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
<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'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>