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Administered by: Private      Purchased by: Unknown
Symptoms: Haematochezia, Intussusception, Irritability, Enema administration

Life Threatening? Yes
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: radiological LABS: KUB dialted loops of small bowel. Abdominal US (+) for IS x 2. Air enema reduction of IS x 2.
CDC 'Split Type':

Write-up: Intussusception requiring reduction. Repeat intussusception needing second procedure. 12/21/07 Reviewed vax record which confirms dose & lot #s as reported. 12/28/07 Reviewed hospital medical records which reveal patient experienced vomiting, bloody st"ool, reduced oral intake, irritability & lethargy. Admitted 11/16-11/17/2007. Enema successfully reduced IS. Admitted for overnight observation. Did well & was d/c to home. Readmitted 11/19-11/20/2007 for recurrence of vomiting & bloody stools. 2nd

Changed on 12/8/2009

Administered by: Private      Purchased by: Unknown
Symptoms: Haematochezia, Intussusception, Irritability, Lethargy, Urinary system X-ray, Vomiting, Enema administration, Ultrasound abdomen abnormal, Oral intake reduced

Life Threatening? Yes
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: radiological LABS: KUB dialted loops of small bowel. Abdominal US (+) for IS x 2. Air enema reduction of IS x 2.
CDC 'Split Type':

Write-up: Intussusception requiring reduction. Repeat intussusception needing second procedure. 12/21/07 Reviewed vax record which confirms dose & lot #s as reported. 12/28/07 Reviewed hospital medical records which reveal patient experienced vomiting, bloody st"ool, stool, reduced oral intake, irritability & lethargy. Admitted 11/16-11/17/2007. Enema successfully reduced IS. Admitted for overnight observation. Did well & was d/c to home. Readmitted 11/19-11/20/2007 for recurrence of vomiting & bloody stools. 2nd abdominal US (+) for IS & was successfully reduced w/air contrast enema. Kept overnight for observation. Did well & d/c to home. FINAL DX: Recurrent ileocolic intussusception at hepatic flexure, enema reduced x 2.

Changed on 1/5/2010

Administered by: Private      Purchased by: Unknown
Symptoms: Haematochezia, Intussusception, Irritability, Lethargy, Urinary system X-ray, Vomiting, Enema administration, Ultrasound abdomen abnormal, Oral intake reduced

Life Threatening? Yes
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: radiological LABS: KUB dialted loops of small bowel. Abdominal US (+) for IS x 2. Air enema reduction of IS x 2.
CDC 'Split Type':

Write-up: Intussusception requiring reduction. Repeat intussusception needing second procedure. 12/21/07 Reviewed vax record which confirms dose & lot #s as reported. 12/28/07 Reviewed hospital medical records which reveal patient experienced vomiting, bloody stool, reduced oral intake, irritability & lethargy. Admitted 11/16-11/17/2007. Enema successfully reduced IS. Admitted for overnight observation. Did well & was d/c to home. Readmitted 11/19-11/20/2007 for recurrence of vomiting & bloody stools. 2nd abdominal US (+) for IS & was successfully reduced w/air contrast enema. Kept overnight for observation. Did well & d/c to home. FINAL DX: Recurrent ileocolic intussusception at hepatic flexure, enema reduced x 2.

Changed on 3/2/2010

Administered by: Private      Purchased by: Unknown
Symptoms: Intussusception

Life Threatening? Yes
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: radiological LABS: KUB dialted loops of small bowel. Abdominal US (+) for IS x 2. Air enema reduction of IS x 2.
CDC 'Split Type':

Write-up: Intussusception requiring reduction. Repeat intussusception needing second procedure. 12/21/07 Reviewed vax record which confirms dose & lot #s as reported. 12/28/07 Reviewed hospital medical records which reveal patient experienced vomiting, bloody stool, reduced oral intake, irritability & lethargy. Admitted 11/16-11/17/2007. Enema successfully reduced IS. Admitted for overnight observation. Did well & was d/c to home. Readmitted 11/19-11/20/2007 for recurrence of vomiting & bloody stools. 2nd abdominal US (+) for IS & was successfully reduced w/air contrast enema. Kept overnight for observation. Did well & d/c to home. FINAL DX: Recurrent ileocolic intussusception at hepatic flexure, enema reduced x 2.

Changed on 4/7/2010

Administered by: Private      Purchased by: Unknown
Symptoms: Intussusception

Life Threatening? Yes
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: radiological LABS: KUB dialted loops of small bowel. Abdominal US (+) for IS x 2. Air enema reduction of IS x 2.
CDC 'Split Type':

Write-up: Intussusception requiring reduction. Repeat intussusception needing second procedure. 12/21/07 Reviewed vax record which confirms dose & lot #s as reported. 12/28/07 Reviewed hospital medical records which reveal patient experienced vomiting, bloody stool, reduced oral intake, irritability & lethargy. Admitted 11/16-11/17/2007. Enema successfully reduced IS. Admitted for overnight observation. Did well & was d/c to home. Readmitted 11/19-11/20/2007 for recurrence of vomiting & bloody stools. 2nd abdominal US (+) for IS & was successfully reduced w/air contrast enema. Kept overnight for observation. Did well & d/c to home. FINAL DX: Recurrent ileocolic intussusception at hepatic flexure, enema reduced x 2.

Changed on 8/31/2010

Administered by: Private      Purchased by: Unknown
Symptoms: Intussusception

Life Threatening? Yes
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: radiological LABS: KUB dialted loops of small bowel. Abdominal US (+) for IS x 2. Air enema reduction of IS x 2.
CDC 'Split Type':

Write-up: Intussusception requiring reduction. Repeat intussusception needing second procedure. 12/21/07 Reviewed vax record which confirms dose & lot #s as reported. 12/28/07 Reviewed hospital medical records which reveal patient experienced vomiting, bloody stool, reduced oral intake, irritability & lethargy. Admitted 11/16-11/17/2007. Enema successfully reduced IS. Admitted for overnight observation. Did well & was d/c to home. Readmitted 11/19-11/20/2007 for recurrence of vomiting & bloody stools. 2nd abdominal US (+) for IS & was successfully reduced w/air contrast enema. Kept overnight for observation. Did well & d/c to home. FINAL DX: Recurrent ileocolic intussusception at hepatic flexure, enema reduced x 2.

Changed on 4/13/2011

Administered by: Private      Purchased by: Unknown
Symptoms: Haematochezia, Intussusception, Irritability, Lethargy, Urinary system X-ray, Vomiting, Enema administration, Ultrasound abdomen abnormal, Oral intake reduced

Life Threatening? Yes
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: radiological LABS: KUB dialted loops of small bowel. Abdominal US (+) for IS x 2. Air enema reduction of IS x 2.
CDC 'Split Type':

Write-up: Intussusception requiring reduction. Repeat intussusception needing second procedure. 12/21/07 Reviewed vax record which confirms dose & lot #s as reported. 12/28/07 Reviewed hospital medical records which reveal patient experienced vomiting, bloody stool, reduced oral intake, irritability & lethargy. Admitted 11/16-11/17/2007. Enema successfully reduced IS. Admitted for overnight observation. Did well & was d/c to home. Readmitted 11/19-11/20/2007 for recurrence of vomiting & bloody stools. 2nd abdominal US (+) for IS & was successfully reduced w/air contrast enema. Kept overnight for observation. Did well & d/c to home. FINAL DX: Recurrent ileocolic intussusception at hepatic flexure, enema reduced x 2.

Changed on 5/13/2011

Administered by: Private      Purchased by: Unknown
Symptoms: Haematochezia, Intussusception, Irritability, Lethargy, Urinary system X-ray, Vomiting, Enema administration, Ultrasound abdomen abnormal, Oral intake reduced

Life Threatening? Yes
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: radiological LABS: KUB dialted loops of small bowel. Abdominal US (+) for IS x 2. Air enema reduction of IS x 2.
CDC 'Split Type':

Write-up: Intussusception requiring reduction. Repeat intussusception needing second procedure. 12/21/07 Reviewed vax record which confirms dose & lot #s as reported. 12/28/07 Reviewed hospital medical records which reveal patient experienced vomiting, bloody stool, reduced oral intake, irritability & lethargy. Admitted 11/16-11/17/2007. Enema successfully reduced IS. Admitted for overnight observation. Did well & was d/c to home. Readmitted 11/19-11/20/2007 for recurrence of vomiting & bloody stools. 2nd abdominal US (+) for IS & was successfully reduced w/air contrast enema. Kept overnight for observation. Did well & d/c to home. FINAL DX: Recurrent ileocolic intussusception at hepatic flexure, enema reduced x 2.

Changed on 6/11/2011

Administered by: Private      Purchased by: Unknown
Symptoms: Haematochezia, Intussusception, Irritability, Lethargy, Urinary system X-ray, Vomiting, Enema administration, Ultrasound abdomen abnormal, Oral intake reduced

Life Threatening? Yes
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: radiological LABS: KUB dialted loops of small bowel. Abdominal US (+) for IS x 2. Air enema reduction of IS x 2.
CDC 'Split Type':

Write-up: Intussusception requiring reduction. Repeat intussusception needing second procedure. 12/21/07 Reviewed vax record which confirms dose & lot #s as reported. 12/28/07 Reviewed hospital medical records which reveal patient experienced vomiting, bloody stool, reduced oral intake, irritability & lethargy. Admitted 11/16-11/17/2007. Enema successfully reduced IS. Admitted for overnight observation. Did well & was d/c to home. Readmitted 11/19-11/20/2007 for recurrence of vomiting & bloody stools. 2nd abdominal US (+) for IS & was successfully reduced w/air contrast enema. Kept overnight for observation. Did well & d/c to home. FINAL DX: Recurrent ileocolic intussusception at hepatic flexure, enema reduced x 2.

Changed on 5/13/2013

Administered by: Private      Purchased by: Unknown
Symptoms: Haematochezia, Intussusception, Irritability, Lethargy, Urinary system X-ray, Vomiting, Enema administration, Ultrasound abdomen abnormal, Oral intake reduced

Life Threatening? Yes
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: radiological LABS: KUB dialted loops of small bowel. Abdominal US (+) for IS x 2. Air enema reduction of IS x 2.
CDC 'Split Type':

Write-up: Intussusception requiring reduction. Repeat intussusception needing second procedure. 12/21/07 Reviewed vax record which confirms dose & lot #s as reported. 12/28/07 Reviewed hospital medical records which reveal patient experienced vomiting, bloody stool, reduced oral intake, irritability & lethargy. Admitted 11/16-11/17/2007. Enema successfully reduced IS. Admitted for overnight observation. Did well & was d/c to home. Readmitted 11/19-11/20/2007 for recurrence of vomiting & bloody stools. 2nd abdominal US (+) for IS & was successfully reduced w/air contrast enema. Kept overnight for observation. Did well & d/c to home. FINAL DX: Recurrent ileocolic intussusception at hepatic flexure, enema reduced x 2.

Changed on 6/14/2014

Administered by: Private      Purchased by: Unknown
Symptoms: Haematochezia, Intussusception, Irritability, Lethargy, Urinary system X-ray, Vomiting, Enema administration, Ultrasound abdomen abnormal, Oral intake reduced

Life Threatening? Yes
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: radiological LABS: KUB dialted loops of small bowel. Abdominal US (+) for IS x 2. Air enema reduction of IS x 2.
CDC 'Split Type':

Write-up: Intussusception requiring reduction. Repeat intussusception needing second procedure. 12/21/07 Reviewed vax record which confirms dose & lot #s as reported. 12/28/07 Reviewed hospital medical records which reveal patient experienced vomiting, bloody stool, reduced oral intake, irritability & lethargy. Admitted 11/16-11/17/2007. Enema successfully reduced IS. Admitted for overnight observation. Did well & was d/c to home. Readmitted 11/19-11/20/2007 for recurrence of vomiting & bloody stools. 2nd abdominal US (+) for IS & was successfully reduced w/air contrast enema. Kept overnight for observation. Did well & d/c to home. FINAL DX: Recurrent ileocolic intussusception at hepatic flexure, enema reduced x 2.

Changed on 2/14/2017

Administered by: Private      Purchased by: Unknown
Symptoms: Haematochezia, Intussusception, Irritability, Lethargy, Urinary system X-ray, Vomiting, Enema administration, Ultrasound abdomen abnormal, Oral intake reduced

Life Threatening? Yes
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: radiological LABS: KUB dialted loops of small bowel. Abdominal US (+) for IS x 2. Air enema reduction of IS x 2.
CDC 'Split Type':

Write-up: Intussusception requiring reduction. Repeat intussusception needing second procedure. 12/21/07 Reviewed vax record which confirms dose & lot #s as reported. 12/28/07 Reviewed hospital medical records which reveal patient experienced vomiting, bloody stool, reduced oral intake, irritability & lethargy. Admitted 11/16-11/17/2007. Enema successfully reduced IS. Admitted for overnight observation. Did well & was d/c to home. Readmitted 11/19-11/20/2007 for recurrence of vomiting & bloody stools. 2nd abdominal US (+) for IS & was successfully reduced w/air contrast enema. Kept overnight for observation. Did well & d/c to home. FINAL DX: Recurrent ileocolic intussusception at hepatic flexure, enema reduced x 2.

Changed on 9/14/2017

Administered by: Private      Purchased by: Unknown
Symptoms: Intussusception

Life Threatening? Yes
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: radiological LABS: KUB dialted loops of small bowel. Abdominal US (+) for IS x 2. Air enema reduction of IS x 2.
CDC 'Split Type':

Write-up: Intussusception requiring reduction. Repeat intussusception needing second procedure. 12/21/07 Reviewed vax record which confirms dose & lot #s as reported. 12/28/07 Reviewed hospital medical records which reveal patient experienced vomiting, bloody stool, reduced oral intake, irritability & lethargy. Admitted 11/16-11/17/2007. Enema successfully reduced IS. Admitted for overnight observation. Did well & was d/c to home. Readmitted 11/19-11/20/2007 for recurrence of vomiting & bloody stools. 2nd abdominal US (+) for IS & was successfully reduced w/air contrast enema. Kept overnight for observation. Did well & d/c to home. FINAL DX: Recurrent ileocolic intussusception at hepatic flexure, enema reduced x 2.

Changed on 2/14/2018

Administered by: Private      Purchased by: Unknown
Symptoms: Intussusception

Life Threatening? Yes
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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: radiological LABS: KUB dialted loops of small bowel. Abdominal US (+) for IS x 2. Air enema reduction of IS x 2.
CDC 'Split Type':

Write-up: Intussusception requiring reduction. Repeat intussusception needing second procedure. 12/21/07 Reviewed vax record which confirms dose & lot #s as reported. 12/28/07 Reviewed hospital medical records which reveal patient experienced vomiting, bloody stool, reduced oral intake, irritability & lethargy. Admitted 11/16-11/17/2007. Enema successfully reduced IS. Admitted for overnight observation. Did well & was d/c to home. Readmitted 11/19-11/20/2007 for recurrence of vomiting & bloody stools. 2nd abdominal US (+) for IS & was successfully reduced w/air contrast enema. Kept overnight for observation. Did well & d/c to home. FINAL DX: Recurrent ileocolic intussusception at hepatic flexure, enema reduced x 2.

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