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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 5212204 | 6237365 | I | 5212204-9 | 20060824 | 20060827 | 20061120 | PER | US-2006-029481 | BERLEX INC. | 32 | YR | F | N | 59 | KG | 20061111 | CN | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 5212204 | 1008054957 | PS | ULTRAVIST (PHARMACY BULK) | 1 | INTRAVENOUS | 110 ML, 1 DOSE, INTRAVENOUS | D | D | 54520A | 21425 |
Indications of drugs used
| Event ID | DRUG SEQ | INDI PT |
|---|---|---|
| 5212204 | 1008054957 | COMPUTERISED TOMOGRAM ABDOMEN |
Outcome of event
| Event ID | OUTC COD |
|---|---|
| 5212204 | OT |
Reactions reported
| Event ID | PT |
|---|---|
| 5212204 | ERYTHEMA |
| 5212204 | HEARING IMPAIRED |
| 5212204 | HEART RATE DECREASED |
| 5212204 | HYPOTENSION |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | RPSR COD |
|---|---|
| 5212204 | HP |
Therapies reported
| Event ID | DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|
| 5212204 | 1008054957 | 20060824 | 20060824 |