Person who experienced the adverse event (patient)
| Event ID | CASEID | CASEVERSION | I F COD | EVENT DT | MFR DT | INIT FDA DT | FDA DT | REPT COD | AUTH NUM | MFR NUM | MFR SNDR | LIT REF | AGE | AGE COD | AGE GRP | GNDR COD | E SUB | WT | WT COD | REPT DT | TO MFR | OCCP COD | REPORTER COUNTRY | OCCR COUNTRY |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 125743381 | 12574338 | 1 | I | 20160627 | 0 | 20160719 | 20160719 | DIR | 38.00 | YR | M | N | 220.00000 | LBS | 20160627 | Y | OT | US |
Drug(s) used by person
| Event ID | CASEID | DRUG SEQ | ROLE COD | DRUGNAME | PROD AI | VAL VBM | ROUTE | DOSE VBM | CUM DOSE CHR | CUM DOSE UNIT | DECHAL | RECHAL | LOT NUM | EXP DT | NDA NUM | DOSE AMT | DOSE UNIT | DOSE FORM | DOSE FREQ |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 125743381 | 12574338 | 1 | PS | MAGNEVIST | GADOPENTETATE DIMEGLUMINE | 1 | Intravenous (not otherwise specified) | 15 CC 1 IV ANTICUPITAL VEIN | D | 431248 | 20170831 | 0 | 15 | DF | 1X |
Indications of drugs used
| Event ID | CASEID | INDI DRUG SEQ | INDI PT |
|---|---|---|---|
| 125743381 | 12574338 | 1 | Mass |
Outcome of event
| Event ID | CASEID | OUTC COD |
|---|---|---|
| 125743381 | 12574338 | RI |
| 125743381 | 12574338 | LT |
Reactions reported
| Event ID | CASEID | DRUG REC ACT | PT |
|---|---|---|---|
| 125743381 | 12574338 | Asthenia | |
| 125743381 | 12574338 | Contrast media allergy | |
| 125743381 | 12574338 | Nausea | |
| 125743381 | 12574338 | Pulse abnormal | |
| 125743381 | 12574338 | Vomiting |
Reporting Sources (this data is often not reported and may therefore be missing here)
| Event ID | CASEID | RPSR COD |
|---|---|---|
| 125743381 | 12574338 | HP |
Therapies reported
| Event ID | CASEID | DSG DRUG SEQ | START DT | END DT | DUR | DUR COD |
|---|---|---|---|---|---|---|
| 125743381 | 12574338 | 1 | 20160627 | 20160627 | 0 |