Person who experienced the adverse event (patient)
| Event ID | CASE | I F COD | FOLL SEQ | IMAGE | EVENT DT | MFR DT | FDA DT | REPT COD | MFR NUM | MFR SNDR | AGE | AGE COD | GNDR COD | E SUB | WT | WT COD | REPT DT | OCCP COD | DEATH DT | TO MFR | CONFID | REPORTER COUNTRY |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4330788 | 4120999 | I | 4330788-X | 19560101 | 20040311 | 20040331 | EXP | USA040361779 | ELI LILLY AND COMPANY | 14 | YR | M | N | 56 | KG | 20040324 |
Drug(s) used by person
| Event ID | DRUG SEQ | ROLE COD | DRUGNAME | VAL VBM | ROUTE | DOSE VBM | DECHAL | RECHAL | LOT NUM | EXP DT | NDA NUM |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 4330788 | 1004757086 | PS | ILETIN-INSULIN-ANIMAL (UNKNOWN FORMULATION) (INSULI | 2 | D | 17931 | |||||
| 4330788 | 1004766341 | C | LANTUS | 1 |
Indications of drugs used
| Event ID | DRUG SEQ | INDI PT |
|---|---|---|
| 4330788 | 1004757086 | DIABETES MELLITUS |
Outcome of event
| Event ID | OUTC COD |
|---|---|
| 4330788 | OT |
Reactions reported
| Event ID | PT |
|---|---|
| 4330788 | ARTHRITIS |
| 4330788 | DEVICE FAILURE |
| 4330788 | INJECTION SITE MASS |
| 4330788 | NEUROPATHY |
| 4330788 | PHARMACEUTICAL PRODUCT COMPLAINT |
| 4330788 | SPINAL MUSCULAR ATROPHY CONGENITAL |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | RPSR COD |
|---|---|
| 4330788 | CSM |
Therapies reported
| Event ID | DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|
| 4330788 | 1004757086 | 19560101 | 20010101 |