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Found 14 cases where Vaccine is RV5 and Symptom is Intussusception and Patient Died

Table

   
AgeCountPercent
< 3 Years1392.86%
Unknown17.14%
TOTAL14100%

Case Details

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VAERS ID: 283501 (history)  
Form: Version 1.0  
Age: 0.33  
Gender: Female  
Location: Foreign  
Vaccinated:2006-11-03
Onset:2006-11-27
   Days after vaccination:24
Submitted: 2007-06-29
   Days after onset:213
Entered: 2007-07-02
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / UNK MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Crying, Death, Haematochezia, Intussusception, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2006-11-27
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Diarrhoea; Malnutrition
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0706CRI00010

Write-up: Information has been received from a health professional concerning a 4 month old female with a history of diarrhoea and malnutrition who on 03-NOV-2006 was vaccinated with Rotateq. There was no concomitant medication. On approximately 27-NOV-2006 the patient experienced intussusception, crying, hematochezia and vomiting and was hospitalized. The reporter felt that intussusception, crying, hematochezia and vomiting were not related to therapy with Rotateq. Patient died on 27-NOV-06. Additional information is not expected.


VAERS ID: 336841 (history)  
Form: Version 1.0  
Age: 0.17  
Gender: Female  
Location: Illinois  
Vaccinated:2008-11-18
Onset:2008-12-04
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2009-01-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2956AA / 1 LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF515AA / 1 RL / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR A0836 / 1 RL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH C68309 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 0641X / 1 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Autopsy, Death, Intussusception, Unresponsive to stimuli
SMQs:, Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal obstruction (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2008-12-04
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? 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.


VAERS ID: 338775 (history)  
Form: Version 1.0  
Age: 0.4  
Gender: Female  
Location: Foreign  
Vaccinated:2008-12-22
Onset:2009-01-04
   Days after vaccination:13
Submitted: 2009-01-30
   Days after onset:26
Entered: 2009-02-02
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTPHEP: DTP + HEP B (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 UN / UN
OPV: POLIO VIRUS, ORAL (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 MO / PO
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 3 MO / PO

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal distension, Congenital anomaly, Death, Decreased activity, Dehydration, Diarrhoea, Faeces discoloured, Gastrointestinal necrosis, Haematochezia, Intussusception, Lethargy, Nausea, Pallor, Pyrexia, Surgery, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Congenital, familial and genetic disorders (narrow), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (narrow), Hypotonic-hyporesponsive episode (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2009-01-08
   Days after onset: 4
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Malnutrition; prophylaxis
Preexisting Conditions: Scabies infestation; Pediculosis corporis; Immunisation
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0901CRI00001

Write-up: Information has been received from a physician concerning a 19 week old female with malnutrition and a history of lice infestation, scabies infestation and vaccination BCG on 21-Aug-08 who on 24-Oct-2008 received first vaccination of ROTATEQ and second vaccination on 22-Dec-2008. Concomitant vaccine therapy included the first and second doses of PENTAVALENTE and polio given on 24-Oct-08 and 22-Dec-08. On 08-Jan-2009 the patient died. The cause of death was intussusception. Infant started vomiting and nauseas within the 5 previous days (#5 a day) before visiting the hospital. Treated with oral rehydration solution at health care center two days before. Signs and symptoms registered: Diarrhea with mucus, green-colored, no blood (however mother referred bloody stools), twice a day, no abdominal pain. Treated with laxatives by non-medical personnel. Clinical symptoms remained the same for 2 days, then starts fever. Physical Evaluation: FC 160x FR 48 t 39 height 62 cm. Hypoactive, lethargic, dehydration signs, with fever, pale and showing sign of capillary fragility. Capillary refill 4 seconds; abdominal distention = 42 cm, no mass or abdominal pain. Rectum and anus: normal. On January 2009 (day unknown) patient required surgery for intestinal necrosis ileo-colic section. Surgeon stated an intestinal invagination probably associated to congenital malformation of the intestine. Additional information has been request.


VAERS ID: 341949 (history)  
Form: Version 1.0  
Age: 0.2  
Gender: Female  
Location: Illinois  
Vaccinated:2009-03-06
Onset:2009-03-11
   Days after vaccination:5
Submitted: 2009-03-17
   Days after onset:6
Entered: 2009-03-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR 3000AA / 1 UN / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR UF402HH / 1 UN / IM
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / PFIZER/WYETH B0009 / UNK UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH D33126 / UNK UN / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1472X / 1 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Intestinal resection, Intussusception
SMQs:, Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2009-07-05
   Days after onset: 116
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 117 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: REGLAN
Current Illness: none
Preexisting Conditions: Down''s Syndrome; AV canal; Reflux (G-E); Myeloproliferative disorder 5/19/09-records received-PMH: Down Syndrome with transient myeloproliferative disorder. Congenital heart disease.
Allergies:
Diagnostic Lab Data: 5/21/09-records received-Echo abnormal. Ultrasound diagnosis of intussusception.. LABS and DIAGNOSTICS; Thyroid function tests abnormal. Creatinine levels high. Blood cultures (+). Echocardiogram. ECG - abnormal. CT - Abnormal. Lactic acids. Blood gases. Vascular Doppler - Abnormal. KBU - abnormal. Electrolytes abnormal.
CDC Split Type:

Write-up: Intussusception (ileo-cecal) requiring bowel resection. 5/19/09-records received for DOS 1/2/09 and 3/5/09 -clinic notes for follow-up-3/13/09-seen in clinic after presenting to ED with large bloody stools times 2 days, developed respiratory distress. Transfusions. Intubated. PICU. Impression: rectal bleeding, DIC, leukocytosis. 5/21/09-operative report received for DOS 3/13/09-exploratory laparotomy with right hemicolectomy and ileocolostomy. DX: Intussusception. Presented with C/O abdominal tenderness and distended abdomen, rectal bleeding. Post operatively developed ARDS, ventialtor dependent. Subsequent surgery 5/7/09 Median sternotomy, PDA ligation, pulmonary artery banding, insertion of right femoral arterial line. 5/12/09-subsequent surgery for closure of sternal wound. Failure to wean from ventilator. 8/11/09 Hospital DC summary, ICD-9 codes received DOS 3/11/09 to 7/5/09. Assessment: Intussusception status post bowel resection, ischemic colitis - septic shock, multi organ system dysfunction. Additional clinical data abstracted: 5/28/09 Continued fever. Signs of sepsis. Parental decision to withdraw care on 7/5/09. Patient expired on 7/5/09. ICD-9 Codes: 786.05 Shortness of breath, 560.0 Intussusception, 286.6 Defibrination syndrome, 557.0 Acute vascular insufficiency of intestine, 785.52 Septic shock, 569.83 Perforation of intestine, 038.49 Septicemia due to gram-negative organism, 038.43 Septicemia due to Pseudomonas, 518.5 Pulmonary insufficiency following trauma and surgery, 745.69 Endocardial cushion defect, 747.0 Patent ductus arteriousus, 238.79 Neoplasm of uncertain behavior of other lymphatic and hematopoietic tissue, 995.92 Severe sepsis, 599.0 Urinary tract infection site not specified, 758.0 Down''s syndrome, 427.5 Cardiac arrest.


VAERS ID: 456644 (history)  
Form: Version 1.0  
Age: 0.51  
Gender: Male  
Location: New York  
Vaccinated:2012-05-24
Onset:2012-05-28
   Days after vaccination:4
Submitted: 2012-06-01
   Days after onset:4
Entered: 2012-06-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS AC21B305CA / 3 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. UH416AB / 3 RL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH F65442 / 3 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. 1474AA / 3 MO / PO

Administered by: Private       Purchased by: Other
Symptoms: Abdominal X-ray, Abdominal mass, Abnormal behaviour, Apnoeic attack, Autopsy, Cardiac arrest, Death, Diarrhoea, Flatulence, Haematochezia, Intussusception, Irritability, Mechanical ventilation, Resuscitation, X-ray abnormal
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Arrhythmia related investigations, signs and symptoms (broad), Shock-associated circulatory or cardiac conditions (excl torsade de pointes) (narrow), Dementia (broad), Pseudomembranous colitis (broad), Gastrointestinal obstruction (narrow), Gastrointestinal haemorrhage (narrow), Acute central respiratory depression (narrow), Psychosis and psychotic disorders (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (broad), Cardiomyopathy (broad), Noninfectious diarrhoea (narrow), Respiratory failure (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2012-05-29
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: amoxicillin (started same day, not prior to vaccines)
Current Illness: Otitis media, cough
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Xray: No focal pulmonary consolidation. Multiple prominent air filled bowel loops. No free air.
CDC Split Type:

Write-up: On 5/28/2012 began having diarrhea. On 5/29/12 am, he was a little fussy in the morning - mom gave gripe water and baby oragel. The babysitter called dad in the afternoon saying that the patient was not himself. When the dad picked him up he said the child was "out of it". Went to grandfathers house and called EMS. On EMS arrival patient had pulse in the 140''s and RR in the 30''s, by the time patient arrived at the ED patient was apneic and asystolic with bag valve mask ventilation being performed. Resusscitation was unsuccessful and the patient passed away. Upon attempt at a rectal temperature, bloody stool was noted in the diaper. There was also a palpable mass in the abdomen. The medical examiner confirmed the presence of intussusception on the autopsy.


VAERS ID: 527098 (history)  
Form: Version 1.0  
Age: 0.3  
Gender: Female  
Location: Foreign  
Vaccinated:2013-10-02
Onset:2014-01-04
   Days after vaccination:94
Submitted: 2014-03-28
   Days after onset:82
Entered: 2014-03-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPH: DTAP + HIB (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
IPV: POLIO VIRUS, INACT. (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH - / UNK UN / UN
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. H016909 / 1 MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Constipation, Cyanosis, Enema administration, Intussusception, Pallor, Somnolence, Sudden infant death syndrome, Urine output decreased, Vomiting
SMQs:, Acute renal failure (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Dementia (broad), Gastrointestinal obstruction (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Neonatal disorders (narrow), Hypotonic-hyporesponsive episode (broad), Chronic kidney disease (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2014-01-04
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Prophylaxis
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: The patient was diagnosed at US-intussusception. Air enema was successful. Another ultrasound was performed and the result was ok.
CDC Split Type: WAES1403ISR012065

Write-up: This spontaneous report as received from via an agency from a physician refers to a 4 month old female patient who on 02-OCT-2013, was vaccinated with the first dose of ROTATEQ lot # H016909, Exp. Date: 30-JUN-2014, oral (dose not reported). Concomitant therapies included PREVENAR and DTaP/Hib and IPV (unspecified). It was reported that on 10-NOV-2013, the patient was admitted in the hospital due to three days of vomiting and constipation. According to her parents she also had less urine than usual. There was no fever. According to the mother the baby was sleepy. The patient was diagnosed at US-intussusception. Air enema was successful. Another ultrasound was performed and the result was ok. The baby was released from the hospital on 11-NOV-2013. The baby died on 04-JAN-2014. The mother got up from her sleep and went to the baby. The baby was pale with blue spots on the face. Classification after death was sudden infant death syndrome (SIDS). The related ness for intussusception and sudden infant death syndrome (SIDS) and ROTATEQ was unknown. Additional information has been requested.


VAERS ID: 531508 (history)  
Form: Version 1.0  
Age: 0.9  
Gender: Female  
Location: Foreign  
Vaccinated:2014-01-16
Onset:0000-00-00
Submitted: 2014-05-21
Entered: 2014-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. H019432 / 1 UN / UN

Administered by: Public       Purchased by: Other
Symptoms: Death, Intussusception, Respiratory tract infection
SMQs:, Gastrointestinal obstruction (narrow), Infective pneumonia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2014-02-25
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES1405MEX008810

Write-up: This spontaneous report as received from a health care professional via CENSIA (Institution that coordinates child vaccination) refers to a 9 months old female patient. Patient''s medical history was unknown. On 16-JAN-2014, the patient was vaccinated with ROTATEQ (Lot # H019432, Expiration date: July 2014) (Strength: 0.5 millilitre(ml), Frequency: single, route of administration: unknown) in a public Hospital. No concomitant medication reported. On 22-FEB-2014, the patient was admitted in the hospital due to Respiratory tract infection and Intussusception (death and hospitalization). The outcome of respiratory tract infection and intussusception was reported as fatal. The patient died on 25-FEB-2014. This case has been related to 1405MEX008648, 1405MEX008653, 1405MEX008915, 1405MEX008650, 1405MEX008657, 1405MEX008837, 1405MEX008700, and 2014PVMX0167.


VAERS ID: 556938 (history)  
Form: Version 1.0  
Age: 0.5  
Gender: Male  
Location: Foreign  
Vaccinated:0000-00-00
Onset:2012-11-01
Submitted: 2014-11-07
   Days after onset:736
Entered: 2014-11-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. - / 3 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Death, Intussusception, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 0000-00-00
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Immunisation
Preexisting Conditions: ROTATEQ, First and second doses of ROTATEQ on unspecified dates. Tolerance not reported
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES1411FRA002170

Write-up: Information has been received from SANOFI PASTEUR MSD (SPM) (manufacture control # E2014-10320) on 05-NOV-2014. Case received from two paediatricians on 31-Oct-2014 and linked to serious case E2014-10321 (same reporter, same vaccine, patients were brothers). An infant male patient had received the third dose of ROTATEQ (batch number not reported) on an unspecified date. In Nov-2012, at the age of 6 months old, he died from an undiagnosed atypical subacute intussusception. The symptoms were atypical and occurred abruptly. The patient vomited and was febrile. He died in his bed 36 hours after the first signs. The diagnosis of intussusception was determined by the autopsy. According to the paediatrician, the mother had called the emergency medical service for the symptoms that her child presented with (no further details). The physician had reportedly been reassuring. The symptoms persisted so after 2 to 3 days the mother went to the Emergency Unit Care. Intussusception was diagnosed but it was too late for an effective management of the events. To be noted that the patient was born from a different father than the patient of case E2014-10321. The tolerance of the first and second doses of ROTATEQ were not known.


VAERS ID: 587213 (history)  
Form: Version 1.0  
Age: 0.18  
Gender: Male  
Location: Texas  
Vaccinated:2015-02-16
Onset:2015-03-03
   Days after vaccination:15
Submitted: 2015-07-18
   Days after onset:136
Entered: 2015-07-27
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPIPVHIB: DTAP + IPV + HIB (PENTACEL) / SANOFI PASTEUR C4870AA / 1 RL / IM
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. K010535 / 2 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH J80526 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. K013661 / 1 MO / PO

Administered by: Private       Purchased by: Private
Symptoms: Death, Intussusception, Irritability, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal obstruction (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died: 2015-03-03
   Days after onset: 0
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PRILOSEC
Current Illness: None
Preexisting Conditions: Milk allergy; GERD; 36 wk gest / maternal preeclampsia
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Intussusception; 15 days after receiving vaccinations. Presented to local ER with vomiting and irritability.


VAERS ID: 658520 (history)  
Form: Version 1.0  
Age: 0.08  
Gender: Male  
Location: North Carolina  
Vaccinated:2016-10-04
Onset:2016-10-06
   Days after vaccination:2
Submitted: 2016-10-11
   Days after onset:5
Entered: 2016-10-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS 33E9E / 1 RL / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. M020100 / 1 LL / IM
PNC13: PNEUMO (PREVNAR13) / PFIZER/WYETH N24040 / 1 LL / IM
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. L046320 / 1 MO / PO

Administered by: Unknown       Purchased by: Public
Symptoms: Abdominal compartment syndrome, Abdominal distension, Abdominal operation, Bladder catheterisation, Blood lactic acid increased, Blood pH decreased, Central venous catheterisation, Colitis, Colostomy, Death, Depressed level of consciousness, Echocardiogram abnormal, Ejection fraction decreased, Endotracheal intubation, Gastrointestinal necrosis, General physical health deterioration, Hypoglycaemia, Hypotension, Infection, Intensive care, Intestinal ischaemia, Intestinal resection, Intussusception, Irritability, Malaise, Pallor, Pathology test, Synovial cyst, Transfusion, Vomiting, Wound closure, Wound evisceration
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Angioedema (broad), Lactic acidosis (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Embolic and thrombotic events, venous (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Gastrointestinal obstruction (narrow), Acute central respiratory depression (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific inflammation (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hostility/aggression (broad), Ischaemic colitis (narrow), Cardiomyopathy (narrow), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Noninfectious diarrhoea (broad), Respiratory failure (broad), Hypoglycaemia (narrow)

Life Threatening? Yes
Birth Defect? No
Died? Yes
   Date died: 2016-10-07
   Days after onset: 1
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: cleft lip and palate
Allergies:
Diagnostic Lab Data: see above. pH 6.5; Lactic acid $g20
CDC Split Type:

Write-up: Per mom, patient was fine when seen at well child visit and vaccinations on 10/4. He became irritable that night and more irritable the next day. Pt developed emesis x1 late on 10/05 and again on 10/06. Presented to outside emergency room where patient was distended, hypoglycemic, and severely ill appearing. Fluids and antibiotics given. In transport to us, required start of Dopamine. On arrival patient was hypotensive to 42/20 and epinephrine started. Pt was obtunded and grey appearing. Intubated emergently without need for sedation. Based on tense abdomen, patient was taken emergently to the operating room. After placement of central lines and a urinary catheter, the abdomen was opened. At this point labs returned with a pH of 6.5. He was felt to have abdominal compartment syndrome. The bowel was generally ischemic, but perfusion began to improve with the abdomen open and transfusion of blood and albumin. Exploration revealed an ileo-ileal intussusception. This was able to be reduced. Additionally, the patient had dilation of the descending and sigmoid colons with thickening consistent with colitis. A portion of the sigmoid colon was resected and sent for frozen section. Ganglion cells were identified and the pathologists noted colitis was more consistent with infectious etiology. An end colostomy was brought up and the abdomen was left open with a wound vac. On initial return to the ICU, the blood pressure was improved to 60-80 systolic. The patient was making good urine. Extremity perfusion was improved. About an hour and a half later, the patient began to deteriorate again. Lactic acid was rising to $g20. An echocardiogram revealed an ejection fraction of only 15%. I removed the abdominal dressing and the bowel below had clear necrosis. I re-explored him at the bedside. With evisceration of the bowel, the ejection fraction went up to 35%. On inspection, the ileum that had previously been intussuscepted was necrotic. This was approximately a foot and a half of bowel. This was resected. The remaining left colon and 1/2 of the transverse colon was now necrotic as well and was resected. The terminal ileum and right colon were viable, as was the small bowel proximal to the intussusception. The remaining bowel was placed in a silo bag. The patient continued to deteriorate. Six hours later, all visible bowel was necrotic. The patient was made comfort measures only and expired.


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