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This is VAERS ID 312391

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

VAERS ID: 312391
VAERS Form:
Age:0.5
Gender:Male
Location:Oregon
Vaccinated:2007-12-18
Onset:2008-05-08
Submitted:2008-05-15
Entered:2008-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2765AA / 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0169 / 2 LL / SC
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC C45888 / 2 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0903U / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal pain, Barium double contrast, Crying, Blood test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: ultrasound for diagnosis and xrays before and after and rountine blood work 6/20/08-records received- Stool quaiac positive and KUB showed possibly gas in right side of abdomen.. Ultrasound showed ileocecal intussusception.
CDC 'Split Type':

Write-up: on 5/10/2008 Adnitted to Hospital for vomitting and diarrhea, bloody stools. Abd ultrasound consisitent with Ileocolic Intussusception! Air Reduction Kit utilized and no obstruction and a successdul reduction if the intussusception done. Patient was in th"e hospital for 4 days 6/20/08-records received for Dos 5/8-5/13/08- DC DX:Ileocecal Intussusception. Therapeutic air contrast enema for reduction was successful. Admitted with nausea and vomiting, on 3rd day of hospitalization episodic crying and attacks


Changed on 12/8/2009

VAERS ID: 312391 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Oregon
Vaccinated:2007-12-18
Onset:2008-05-08
Submitted:2008-05-15
Entered:2008-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2765AA / 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0169 / 2 LL / SC
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC C45888 / 2 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0903U / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal pain, Barium double contrast, Crying, Diarrhoea, Haematochezia, Intussusception, Ultrasound scan, Urinary system X-ray, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Blood test, Occult blood positive, Gastrointestinal sounds abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: ultrasound for diagnosis and xrays before and after and rountine blood work 6/20/08-records received- Stool quaiac positive and KUB showed possibly gas in right side of abdomen.. Ultrasound showed ileocecal intussusception.
CDC 'Split Type':

Write-up: on 5/10/2008 Adnitted to Hospital for vomitting and diarrhea, bloody stools. Abd ultrasound consisitent with Ileocolic Intussusception! Air Reduction Kit utilized and no obstruction and a successdul reduction if the intussusception done. Patient was in th"e the hospital for 4 days 6/20/08-records received for Dos 5/8-5/13/08- DC DX:Ileocecal Intussusception. Therapeutic air contrast enema for reduction was successful. Admitted with nausea and vomiting, on 3rd day of hospitalization episodic crying and attacks of abdominal pain, more vomiting. Abdomen distended. Hypoactive bowel sounds


Changed on 3/2/2010

VAERS ID: 312391 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Oregon
Vaccinated:2007-12-18
Onset:2008-05-08
Submitted:2008-05-15
Entered:2008-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2765AA / 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0169 / 2 LL / SC
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC C45888 / 2 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0903U / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal pain, Barium double contrast, Crying, Diarrhoea, Haematochezia, Intussusception, Ultrasound scan, Urinary system X-ray, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Blood test, Occult blood positive, Gastrointestinal sounds abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: ultrasound for diagnosis and xrays before and after and rountine blood work 6/20/08-records received- Stool quaiac positive and KUB showed possibly gas in right side of abdomen.. Ultrasound showed ileocecal intussusception.
CDC 'Split Type':

Write-up: on 5/10/2008 Adnitted to Hospital for vomitting and diarrhea, bloody stools. Abd ultrasound consisitent with Ileocolic Intussusception! Air Reduction Kit utilized and no obstruction and a successdul reduction if the intussusception done. Patient was in the hospital for 4 days 6/20/08-records received for Dos 5/8-5/13/08- DC DX:Ileocecal Intussusception. Therapeutic air contrast enema for reduction was successful. Admitted with nausea and vomiting, on 3rd day of hospitalization episodic crying and attacks of abdominal pain, more vomiting. Abdomen distended. Hypoactive bowel sounds


Changed on 4/7/2010

VAERS ID: 312391 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Oregon
Vaccinated:2007-12-18
Onset:2008-05-08
Submitted:2008-05-15
Entered:2008-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2765AA / 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0169 / 2 LL / SC
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC C45888 / 2 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0903U / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal pain, Barium double contrast, Crying, Diarrhoea, Haematochezia, Intussusception, Ultrasound scan, Urinary system X-ray, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Blood test, Occult blood positive, Gastrointestinal sounds abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: ultrasound for diagnosis and xrays before and after and rountine blood work 6/20/08-records received- Stool quaiac positive and KUB showed possibly gas in right side of abdomen.. Ultrasound showed ileocecal intussusception.
CDC 'Split Type':

Write-up: on 5/10/2008 Adnitted to Hospital for vomitting and diarrhea, bloody stools. Abd ultrasound consisitent with Ileocolic Intussusception! Air Reduction Kit utilized and no obstruction and a successdul reduction if the intussusception done. Patient was in the hospital for 4 days 6/20/08-records received for Dos 5/8-5/13/08- DC DX:Ileocecal Intussusception. Therapeutic air contrast enema for reduction was successful. Admitted with nausea and vomiting, on 3rd day of hospitalization episodic crying and attacks of abdominal pain, more vomiting. Abdomen distended. Hypoactive bowel sounds


Changed on 8/31/2010

VAERS ID: 312391 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Oregon
Vaccinated:2007-12-18
Onset:2008-05-08
Submitted:2008-05-15
Entered:2008-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2765AA / 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0169 / 2 LL / SC
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH C45888 / 2 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0903U / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal pain, Barium double contrast, Crying, Diarrhoea, Haematochezia, Intussusception, Ultrasound scan, Urinary system X-ray, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Blood test, Occult blood positive, Gastrointestinal sounds abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: ultrasound for diagnosis and xrays before and after and rountine blood work 6/20/08-records received- Stool quaiac positive and KUB showed possibly gas in right side of abdomen.. Ultrasound showed ileocecal intussusception.
CDC 'Split Type':

Write-up: on 5/10/2008 Adnitted to Hospital for vomitting and diarrhea, bloody stools. Abd ultrasound consisitent with Ileocolic Intussusception! Air Reduction Kit utilized and no obstruction and a successdul reduction if the intussusception done. Patient was in the hospital for 4 days 6/20/08-records received for Dos 5/8-5/13/08- DC DX:Ileocecal Intussusception. Therapeutic air contrast enema for reduction was successful. Admitted with nausea and vomiting, on 3rd day of hospitalization episodic crying and attacks of abdominal pain, more vomiting. Abdomen distended. Hypoactive bowel sounds


Changed on 5/13/2013

VAERS ID: 312391 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Oregon
Vaccinated:2007-12-18
Onset:2008-05-08
Submitted:2008-05-15
Entered:2008-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2765AA / 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0169 / 2 LL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C45888 / 2 RL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0903U / 2 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0903U / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal pain, Barium double contrast, Crying, Diarrhoea, Haematochezia, Intussusception, Ultrasound scan, Urinary system X-ray, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Blood test, Occult blood positive, Gastrointestinal sounds abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: ultrasound for diagnosis and xrays before and after and rountine blood work 6/20/08-records received- Stool quaiac positive and KUB showed possibly gas in right side of abdomen.. Ultrasound showed ileocecal intussusception.
CDC 'Split Type':

Write-up: on 5/10/2008 Adnitted to Hospital for vomitting and diarrhea, bloody stools. Abd ultrasound consisitent with Ileocolic Intussusception! Air Reduction Kit utilized and no obstruction and a successdul reduction if the intussusception done. Patient was in the hospital for 4 days 6/20/08-records received for Dos 5/8-5/13/08- DC DX:Ileocecal Intussusception. Therapeutic air contrast enema for reduction was successful. Admitted with nausea and vomiting, on 3rd day of hospitalization episodic crying and attacks of abdominal pain, more vomiting. Abdomen distended. Hypoactive bowel sounds


Changed on 4/14/2017

VAERS ID: 312391 Before After
VAERS Form:
Age:0.5
Gender:Male
Location:Oregon
Vaccinated:2007-12-18
Onset:2008-05-08
Submitted:2008-05-15
Entered:2008-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2765AA / 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0169 / 2 LL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C45888 / 2 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0903U / 2 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal pain, Barium double contrast, Crying, Diarrhoea, Haematochezia, Intussusception, Ultrasound scan, Urinary system X-ray, Vomiting, X-ray abnormal, Ultrasound abdomen abnormal, Blood test, Occult blood positive, Gastrointestinal sounds abnormal

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: ultrasound for diagnosis and xrays before and after and rountine blood work 6/20/08-records received- Stool quaiac positive and KUB showed possibly gas in right side of abdomen.. Ultrasound showed ileocecal intussusception.
CDC 'Split Type':

Write-up: on 5/10/2008 Adnitted to Hospital for vomitting and diarrhea, bloody stools. Abd ultrasound consisitent with Ileocolic Intussusception! Air Reduction Kit utilized and no obstruction and a successdul reduction if the intussusception done. Patient was in the hospital for 4 days 6/20/08-records received for Dos 5/8-5/13/08- DC DX:Ileocecal Intussusception. Therapeutic air contrast enema for reduction was successful. Admitted with nausea and vomiting, on 3rd day of hospitalization episodic crying and attacks of abdominal pain, more vomiting. Abdomen distended. Hypoactive bowel sounds


Changed on 9/14/2017

VAERS ID: 312391 Before After
VAERS Form:(blank) 1
Age:0.5
Gender:Male
Location:Oregon
Vaccinated:2007-12-18
Onset:2008-05-08
Submitted:2008-05-15
Entered:2008-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2765AA / 2 3 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0169 / 2 3 LL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C45888 / 2 3 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0903U / 2 3 - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diarrhoea, Haematochezia, Intussusception, Ultrasound scan, Vomiting, Blood test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: ultrasound for diagnosis and xrays before and after and rountine blood work 6/20/08-records received- Stool quaiac positive and KUB showed possibly gas in right side of abdomen.. Ultrasound showed ileocecal intussusception.
CDC 'Split Type':

Write-up: on 5/10/2008 Adnitted to Hospital for vomitting and diarrhea, bloody stools. Abd ultrasound consisitent with Ileocolic Intussusception! Air Reduction Kit utilized and no obstruction and a successdul reduction if the intussusception done. Patient was in the hospital for 4 days 6/20/08-records received for Dos 5/8-5/13/08- DC DX:Ileocecal Intussusception. Therapeutic air contrast enema for reduction was successful. Admitted with nausea and vomiting, on 3rd day of hospitalization episodic crying and attacks of abdominal pain, more vomiting. Abdomen distended. Hypoactive bowel sounds


Changed on 2/14/2018

VAERS ID: 312391 Before After
VAERS Form:1
Age:0.5
Gender:Male
Location:Oregon
Vaccinated:2007-12-18
Onset:2008-05-08
Submitted:2008-05-15
Entered:2008-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2765AA / 3 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0169 / 3 LL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C45888 / 3 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0903U / 3 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diarrhoea, Haematochezia, Intussusception, Ultrasound scan, Vomiting, Blood test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: ultrasound for diagnosis and xrays before and after and rountine blood work 6/20/08-records received- Stool quaiac positive and KUB showed possibly gas in right side of abdomen.. Ultrasound showed ileocecal intussusception.
CDC 'Split Type':

Write-up: on 5/10/2008 Adnitted to Hospital for vomitting and diarrhea, bloody stools. Abd ultrasound consisitent with Ileocolic Intussusception! Air Reduction Kit utilized and no obstruction and a successdul reduction if the intussusception done. Patient was in the hospital for 4 days 6/20/08-records received for Dos 5/8-5/13/08- DC DX:Ileocecal Intussusception. Therapeutic air contrast enema for reduction was successful. Admitted with nausea and vomiting, on 3rd day of hospitalization episodic crying and attacks of abdominal pain, more vomiting. Abdomen distended. Hypoactive bowel sounds


Changed on 6/14/2018

VAERS ID: 312391 Before After
VAERS Form:1
Age:0.5
Gender:Male
Location:Oregon
Vaccinated:2007-12-18
Onset:2008-05-08
Submitted:2008-05-15
Entered:2008-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2765AA / 3 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0169 / 3 LL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C45888 / 3 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0903U / 3 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diarrhoea, Haematochezia, Intussusception, Ultrasound scan, Vomiting, Blood test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: ultrasound for diagnosis and xrays before and after and rountine blood work 6/20/08-records received- Stool quaiac positive and KUB showed possibly gas in right side of abdomen.. Ultrasound showed ileocecal intussusception.
CDC 'Split Type':

Write-up: on 5/10/2008 Adnitted to Hospital for vomitting and diarrhea, bloody stools. Abd ultrasound consisitent with Ileocolic Intussusception! Air Reduction Kit utilized and no obstruction and a successdul reduction if the intussusception done. Patient was in the hospital for 4 days 6/20/08-records received for Dos 5/8-5/13/08- DC DX:Ileocecal Intussusception. Therapeutic air contrast enema for reduction was successful. Admitted with nausea and vomiting, on 3rd day of hospitalization episodic crying and attacks of abdominal pain, more vomiting. Abdomen distended. Hypoactive bowel sounds


Changed on 8/14/2018

VAERS ID: 312391 Before After
VAERS Form:1
Age:0.5
Gender:Male
Location:Oregon
Vaccinated:2007-12-18
Onset:2008-05-08
Submitted:2008-05-15
Entered:2008-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2765AA / 3 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0169 / 3 LL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C45888 / 3 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0903U / 3 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diarrhoea, Haematochezia, Intussusception, Ultrasound scan, Vomiting, Blood test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: ultrasound for diagnosis and xrays before and after and rountine blood work 6/20/08-records received- Stool quaiac positive and KUB showed possibly gas in right side of abdomen.. Ultrasound showed ileocecal intussusception.
CDC 'Split Type':

Write-up: on 5/10/2008 Adnitted to Hospital for vomitting and diarrhea, bloody stools. Abd ultrasound consisitent with Ileocolic Intussusception! Air Reduction Kit utilized and no obstruction and a successdul reduction if the intussusception done. Patient was in the hospital for 4 days 6/20/08-records received for Dos 5/8-5/13/08- DC DX:Ileocecal Intussusception. Therapeutic air contrast enema for reduction was successful. Admitted with nausea and vomiting, on 3rd day of hospitalization episodic crying and attacks of abdominal pain, more vomiting. Abdomen distended. Hypoactive bowel sounds


Changed on 9/14/2018

VAERS ID: 312391 Before After
VAERS Form:1
Age:0.5
Gender:Male
Location:Oregon
Vaccinated:2007-12-18
Onset:2008-05-08
Submitted:2008-05-15
Entered:2008-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2765AA / 3 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0169 / 3 LL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C45888 / 3 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0903U / 3 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diarrhoea, Haematochezia, Intussusception, Ultrasound scan, Vomiting, Blood test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: ultrasound for diagnosis and xrays before and after and rountine blood work 6/20/08-records received- Stool quaiac positive and KUB showed possibly gas in right side of abdomen.. Ultrasound showed ileocecal intussusception.
CDC 'Split Type':

Write-up: on 5/10/2008 Adnitted to Hospital for vomitting and diarrhea, bloody stools. Abd ultrasound consisitent with Ileocolic Intussusception! Air Reduction Kit utilized and no obstruction and a successdul reduction if the intussusception done. Patient was in the hospital for 4 days 6/20/08-records received for Dos 5/8-5/13/08- DC DX:Ileocecal Intussusception. Therapeutic air contrast enema for reduction was successful. Admitted with nausea and vomiting, on 3rd day of hospitalization episodic crying and attacks of abdominal pain, more vomiting. Abdomen distended. Hypoactive bowel sounds


Changed on 10/14/2018

VAERS ID: 312391 Before After
VAERS Form:1
Age:0.5
Gender:Male
Location:Oregon
Vaccinated:2007-12-18
Onset:2008-05-08
Submitted:2008-05-15
Entered:2008-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2765AA / 3 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0169 / 3 LL / SC
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C45888 / 3 RL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0903U / 3 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diarrhoea, Haematochezia, Intussusception, Ultrasound scan, Vomiting, Blood test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data: ultrasound for diagnosis and xrays before and after and rountine blood work 6/20/08-records received- Stool quaiac positive and KUB showed possibly gas in right side of abdomen.. Ultrasound showed ileocecal intussusception.
CDC 'Split Type':

Write-up: on 5/10/2008 Adnitted to Hospital for vomitting and diarrhea, bloody stools. Abd ultrasound consisitent with Ileocolic Intussusception! Air Reduction Kit utilized and no obstruction and a successdul reduction if the intussusception done. Patient was in the hospital for 4 days 6/20/08-records received for Dos 5/8-5/13/08- DC DX:Ileocecal Intussusception. Therapeutic air contrast enema for reduction was successful. Admitted with nausea and vomiting, on 3rd day of hospitalization episodic crying and attacks of abdominal pain, more vomiting. Abdomen distended. Hypoactive bowel sounds

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