This page is part of the FHIR Specification (v0.4.0: DSTU 2 Draft). The current version which supercedes this version is 5.0.0. For a full list of available versions, see the Directory of published versions 
This is an example form generated from the questionnaire. See also the XML or JSON format.
This is an example form generated from the questionnaire. See also the XML or JSON format
Substances include, but are not limited to: a therapeutic substance administered correctly at an appropriate dosage for the individual; food; material derived from plants or animals; or venom from insect stings.
| Logical id of this artefact |
Metadata about the resource
| A set of rules under which this content was created |
| language |
Text summary of the resource, for human interpretation
Contained, inline Resources
External Ids for this item
| label: | |
| system: | |
| value: |
| When recorded |
Who recorded the sensitivity
| type |
| Practitioner |
|
| Patient |
|
| Who the sensitivity is for |
|
Substance, (or class) considered to be responsible for risk
| code: | |
| text: |
| status |
| criticality |
| type |
| category |
| Date(/time) of last known occurence of a reaction |
| Additional text not captured in other fields |
| xml:id (or equivalent in JSON) |
Specific substance considered to be responsible for event
| code: | |
| text: |
| certainty |
Clinical symptoms/signs associated with the Event
| code: | |
| text: |
| Description of the event as a whole |
| Date(/time) when manifestations showed |
How long Manifestations persisted
| value: | |
| units: |
| severity |
How the subject was exposed to the substance
| code: | |
| text: |
| Text about event not captured in other fields |