This page is part of the Adverse Event Clinical Research R4 Backport (v1.0.1: STU 1) based on FHIR (HL7® FHIR® Standard) R4. This is the current published version. For a full list of available versions, see the Directory of published versions
<AdverseEvent xmlns="http://hl7.org/fhir">
<id value="adverse-event-device-death"/>
<meta>
<profile
value="http://hl7.org/fhir/uv/ae-research-backport-ig/StructureDefinition/AdverseEvent-clinical-research"/>
</meta>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative: AdverseEvent</b><a name="adverse-event-device-death"> </a><a name="hcadverse-event-device-death"> </a></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 AdverseEvent "adverse-event-device-death" </p><p style="margin-bottom: 0px">Profile: <a href="StructureDefinition-AdverseEvent-clinical-research.html">Adverse Event Clinical Research</a></p></div><p><b>Adverse Event Grade</b>: Grade 5 Death related to adverse event <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-nciThesaurus.html">NCI Thesaurus</a>#C48275)</span></p><blockquote><p><b>Criteria reviewed in determining serious adverse event</b></p><blockquote><p><b>url</b></p><code>criterionCode</code></blockquote><p><b>value</b>: Results In Persistent Or Significant Disability <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-nciThesaurus.html">NCI Thesaurus</a>#C11338)</span></p><blockquote><p><b>url</b></p><code>criterionPresent</code></blockquote><p><b>value</b>: false</p></blockquote><blockquote><p><b>Criteria reviewed in determining serious adverse event</b></p><blockquote><p><b>url</b></p><code>criterionCode</code></blockquote><p><b>value</b>: Requires Inpatient Hospitalization <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-nciThesaurus.html">NCI Thesaurus</a>#C83052)</span></p><blockquote><p><b>url</b></p><code>criterionPresent</code></blockquote><p><b>value</b>: false</p></blockquote><blockquote><p><b>Criteria reviewed in determining serious adverse event</b></p><blockquote><p><b>url</b></p><code>criterionCode</code></blockquote><p><b>value</b>: Death Related to Adverse Event <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-nciThesaurus.html">NCI Thesaurus</a>#C48275)</span></p><blockquote><p><b>url</b></p><code>criterionPresent</code></blockquote><p><b>value</b>: true</p></blockquote><blockquote><p><b>Criteria reviewed in determining serious adverse event</b></p><blockquote><p><b>url</b></p><code>criterionCode</code></blockquote><p><b>value</b>: Is Life Threatening <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-nciThesaurus.html">NCI Thesaurus</a>#C84266)</span></p><blockquote><p><b>url</b></p><code>criterionPresent</code></blockquote><p><b>value</b>: false</p></blockquote><blockquote><p><b>Criteria reviewed in determining serious adverse event</b></p><blockquote><p><b>url</b></p><code>criterionCode</code></blockquote><p><b>value</b>: Congenital Anomaly or Birth Defect <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-nciThesaurus.html">NCI Thesaurus</a>#C83117)</span></p><blockquote><p><b>url</b></p><code>criterionPresent</code></blockquote><p><b>value</b>: false</p></blockquote><blockquote><p><b>Criteria reviewed in determining serious adverse event</b></p><blockquote><p><b>url</b></p><code>criterionCode</code></blockquote><p><b>value</b>: Other Medically Important Condition <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-nciThesaurus.html">NCI Thesaurus</a>#C82521)</span></p><blockquote><p><b>url</b></p><code>criterionPresent</code></blockquote><p><b>value</b>: false</p></blockquote><blockquote><p><b>Criteria reviewed in determining serious adverse event</b></p><blockquote><p><b>url</b></p><code>criterionCode</code></blockquote><p><b>value</b>: Required Intervention to Prevent Permanent Impairment/damage <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-nciThesaurus.html">NCI Thesaurus</a>#C201939)</span></p><blockquote><p><b>url</b></p><code>criterionPresent</code></blockquote><p><b>value</b>: false</p></blockquote><p><b>Resulting Effect</b>: <span>: Condition with Deep puncture wound (disorder) - SNOMED CT code. Note this different than the AdverseEvent.code in this instance.</span></p><blockquote><p><b>Participant</b></p><blockquote><p><b>url</b></p><code>function</code></blockquote><p><b>value</b>: authenticator <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-ParticipationType.html">ParticipationType</a>#AUTHEN)</span></p><blockquote><p><b>url</b></p><code>actor</code></blockquote><p><b>value</b>: <a href="Practitioner-practitioner-owen-oncologist.html">Practitioner/practitioner-owen-oncologist</a> " ONCOLOGIST"</p></blockquote><blockquote><p><b>Suspect Entity</b></p><blockquote><p><b>url</b></p><code>instance</code></blockquote><p><b>value</b>: <a href="Device-device-infuser.html">Device/device-infuser</a></p><blockquote><p><b>url</b></p><code>causality</code></blockquote></blockquote><blockquote><p><b>Suspect Entity</b></p><blockquote><p><b>url</b></p><code>instance</code></blockquote><p><b>value</b>: <a href="MedicationAdministration-medication-administration-kadcyla1.html">MedicationAdministration/medication-administration-kadcyla1</a></p><blockquote><p><b>url</b></p><code>causality</code></blockquote></blockquote><p><b>Expected In Research Study</b>: false</p><p><b>Note</b>: During infusion of kadcyla an infuser exploded, shrapnel from the explosion caused a fatal puncture wound.</p><blockquote><p><b>modifierExtension[http://hl7.org/fhir/uv/ae-research-backport-ig/StructureDefinition/status]</b></p></blockquote><p><b>actuality</b>: actual</p><p><b>category</b>: Device <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-adverse-event-category.html">AdverseEventCategory</a>#device)</span></p><p><b>event</b>: Patient death due to device explosion <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="https://browser.ihtsdotools.org/">SNOMED CT</a>#370903006 "Patient death or serious disability associated with the use or function of a device in patient care, in which the device is used or functions other than as intended (event)")</span></p><p><b>subject</b>: <a href="Patient-patient-example-kaitlyn-b1.html">Patient/patient-example-kaitlyn-b1</a> " HAMMER"</p><p><b>date</b>: 2020-05-20</p><p><b>seriousness</b>: Serious <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-adverse-event-seriousness.html">AdverseEventSeriousness</a>#serious)</span></p><p><b>outcome</b>: Fatal <span style="background: LightGoldenRodYellow; margin: 4px; border: 1px solid khaki"> (<a href="http://terminology.hl7.org/5.5.0/CodeSystem-v3-nciThesaurus.html">NCI Thesaurus</a>#C48275)</span></p><p><b>recorder</b>: <a href="Practitioner-practitioner-oncology-nurse-jane.html">Practitioner/practitioner-oncology-nurse-jane</a> " NURSE"</p><p><b>study</b>: <a href="ResearchStudy-clinical-trial-example-compass.html">ResearchStudy/clinical-trial-example-compass</a></p></div>
</text>
<extension
url="http://hl7.org/fhir/uv/ae-research-backport-ig/StructureDefinition/ae-grade">
<valueCodeableConcept>
<coding>
<system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C48275"/>
</coding>
<text value="Grade 5 Death related to adverse event"/>
</valueCodeableConcept>
</extension>
<extension
url="http://hl7.org/fhir/uv/ae-research-backport-ig/StructureDefinition/seriousness-criteria">
<extension url="criterionCode">
<valueCodeableConcept>
<coding>
<system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C11338"/>
<display value="Results In Persistent Or Significant Disability"/>
</coding>
</valueCodeableConcept>
</extension>
<extension url="criterionPresent">
<valueBoolean value="false"/>
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<extension
url="http://hl7.org/fhir/uv/ae-research-backport-ig/StructureDefinition/seriousness-criteria">
<extension url="criterionCode">
<valueCodeableConcept>
<coding>
<system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C83052"/>
<display value="Requires Inpatient Hospitalization"/>
</coding>
</valueCodeableConcept>
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<extension url="criterionPresent">
<valueBoolean value="false"/>
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<extension
url="http://hl7.org/fhir/uv/ae-research-backport-ig/StructureDefinition/seriousness-criteria">
<extension url="criterionCode">
<valueCodeableConcept>
<coding>
<system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C48275"/>
<display value="Death Related to Adverse Event"/>
</coding>
</valueCodeableConcept>
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<extension url="criterionPresent">
<valueBoolean value="true"/>
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<extension
url="http://hl7.org/fhir/uv/ae-research-backport-ig/StructureDefinition/seriousness-criteria">
<extension url="criterionCode">
<valueCodeableConcept>
<coding>
<system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C84266"/>
<display value="Is Life Threatening"/>
</coding>
</valueCodeableConcept>
</extension>
<extension url="criterionPresent">
<valueBoolean value="false"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/ae-research-backport-ig/StructureDefinition/seriousness-criteria">
<extension url="criterionCode">
<valueCodeableConcept>
<coding>
<system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C83117"/>
<display value="Congenital Anomaly or Birth Defect"/>
</coding>
</valueCodeableConcept>
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<extension url="criterionPresent">
<valueBoolean value="false"/>
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<extension
url="http://hl7.org/fhir/uv/ae-research-backport-ig/StructureDefinition/seriousness-criteria">
<extension url="criterionCode">
<valueCodeableConcept>
<coding>
<system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C82521"/>
<display value="Other Medically Important Condition"/>
</coding>
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<extension url="criterionPresent">
<valueBoolean value="false"/>
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<extension
url="http://hl7.org/fhir/uv/ae-research-backport-ig/StructureDefinition/seriousness-criteria">
<extension url="criterionCode">
<valueCodeableConcept>
<coding>
<system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C201939"/>
<display
value="Required Intervention to Prevent Permanent Impairment/damage"/>
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<extension url="criterionPresent">
<valueBoolean value="false"/>
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<extension
url="http://hl7.org/fhir/uv/ae-research-backport-ig/StructureDefinition/resultingEffect">
<valueReference>
<display
value="Condition with Deep puncture wound (disorder) - SNOMED CT code. Note this different than the AdverseEvent.code in this instance."/>
</valueReference>
</extension>
<extension
url="http://hl7.org/fhir/uv/ae-research-backport-ig/StructureDefinition/participant">
<extension url="function">
<valueCodeableConcept>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/v3-ParticipationType"/>
<code value="AUTHEN"/>
</coding>
</valueCodeableConcept>
</extension>
<extension url="actor">
<valueReference>🔗
<reference value="Practitioner/practitioner-owen-oncologist"/>
</valueReference>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/ae-research-backport-ig/StructureDefinition/suspect-entity">
<extension url="instance">
<valueReference>🔗
<reference value="Device/device-infuser"/>
</valueReference>
</extension>
<extension url="causality">
<extension url="entityRelatedness">
<valueCodeableConcept>
<coding>
<system
value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C53260"/>
<display value="Related"/>
</coding>
</valueCodeableConcept>
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</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/ae-research-backport-ig/StructureDefinition/suspect-entity">
<extension url="instance">
<valueReference>🔗
<reference
value="MedicationAdministration/medication-administration-kadcyla1"/>
</valueReference>
</extension>
<extension url="causality">
<extension url="entityRelatedness">
<valueCodeableConcept>
<coding>
<system
value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C53256"/>
<display value="Not Related"/>
</coding>
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</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/ae-research-backport-ig/StructureDefinition/expected-in-research-study">
<valueBoolean value="false"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/ae-research-backport-ig/StructureDefinition/note">
<valueAnnotation>
<text
value="During infusion of kadcyla an infuser exploded, shrapnel from the explosion caused a fatal puncture wound."/>
</valueAnnotation>
</extension>
<modifierExtension
url="http://hl7.org/fhir/uv/ae-research-backport-ig/StructureDefinition/status">
<valueCode value="completed"/>
</modifierExtension>
<actuality value="actual"/>
<category>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/adverse-event-category"/>
<code value="device"/>
<display value="Device"/>
</coding>
</category>
<event>
<coding>
<system value="http://snomed.info/sct"/>
<code value="370903006"/>
<display
value="Patient death or serious disability associated with the use or function of a device in patient care, in which the device is used or functions other than as intended (event)"/>
</coding>
<text value="Patient death due to device explosion"/>
</event>
<subject>🔗
<reference value="Patient/patient-example-kaitlyn-b1"/>
</subject>
<date value="2020-05-20"/>
<seriousness>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/adverse-event-seriousness"/>
<code value="serious"/>
<display value="Serious"/>
</coding>
</seriousness>
<outcome>
<coding>
<system value="http://ncicb.nci.nih.gov/xml/owl/EVS/Thesaurus.owl"/>
<code value="C48275"/>
</coding>
<text value="Fatal"/>
</outcome>
<recorder>🔗
<reference value="Practitioner/practitioner-oncology-nurse-jane"/>
</recorder>
<study>🔗
<reference value="ResearchStudy/clinical-trial-example-compass"/>
</study>
</AdverseEvent>