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This is VAERS ID 383903

(NOTE: This result is from the 3/14/2015 version of the VAERS database)

Case Details

VAERS ID: 383903 (history)  
Form: Version .0  
Age: 0.3  
Gender: Female  
Location: North Carolina  
Vaccinated:2010-03-18
Onset:2010-03-25
   Days after vaccination:7
Submitted: 2010-03-29
   Days after onset:4
Entered: 2010-03-31
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C3542AA / 1 LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D888183 / 1 RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS A41FB057A / 1 - / PO

Administered by: Private       Purchased by: Public
Symptoms: Abdominal operation, Enema administration, Intestinal mass, Intussusception
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Intussusception - failed enema reduction X3. Abd surgery to reduce, also found mass (duplication of cecum). Final Dx intussusception duplicate cecum.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20150314&IDNUMBER=383903


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