This is VAERS ID 331912

Case Details

VAERS ID:	331912 (history)
Form:	Version 1.0
Age:	0.5
Sex:	Female
Location:	Oregon

Vaccinated:	2008-10-30
Onset:	2008-11-05
Days after vaccination:	6
Submitted:	2008-11-10
Days after onset:	5
Entered:	2008-11-10

Vaccination / Manufacturer	Lot / Dose	Site / Route
DTAPHEPBIP: DTAP + HEPB + IPV (PEDIARIX) / GLAXOSMITHKLINE BIOLOGICALS	AC21B192CA / 3	LL / IM
HIBV: HIB (ACTHIB) / SANOFI PASTEUR	UF505AB / 3	LL / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH	UNKNOWN / 3	RL / IM
RV1: ROTAVIRUS (ROTARIX) / GLAXOSMITHKLINE BIOLOGICALS	A41FA692A / 1	MO / PO

Administered by: Unknown Purchased by: Unknown
Symptoms: Enema administration, Intussusception, Surgery, Urinary system X-ray
SMQs:, Gastrointestinal obstruction (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 3 days
Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none. PMH: none
Allergies:
Diagnostic Lab Data: KUB/contrast enemas. Labs and Diagnostics: Air contrast enema (+) for IS. Abd X-ray c/w IS. HCT 31.5. Hgb 10.4. Platelets 15.2K.
CDC Split Type:

Write-up: Intussusception - symptoms started 11/5/08; confirmed by x-ray on 11/6/08; unable to reduce by air contrast and barium contrast; required air transport to tertiary hospital and subsequent surgery. 11/18/2008 D/C Summary recieved for DOS 11/17-19/2008 with Final DX: Intussusception-ileocolic. Pt initially presented with pain, moaning, vomiting and blood streaked stool. Pt presented to hospital from another facility following failed reduction of IS via air contrast barium enema. Again, uanable to reduce so taken to OR for Laparoscopic reduction. Pt tolerated well, diet advance and d/c 11/9/08.

New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=331912