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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 5381310 | 6407269 | I | 5381310-0 | 20060901 | 20061201 | 20070629 | PER | VISP-PR-0609S-0653 | GE HEALTHCARE- | 48 | YR | M | N | 210 | LBS | 20070613 | PH | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 5381310 | 1008674597 | PS | VISIPAQUE | 1 | INTRAVENOUS | 180 ML, SINGLE DOSE, I.V. | D | D | 10388747 | 20090501 | 20351 |
| 5381310 | 1008784013 | SS | VISIPAQUE | 1 | 10382295 | 20081001 |
Indications of drugs used
| Event ID | DRUG SEQ | INDI PT |
|---|---|---|
| 5381310 | 1008674597 | DRUG USE FOR UNKNOWN INDICATION |
Outcome of event
| Event ID | OUTC COD |
|---|---|
| 5381310 | HO |
Reactions reported
| Event ID | PT |
|---|---|
| 5381310 | HYPERSENSITIVITY |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | RPSR COD |
|---|---|
| 5381310 | CR |
| 5381310 | FGN |
| 5381310 | HP |
Therapies reported
| Event ID | DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|
| 5381310 | 1008674597 | 20060929 | 20060929 |