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Administered by: Private      Purchased by: Private
Symptoms: Death, Intussusception, Nasopharyngitis, Pneumonia, Pyrexia, Unresponsive to stimuli, Autopsy, Inflammation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-12-04
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None except runny nose
Preexisting Conditions: Pre-maturity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive in crib by parents. No symptoms prior - autopsy revealed intussusception. Pronounced dead at ER. 1/23/09 Autopsy report states COD as complications of intussusception. Also states: six areas of IS of small intestine; changes of distant intestine present; early pneumonia; inflammation of lung tissue & small airways. Patient had been found unresponsive in crib after recent history of cold like symptoms with fever.

Changed on 3/2/2010

Administered by: Private      Purchased by: Private
Symptoms: Death, Intussusception, Nasopharyngitis, Pneumonia, Pyrexia, Unresponsive to stimuli, Autopsy, Inflammation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-12-04
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None except runny nose
Preexisting Conditions: Pre-maturity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive in crib by parents. No symptoms prior - autopsy revealed intussusception. Pronounced dead at ER. 1/23/09 Autopsy report states COD as complications of intussusception. Also states: six areas of IS of small intestine; changes of distant intestine present; early pneumonia; inflammation of lung tissue & small airways. Patient had been found unresponsive in crib after recent history of cold like symptoms with fever.

Changed on 4/7/2010

Administered by: Private      Purchased by: Private
Symptoms: Death, Intussusception, Nasopharyngitis, Pneumonia, Pyrexia, Unresponsive to stimuli, Autopsy, Inflammation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-12-04
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None except runny nose
Preexisting Conditions: Pre-maturity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive in crib by parents. No symptoms prior - autopsy revealed intussusception. Pronounced dead at ER. 1/23/09 Autopsy report states COD as complications of intussusception. Also states: six areas of IS of small intestine; changes of distant intestine present; early pneumonia; inflammation of lung tissue & small airways. Patient had been found unresponsive in crib after recent history of cold like symptoms with fever.

Changed on 8/31/2010

Administered by: Private      Purchased by: Private
Symptoms: Death, Intussusception, Nasopharyngitis, Pneumonia, Pyrexia, Unresponsive to stimuli, Autopsy, Inflammation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-12-04
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None except runny nose
Preexisting Conditions: Pre-maturity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive in crib by parents. No symptoms prior - autopsy revealed intussusception. Pronounced dead at ER. 1/23/09 Autopsy report states COD as complications of intussusception. Also states: six areas of IS of small intestine; changes of distant intestine present; early pneumonia; inflammation of lung tissue & small airways. Patient had been found unresponsive in crib after recent history of cold like symptoms with fever.

Changed on 5/13/2013

Administered by: Private      Purchased by: Private
Symptoms: Death, Intussusception, Nasopharyngitis, Pneumonia, Pyrexia, Unresponsive to stimuli, Autopsy, Inflammation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-12-04
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None except runny nose
Preexisting Conditions: Pre-maturity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive in crib by parents. No symptoms prior - autopsy revealed intussusception. Pronounced dead at ER. 1/23/09 Autopsy report states COD as complications of intussusception. Also states: six areas of IS of small intestine; changes of distant intestine present; early pneumonia; inflammation of lung tissue & small airways. Patient had been found unresponsive in crib after recent history of cold like symptoms with fever.

Changed on 6/14/2014

Administered by: Private      Purchased by: Private
Symptoms: Death, Intussusception, Nasopharyngitis, Pneumonia, Pyrexia, Unresponsive to stimuli, Autopsy, Inflammation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-12-04
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None except runny nose
Preexisting Conditions: Pre-maturity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive in crib by parents. No symptoms prior - autopsy revealed intussusception. Pronounced dead at ER. 1/23/09 Autopsy report states COD as complications of intussusception. Also states: six areas of IS of small intestine; changes of distant intestine present; early pneumonia; inflammation of lung tissue & small airways. Patient had been found unresponsive in crib after recent history of cold like symptoms with fever.

Changed on 3/14/2015

Administered by: Private      Purchased by: Private
Symptoms: Death, Intussusception, Nasopharyngitis, Pneumonia, Pyrexia, Unresponsive to stimuli, Autopsy, Inflammation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-12-04
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None except runny nose
Preexisting Conditions: Pre-maturity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive in crib by parents. No symptoms prior - autopsy revealed intussusception. Pronounced dead at ER. 1/23/09 Autopsy report states COD as complications of intussusception. Also states: six areas of IS of small intestine; changes of distant intestine present; early pneumonia; inflammation of lung tissue & small airways. Patient had been found unresponsive in crib after recent history of cold like symptoms with fever.

Changed on 2/14/2017

Administered by: Private      Purchased by: Private
Symptoms: Death, Intussusception, Nasopharyngitis, Pneumonia, Pyrexia, Unresponsive to stimuli, Autopsy, Inflammation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-12-04
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None except runny nose
Preexisting Conditions: Pre-maturity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive in crib by parents. No symptoms prior - autopsy revealed intussusception. Pronounced dead at ER. 1/23/09 Autopsy report states COD as complications of intussusception. Also states: six areas of IS of small intestine; changes of distant intestine present; early pneumonia; inflammation of lung tissue & small airways. Patient had been found unresponsive in crib after recent history of cold like symptoms with fever.

Changed on 3/14/2017

Administered by: Private      Purchased by: Private
Symptoms: Death, Intussusception, Nasopharyngitis, Pneumonia, Pyrexia, Unresponsive to stimuli, Autopsy, Inflammation

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-12-04
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None except runny nose
Preexisting Conditions: Pre-maturity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive in crib by parents. No symptoms prior - autopsy revealed intussusception. Pronounced dead at ER. 1/23/09 Autopsy report states COD as complications of intussusception. Also states: six areas of IS of small intestine; changes of distant intestine present; early pneumonia; inflammation of lung tissue & small airways. Patient had been found unresponsive in crib after recent history of cold like symptoms with fever.

Changed on 4/14/2017

Administered by: Private      Purchased by: Private
Symptoms: Death, Intussusception, Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-12-04
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None except runny nose
Preexisting Conditions: Pre-maturity Prematurity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive in crib by parents. No symptoms prior - autopsy revealed intussusception. Pronounced dead at ER. 1/23/09 Autopsy report states COD as complications of intussusception. Also states: six areas of IS of small intestine; changes of distant intestine present; early pneumonia; inflammation of lung tissue & small airways. Patient had been found unresponsive in crib after recent history of cold like symptoms with fever.

Changed on 9/14/2017

Administered by: Private      Purchased by: Private
Symptoms: Death, Intussusception, Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-12-04
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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None except runny nose
Preexisting Conditions: Prematurity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive in crib by parents. No symptoms prior - autopsy revealed intussusception. Pronounced dead at ER. 1/23/09 Autopsy report states COD as complications of intussusception. Also states: six areas of IS of small intestine; changes of distant intestine present; early pneumonia; inflammation of lung tissue & small airways. Patient had been found unresponsive in crib after recent history of cold like symptoms with fever.

Changed on 2/14/2018

Administered by: Private      Purchased by: Private
Symptoms: Death, Intussusception, Unresponsive to stimuli, Autopsy

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-12-04
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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None except runny nose
Preexisting Conditions: Prematurity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient found unresponsive in crib by parents. No symptoms prior - autopsy revealed intussusception. Pronounced dead at ER. 1/23/09 Autopsy report states COD as complications of intussusception. Also states: six areas of IS of small intestine; changes of distant intestine present; early pneumonia; inflammation of lung tissue & small airways. Patient had been found unresponsive in crib after recent history of cold like symptoms with fever.

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