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 - XML Representation

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<AdverseEvent xmlns="http://hl7.org/fhir">
  <id value="VAERSExampleEvent"/>
  <meta>
    <profile
             value="http://hl7.org/fhir/us/icsr-ae-reporting/StructureDefinition/ibm-fda-vaers-adverseevent"/>
  </meta>
  <text>
    <status value="generated"/>
    <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>
  </text>
  <actuality value="actual"/>
  <event>
    <coding>
      <system value="http://meddra.org"/>
      <code value="10004223"/>
      <display value="Bell&#39;s Palsy"/>
    </coding>
  </event>
  <subject>
    <reference value="Patient/VAERSPatient"/>
  </subject>
  <date value="2017-04-23"/>
  <seriousness>
    <coding>
      <system value="urn:oid:2.16.840.1.113883.3.989.2.1.1.19"/>
      <code value="26"/>
    </coding>
  </seriousness>
  <outcome>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/adverse-event-outcome"/>
      <code value="recovering"/>
    </coding>
  </outcome>
  <suspectEntity>
    <instance>
      <reference value="Immunization/VAERSExampleImmunization"/>
    </instance>
    <causality>
      <productRelatedness value="Suspect"/>
    </causality>
  </suspectEntity>
  <suspectEntity>
    <instance>
      <reference
                 value="MedicationAdministration/VAERSHydrocortisoneAdministration"/>
    </instance>
    <causality>
      <productRelatedness value="Concomitant"/>
    </causality>
  </suspectEntity>
</AdverseEvent>