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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 5212201 | 6237353 | I | 5212201-3 | 20060615 | 20060615 | 20061120 | PER | US-2006-015603 | BERLEX INC. | 45 | YR | F | N | 86 | KG | 20061111 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 5212201 | 1008054953 | PS | ULTRAVIST (PHARMACY BULK) | 1 | INTRAVENOUS | 150 ML, 1 DOSE, INTRAVENOUS | D | D | 21425 |
Indications of drugs used
| Event ID | DRUG SEQ | INDI PT |
|---|---|---|
| 5212201 | 1008054953 | COMPUTERISED TOMOGRAM ABDOMEN |
Outcome of event
| Event ID | OUTC COD |
|---|---|
| 5212201 | OT |
Reactions reported
| Event ID | PT |
|---|---|
| 5212201 | BURNING SENSATION |
| 5212201 | CHEST DISCOMFORT |
| 5212201 | COUGH |
| 5212201 | DYSPNOEA |
| 5212201 | URTICARIA |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | RPSR COD |
|---|---|
| 5212201 | HP |
Therapies reported
| Event ID | DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|
| 5212201 | 1008054953 | 20060615 | 20060615 |