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

This page is part of the Profiles for ICSR Transfusion and Vaccination Adverse Event Detection and Reporting (v1.0.0: STU 1) based on FHIR R4. This is the current published version. 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/vaers-adverseevent"/>
  </meta>
  <text>
    <status value="generated"/>
    <div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><div style="display: inline-block; background-color: #d9e0e7; padding: 6px; margin: 4px; border: 1px solid #8da1b4; border-radius: 5px; line-height: 60%"><p style="margin-bottom: 0px">Resource "VAERSExampleEvent" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-vaers-adverseevent.html">VAERS Adverse Event</a></p></div><p><b>actuality</b>: actual</p><p><b>event</b>: Bell's Palsy <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (meddra.org#10004223)</span></p><p><b>subject</b>: <a href="Patient-VAERSPatient.html">Patient/VAERSPatient</a> " LNAME"</p><p><b>date</b>: 2017-04-23</p><p><b>seriousness</b>: Serious <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/3.0.0/CodeSystem-adverse-event-seriousness.html">AdverseEventSeriousness</a>#serious)</span></p><p><b>outcome</b>: Recovering <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://hl7.org/fhir/R4/codesystem-adverse-event-outcome.html">AdverseEventOutcome</a>#recovering)</span></p><blockquote><p><b>suspectEntity</b></p><p><b>instance</b>: <a href="Immunization-VAERSExampleImmunization.html">Immunization/VAERSExampleImmunization</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">MedicationAdministration/VAERSHydrocortisoneAdministration</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>
    <extension
               url="http://hl7.org/fhir/us/icsr-ae-reporting/StructureDefinition/icsr-ext-eventseriousness">
      <valueCodeableConcept>
        <coding>
          <system value="urn:oid:2.16.840.1.113883.3.989.2.1.1.19"/>
          <code value="26"/>
        </coding>
      </valueCodeableConcept>
    </extension>
    <coding>
      <system
              value="http://terminology.hl7.org/CodeSystem/adverse-event-seriousness"/>
      <code value="serious"/>
    </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>