Age: 0.2
Sex: M
Vaccine: DTAP, HEP, HIBV, IPV, DTAP, HEP, HIBV, IPV, PNC, DTAP, HEP, HIBV, IPV, PNC
Symptoms: Nasal congestion, Pharyngitis, Rhinitis, Sudden infant death syndrome
Clinical narrative: From initial correspondence received at manufacturer as a phase IV study report on 2/27/03, it was reported that an 11 week old male patient received DAPTACEL, IPOL, PRP-T, HEPATITIS B VACCINE and PNEUMO CONJ on 11/18/02. Lot numbers and the site/route for the vaccines were not reported. On 12/7/02, the patient suffered from a cold/congestion and was given Tylenol Cold Drops for infants every 8 hours. Patient's last dose was on the evening of 12/8/02. on 12/9/02, the decedent was taken to the day care provider at about 8:00 AM. He reportedly was placed down for a nap at 9:30 AM on his side/stomach. He was stirring around 11:00 AM. The day care provider checked on him again at 11:30 and observed the decedent unresponsive. She called the emergency services and the decedent was transported to hospital. Doctor pronounced death at 12:57 PM. Patient died on 12/9/02 from SUDDEN INFANT DEATH SYNDROME. The decedent was brought to the coroner's office for examination, an autopsy was done on 12/10/02 at 10:00 AM. Pathologic diagnosis: There is clinical history of the decedent being found deceased at the day care (prone sleeping position). No evidence of injury or congenital malformation. Negative post-mortem microbiology, toxicology and genetics testing. Clinical history of recent upper respiratory infection. Post mortem toxicology, bacteriology virology and biochemical testing negative. Cause of Death: Sudden infant death syndrome. Other significant conditions were prone sleeping positions. The manner of death was natural. Report of scene investigation: On Monday 12/9/02 at approximately 1:40 PM, the coroner was contacted at the office by the investigator regarding the death of a 11 week old, currently at hospital. The coroner contacted the investigator via telephone and informed him of the circumstances, agreeing to meet him at the hospital, he departed for the hospital at 1:50 PM. He arrived at the hospital at approximately 8:30 that morning. Four children total, are being cared for by the day care operator. The baby was given approximately 4/10 of a cc of infant Tylenol due to a cold, and was placed face down, at the mom's request, in a playpen with a blanket covering the child at approximately 9:30 AM. At 11:00 AM, the child was noted to stir, and at 11:45 AM the child was found to be unresponsive. Paramedics were called and the child was transported to hospital. The child is a well-developed, well-nourished appearing male infant. Rigidity is fully developed in the bilateral lower extremities and the right upper extremity but appears to have been broken in the left upper extremity. It is fully developed at the jaw. Lividity is in a somewhat mixed distribution but somewhat heavier over the back, with clearing over pressure points. It blanches with pressure. The hands are clenched. Evidence of medical therapy is present, including a left intraosseous pretibial catheter, a hospital identification bag at the right ankle, multiple EKG pads and defibrillator pads and an endotracheal tube present in the mouth. No signs of injury are noted on the child.  The child is wrapped in a blanket and there is a clean appearing disposable diaper appropriately positioned. The genitalia are unremarkable. No intraoral or ocular petechiae noted. The fundi are examined with the ophthalmoscope present in the room, and there is some haziness present, but the vessels are seen in both eyes and no evidence of retinal hemorrhage is appreciated. The anterior fontanel is flat and non-bulging. The head is normocephalic and shows no evidence of trauma. There are also a pair of socks present on the bilateral feet. Photographs are taken and then the infant is undressed and the majority of the medical instrumentation is taken off and additional photographs are obtained. Following his examination, he leaves the baby in the custody of investigator B, waiting for the arrival of investigator R. The coroner then departs the hospital for the scene at 2:40 PM. He arrives at