0408U / 2 | - / PO |
Administered by: Private Purchased by: Public
Symptoms: Abdominal pain, Barium enema, Dehydration, Diarrhoea, Intussusception, Irritability, Lymphocyte count decreased, Protein total normal, Pyrexia, Retching, Sleep disorder, Urinary system X-ray, Vomiting, Platelet count increased, Neutrophil percentage increased, Monocyte percentage increased, Blood alkaline phosphatase increased, Urine analysis normal, Abdominal X-ray, Oral intake reduced
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Intussusception. 11/02/07 Reviewed medical records from 2nd ER of 10/19/07 which reveal patient experienced pulling up of legs, vomiting & apparent abdominal pain. Seen in outlying ER & admitted overnight. Tx w/IVF & serial abdominal exams. D/c to home & had continued gagging, reduced oral intake, irritability, decreased sleep & uncomfortable abdomen. BE reduced IS & admitted overnight for observation s/p reduction. FINAL DX: Intussusception, enema reduced. Records faxed to CDC. 11/13/07 Reviewed hospital medical records which reveal patient experienced vomiting, fever & abdominal pain. Admitted 10/18-10/19/2007. Abdomen was diffusely tender. Tx w/IVF, antipyretic & antinausea meds. Improved & d/c to home. ER Diagnosis: dehydration, vomiting & abdominal pain. Seen at outlying hospital for persistent vomiting where IS was dx & reduced by BE. Admitted overnight for observation & d/c to home. Continued to run fever & had diarrhea & returned to ER. Temp 103 in ER. Tx w/antipyretic & d/c to home. Final ER dx: fever secondary to vaccines. Records faxed to CDC. 11/16/07 Received vax record from pcp which confirms RO dose & lot as reported. Record faxed to CDC.
Vaccinated: | 2007-10-17 |
Onset: | 2007-10-17 |
Submitted: | 2007-10-22 |
Entered: | 2007-10-24 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B127AA / 2 | RL / UN |
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U245BA / 0 | RL / UN |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF192AA / 2 | LL / UN |
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH | B47300F / 2 | RL / UN |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0408U / 2 | - / PO |
Administered by: Private Purchased by: Public
Symptoms: Abdominal pain, Barium enema, Dehydration, Diarrhoea, Intussusception, Irritability, Lymphocyte count decreased, Protein total normal, Pyrexia, Retching, Sleep disorder, Urinary system X-ray, Vomiting, Platelet count increased, Neutrophil percentage increased, Monocyte percentage increased, Blood alkaline phosphatase increased, Urine analysis normal, Abdominal X-ray, Oral intake reduced
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Intussusception. 11/02/07 Reviewed medical records from 2nd ER of 10/19/07 which reveal patient experienced pulling up of legs, vomiting & apparent abdominal pain. Seen in outlying ER & admitted overnight. Tx w/IVF & serial abdominal exams. D/c to home & had continued gagging, reduced oral intake, irritability, decreased sleep & uncomfortable abdomen. BE reduced IS & admitted overnight for observation s/p reduction. FINAL DX: Intussusception, enema reduced. Records faxed to CDC. 11/13/07 Reviewed hospital medical records which reveal patient experienced vomiting, fever & abdominal pain. Admitted 10/18-10/19/2007. Abdomen was diffusely tender. Tx w/IVF, antipyretic & antinausea meds. Improved & d/c to home. ER Diagnosis: dehydration, vomiting & abdominal pain. Seen at outlying hospital for persistent vomiting where IS was dx & reduced by BE. Admitted overnight for observation & d/c to home. Continued to run fever & had diarrhea & returned to ER. Temp 103 in ER. Tx w/antipyretic & d/c to home. Final ER dx: fever secondary to vaccines. Records faxed to CDC. 11/16/07 Received vax record from pcp which confirms RO dose & lot as reported. Record faxed to CDC.
Vaccinated: | 2007-10-17 |
Onset: | 2007-10-17 |
Submitted: | 2007-10-22 |
Entered: | 2007-10-24 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B127AA / 2 | RL / UN |
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U245BA / 0 | RL / UN |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF192AA / 2 | LL / UN |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B47300F / 2 | RL / UN |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0408U / 2 | - / PO |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0408U / 2 | - / PO |
Administered by: Private Purchased by: Public
Symptoms: Abdominal pain, Barium enema, Dehydration, Diarrhoea, Intussusception, Irritability, Lymphocyte count decreased, Protein total normal, Pyrexia, Retching, Sleep disorder, Urinary system X-ray, Vomiting, Platelet count increased, Neutrophil percentage increased, Monocyte percentage increased, Blood alkaline phosphatase increased, Urine analysis normal, Abdominal X-ray, Oral intake reduced
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Intussusception. 11/02/07 Reviewed medical records from 2nd ER of 10/19/07 which reveal patient experienced pulling up of legs, vomiting & apparent abdominal pain. Seen in outlying ER & admitted overnight. Tx w/IVF & serial abdominal exams. D/c to home & had continued gagging, reduced oral intake, irritability, decreased sleep & uncomfortable abdomen. BE reduced IS & admitted overnight for observation s/p reduction. FINAL DX: Intussusception, enema reduced. Records faxed to CDC. 11/13/07 Reviewed hospital medical records which reveal patient experienced vomiting, fever & abdominal pain. Admitted 10/18-10/19/2007. Abdomen was diffusely tender. Tx w/IVF, antipyretic & antinausea meds. Improved & d/c to home. ER Diagnosis: dehydration, vomiting & abdominal pain. Seen at outlying hospital for persistent vomiting where IS was dx & reduced by BE. Admitted overnight for observation & d/c to home. Continued to run fever & had diarrhea & returned to ER. Temp 103 in ER. Tx w/antipyretic & d/c to home. Final ER dx: fever secondary to vaccines. Records faxed to CDC. 11/16/07 Received vax record from pcp which confirms RO dose & lot as reported. Record faxed to CDC.
Vaccinated: | 2007-10-17 |
Onset: | 2007-10-17 |
Submitted: | 2007-10-22 |
Entered: | 2007-10-24 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B127AA / 2 | RL / UN |
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U245BA / 0 | RL / UN |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U245BA / 0 | RL / UN |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF192AA / 2 | LL / UN |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B47300F / 2 | RL / UN |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0408U / 2 | - / PO |
Administered by: Private Purchased by: Public
Symptoms: Abdominal pain, Barium enema, Dehydration, Diarrhoea, Intussusception, Irritability, Lymphocyte count decreased, Protein total normal, Pyrexia, Retching, Sleep disorder, Urinary system X-ray, Vomiting, Platelet count increased, Neutrophil percentage increased, Monocyte percentage increased, Blood alkaline phosphatase increased, Urine analysis normal, Abdominal X-ray, Oral intake reduced
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Intussusception. 11/02/07 Reviewed medical records from 2nd ER of 10/19/07 which reveal patient experienced pulling up of legs, vomiting & apparent abdominal pain. Seen in outlying ER & admitted overnight. Tx w/IVF & serial abdominal exams. D/c to home & had continued gagging, reduced oral intake, irritability, decreased sleep & uncomfortable abdomen. BE reduced IS & admitted overnight for observation s/p reduction. FINAL DX: Intussusception, enema reduced. Records faxed to CDC. 11/13/07 Reviewed hospital medical records which reveal patient experienced vomiting, fever & abdominal pain. Admitted 10/18-10/19/2007. Abdomen was diffusely tender. Tx w/IVF, antipyretic & antinausea meds. Improved & d/c to home. ER Diagnosis: dehydration, vomiting & abdominal pain. Seen at outlying hospital for persistent vomiting where IS was dx & reduced by BE. Admitted overnight for observation & d/c to home. Continued to run fever & had diarrhea & returned to ER. Temp 103 in ER. Tx w/antipyretic & d/c to home. Final ER dx: fever secondary to vaccines. Records faxed to CDC. 11/16/07 Received vax record from pcp which confirms RO dose & lot as reported. Record faxed to CDC.
Vaccinated: | 2007-10-17 |
Onset: | 2007-10-17 |
Submitted: | 2007-10-22 |
Entered: | 2007-10-24 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B127AA / 2 | RL / UN |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U245BA / 0 | RL / UN |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF192AA / 2 | LL / UN |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B47300F / 2 | RL / UN |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0408U / 2 | - / PO |
Administered by: Private Purchased by: Public
Symptoms: Abdominal pain, Barium enema, Dehydration, Diarrhoea, Intussusception, Irritability, Lymphocyte count decreased, Protein total normal, Pyrexia, Retching, Sleep disorder, Urinary system X-ray, Vomiting, Platelet count increased, Neutrophil percentage increased, Monocyte percentage increased, Blood alkaline phosphatase increased, Urine analysis normal, Abdominal X-ray, Oral intake reduced
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Intussusception. 11/02/07 Reviewed medical records from 2nd ER of 10/19/07 which reveal patient experienced pulling up of legs, vomiting & apparent abdominal pain. Seen in outlying ER & admitted overnight. Tx w/IVF & serial abdominal exams. D/c to home & had continued gagging, reduced oral intake, irritability, decreased sleep & uncomfortable abdomen. BE reduced IS & admitted overnight for observation s/p reduction. FINAL DX: Intussusception, enema reduced. Records faxed to CDC. 11/13/07 Reviewed hospital medical records which reveal patient experienced vomiting, fever & abdominal pain. Admitted 10/18-10/19/2007. Abdomen was diffusely tender. Tx w/IVF, antipyretic & antinausea meds. Improved & d/c to home. ER Diagnosis: dehydration, vomiting & abdominal pain. Seen at outlying hospital for persistent vomiting where IS was dx & reduced by BE. Admitted overnight for observation & d/c to home. Continued to run fever & had diarrhea & returned to ER. Temp 103 in ER. Tx w/antipyretic & d/c to home. Final ER dx: fever secondary to vaccines. Records faxed to CDC. 11/16/07 Received vax record from pcp which confirms RO dose & lot as reported. Record faxed to CDC.
Vaccinated: | 2007-10-17 |
Onset: | 2007-10-17 |
Submitted: | 2007-10-22 |
Entered: | 2007-10-24 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B127AA / 2 3 | RL / UN |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U245BA / 0 1 | RL / UN |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF192AA / 2 3 | LL / UN |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B47300F / 2 3 | RL / UN |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0408U / 2 3 | - MO / PO |
Administered by: Private Purchased by: Public
Symptoms: Barium enema, Intussusception
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Intussusception. 11/02/07 Reviewed medical records from 2nd ER of 10/19/07 which reveal patient experienced pulling up of legs, vomiting & apparent abdominal pain. Seen in outlying ER & admitted overnight. Tx w/IVF & serial abdominal exams. D/c to home & had continued gagging, reduced oral intake, irritability, decreased sleep & uncomfortable abdomen. BE reduced IS & admitted overnight for observation s/p reduction. FINAL DX: Intussusception, enema reduced. Records faxed to CDC. 11/13/07 Reviewed hospital medical records which reveal patient experienced vomiting, fever & abdominal pain. Admitted 10/18-10/19/2007. Abdomen was diffusely tender. Tx w/IVF, antipyretic & antinausea meds. Improved & d/c to home. ER Diagnosis: dehydration, vomiting & abdominal pain. Seen at outlying hospital for persistent vomiting where IS was dx & reduced by BE. Admitted overnight for observation & d/c to home. Continued to run fever & had diarrhea & returned to ER. Temp 103 in ER. Tx w/antipyretic & d/c to home. Final ER dx: fever secondary to vaccines. Records faxed to CDC. 11/16/07 Received vax record from pcp which confirms RO dose & lot as reported. Record faxed to CDC.
Vaccinated: | 2007-10-17 |
Onset: | 2007-10-17 |
Submitted: | 2007-10-22 |
Entered: | 2007-10-24 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B127AA / 3 | RL / UN |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U245BA / 1 | RL / UN |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF192AA / 3 | LL / UN |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B47300F / 3 | RL / UN |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0408U / 3 | MO / PO |
Administered by: Private Purchased by: Public
Symptoms: Barium enema, Intussusception
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Intussusception. 11/02/07 Reviewed medical records from 2nd ER of 10/19/07 which reveal patient experienced pulling up of legs, vomiting & apparent abdominal pain. Seen in outlying ER & admitted overnight. Tx w/IVF & serial abdominal exams. D/c to home & had continued gagging, reduced oral intake, irritability, decreased sleep & uncomfortable abdomen. BE reduced IS & admitted overnight for observation s/p reduction. FINAL DX: Intussusception, enema reduced. Records faxed to CDC. 11/13/07 Reviewed hospital medical records which reveal patient experienced vomiting, fever & abdominal pain. Admitted 10/18-10/19/2007. Abdomen was diffusely tender. Tx w/IVF, antipyretic & antinausea meds. Improved & d/c to home. ER Diagnosis: dehydration, vomiting & abdominal pain. Seen at outlying hospital for persistent vomiting where IS was dx & reduced by BE. Admitted overnight for observation & d/c to home. Continued to run fever & had diarrhea & returned to ER. Temp 103 in ER. Tx w/antipyretic & d/c to home. Final ER dx: fever secondary to vaccines. Records faxed to CDC. 11/16/07 Received vax record from pcp which confirms RO dose & lot as reported. Record faxed to CDC.
Vaccinated: | 2007-10-17 |
Onset: | 2007-10-17 |
Submitted: | 2007-10-22 |
Entered: | 2007-10-24 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B127AA / 3 | RL / UN |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U245BA / 1 | RL / UN |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF192AA / 3 | LL / UN |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B47300F / 3 | RL / UN |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0408U / 3 | MO / PO |
Administered by: Private Purchased by: Public
Symptoms: Barium enema, Intussusception
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Intussusception. 11/02/07 Reviewed medical records from 2nd ER of 10/19/07 which reveal patient experienced pulling up of legs, vomiting & apparent abdominal pain. Seen in outlying ER & admitted overnight. Tx w/IVF & serial abdominal exams. D/c to home & had continued gagging, reduced oral intake, irritability, decreased sleep & uncomfortable abdomen. BE reduced IS & admitted overnight for observation s/p reduction. FINAL DX: Intussusception, enema reduced. Records faxed to CDC. 11/13/07 Reviewed hospital medical records which reveal patient experienced vomiting, fever & abdominal pain. Admitted 10/18-10/19/2007. Abdomen was diffusely tender. Tx w/IVF, antipyretic & antinausea meds. Improved & d/c to home. ER Diagnosis: dehydration, vomiting & abdominal pain. Seen at outlying hospital for persistent vomiting where IS was dx & reduced by BE. Admitted overnight for observation & d/c to home. Continued to run fever & had diarrhea & returned to ER. Temp 103 in ER. Tx w/antipyretic & d/c to home. Final ER dx: fever secondary to vaccines. Records faxed to CDC. 11/16/07 Received vax record from pcp which confirms RO dose & lot as reported. Record faxed to CDC.
Vaccinated: | 2007-10-17 |
Onset: | 2007-10-17 |
Submitted: | 2007-10-22 |
Entered: | 2007-10-24 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B127AA / 3 | RL / UN |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U245BA / 1 | RL / UN |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF192AA / 3 | LL / UN |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B47300F / 3 | RL / UN |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0408U / 3 | MO / PO |
Administered by: Private Purchased by: Public
Symptoms: Barium enema, Intussusception
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Intussusception. 11/02/07 Reviewed medical records from 2nd ER of 10/19/07 which reveal patient experienced pulling up of legs, vomiting & apparent abdominal pain. Seen in outlying ER & admitted overnight. Tx w/IVF & serial abdominal exams. D/c to home & had continued gagging, reduced oral intake, irritability, decreased sleep & uncomfortable abdomen. BE reduced IS & admitted overnight for observation s/p reduction. FINAL DX: Intussusception, enema reduced. Records faxed to CDC. 11/13/07 Reviewed hospital medical records which reveal patient experienced vomiting, fever & abdominal pain. Admitted 10/18-10/19/2007. Abdomen was diffusely tender. Tx w/IVF, antipyretic & antinausea meds. Improved & d/c to home. ER Diagnosis: dehydration, vomiting & abdominal pain. Seen at outlying hospital for persistent vomiting where IS was dx & reduced by BE. Admitted overnight for observation & d/c to home. Continued to run fever & had diarrhea & returned to ER. Temp 103 in ER. Tx w/antipyretic & d/c to home. Final ER dx: fever secondary to vaccines. Records faxed to CDC. 11/16/07 Received vax record from pcp which confirms RO dose & lot as reported. Record faxed to CDC.
Vaccinated: | 2007-10-17 |
Onset: | 2007-10-17 |
Submitted: | 2007-10-22 |
Entered: | 2007-10-24 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B127AA / 3 | RL / UN |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U245BA / 1 | RL / UN |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF192AA / 3 | LL / UN |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B47300F / 3 | RL / UN |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0408U / 3 | MO / PO |
Administered by: Private Purchased by: Public
Symptoms: Barium enema, Intussusception
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Intussusception. 11/02/07 Reviewed medical records from 2nd ER of 10/19/07 which reveal patient experienced pulling up of legs, vomiting & apparent abdominal pain. Seen in outlying ER & admitted overnight. Tx w/IVF & serial abdominal exams. D/c to home & had continued gagging, reduced oral intake, irritability, decreased sleep & uncomfortable abdomen. BE reduced IS & admitted overnight for observation s/p reduction. FINAL DX: Intussusception, enema reduced. Records faxed to CDC. 11/13/07 Reviewed hospital medical records which reveal patient experienced vomiting, fever & abdominal pain. Admitted 10/18-10/19/2007. Abdomen was diffusely tender. Tx w/IVF, antipyretic & antinausea meds. Improved & d/c to home. ER Diagnosis: dehydration, vomiting & abdominal pain. Seen at outlying hospital for persistent vomiting where IS was dx & reduced by BE. Admitted overnight for observation & d/c to home. Continued to run fever & had diarrhea & returned to ER. Temp 103 in ER. Tx w/antipyretic & d/c to home. Final ER dx: fever secondary to vaccines. Records faxed to CDC. 11/16/07 Received vax record from pcp which confirms RO dose & lot as reported. Record faxed to CDC.
Vaccinated: | 2007-10-17 |
Onset: | 2007-10-17 |
Submitted: | 2007-10-22 |
Entered: | 2007-10-24 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B127AA / 3 | RL / UN |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U245BA / 1 | RL / UN |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF192AA / 3 | LL / UN |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B47300F / 3 | RL / UN |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0408U / 3 | MO / PO |
Administered by: Private Purchased by: Public
Symptoms: Barium enema, Intussusception
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Intussusception. 11/02/07 Reviewed medical records from 2nd ER of 10/19/07 which reveal patient experienced pulling up of legs, vomiting & apparent abdominal pain. Seen in outlying ER & admitted overnight. Tx w/IVF & serial abdominal exams. D/c to home & had continued gagging, reduced oral intake, irritability, decreased sleep & uncomfortable abdomen. BE reduced IS & admitted overnight for observation s/p reduction. FINAL DX: Intussusception, enema reduced. Records faxed to CDC. 11/13/07 Reviewed hospital medical records which reveal patient experienced vomiting, fever & abdominal pain. Admitted 10/18-10/19/2007. Abdomen was diffusely tender. Tx w/IVF, antipyretic & antinausea meds. Improved & d/c to home. ER Diagnosis: dehydration, vomiting & abdominal pain. Seen at outlying hospital for persistent vomiting where IS was dx & reduced by BE. Admitted overnight for observation & d/c to home. Continued to run fever & had diarrhea & returned to ER. Temp 103 in ER. Tx w/antipyretic & d/c to home. Final ER dx: fever secondary to vaccines. Records faxed to CDC. 11/16/07 Received vax record from pcp which confirms RO dose & lot as reported. Record faxed to CDC.
Vaccinated: | 2007-10-17 |
Onset: | 2007-10-17 |
Submitted: | 2007-10-22 |
Entered: | 2007-10-24 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B127AA / 3 | RL / UN |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U245BA / 1 | RL / UN |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF192AA / 3 | LL / UN |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B47300F / 3 | RL / UN |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0408U / 3 | MO / PO |
Administered by: Private Purchased by: Public
Symptoms: Barium enema, Intussusception
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Intussusception. 11/02/07 Reviewed medical records from 2nd ER of 10/19/07 which reveal patient experienced pulling up of legs, vomiting & apparent abdominal pain. Seen in outlying ER & admitted overnight. Tx w/IVF & serial abdominal exams. D/c to home & had continued gagging, reduced oral intake, irritability, decreased sleep & uncomfortable abdomen. BE reduced IS & admitted overnight for observation s/p reduction. FINAL DX: Intussusception, enema reduced. Records faxed to CDC. 11/13/07 Reviewed hospital medical records which reveal patient experienced vomiting, fever & abdominal pain. Admitted 10/18-10/19/2007. Abdomen was diffusely tender. Tx w/IVF, antipyretic & antinausea meds. Improved & d/c to home. ER Diagnosis: dehydration, vomiting & abdominal pain. Seen at outlying hospital for persistent vomiting where IS was dx & reduced by BE. Admitted overnight for observation & d/c to home. Continued to run fever & had diarrhea & returned to ER. Temp 103 in ER. Tx w/antipyretic & d/c to home. Final ER dx: fever secondary to vaccines. Records faxed to CDC. 11/16/07 Received vax record from pcp which confirms RO dose & lot as reported. Record faxed to CDC.
Vaccinated: | 2007-10-17 |
Onset: | 2007-10-17 |
Submitted: | 2007-10-22 |
Entered: | 2007-10-24 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS | AC21B127AA / 3 | RL / UN |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U245BA / 1 | RL / UN |
HIBV: HIB (ACTHIB) / SANOFI PASTEUR | UF192AA / 3 | LL / UN |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | B47300F / 3 | RL / UN |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0408U / 3 | MO / PO |
Administered by: Private Purchased by: Public
Symptoms: Barium enema, Intussusception
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Intussusception. 11/02/07 Reviewed medical records from 2nd ER of 10/19/07 which reveal patient experienced pulling up of legs, vomiting & apparent abdominal pain. Seen in outlying ER & admitted overnight. Tx w/IVF & serial abdominal exams. D/c to home & had continued gagging, reduced oral intake, irritability, decreased sleep & uncomfortable abdomen. BE reduced IS & admitted overnight for observation s/p reduction. FINAL DX: Intussusception, enema reduced. Records faxed to CDC. 11/13/07 Reviewed hospital medical records which reveal patient experienced vomiting, fever & abdominal pain. Admitted 10/18-10/19/2007. Abdomen was diffusely tender. Tx w/IVF, antipyretic & antinausea meds. Improved & d/c to home. ER Diagnosis: dehydration, vomiting & abdominal pain. Seen at outlying hospital for persistent vomiting where IS was dx & reduced by BE. Admitted overnight for observation & d/c to home. Continued to run fever & had diarrhea & returned to ER. Temp 103 in ER. Tx w/antipyretic & d/c to home. Final ER dx: fever secondary to vaccines. Records faxed to CDC. 11/16/07 Received vax record from pcp which confirms RO dose & lot as reported. Record faxed to CDC.
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