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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4711981 | 6020840 | I | 4711981-0 | 20041007 | 20050426 | 20050708 | PER | US-2004-033251 | BERLEX INC. | 60 | YR | F | N | 20050706 | OT | UNITED STATES |
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 4711981 | 1006195466 | PS | ULTRAVIST 300 | 1 | INTRAVENOUS | 100 ML, 1 DOSE, INTRAVENOUS | D | D | 131272T | 20070101 | 20220 |
Indications of drugs used
| Event ID | DRUG SEQ | INDI PT |
|---|---|---|
| 4711981 | 1006195466 | COMPUTERISED TOMOGRAM HEAD |
Outcome of event
| Event ID | OUTC COD |
|---|---|
| 4711981 | OT |
Reactions reported
| Event ID | PT |
|---|---|
| 4711981 | BLOOD PRESSURE INCREASED |
| 4711981 | CHEST PAIN |
| 4711981 | DYSPNOEA |
| 4711981 | HEADACHE |
| 4711981 | HYPOAESTHESIA |
| 4711981 | LOSS OF CONSCIOUSNESS |
| 4711981 | MUSCLE TWITCHING |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | RPSR COD |
|---|---|
| 4711981 | CR |
| 4711981 | HP |
Therapies reported
| Event ID | DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|
| 4711981 | 1006195466 | 20041007 | 20041007 |