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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 126244891 | 12624489 | 1 | I | 20160515 | 20160802 | 20160805 | 20160805 | EXP | IT-ROCHE-1808145 | ROCHE | 43.84 | YR | M | Y | 0.00000 | 20160805 | OT | IT | IT |
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 126244891 | 12624489 | 1 | PS | CLONAZEPAM. | CLONAZEPAM | 1 | Oral | U | 17533 | ||||||||||
| 126244891 | 12624489 | 2 | SS | VALIUM | DIAZEPAM | 1 | Oral | '5MG/ML ORAL DROPS, SOLUTION' 20 ML BOTTLE | U | 13263 | ORAL SOLUTION | ||||||||
| 126244891 | 12624489 | 3 | SS | HEROIN | DIACETYLMORPHINE | 1 | Unknown | U | 0 | ||||||||||
| 126244891 | 12624489 | 4 | SS | COCAINE | COCAINE | 1 | Unknown | U | 0 |
Indications of drugs used
| Event ID | CASEID | INDI DRUG SEQ | INDI PT |
|---|---|---|---|
| 126244891 | 12624489 | 1 | Product used for unknown indication |
| 126244891 | 12624489 | 2 | Product used for unknown indication |
| 126244891 | 12624489 | 3 | Product used for unknown indication |
| 126244891 | 12624489 | 4 | Product used for unknown indication |
Outcome of event
| Event ID | CASEID | OUTC COD |
|---|---|---|
| 126244891 | 12624489 | OT |
Reactions reported
| Event ID | CASEID | DRUG REC ACT | PT |
|---|---|---|---|
| 126244891 | 12624489 | Drug abuse | |
| 126244891 | 12624489 | Intentional self-injury | |
| 126244891 | 12624489 | Loss of consciousness | |
| 126244891 | 12624489 | Substance abuse |
Reporting Sources (this data is often not reported and may therefore be missing here)
| no results found |
Therapies reported
| no results found |