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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4390412 | 4154183 | F | 1 | 4390412-7 | 20040401 | 20040616 | 20040630 | EXP | USA-2004-0013977 | PURDUE PHARMA L.P. | 48 | YR | M | N | 76.2 | KG | 20040629 | MD | 20040419 |
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 4390412 | 1004989431 | PS | OXYCONTIN | 1 | ORAL | SEE IMAGE | D | D | 20553 | ||
| 4390412 | 1005005644 | SS | BENZODIAZEPINE DERIVATIVES() | 2 | D | D | |||||
| 4390412 | 1005005646 | SS | TRAMADOL HCL | 1 | D | D | |||||
| 4390412 | 1005005649 | SS | OXYMORPHONE HYDROCHLORIDE | 1 | D | D | |||||
| 4390412 | 1005005650 | C | ULTRAM | 1 | |||||||
| 4390412 | 1005005653 | C | CELEBREX | 1 | |||||||
| 4390412 | 1005005654 | C | SOMA | 1 |
Indications of drugs used
| Event ID | DRUG SEQ | INDI PT |
|---|---|---|
| 4390412 | 1004989431 | PAIN |
Outcome of event
| Event ID | OUTC COD |
|---|---|
| 4390412 | DE |
| 4390412 | OT |
Reactions reported
| Event ID | PT |
|---|---|
| 4390412 | ACCIDENTAL OVERDOSE |
| 4390412 | CARDIAC ARREST |
| 4390412 | CIRCULATORY COLLAPSE |
| 4390412 | DRUG DEPENDENCE |
| 4390412 | MALAISE |
| 4390412 | NAUSEA |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | RPSR COD |
|---|---|
| 4390412 | HP |
| 4390412 | OTH |
| 4390412 | SDY |
Therapies reported
| Event ID | DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|
| 4390412 | 1004989431 | 20030710 | 20040220 | ||
| 4390412 | 1004989431 | 20040408 |