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This is VAERS ID 306984

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

VAERS ID: 306984
VAERS Form:
Age:0.5
Sex:Male
Location:Georgia
Vaccinated:2007-11-20
Onset:2008-02-02
Submitted:2008-03-10
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B125BA / 2 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF211AA / 2 LL / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B54007H / 2 RL / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 13934 / 2 - / PO

Administered by: Private      Purchased by: Unknown
Symptoms: Barium double contrast, Blood gases abnormal, Blood pH decreased, Computerised tomogram abnormal, Diet refusal

Life Threatening? Yes
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topicort 0.05%
Current Illness:
Preexisting Conditions: Atopic Dermatitis 3/14/08-records received-PMH: allergies to wheat, egg and cat dander. Develops rash with wheat.
Allergies:
Diagnostic Lab Data: Air contrast enema 2/2/08 3/14/08-records received-CT head unremarkable. Abdominal CT revealed probable ileocolic intussusception, air contrast enema with successful reduction. Blood gas 7.26 ph, CO2 40. Hgb 9.8.
CDC 'Split Type':

Write-up: He was diagnosed with intussusception 2/2/08 with respiratory failure. Intussusception relieved via air contrast and reduction. 3/14/08-DC summary received for DOS 2/2/08- 2/5/08-DX Inutssusception. Afternoon of admission became fussy, refused to eat and"developed pale lips. Intubated. Respiratory failure secondary to intussusception. Extubated with stridor improved to room air.


Changed on 12/8/2009

VAERS ID: 306984 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:Georgia
Vaccinated:2007-11-20
Onset:2008-02-02
Submitted:2008-03-10
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHE: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B125BA / 2 LL / UN
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B125BA / 2 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF211AA / 2 LL / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B54007H / 2 RL / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 13934 / 2 - / PO

Administered by: Private      Purchased by: Unknown Other
Symptoms: Barium double contrast, Blood gases abnormal, Blood pH decreased, Computerised tomogram abnormal, Diet refusal, Extubation, Haemoglobin decreased, Intubation, Intussusception, Irritability, Pallor, Respiratory failure, Stridor, Enema administration

Life Threatening? Yes
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topicort 0.05%
Current Illness:
Preexisting Conditions: Atopic Dermatitis 3/14/08-records received-PMH: allergies to wheat, egg and cat dander. Develops rash with wheat.
Allergies:
Diagnostic Lab Data: Air contrast enema 2/2/08 3/14/08-records received-CT head unremarkable. Abdominal CT revealed probable ileocolic intussusception, air contrast enema with successful reduction. Blood gas 7.26 ph, CO2 40. Hgb 9.8.
CDC 'Split Type':

Write-up: He was diagnosed with intussusception 2/2/08 with respiratory failure. Intussusception relieved via air contrast and reduction. 3/14/08-DC summary received for DOS 2/2/08- 2/5/08-DX Inutssusception. Afternoon of admission became fussy, refused to eat and"developed and developed pale lips. Intubated. Respiratory failure secondary to intussusception. Extubated with stridor improved to room air.


Changed on 3/2/2010

VAERS ID: 306984 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:Georgia
Vaccinated:2007-11-20
Onset:2008-02-02
Submitted:2008-03-10
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B125BA / 2 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF211AA / 2 LL / UN
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC B54007H / 2 RL / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 13934 / 2 - / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium double contrast, Blood gases abnormal, Blood pH decreased, Computerised tomogram abnormal, Diet refusal, Extubation, Haemoglobin decreased, Intubation, Intussusception, Irritability, Pallor, Respiratory failure, Stridor, Enema administration

Life Threatening? Yes
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topicort 0.05%
Current Illness:
Preexisting Conditions: Atopic Dermatitis 3/14/08-records received-PMH: allergies to wheat, egg and cat dander. Develops rash with wheat.
Allergies:
Diagnostic Lab Data: Air contrast enema 2/2/08 3/14/08-records received-CT head unremarkable. Abdominal CT revealed probable ileocolic intussusception, air contrast enema with successful reduction. Blood gas 7.26 ph, CO2 40. Hgb 9.8.
CDC 'Split Type':

Write-up: He was diagnosed with intussusception 2/2/08 with respiratory failure. Intussusception relieved via air contrast and reduction. 3/14/08-DC summary received for DOS 2/2/08- 2/5/08-DX Inutssusception. Afternoon of admission became fussy, refused to eat and developed pale lips. Intubated. Respiratory failure secondary to intussusception. Extubated with stridor improved to room air.


Changed on 4/7/2010

VAERS ID: 306984 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:Georgia
Vaccinated:2007-11-20
Onset:2008-02-02
Submitted:2008-03-10
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B125BA / 2 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF211AA / 2 LL / UN
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B54007H / 2 RL / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 13934 / 2 - / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium double contrast, Blood gases abnormal, Blood pH decreased, Computerised tomogram abnormal, Diet refusal, Extubation, Haemoglobin decreased, Intubation, Intussusception, Irritability, Pallor, Respiratory failure, Stridor, Enema administration

Life Threatening? Yes
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topicort 0.05%
Current Illness:
Preexisting Conditions: Atopic Dermatitis 3/14/08-records received-PMH: allergies to wheat, egg and cat dander. Develops rash with wheat.
Allergies:
Diagnostic Lab Data: Air contrast enema 2/2/08 3/14/08-records received-CT head unremarkable. Abdominal CT revealed probable ileocolic intussusception, air contrast enema with successful reduction. Blood gas 7.26 ph, CO2 40. Hgb 9.8.
CDC 'Split Type':

Write-up: He was diagnosed with intussusception 2/2/08 with respiratory failure. Intussusception relieved via air contrast and reduction. 3/14/08-DC summary received for DOS 2/2/08- 2/5/08-DX Inutssusception. Afternoon of admission became fussy, refused to eat and developed pale lips. Intubated. Respiratory failure secondary to intussusception. Extubated with stridor improved to room air.


Changed on 8/31/2010

VAERS ID: 306984 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:Georgia
Vaccinated:2007-11-20
Onset:2008-02-02
Submitted:2008-03-10
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B125BA / 2 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF211AA / 2 LL / UN
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH B54007H / 2 RL / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 13934 / 2 - / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium double contrast, Blood gases abnormal, Blood pH decreased, Computerised tomogram abnormal, Diet refusal, Extubation, Haemoglobin decreased, Intubation, Intussusception, Irritability, Pallor, Respiratory failure, Stridor, Enema administration

Life Threatening? Yes
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topicort 0.05%
Current Illness:
Preexisting Conditions: Atopic Dermatitis 3/14/08-records received-PMH: allergies to wheat, egg and cat dander. Develops rash with wheat.
Allergies:
Diagnostic Lab Data: Air contrast enema 2/2/08 3/14/08-records received-CT head unremarkable. Abdominal CT revealed probable ileocolic intussusception, air contrast enema with successful reduction. Blood gas 7.26 ph, CO2 40. Hgb 9.8.
CDC 'Split Type':

Write-up: He was diagnosed with intussusception 2/2/08 with respiratory failure. Intussusception relieved via air contrast and reduction. 3/14/08-DC summary received for DOS 2/2/08- 2/5/08-DX Inutssusception. Afternoon of admission became fussy, refused to eat and developed pale lips. Intubated. Respiratory failure secondary to intussusception. Extubated with stridor improved to room air.


Changed on 5/13/2013

VAERS ID: 306984 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:Georgia
Vaccinated:2007-11-20
Onset:2008-02-02
Submitted:2008-03-10
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B125BA / 2 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF211AA / 2 LL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B54007H / 2 RL / UN
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 13934 / 2 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 13934 / 2 - / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium double contrast, Blood gases abnormal, Blood pH decreased, Computerised tomogram abnormal, Diet refusal, Extubation, Haemoglobin decreased, Intubation, Intussusception, Irritability, Pallor, Respiratory failure, Stridor, Enema administration

Life Threatening? Yes
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topicort 0.05%
Current Illness:
Preexisting Conditions: Atopic Dermatitis 3/14/08-records received-PMH: allergies to wheat, egg and cat dander. Develops rash with wheat.
Allergies:
Diagnostic Lab Data: Air contrast enema 2/2/08 3/14/08-records received-CT head unremarkable. Abdominal CT revealed probable ileocolic intussusception, air contrast enema with successful reduction. Blood gas 7.26 ph, CO2 40. Hgb 9.8.
CDC 'Split Type':

Write-up: He was diagnosed with intussusception 2/2/08 with respiratory failure. Intussusception relieved via air contrast and reduction. 3/14/08-DC summary received for DOS 2/2/08- 2/5/08-DX Inutssusception. Afternoon of admission became fussy, refused to eat and developed pale lips. Intubated. Respiratory failure secondary to intussusception. Extubated with stridor improved to room air.


Changed on 4/14/2017

VAERS ID: 306984 Before After
VAERS Form:
Age:0.5
Sex:Male
Location:Georgia
Vaccinated:2007-11-20
Onset:2008-02-02
Submitted:2008-03-10
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B125BA / 2 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF211AA / 2 LL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B54007H / 2 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 13934 / 2 - / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium double contrast, Blood gases abnormal, Blood pH decreased, Computerised tomogram abnormal, Diet refusal, Extubation, Haemoglobin decreased, Intubation, Intussusception, Irritability, Pallor, Respiratory failure, Stridor, Enema administration

Life Threatening? Yes
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topicort 0.05%
Current Illness:
Preexisting Conditions: Atopic Dermatitis 3/14/08-records received-PMH: allergies to wheat, egg and cat dander. Develops rash with wheat.
Allergies:
Diagnostic Lab Data: Air contrast enema 2/2/08 3/14/08-records received-CT head unremarkable. Abdominal CT revealed probable ileocolic intussusception, air contrast enema with successful reduction. Blood gas 7.26 ph, CO2 40. Hgb 9.8.
CDC 'Split Type':

Write-up: He was diagnosed with intussusception 2/2/08 with respiratory failure. Intussusception relieved via air contrast and reduction. 3/14/08-DC summary received for DOS 2/2/08- 2/5/08-DX Inutssusception. Afternoon of admission became fussy, refused to eat and developed pale lips. Intubated. Respiratory failure secondary to intussusception. Extubated with stridor improved to room air.


Changed on 9/14/2017

VAERS ID: 306984 Before After
VAERS Form:(blank) 1
Age:0.5
Sex:Male
Location:Georgia
Vaccinated:2007-11-20
Onset:2008-02-02
Submitted:2008-03-10
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B125BA / 2 3 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF211AA / 2 3 LL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B54007H / 2 3 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 13934 / 2 3 - MO / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium double contrast, Intussusception, Respiratory failure

Life Threatening? Yes
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topicort 0.05%
Current Illness:
Preexisting Conditions: Atopic Dermatitis 3/14/08-records received-PMH: allergies to wheat, egg and cat dander. Develops rash with wheat.
Allergies:
Diagnostic Lab Data: Air contrast enema 2/2/08 3/14/08-records received-CT head unremarkable. Abdominal CT revealed probable ileocolic intussusception, air contrast enema with successful reduction. Blood gas 7.26 ph, CO2 40. Hgb 9.8.
CDC 'Split Type':

Write-up: He was diagnosed with intussusception 2/2/08 with respiratory failure. Intussusception relieved via air contrast and reduction. 3/14/08-DC summary received for DOS 2/2/08- 2/5/08-DX Inutssusception. Afternoon of admission became fussy, refused to eat and developed pale lips. Intubated. Respiratory failure secondary to intussusception. Extubated with stridor improved to room air.


Changed on 2/14/2018

VAERS ID: 306984 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:Georgia
Vaccinated:2007-11-20
Onset:2008-02-02
Submitted:2008-03-10
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B125BA / 3 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF211AA / 3 LL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B54007H / 3 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 13934 / 3 MO / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium double contrast, Intussusception, Respiratory failure

Life Threatening? Yes
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topicort 0.05%
Current Illness:
Preexisting Conditions: Atopic Dermatitis 3/14/08-records received-PMH: allergies to wheat, egg and cat dander. Develops rash with wheat.
Allergies:
Diagnostic Lab Data: Air contrast enema 2/2/08 3/14/08-records received-CT head unremarkable. Abdominal CT revealed probable ileocolic intussusception, air contrast enema with successful reduction. Blood gas 7.26 ph, CO2 40. Hgb 9.8.
CDC 'Split Type':

Write-up: He was diagnosed with intussusception 2/2/08 with respiratory failure. Intussusception relieved via air contrast and reduction. 3/14/08-DC summary received for DOS 2/2/08- 2/5/08-DX Inutssusception. Afternoon of admission became fussy, refused to eat and developed pale lips. Intubated. Respiratory failure secondary to intussusception. Extubated with stridor improved to room air.


Changed on 6/14/2018

VAERS ID: 306984 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:Georgia
Vaccinated:2007-11-20
Onset:2008-02-02
Submitted:2008-03-10
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B125BA / 3 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF211AA / 3 LL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B54007H / 3 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 13934 / 3 MO / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium double contrast, Intussusception, Respiratory failure

Life Threatening? Yes
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topicort 0.05%
Current Illness:
Preexisting Conditions: Atopic Dermatitis 3/14/08-records received-PMH: allergies to wheat, egg and cat dander. Develops rash with wheat.
Allergies:
Diagnostic Lab Data: Air contrast enema 2/2/08 3/14/08-records received-CT head unremarkable. Abdominal CT revealed probable ileocolic intussusception, air contrast enema with successful reduction. Blood gas 7.26 ph, CO2 40. Hgb 9.8.
CDC 'Split Type':

Write-up: He was diagnosed with intussusception 2/2/08 with respiratory failure. Intussusception relieved via air contrast and reduction. 3/14/08-DC summary received for DOS 2/2/08- 2/5/08-DX Inutssusception. Afternoon of admission became fussy, refused to eat and developed pale lips. Intubated. Respiratory failure secondary to intussusception. Extubated with stridor improved to room air.


Changed on 8/14/2018

VAERS ID: 306984 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:Georgia
Vaccinated:2007-11-20
Onset:2008-02-02
Submitted:2008-03-10
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B125BA / 3 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF211AA / 3 LL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B54007H / 3 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 13934 / 3 MO / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium double contrast, Intussusception, Respiratory failure

Life Threatening? Yes
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topicort 0.05%
Current Illness:
Preexisting Conditions: Atopic Dermatitis 3/14/08-records received-PMH: allergies to wheat, egg and cat dander. Develops rash with wheat.
Allergies:
Diagnostic Lab Data: Air contrast enema 2/2/08 3/14/08-records received-CT head unremarkable. Abdominal CT revealed probable ileocolic intussusception, air contrast enema with successful reduction. Blood gas 7.26 ph, CO2 40. Hgb 9.8.
CDC 'Split Type':

Write-up: He was diagnosed with intussusception 2/2/08 with respiratory failure. Intussusception relieved via air contrast and reduction. 3/14/08-DC summary received for DOS 2/2/08- 2/5/08-DX Inutssusception. Afternoon of admission became fussy, refused to eat and developed pale lips. Intubated. Respiratory failure secondary to intussusception. Extubated with stridor improved to room air.


Changed on 9/14/2018

VAERS ID: 306984 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:Georgia
Vaccinated:2007-11-20
Onset:2008-02-02
Submitted:2008-03-10
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B125BA / 3 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF211AA / 3 LL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B54007H / 3 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 13934 / 3 MO / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium double contrast, Intussusception, Respiratory failure

Life Threatening? Yes
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topicort 0.05%
Current Illness:
Preexisting Conditions: Atopic Dermatitis 3/14/08-records received-PMH: allergies to wheat, egg and cat dander. Develops rash with wheat.
Allergies:
Diagnostic Lab Data: Air contrast enema 2/2/08 3/14/08-records received-CT head unremarkable. Abdominal CT revealed probable ileocolic intussusception, air contrast enema with successful reduction. Blood gas 7.26 ph, CO2 40. Hgb 9.8.
CDC 'Split Type':

Write-up: He was diagnosed with intussusception 2/2/08 with respiratory failure. Intussusception relieved via air contrast and reduction. 3/14/08-DC summary received for DOS 2/2/08- 2/5/08-DX Inutssusception. Afternoon of admission became fussy, refused to eat and developed pale lips. Intubated. Respiratory failure secondary to intussusception. Extubated with stridor improved to room air.


Changed on 10/14/2018

VAERS ID: 306984 Before After
VAERS Form:1
Age:0.5
Sex:Male
Location:Georgia
Vaccinated:2007-11-20
Onset:2008-02-02
Submitted:2008-03-10
Entered:2008-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B125BA / 3 LL / UN
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF211AA / 3 LL / UN
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B54007H / 3 RL / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 13934 / 3 MO / PO

Administered by: Private      Purchased by: Other
Symptoms: Barium double contrast, Intussusception, Respiratory failure

Life Threatening? Yes
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     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topicort 0.05%
Current Illness:
Preexisting Conditions: Atopic Dermatitis 3/14/08-records received-PMH: allergies to wheat, egg and cat dander. Develops rash with wheat.
Allergies:
Diagnostic Lab Data: Air contrast enema 2/2/08 3/14/08-records received-CT head unremarkable. Abdominal CT revealed probable ileocolic intussusception, air contrast enema with successful reduction. Blood gas 7.26 ph, CO2 40. Hgb 9.8.
CDC 'Split Type':

Write-up: He was diagnosed with intussusception 2/2/08 with respiratory failure. Intussusception relieved via air contrast and reduction. 3/14/08-DC summary received for DOS 2/2/08- 2/5/08-DX Inutssusception. Afternoon of admission became fussy, refused to eat and developed pale lips. Intubated. Respiratory failure secondary to intussusception. Extubated with stridor improved to room air.

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