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This is VAERS ID 316224

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

VAERS ID: 316224
VAERS Form:
Age:0.3
Sex:Male
Location:Iowa
Vaccinated:2008-03-14
Onset:2008-05-22
Submitted:2008-06-13
Entered:2008-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2799AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF297AA / 1 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0301 / 1 RL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC C54762 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal tenderness, Appendicectomy, Abdominal X-ray, Histology

Life Threatening? No
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: none
Preexisting Conditions: none. PMH: FT, uncomplicated pregnancy & delivery.
Allergies:
Diagnostic Lab Data: LABS: abdominal x-ray revealed complete bowel obstruciton. Path report revealed transmural small bowel necrosis secondary to IS
CDC 'Split Type':

Write-up: Acute bowel obstruction due to irreducible intussusception, required surgery at hospital. Tissue samples sent to CDC Atlanta for testing. Child recovered and discharged home on 5/28/08. 6/24/08 Reviewed hospital medical records of 5/24-5/28/2008. FINAL D"X: bowel obstruction secondary to nonreducible intussusception Records reveal patient had been transferred from outlying ER. Patient experienced bilious vomiting x 2 days, acute blood per rectum, abdominal tenderness & distention. Emergent laparotomy fo


Changed on 12/8/2009

VAERS ID: 316224 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Iowa
Vaccinated:2008-03-14
Onset:2008-05-22
Submitted:2008-06-13
Entered:2008-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2799AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF297AA / 1 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0301 / 1 RL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC C54762 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal tenderness, Appendicectomy, Intestinal obstruction, Intussusception, Laparotomy, Rectal haemorrhage, Surgery, Vomiting, Intestinal resection, Abdominal X-ray, Histology

Life Threatening? No
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: none
Preexisting Conditions: none. PMH: FT, uncomplicated pregnancy & delivery.
Allergies:
Diagnostic Lab Data: LABS: abdominal x-ray revealed complete bowel obstruciton. Path report revealed transmural small bowel necrosis secondary to IS
CDC 'Split Type':

Write-up: Acute bowel obstruction due to irreducible intussusception, required surgery at hospital. Tissue samples sent to CDC Atlanta for testing. Child recovered and discharged home on 5/28/08. 6/24/08 Reviewed hospital medical records of 5/24-5/28/2008. FINAL D"X: DX: bowel obstruction secondary to nonreducible intussusception Records reveal patient had been transferred from outlying ER. Patient experienced bilious vomiting x 2 days, acute blood per rectum, abdominal tenderness & distention. Emergent laparotomy fo for abdominal exploration, ileal resection w/primary anastomosis, appendectomy & CVP placement. Did well post operatively, tolerating oral feeds well & d/c to home


Changed on 3/2/2010

VAERS ID: 316224 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Iowa
Vaccinated:2008-03-14
Onset:2008-05-22
Submitted:2008-06-13
Entered:2008-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2799AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF297AA / 1 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0301 / 1 RL / IM
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC C54762 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal tenderness, Appendicectomy, Intestinal obstruction, Intussusception, Laparotomy, Rectal haemorrhage, Surgery, Vomiting, Intestinal resection, Abdominal X-ray, Histology

Life Threatening? No
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: none
Preexisting Conditions: none. PMH: FT, uncomplicated pregnancy & delivery.
Allergies:
Diagnostic Lab Data: LABS: abdominal x-ray revealed complete bowel obstruciton. Path report revealed transmural small bowel necrosis secondary to IS
CDC 'Split Type':

Write-up: Acute bowel obstruction due to irreducible intussusception, required surgery at hospital. Tissue samples sent to CDC Atlanta for testing. Child recovered and discharged home on 5/28/08. 6/24/08 Reviewed hospital medical records of 5/24-5/28/2008. FINAL DX: bowel obstruction secondary to nonreducible intussusception Records reveal patient had been transferred from outlying ER. Patient experienced bilious vomiting x 2 days, acute blood per rectum, abdominal tenderness & distention. Emergent laparotomy for abdominal exploration, ileal resection w/primary anastomosis, appendectomy & CVP placement. Did well post operatively, tolerating oral feeds well & d/c to home


Changed on 4/7/2010

VAERS ID: 316224 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Iowa
Vaccinated:2008-03-14
Onset:2008-05-22
Submitted:2008-06-13
Entered:2008-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2799AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF297AA / 1 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0301 / 1 RL / IM
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC C54762 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal tenderness, Appendicectomy, Intestinal obstruction, Intussusception, Laparotomy, Rectal haemorrhage, Surgery, Vomiting, Intestinal resection, Abdominal X-ray, Histology

Life Threatening? No
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: none
Preexisting Conditions: none. PMH: FT, uncomplicated pregnancy & delivery.
Allergies:
Diagnostic Lab Data: LABS: abdominal x-ray revealed complete bowel obstruciton. Path report revealed transmural small bowel necrosis secondary to IS
CDC 'Split Type':

Write-up: Acute bowel obstruction due to irreducible intussusception, required surgery at hospital. Tissue samples sent to CDC Atlanta for testing. Child recovered and discharged home on 5/28/08. 6/24/08 Reviewed hospital medical records of 5/24-5/28/2008. FINAL DX: bowel obstruction secondary to nonreducible intussusception Records reveal patient had been transferred from outlying ER. Patient experienced bilious vomiting x 2 days, acute blood per rectum, abdominal tenderness & distention. Emergent laparotomy for abdominal exploration, ileal resection w/primary anastomosis, appendectomy & CVP placement. Did well post operatively, tolerating oral feeds well & d/c to home


Changed on 8/31/2010

VAERS ID: 316224 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Iowa
Vaccinated:2008-03-14
Onset:2008-05-22
Submitted:2008-06-13
Entered:2008-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2799AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF297AA / 1 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0301 / 1 RL / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH C54762 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal tenderness, Appendicectomy, Intestinal obstruction, Intussusception, Laparotomy, Rectal haemorrhage, Surgery, Vomiting, Intestinal resection, Abdominal X-ray, Histology

Life Threatening? No
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: none
Preexisting Conditions: none. PMH: FT, uncomplicated pregnancy & delivery.
Allergies:
Diagnostic Lab Data: LABS: abdominal x-ray revealed complete bowel obstruciton. Path report revealed transmural small bowel necrosis secondary to IS
CDC 'Split Type':

Write-up: Acute bowel obstruction due to irreducible intussusception, required surgery at hospital. Tissue samples sent to CDC Atlanta for testing. Child recovered and discharged home on 5/28/08. 6/24/08 Reviewed hospital medical records of 5/24-5/28/2008. FINAL DX: bowel obstruction secondary to nonreducible intussusception Records reveal patient had been transferred from outlying ER. Patient experienced bilious vomiting x 2 days, acute blood per rectum, abdominal tenderness & distention. Emergent laparotomy for abdominal exploration, ileal resection w/primary anastomosis, appendectomy & CVP placement. Did well post operatively, tolerating oral feeds well & d/c to home


Changed on 5/13/2013

VAERS ID: 316224 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Iowa
Vaccinated:2008-03-14
Onset:2008-05-22
Submitted:2008-06-13
Entered:2008-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2799AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF297AA / 1 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0301 / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C54762 / 1 LL / IM
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 - / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal tenderness, Appendicectomy, Intestinal obstruction, Intussusception, Laparotomy, Rectal haemorrhage, Surgery, Vomiting, Intestinal resection, Abdominal X-ray, Histology

Life Threatening? No
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: none
Preexisting Conditions: none. PMH: FT, uncomplicated pregnancy & delivery.
Allergies:
Diagnostic Lab Data: LABS: abdominal x-ray revealed complete bowel obstruciton. Path report revealed transmural small bowel necrosis secondary to IS
CDC 'Split Type':

Write-up: Acute bowel obstruction due to irreducible intussusception, required surgery at hospital. Tissue samples sent to CDC Atlanta for testing. Child recovered and discharged home on 5/28/08. 6/24/08 Reviewed hospital medical records of 5/24-5/28/2008. FINAL DX: bowel obstruction secondary to nonreducible intussusception Records reveal patient had been transferred from outlying ER. Patient experienced bilious vomiting x 2 days, acute blood per rectum, abdominal tenderness & distention. Emergent laparotomy for abdominal exploration, ileal resection w/primary anastomosis, appendectomy & CVP placement. Did well post operatively, tolerating oral feeds well & d/c to home


Changed on 4/14/2017

VAERS ID: 316224 Before After
VAERS Form:
Age:0.3
Sex:Male
Location:Iowa
Vaccinated:2008-03-14
Onset:2008-05-22
Submitted:2008-06-13
Entered:2008-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2799AA / 1 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF297AA / 1 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0301 / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C54762 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 - / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal distension, Abdominal tenderness, Appendicectomy, Intestinal obstruction, Intussusception, Laparotomy, Rectal haemorrhage, Surgery, Vomiting, Intestinal resection, Abdominal X-ray, Histology

Life Threatening? No
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: none
Preexisting Conditions: none. PMH: FT, uncomplicated pregnancy & delivery.
Allergies:
Diagnostic Lab Data: LABS: abdominal x-ray revealed complete bowel obstruciton. Path report revealed transmural small bowel necrosis secondary to IS
CDC 'Split Type':

Write-up: Acute bowel obstruction due to irreducible intussusception, required surgery at hospital. Tissue samples sent to CDC Atlanta for testing. Child recovered and discharged home on 5/28/08. 6/24/08 Reviewed hospital medical records of 5/24-5/28/2008. FINAL DX: bowel obstruction secondary to nonreducible intussusception Records reveal patient had been transferred from outlying ER. Patient experienced bilious vomiting x 2 days, acute blood per rectum, abdominal tenderness & distention. Emergent laparotomy for abdominal exploration, ileal resection w/primary anastomosis, appendectomy & CVP placement. Did well post operatively, tolerating oral feeds well & d/c to home


Changed on 9/14/2017

VAERS ID: 316224 Before After
VAERS Form:(blank) 1
Age:0.3
Sex:Male
Location:Iowa
Vaccinated:2008-03-14
Onset:2008-05-22
Submitted:2008-06-13
Entered:2008-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2799AA / 1 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF297AA / 1 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0301 / 1 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C54762 / 1 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 1 2 - MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intestinal obstruction, Intussusception, Surgery

Life Threatening? No
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: none
Preexisting Conditions: none. PMH: FT, uncomplicated pregnancy & delivery.
Allergies:
Diagnostic Lab Data: LABS: abdominal x-ray revealed complete bowel obstruciton. Path report revealed transmural small bowel necrosis secondary to IS
CDC 'Split Type':

Write-up: Acute bowel obstruction due to irreducible intussusception, required surgery at hospital. Tissue samples sent to CDC Atlanta for testing. Child recovered and discharged home on 5/28/08. 6/24/08 Reviewed hospital medical records of 5/24-5/28/2008. FINAL DX: bowel obstruction secondary to nonreducible intussusception Records reveal patient had been transferred from outlying ER. Patient experienced bilious vomiting x 2 days, acute blood per rectum, abdominal tenderness & distention. Emergent laparotomy for abdominal exploration, ileal resection w/primary anastomosis, appendectomy & CVP placement. Did well post operatively, tolerating oral feeds well & d/c to home


Changed on 2/14/2018

VAERS ID: 316224 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Iowa
Vaccinated:2008-03-14
Onset:2008-05-22
Submitted:2008-06-13
Entered:2008-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2799AA / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF297AA / 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0301 / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C54762 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 2 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intestinal obstruction, Intussusception, Surgery

Life Threatening? No
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: none
Preexisting Conditions: none. PMH: FT, uncomplicated pregnancy & delivery.
Allergies:
Diagnostic Lab Data: LABS: abdominal x-ray revealed complete bowel obstruciton. Path report revealed transmural small bowel necrosis secondary to IS
CDC 'Split Type':

Write-up: Acute bowel obstruction due to irreducible intussusception, required surgery at hospital. Tissue samples sent to CDC Atlanta for testing. Child recovered and discharged home on 5/28/08. 6/24/08 Reviewed hospital medical records of 5/24-5/28/2008. FINAL DX: bowel obstruction secondary to nonreducible intussusception Records reveal patient had been transferred from outlying ER. Patient experienced bilious vomiting x 2 days, acute blood per rectum, abdominal tenderness & distention. Emergent laparotomy for abdominal exploration, ileal resection w/primary anastomosis, appendectomy & CVP placement. Did well post operatively, tolerating oral feeds well & d/c to home


Changed on 6/14/2018

VAERS ID: 316224 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Iowa
Vaccinated:2008-03-14
Onset:2008-05-22
Submitted:2008-06-13
Entered:2008-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2799AA / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF297AA / 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0301 / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C54762 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 2 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intestinal obstruction, Intussusception, Surgery

Life Threatening? No
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: none
Preexisting Conditions: none. PMH: FT, uncomplicated pregnancy & delivery.
Allergies:
Diagnostic Lab Data: LABS: abdominal x-ray revealed complete bowel obstruciton. Path report revealed transmural small bowel necrosis secondary to IS
CDC 'Split Type':

Write-up: Acute bowel obstruction due to irreducible intussusception, required surgery at hospital. Tissue samples sent to CDC Atlanta for testing. Child recovered and discharged home on 5/28/08. 6/24/08 Reviewed hospital medical records of 5/24-5/28/2008. FINAL DX: bowel obstruction secondary to nonreducible intussusception Records reveal patient had been transferred from outlying ER. Patient experienced bilious vomiting x 2 days, acute blood per rectum, abdominal tenderness & distention. Emergent laparotomy for abdominal exploration, ileal resection w/primary anastomosis, appendectomy & CVP placement. Did well post operatively, tolerating oral feeds well & d/c to home


Changed on 8/14/2018

VAERS ID: 316224 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Iowa
Vaccinated:2008-03-14
Onset:2008-05-22
Submitted:2008-06-13
Entered:2008-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2799AA / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF297AA / 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0301 / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C54762 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 2 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intestinal obstruction, Intussusception, Surgery

Life Threatening? No
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: none
Preexisting Conditions: none. PMH: FT, uncomplicated pregnancy & delivery.
Allergies:
Diagnostic Lab Data: LABS: abdominal x-ray revealed complete bowel obstruciton. Path report revealed transmural small bowel necrosis secondary to IS
CDC 'Split Type':

Write-up: Acute bowel obstruction due to irreducible intussusception, required surgery at hospital. Tissue samples sent to CDC Atlanta for testing. Child recovered and discharged home on 5/28/08. 6/24/08 Reviewed hospital medical records of 5/24-5/28/2008. FINAL DX: bowel obstruction secondary to nonreducible intussusception Records reveal patient had been transferred from outlying ER. Patient experienced bilious vomiting x 2 days, acute blood per rectum, abdominal tenderness & distention. Emergent laparotomy for abdominal exploration, ileal resection w/primary anastomosis, appendectomy & CVP placement. Did well post operatively, tolerating oral feeds well & d/c to home


Changed on 9/14/2018

VAERS ID: 316224 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Iowa
Vaccinated:2008-03-14
Onset:2008-05-22
Submitted:2008-06-13
Entered:2008-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2799AA / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF297AA / 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0301 / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C54762 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 2 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intestinal obstruction, Intussusception, Surgery

Life Threatening? No
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: none
Preexisting Conditions: none. PMH: FT, uncomplicated pregnancy & delivery.
Allergies:
Diagnostic Lab Data: LABS: abdominal x-ray revealed complete bowel obstruciton. Path report revealed transmural small bowel necrosis secondary to IS
CDC 'Split Type':

Write-up: Acute bowel obstruction due to irreducible intussusception, required surgery at hospital. Tissue samples sent to CDC Atlanta for testing. Child recovered and discharged home on 5/28/08. 6/24/08 Reviewed hospital medical records of 5/24-5/28/2008. FINAL DX: bowel obstruction secondary to nonreducible intussusception Records reveal patient had been transferred from outlying ER. Patient experienced bilious vomiting x 2 days, acute blood per rectum, abdominal tenderness & distention. Emergent laparotomy for abdominal exploration, ileal resection w/primary anastomosis, appendectomy & CVP placement. Did well post operatively, tolerating oral feeds well & d/c to home


Changed on 10/14/2018

VAERS ID: 316224 Before After
VAERS Form:1
Age:0.3
Sex:Male
Location:Iowa
Vaccinated:2008-03-14
Onset:2008-05-22
Submitted:2008-06-13
Entered:2008-06-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2799AA / 2 RL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF297AA / 2 LL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0301 / 2 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C54762 / 2 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1620U / 2 MO / PO

Administered by: Unknown      Purchased by: Unknown
Symptoms: Intestinal obstruction, Intussusception, Surgery

Life Threatening? No
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: none
Preexisting Conditions: none. PMH: FT, uncomplicated pregnancy & delivery.
Allergies:
Diagnostic Lab Data: LABS: abdominal x-ray revealed complete bowel obstruciton. Path report revealed transmural small bowel necrosis secondary to IS
CDC 'Split Type':

Write-up: Acute bowel obstruction due to irreducible intussusception, required surgery at hospital. Tissue samples sent to CDC Atlanta for testing. Child recovered and discharged home on 5/28/08. 6/24/08 Reviewed hospital medical records of 5/24-5/28/2008. FINAL DX: bowel obstruction secondary to nonreducible intussusception Records reveal patient had been transferred from outlying ER. Patient experienced bilious vomiting x 2 days, acute blood per rectum, abdominal tenderness & distention. Emergent laparotomy for abdominal exploration, ileal resection w/primary anastomosis, appendectomy & CVP placement. Did well post operatively, tolerating oral feeds well & d/c to home

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