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VAERS ID: | 308360 |
VAERS Form: | |
Age: | 0.3 |
Sex: | Male |
Location: | Connecticut |
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 1 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC | C45153 / 1 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 1 | - / PO |
Administered by: Military Purchased by: Unknown
Symptoms: Abdominal mass, Barium double contrast, Barium enema, Barium enema abnormal, Abdominal X-ray
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception". Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 1 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC | C45153 / 1 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 1 | - / PO |
Administered by: Military Purchased by: Unknown Military
Symptoms: Abdominal mass, Barium double contrast, Barium enema, Barium enema abnormal, Chest X-ray abnormal, Crying, Dyspnoea, Extubation, Full blood count, Haematemesis, Haematochezia, Haematocrit decreased, Intussusception, Stridor, Ultrasound abdomen abnormal, Abdominal X-ray, Blood test, Breath sounds abnormal, Endotracheal intubation
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception". Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 1 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC | C45153 / 1 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 1 | - / PO |
Administered by: Military Purchased by: Military
Symptoms: Abdominal mass, Barium double contrast, Barium enema, Barium enema abnormal, Chest X-ray abnormal, Crying, Dyspnoea, Extubation, Full blood count, Haematemesis, Haematochezia, Haematocrit decreased, Intussusception, Stridor, Ultrasound abdomen abnormal, Abdominal X-ray, Blood test, Breath sounds abnormal, Endotracheal intubation
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 1 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC | C45153 / 1 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 1 | - / PO |
Administered by: Military Purchased by: Military
Symptoms: Haematemesis, Haematochezia, Intussusception, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 1 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC | C45153 / 1 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 1 | - / PO |
Administered by: Military Purchased by: Military
Symptoms: Haematemesis, Haematochezia, Intussusception, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 1 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH | C45153 / 1 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 1 | - / PO |
Administered by: Military Purchased by: Military
Symptoms: Haematemesis, Haematochezia, Intussusception, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 1 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | C45153 / 1 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 1 | - / PO |
Administered by: Military Purchased by: Military
Symptoms: Haematemesis, Haematochezia, Intussusception, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 1 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | C45153 / 1 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 1 | - / PO |
Administered by: Military Purchased by: Military
Symptoms: Abdominal mass, Barium double contrast, Barium enema, Barium enema abnormal, Chest X-ray abnormal, Crying, Dyspnoea, Extubation, Full blood count, Haematemesis, Haematochezia, Haematocrit decreased, Intussusception, Stridor, Ultrasound abdomen abnormal, Abdominal X-ray, Blood test, Breath sounds abnormal, Endotracheal intubation
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 1 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | C45153 / 1 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 1 | - / PO |
Administered by: Military Purchased by: Military
Symptoms: Abdominal mass, Barium double contrast, Barium enema, Barium enema abnormal, Chest X-ray abnormal, Crying, Dyspnoea, Extubation, Full blood count, Haematemesis, Haematochezia, Haematocrit decreased, Intussusception, Stridor, Ultrasound abdomen abnormal, Abdominal X-ray, Blood test, Breath sounds abnormal, Endotracheal intubation
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 1 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | C45153 / 1 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 1 | - / PO |
Administered by: Military Purchased by: Military
Symptoms: Abdominal mass, Barium double contrast, Barium enema, Barium enema abnormal, Chest X-ray abnormal, Crying, Dyspnoea, Extubation, Full blood count, Haematemesis, Haematochezia, Haematocrit decreased, Intussusception, Stridor, Ultrasound abdomen abnormal, Abdominal X-ray, Blood test, Breath sounds abnormal, Endotracheal intubation
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 1 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | C45153 / 1 | LL / IM |
ROTHB5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 1 | - / PO |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 1 | - / PO |
Administered by: Military Purchased by: Military
Symptoms: Abdominal mass, Barium double contrast, Barium enema, Barium enema abnormal, Chest X-ray abnormal, Crying, Dyspnoea, Extubation, Full blood count, Haematemesis, Haematochezia, Haematocrit decreased, Intussusception, Stridor, Ultrasound abdomen abnormal, Abdominal X-ray, Blood test, Breath sounds abnormal, Endotracheal intubation
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 1 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | C45153 / 1 | LL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 1 | - / PO |
Administered by: Military Purchased by: Military
Symptoms: Abdominal mass, Barium double contrast, Barium enema, Barium enema abnormal, Chest X-ray abnormal, Crying, Dyspnoea, Extubation, Full blood count, Haematemesis, Haematochezia, Haematocrit decreased, Intussusception, Stridor, Ultrasound abdomen abnormal, Abdominal X-ray, Blood test, Breath sounds abnormal, Endotracheal intubation
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 1 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 0 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 1 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | C45153 / 1 | LL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 1 | - / PO |
Administered by: Military Purchased by: Military
Symptoms: Abdominal mass, Barium double contrast, Barium enema, Barium enema abnormal, Chest X-ray abnormal, Crying, Dyspnoea, Extubation, Full blood count, Haematemesis, Haematochezia, Haematocrit decreased, Intussusception, Stridor, Ultrasound abdomen abnormal, Abdominal X-ray, Blood test, Breath sounds abnormal, Endotracheal intubation
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 1 2 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 0 1 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 1 2 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | C45153 / 1 2 | LL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 1 2 | - MO / PO |
Administered by: Military Purchased by: Military
Symptoms: Haematemesis, Haematochezia, Intussusception, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 2 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 1 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 2 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | C45153 / 2 | LL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 2 | MO / PO |
Administered by: Military Purchased by: Military
Symptoms: Haematemesis, Haematochezia, Intussusception, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 2 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 1 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 2 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | C45153 / 2 | LL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 2 | MO / PO |
Administered by: Military Purchased by: Military
Symptoms: Haematemesis, Haematochezia, Intussusception, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 2 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 1 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 2 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | C45153 / 2 | LL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 2 | MO / PO |
Administered by: Military Purchased by: Military
Symptoms: Haematemesis, Haematochezia, Intussusception, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 2 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 1 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 2 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | C45153 / 2 | LL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 2 | MO / PO |
Administered by: Military Purchased by: Military
Symptoms: Haematemesis, Haematochezia, Intussusception, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 2 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 1 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 2 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | C45153 / 2 | LL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 2 | MO / PO |
Administered by: Military Purchased by: Military
Symptoms: Haematemesis, Haematochezia, Intussusception, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 2 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 1 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 2 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | C45153 / 2 | LL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 2 | MO / PO |
Administered by: Military Purchased by: Military
Symptoms: Haematemesis, Haematochezia, Intussusception, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
Vaccinated: | 2008-02-14 |
Onset: | 2008-03-20 |
Submitted: | 0000-00-00 |
Entered: | 2008-03-27 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS | AC14B073AA / 2 | RL / IM |
HBHEPB: HIB + HEP B (COMVAX) / MERCK & CO. INC. | 1244F / 1 | RL / IM |
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR | A0273 / 2 | LL / IM |
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH | C45153 / 2 | LL / IM |
RV5: ROTAVIRUS (ROTATEQ) / MERCK & CO. INC. | 0903U / 2 | MO / PO |
Administered by: Military Purchased by: Military
Symptoms: Haematemesis, Haematochezia, Intussusception, 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3
Write-up: Received 4 month immunization in AM. Vomiting blood and blood in stool in afternoon. Went to hospital ER - transported via ambulance to another hospital. Diagnosis with interruption. 04/09/2008 MR received for DOS 3/20-22/2008 with DX: Intussusception. Pt presented to local hospital with bloody stools and vomit and inconsolable crying. Intubated electively and transported to current facility. Palpable mass noted in LLQ on PE. Barium enema initially unsuccessful at reduction on first try. Reduction later sucessful. Pt extubated with mild WOB and decreased BS noted on L with mild stridor. Resolved with albuterol nebs. Pt to baseline 3/22/08 and D/c.
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