HL7 FHIR Implementation Guide: Profiles for ICSR Transfusion and Vaccination Adverse Event Detection and Reporting
0.1.0 - STU 1 Ballot

This page is part of the Profiles for ICSR Transfusion and Vaccination Adverse Event Detection and Reporting (v0.1.0: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions

: VAERS Sample Event - JSON Representation

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{
  "resourceType" : "AdverseEvent",
  "id" : "VAERSExampleEvent",
  "meta" : {
    "profile" : [
      "http://hl7.org/fhir/us/icsr-ae-reporting/StructureDefinition/ibm-fda-vaers-adverseevent"
    ]
  },
  "text" : {
    "status" : "generated",
    "div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>actuality</b>: actual</p><p><b>event</b>: <span title=\"Codes: {http://meddra.org 10004223}\">Bell's Palsy</span></p><p><b>subject</b>: <a href=\"Patient-VAERSPatient.html\">Generated Summary: id: 123456789; FNAME LNAME ; gender: male; birthDate: 1955-07-22</a></p><p><b>date</b>: 2017-04-23</p><p><b>seriousness</b>: <span title=\"Codes: {urn:oid:2.16.840.1.113883.3.989.2.1.1.19 26}\">26</span></p><p><b>outcome</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/adverse-event-outcome recovering}\">Recovering</span></p><blockquote><p><b>suspectEntity</b></p><p><b>instance</b>: <a href=\"Immunization-VAERSExampleImmunization.html\">Generated Summary: status: completed; <span title=\"Codes: {http://hl7.org/fhir/sid/ndc 7046101903}\">7046101903</span>; occurrence: 2017-04-23; </a></p><h3>Causalities</h3><table class=\"grid\"><tr><td>-</td><td><b>ProductRelatedness</b></td></tr><tr><td>*</td><td>Suspect</td></tr></table></blockquote><blockquote><p><b>suspectEntity</b></p><p><b>instance</b>: <a href=\"MedicationAdministration-VAERSHydrocortisoneAdministration.html\">Generated Summary: status: completed; <span title=\"Codes: {http://www.nlm.nih.gov/research/umls/rxnorm 197782}\">hydrocortisone 10 MG Oral Tablet</span>; effective: 2017-04-23</a></p><h3>Causalities</h3><table class=\"grid\"><tr><td>-</td><td><b>ProductRelatedness</b></td></tr><tr><td>*</td><td>Concomitant</td></tr></table></blockquote></div>"
  },
  "actuality" : "actual",
  "event" : {
    "coding" : [
      {
        "system" : "http://meddra.org",
        "code" : "10004223",
        "display" : "Bell's Palsy"
      }
    ]
  },
  "subject" : {
    "reference" : "Patient/VAERSPatient"
  },
  "date" : "2017-04-23",
  "seriousness" : {
    "coding" : [
      {
        "system" : "urn:oid:2.16.840.1.113883.3.989.2.1.1.19",
        "code" : "26"
      }
    ]
  },
  "outcome" : {
    "coding" : [
      {
        "system" : "http://terminology.hl7.org/CodeSystem/adverse-event-outcome",
        "code" : "recovering"
      }
    ]
  },
  "suspectEntity" : [
    {
      "instance" : {
        "reference" : "Immunization/VAERSExampleImmunization"
      },
      "causality" : [
        {
          "productRelatedness" : "Suspect"
        }
      ]
    },
    {
      "instance" : {
        "reference" : "MedicationAdministration/VAERSHydrocortisoneAdministration"
      },
      "causality" : [
        {
          "productRelatedness" : "Concomitant"
        }
      ]
    }
  ]
}