Release 4 5 Preview #1

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9.9 Resource AdverseEvent - Content

Patient Care Work Group Maturity Level : 0   Trial Use Security Category : Patient Compartments : Patient , Practitioner , RelatedPerson

Actual or potential/avoided An event causing unintended physical injury resulting from or contributed (i.e. any change to by medical care, current patient status) that may be related to unintended effects on a research study patient or other healthcare setting factors that requires research subject. The unintended effects may require additional monitoring, treatment, treatment or hospitalization, hospitalization or that results may result in death. The AdverseEvent resource also extends to potential or avoided events that could have had such effects.

9.9.1 Scope and Usage

AdverseEvent is an event resource from a FHIR workflow perspective - see Workflow Event . A single Adverse Event may need to be reported in multiple ways. The form of the reporting is left to implementation guides based upon appropriate workflow patterns.

This resource applies to events that occur during the course of medical care or medical research which may impact an individual as the recipient of care or the participant in a research study. There are also events that occur within a care setting that might or might not impact an individual but had the potential to cause an adverse event. Health care organizations monitor and report both adverse events as well as events that had the potential to cause patient harm. Data are often aggregated for reporting purposes.

An adverse event is the result of an intervention that caused unintentional harm to a specific subject or group of subjects. Examples of adverse events include the administration of an incorrect drug or an incorrect dose of a drug causing an adverse reaction, the use of an implanted device that causes an infection, or a biologic used during a research study that causes unanticipated renal failure. These events are characterized by the need to capture cause and effect (although they might not be known at the time of the event), severity, and outcome.

The context of an adverse event is also important. A subject may have condition(s) or current treatments (medications, diet, devices) that impact their response to a newly introduced medication, device or procedure. Knowledge of these variables is essential in establishing a cause and effect relationship for an adverse event.

A potential adverse event may also be called a near miss or an error. These are also events but because they were detected did not cause harm to a subject. Examples of potential adverse events include a product problem such as a faulty pacemaker that is detected prior implantation, a doctor working simultaneously on two electronic health records realizing the order for a drug was entered on the incorrect patient and then canceling the order, or a patient with a peanut allergy notices that his hospital dinner tray includes peanuts, and he does not eat the peanuts.

9.9.2 Boundaries and Relationships

The AdverseEvent resource is designed to represent events that have a harmful impact on a subject, or had the potential to cause harm to a subject but were avoided. In the course of medical care there are many actions that may impact how a subject responds to a particular treatment impacting patient safety. Therefore the AdverseEvent resource may reference multiple other resources to represent the context or details of an adverse event including but not limited to Observation, Condition, MedicationAdminsitration, Immunization, Procedure, or ResearchStudy.

A DetectedIssue reference is also related to the context of an AdverseEvent to the extent that a known risk for a potential issue such as a drug-drug interaction is documented. If in the context of a known issue, and adverse event occurs, citing this relationship is important for preventing such an occurrence in the future.

The AdverseEvent resource should not be used when a more specific resource exists.

  • The AllergyIntolerance resource is a case specific means of capturing the condition of an allergy or intolerance and the criticality (or potential for future harm) based on the response of a particular individual.
  • The Clinical Reasoning module provides resources and operations to enable the representation, distribution, and evaluation of clinical knowledge artifacts such as clinical decision support rules, quality measures, order sets, and protocols. The suite of resources within the clinical reasoning module should be used to capture clinical quality measures and clinical protocols that help drive clinical best practices.
  • The AdverseEvent resource is not intended to be used to capture potential subject risk in a prospective manner. A more appropriate resource for this purpose would be Risk Assessment which captures predicted outcomes for a patient or population on the basis of source information. Examples include a prognosis statement for a particular condition, risk of health outcome (heart attack, particular type of cancer) on the basis of lifestyle factors and/or family history or list of potential health risks based on a patient's genetic analysis.

9.9.3 References

No resources refer to this resource directly.

This resource does not implement any patterns.

9.9.3 9.9.4 Resource Content

Structure

Type of the event itself in relation to the subject Refers to the specific entity that caused the adverse event 0..* 0..1
Name Flags Card. Type Description & Constraints doco
. . AdverseEvent Σ TU DomainResource Medical care, research study or other healthcare event causing physical injury
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..1 0..* Identifier Business identifier for the event
. . . actuality status ?! Σ 1..1 code in-progress | completed | entered-in-error | unknown
Adverse Event Status ( Required )
... actuality ?! Σ 1..1 code actual | potential
AdverseEventActuality ( Required )
. . event . code Σ 0..1 CodeableConcept Event or incident that occurred or was averted
SNOMED CT Clinical Findings AdverseEvent Type ( Example )
. . . subject Σ 1..1 Reference ( Patient | Group | Practitioner | RelatedPerson ) Subject impacted by event
. . . encounter Σ 0..1 Reference ( Encounter ) The Encounter during which this AdverseEvent was created as part of
. . date . occurrence[x] Σ 0..1 When the event occurred
.... occurrenceDateTime dateTime When the event occurred
. . . . occurrencePeriod Period
.... occurrenceTiming Timing
. . . detected Σ 0..1 dateTime When the event was detected
. . . recordedDate Σ 0..1 dateTime When the event was recorded
. . . resultingCondition Σ 0..* Reference ( Condition ) Effect on the subject due to this event
. . . location Σ 0..1 Reference ( Location ) Location where adverse event occurred
. . . seriousness Σ 0..1 CodeableConcept Seriousness or gravity of the event
AdverseEventSeriousness ( Example )
. . . severity outcome Σ 0..1 CodeableConcept mild | moderate | severe Type of outcome from the adverse event
AdverseEventSeverity AdverseEvent Outcome ( Required Preferred )
. . outcome . recorder Σ 0..1 CodeableConcept Reference ( Patient resolved | recovering | ongoing | resolvedWithSequelae | fatal Practitioner | unknown AdverseEventOutcome PractitionerRole ( Required | RelatedPerson ) Who recorded the adverse event
. . recorder . participant Σ 0..1 0..* Reference ( Patient | Practitioner | PractitionerRole | RelatedPerson BackboneElement ) Who recorded was involved in the adverse event or the potential adverse event and what they did
. . . contributor . function Σ 0..* 0..1 CodeableConcept Type of involvement
AdverseEvent Participant Function ( Example )
.... actor Σ 1..1 Reference ( Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson ) Who was involved in the adverse event or the potential adverse event
. . . suspectEntity Σ 0..* BackboneElement The suspected agent causing the adverse event
. . . instance . instance[x] Σ 1..1 Refers to the specific entity that caused the adverse event
..... instanceCodeableConcept CodeableConcept
. . . . . instanceReference Reference ( Immunization | Procedure | Substance | Medication | MedicationAdministration | MedicationStatement MedicationUsage | Device )
. . . . causality Σ 0..1 BackboneElement Information on the possible cause of the event
. . . . . assessmentMethod Σ 0..1 CodeableConcept Method of evaluating the relatedness of the suspected entity to the event
AdverseEventCausalityMethod ( Example )
. . . . . assessment entityRelatedness Σ 0..1 CodeableConcept Assessment Result of if the assessment regarding the relatedness of the suspected entity caused to the event
AdverseEventCausalityAssessment ( Example )
. . . . productRelatedness . author Σ 0..1 string Reference ( Practitioner | PractitionerRole | Patient | RelatedPerson ) Author of the information on the possible cause of the event
... contributingFactor Σ 0..* BackboneElement Contributing factors suspected to have increased the probability or severity of the adverse event
.... item[x] AdverseEvent.suspectEntity.causalityProductRelatedness Σ 1..1 Item suspected to have increased the probability or severity of the adverse event
AdverseEvent Contributing Factor ( Example )
. . . . . author itemReference Reference ( Condition | Observation | AllergyIntolerance | FamilyMemberHistory | Immunization | Procedure | DocumentReference )
. . . . . itemCodeableConcept CodeableConcept
... preventiveAction Σ 0..1 0..* BackboneElement Preventive actions that contributed to avoiding the adverse event
.... item[x] Σ 1..1 Action that contributed to avoiding the adverse event
AdverseEvent Preventive Action ( Example )
..... itemReference Reference ( Practitioner Immunization | PractitionerRole Procedure | DocumentReference | MedicationAdministration | MedicationRequest ) AdverseEvent.suspectEntity.causalityAuthor
. . . . . method itemCodeableConcept CodeableConcept
. . . mitigatingAction Σ 0..* BackboneElement Ameliorating actions taken after the adverse event occured in order to reduce the extent of harm
.... item[x] CodeableConcept Σ ProbabilityScale | Bayesian | Checklist 1..1 Ameliorating action taken after the adverse event occured in order to reduce the extent of harm
AdverseEventCausalityMethod AdverseEvent Mitigating Action ( Example )
. . . . . subjectMedicalHistory itemReference Reference ( Procedure | DocumentReference | MedicationAdministration | MedicationRequest )
. . . . . itemCodeableConcept CodeableConcept
... supportingInfo Σ 0..* BackboneElement Supporting information relevant to the event
.... item[x] Σ 1..1 Subject medical history or document relevant to this adverse event
AdverseEvent Supporting Information ( Example )
..... itemReference Reference ( Condition | Observation | AllergyIntolerance | FamilyMemberHistory | Immunization | Procedure | Media | DocumentReference ) AdverseEvent.subjectMedicalHistory
. . referenceDocument . . . itemCodeableConcept Σ 0..* Reference ( DocumentReference CodeableConcept ) AdverseEvent.referenceDocument
. . . study Σ 0..* Reference ( ResearchStudy ) AdverseEvent.study Research study that the subject is enrolled in

doco Documentation for this format

UML Diagram ( Legend )

AdverseEvent ( DomainResource ) Business identifiers assigned to this adverse event by the performer or other systems which remain constant as the resource is updated and propagates from server to server identifier : Identifier [0..1] [0..*] The current state of the data entry of the adverse event or potential adverse event (this element modifies the meaning of other elements) status : code [1..1] « Codes identifying the lifecycle stage of an event. (Strength=Required) AdverseEventStatus ! » Whether the event actually happened, or just had the potential to. Note that this is independent of whether anyone was affected or harmed or how severely (this element modifies the meaning of other elements) actuality : code [1..1] « Overall nature of the adverse event, e.g. real or potential. (Strength=Required) AdverseEventActuality ! » The overall type of event, intended for search and filtering purposes category : CodeableConcept [0..*] « Overall categorization of the event, e.g. product-related or situational. (Strength=Extensible) AdverseEventCategory + » This element defines the specific type of Specific event that occurred or that was prevented from occurring averted, such as patient fall, wrong organ removed, or wrong blood transfused event code : CodeableConcept [0..1] « Detailed type of event. (Strength=Example) SNOMEDCTClinicalFindings AdverseEvent Type ?? » This subject or group impacted by the event subject : Reference [1..1] « Patient | Group | Practitioner | RelatedPerson » The Encounter during which AdverseEvent was created or to which the creation of this record is tightly associated encounter : Reference [0..1] « Encounter » The date (and perhaps time) when the adverse event occurred date occurrence[x] : dateTime DataType [0..1] « dateTime | Period | Timing » Estimated or actual date the AdverseEvent began, in the opinion of the reporter detected : dateTime [0..1] The date on which the existence of the AdverseEvent was first recorded recordedDate : dateTime [0..1] Includes information about the reaction that occurred as a result of exposure to a substance (for example, a drug or a chemical) resultingCondition : Reference [0..*] « Condition » The information about where the adverse event occurred location : Reference [0..1] « Location » Assessment whether this event event, or averted event, was of real clinical importance seriousness : CodeableConcept [0..1] « Overall seriousness of this event for the patient. (Strength=Example) AdverseEventSeriousness ?? » Describes the severity type of outcome from the adverse event, in relation to the subject. Contrast to AdverseEvent.seriousness - a severe rash might not be serious, but a mild heart problem is such as resolved, recovering, ongoing, resolved-with-sequelae, or fatal severity outcome : CodeableConcept [0..1] « The severity of the adverse event itself, in direct relation to the subject. (Strength=Required) AdverseEventSeverity ! » Describes Codes describing the type of outcome from the adverse event event. (Strength=Preferred) outcome : CodeableConcept AdverseEvent Outcome [0..1] « TODO (and should this be required?). (Strength=Required) AdverseEventOutcome ! ? » Information on who recorded the adverse event. May be the patient or a practitioner recorder : Reference [0..1] « Patient | Practitioner | PractitionerRole | RelatedPerson » Parties that may or should contribute or have contributed information to the adverse event, which can consist of one or more activities. Such information includes information leading to the decision to perform the activity and how to perform the activity (e.g. consultant), information The research study that the activity itself seeks to reveal (e.g. informant of clinical history), or information about what activity was performed (e.g. informant witness) subject is enrolled in contributor study : Reference [0..*] « Practitioner | PractitionerRole ResearchStudy | » Device » Participant AdverseEvent.subjectMedicalHistory Distinguishes the type of involvement of the actor in the adverse event, such as contributor or informant subjectMedicalHistory function : Reference CodeableConcept [0..*] [0..1] « Condition | Observation | AllergyIntolerance | FamilyMemberHistory | Immunization | Procedure | Media | DocumentReference Codes describing the type of involvement of the actor in the adverse event. (Strength=Example) AdverseEvent Participant Func... ?? » AdverseEvent.referenceDocument Indicates who or what participated in the event referenceDocument actor : Reference [0..*] [1..1] « DocumentReference Practitioner » | PractitionerRole | AdverseEvent.study study Organization : Reference | CareTeam [0..*] « ResearchStudy | Patient | Device | RelatedPerson » SuspectEntity Identifies the actual instance of what caused the adverse event. May be a substance, medication, medication administration, medication statement or a device instance instance[x] : Reference DataType [1..1] « CodeableConcept | Reference ( Immunization | Procedure | Substance | Medication | MedicationAdministration | MedicationStatement MedicationUsage | Device ) » Causality Assessment The method of if evaluating the relatedness of the suspected entity caused to the event assessmentMethod : CodeableConcept [0..1] « TODO. (Strength=Example) AdverseEventCausalityMethod ?? » The result of the assessment regarding the relatedness of the suspected entity to the event entityRelatedness : CodeableConcept [0..1] « Codes for the assessment of whether the entity caused the event. (Strength=Example) AdverseEventCausalityAssessme... ?? » AdverseEvent.suspectEntity.causalityProductRelatedness The author of the information on the possible cause of the event productRelatedness author : string Reference [0..1] « Practitioner | PractitionerRole | Patient | RelatedPerson » ContributingFactor AdverseEvent.suspectEntity.causalityAuthor The item that is suspected to have increased the probability or severity of the adverse event author item[x] : Reference DataType [0..1] [1..1] « Practitioner Reference ( Condition | PractitionerRole Observation | AllergyIntolerance | FamilyMemberHistory | Immunization | Procedure | DocumentReference )| CodeableConcept ; Codes describing the contributing factors suspected to have increased the probability or severity of the adverse event. (Strength=Example) AdverseEvent Contributing Fac... ?? » PreventiveAction ProbabilityScale The action that contributed to avoiding the adverse event item[x] : DataType [1..1] « Reference ( Immunization | Bayesian Procedure | Checklist DocumentReference | MedicationAdministration | MedicationRequest )| CodeableConcept ; Codes describing the preventive actions that contributed to avoiding the adverse event. (Strength=Example) method AdverseEvent Preventive Action ?? » MitigatingAction The ameliorating action taken after the adverse event occured in order to reduce the extent of harm item[x] : DataType [1..1] « Reference ( Procedure | DocumentReference | MedicationAdministration | MedicationRequest )| CodeableConcept [0..1] ; Codes describing the ameliorating actions taken after the adverse event occured in order to reduce the extent of harm. (Strength=Example) AdverseEvent Mitigating Action ?? » SupportingInfo Relevant past history for the subject. In a clinical care context, an example being a patient had an adverse event following a pencillin administration and the patient had a previously documented penicillin allergy. In a clinical trials context, an example is a bunion or rash that was present prior to the study. Additionally, the supporting item can be a document that is relevant to this instance of the adverse event that is not part of the subject's medical history. For example, a clinical note, staff list, or material safety data sheet (MSDS). Supporting information is not a contributing factor, preventive action, or mitigating action item[x] : DataType [1..1] « Reference ( Condition | Observation | TODO. AllergyIntolerance | FamilyMemberHistory | Immunization | Procedure | DocumentReference )| CodeableConcept ; Codes describing the supporting information relevant to the event. (Strength=Example) AdverseEventCausalityMethod AdverseEvent Supporting Infor... ?? » Indicates who or what participated in the adverse event and how they were involved participant [0..*] Information on the possible cause of the event causality [0..*] [0..1] Describes the entity that is suspected to have caused the adverse event suspectEntity [0..*] The contributing factors suspected to have increased the probability or severity of the adverse event contributingFactor [0..*] Preventive actions that contributed to avoiding the adverse event preventiveAction [0..*] The ameliorating action taken after the adverse event occured in order to reduce the extent of harm mitigatingAction [0..*] Supporting information relevant to the event supportingInfo [0..*]

XML Template 

<

<AdverseEvent xmlns="http://hl7.org/fhir"> doco

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <</identifier>

 <identifier><!-- 0..* Identifier Business identifier for the event --></identifier>
 <status value="[code]"/><!-- 1..1 in-progress | completed | entered-in-error | unknown -->

 <actuality value="[code]"/><!-- 1..1 actual | potential -->
 <category><!-- 0..* CodeableConcept product-problem | product-quality | product-use-error | wrong-dose | incorrect-prescribing-information | wrong-technique | wrong-route-of-administration | wrong-rate | wrong-duration | wrong-time | expired-drug | medical-device-use-error | problem-different-manufacturer | unsafe-physical-environment --></category>
 <</event>
 <</subject>
 <</encounter>
 <

 <code><!-- 0..1 CodeableConcept Event or incident that occurred or was averted --></code>
 <subject><!-- 1..1 Reference(Group|Patient|Practitioner|RelatedPerson) Subject impacted by event --></subject>
 <encounter><!-- 0..1 Reference(Encounter) The Encounter during which this AdverseEvent was created --></encounter>
 <occurrence[x]><!-- 0..1 dateTime|Period|Timing When the event occurred --></occurrence[x]>

 <detected value="[dateTime]"/><!-- 0..1 When the event was detected -->
 <recordedDate value="[dateTime]"/><!-- 0..1 When the event was recorded -->
 <resultingCondition><!-- 0..* Reference(Condition) Effect on the subject due to this event --></resultingCondition>
 <location><!-- 0..1 Reference(Location) Location where adverse event occurred --></location>
 <</seriousness>
 <</severity>
 <</outcome>

 <seriousness><!-- 0..1 CodeableConcept Seriousness or gravity of the event --></seriousness>
 <outcome><!-- 0..1 CodeableConcept Type of outcome from the adverse event --></outcome>

 <recorder><!-- 0..1 Reference(Patient|Practitioner|PractitionerRole|
   RelatedPerson) Who recorded the adverse event --></recorder>
 <</contributor>

 <participant>  <!-- 0..* Who was involved in the adverse event or the potential adverse event and what they did -->
  <function><!-- 0..1 CodeableConcept Type of involvement --></function>
  <actor><!-- 1..1 Reference(CareTeam|Device|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) Who was involved in the adverse event or the potential adverse event --></actor>

 </participant>

 <suspectEntity>  <!-- 0..* The suspected agent causing the adverse event -->
  <|
    </instance>
  <
   <</assessment>
   <
   <</author>
   <</method>

  <instance[x]><!-- 1..1 CodeableConcept|Reference(Device|Immunization|Medication|
    MedicationAdministration|MedicationUsage|Procedure|Substance) Refers to the specific entity that caused the adverse event --></instance[x]>

  <causality>  <!-- 0..1 Information on the possible cause of the event -->
   <assessmentMethod><!-- 0..1 CodeableConcept Method of evaluating the relatedness of the suspected entity to the event --></assessmentMethod>
   <entityRelatedness><!-- 0..1 CodeableConcept Result of the assessment regarding the relatedness of the suspected entity to the event --></entityRelatedness>
   <author><!-- 0..1 Reference(Patient|Practitioner|PractitionerRole|
     RelatedPerson) Author of the information on the possible cause of the event --></author>
  </causality>
 </suspectEntity>
 <|
   |
   </subjectMedicalHistory>
 <</referenceDocument>
 <</study>

 <contributingFactor>  <!-- 0..* Contributing factors suspected to have increased the probability or severity of the adverse event -->
  <item[x]><!-- 1..1 Reference(AllergyIntolerance|Condition|DocumentReference|
    FamilyMemberHistory|Immunization|Observation|Procedure)|CodeableConcept Item suspected to have increased the probability or severity of the adverse event --></item[x]>

 </contributingFactor>
 <preventiveAction>  <!-- 0..* Preventive actions that contributed to avoiding the adverse event -->
  <item[x]><!-- 1..1 Reference(DocumentReference|Immunization|
    MedicationAdministration|MedicationRequest|Procedure)|CodeableConcept Action that contributed to avoiding the adverse event --></item[x]>

 </preventiveAction>
 <mitigatingAction>  <!-- 0..* Ameliorating actions taken after the adverse event occured in order to reduce the extent of harm -->
  <item[x]><!-- 1..1 Reference(DocumentReference|MedicationAdministration|
    MedicationRequest|Procedure)|CodeableConcept Ameliorating action taken after the adverse event occured in order to reduce the extent of harm --></item[x]>

 </mitigatingAction>
 <supportingInfo>  <!-- 0..* Supporting information relevant to the event -->
  <item[x]><!-- 1..1 Reference(AllergyIntolerance|Condition|DocumentReference|
    FamilyMemberHistory|Immunization|Observation|Procedure)|CodeableConcept Subject medical history or document relevant to this adverse event --></item[x]>

 </supportingInfo>
 <study><!-- 0..* Reference(ResearchStudy) Research study that the subject is enrolled in --></study>

</AdverseEvent>

JSON Template 

{doco
  "resourceType" : "",

  "resourceType" : "AdverseEvent",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "

  "identifier" : [{ Identifier }], // Business identifier for the event
  "status" : "<code>", // R!  in-progress | completed | entered-in-error | unknown

  "actuality" : "<code>", // R!  actual | potential
  "category" : [{ CodeableConcept }], // product-problem | product-quality | product-use-error | wrong-dose | incorrect-prescribing-information | wrong-technique | wrong-route-of-administration | wrong-rate | wrong-duration | wrong-time | expired-drug | medical-device-use-error | problem-different-manufacturer | unsafe-physical-environment
  "
  "
  "
  "

  "code" : { CodeableConcept }, // Event or incident that occurred or was averted
  "subject" : { Reference(Group|Patient|Practitioner|RelatedPerson) }, // R!  Subject impacted by event
  "encounter" : { Reference(Encounter) }, // The Encounter during which this AdverseEvent was created
  // occurrence[x]: When the event occurred. One of these 3:

  "occurrenceDateTime" : "<dateTime>",
  "occurrencePeriod" : { Period },
  "occurrenceTiming" : { Timing },

  "detected" : "<dateTime>", // When the event was detected
  "recordedDate" : "<dateTime>", // When the event was recorded
  "resultingCondition" : [{ Reference(Condition) }], // Effect on the subject due to this event
  "location" : { Reference(Location) }, // Location where adverse event occurred
  "
  "
  "

  "seriousness" : { CodeableConcept }, // Seriousness or gravity of the event
  "outcome" : { CodeableConcept }, // Type of outcome from the adverse event

  "recorder" : { Reference(Patient|Practitioner|PractitionerRole|
   RelatedPerson) }, // Who recorded the adverse event
  "

  "participant" : [{ // Who was involved in the adverse event or the potential adverse event and what they did
    "function" : { CodeableConcept }, // Type of involvement
    "actor" : { Reference(CareTeam|Device|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) } // R!  Who was involved in the adverse event or the potential adverse event

  }],

  "suspectEntity" : [{ // The suspected agent causing the adverse event
    "|
    
    "
      "
      "
      "
      "
    }]

    // instance[x]: Refers to the specific entity that caused the adverse event. One of these 2:
    "instanceCodeableConcept" : { CodeableConcept },
    "instanceReference" : { Reference(Device|Immunization|Medication|
    MedicationAdministration|MedicationUsage|Procedure|Substance) },

    "causality" : { // Information on the possible cause of the event
      "assessmentMethod" : { CodeableConcept }, // Method of evaluating the relatedness of the suspected entity to the event
      "entityRelatedness" : { CodeableConcept }, // Result of the assessment regarding the relatedness of the suspected entity to the event
      "author" : { Reference(Patient|Practitioner|PractitionerRole|
     RelatedPerson) } // Author of the information on the possible cause of the event

    }

  }],
  "|
   |
   
  "
  "

  "contributingFactor" : [{ // Contributing factors suspected to have increased the probability or severity of the adverse event
    // item[x]: Item suspected to have increased the probability or severity of the adverse event. One of these 2:

    "itemReference" : { Reference(AllergyIntolerance|Condition|DocumentReference|
    FamilyMemberHistory|Immunization|Observation|Procedure) }

    "itemCodeableConcept" : { CodeableConcept }
  }],
  "preventiveAction" : [{ // Preventive actions that contributed to avoiding the adverse event
    // item[x]: Action that contributed to avoiding the adverse event. One of these 2:

    "itemReference" : { Reference(DocumentReference|Immunization|
    MedicationAdministration|MedicationRequest|Procedure) }

    "itemCodeableConcept" : { CodeableConcept }
  }],
  "mitigatingAction" : [{ // Ameliorating actions taken after the adverse event occured in order to reduce the extent of harm
    // item[x]: 

      Ameliorating action taken after the adverse event occured in order to reduce the extent of harm. One of these 2:
    "itemReference" : { Reference(DocumentReference|MedicationAdministration|
    MedicationRequest|Procedure) }

    "itemCodeableConcept" : { CodeableConcept }
  }],
  "supportingInfo" : [{ // Supporting information relevant to the event
    // item[x]: Subject medical history or document relevant to this adverse event. One of these 2:

    "itemReference" : { Reference(AllergyIntolerance|Condition|DocumentReference|
    FamilyMemberHistory|Immunization|Observation|Procedure) }

    "itemCodeableConcept" : { CodeableConcept }
  }],
  "study" : [{ Reference(ResearchStudy) }] // Research study that the subject is enrolled in

}

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:;

[ a fhir:AdverseEvent;

  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:

  fhir:AdverseEvent.identifier [ Identifier ], ... ; # 0..* Business identifier for the event
  fhir:AdverseEvent.status [ code ]; # 1..1 in-progress | completed | entered-in-error | unknown

  fhir:AdverseEvent.actuality [ code ]; # 1..1 actual | potential
  fhir:AdverseEvent.category [ CodeableConcept ], ... ; # 0..* product-problem | product-quality | product-use-error | wrong-dose | incorrect-prescribing-information | wrong-technique | wrong-route-of-administration | wrong-rate | wrong-duration | wrong-time | expired-drug | medical-device-use-error | problem-different-manufacturer | unsafe-physical-environment
  fhir:
  fhir:
  fhir:
  fhir:

  fhir:AdverseEvent.code [ CodeableConcept ]; # 0..1 Event or incident that occurred or was averted
  fhir:AdverseEvent.subject [ Reference(Group|Patient|Practitioner|RelatedPerson) ]; # 1..1 Subject impacted by event
  fhir:AdverseEvent.encounter [ Reference(Encounter) ]; # 0..1 The Encounter during which this AdverseEvent was created
  # AdverseEvent.occurrence[x] : 0..1 When the event occurred. One of these 3
    fhir:AdverseEvent.occurrenceDateTime [ dateTime ]
    fhir:AdverseEvent.occurrencePeriod [ Period ]
    fhir:AdverseEvent.occurrenceTiming [ Timing ]

  fhir:AdverseEvent.detected [ dateTime ]; # 0..1 When the event was detected
  fhir:AdverseEvent.recordedDate [ dateTime ]; # 0..1 When the event was recorded
  fhir:AdverseEvent.resultingCondition [ Reference(Condition) ], ... ; # 0..* Effect on the subject due to this event
  fhir:AdverseEvent.location [ Reference(Location) ]; # 0..1 Location where adverse event occurred
  fhir:
  fhir:
  fhir:

  fhir:AdverseEvent.seriousness [ CodeableConcept ]; # 0..1 Seriousness or gravity of the event
  fhir:AdverseEvent.outcome [ CodeableConcept ]; # 0..1 Type of outcome from the adverse event

  fhir:AdverseEvent.recorder [ Reference(Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Who recorded the adverse event
  fhir:

  fhir:AdverseEvent.participant [ # 0..* Who was involved in the adverse event or the potential adverse event and what they did
    fhir:AdverseEvent.participant.function [ CodeableConcept ]; # 0..1 Type of involvement
    fhir:AdverseEvent.participant.actor [ Reference(CareTeam|Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 1..1 Who was involved in the adverse event or the potential adverse event
  ], ...;

  fhir:AdverseEvent.suspectEntity [ # 0..* The suspected agent causing the adverse event
    fhir:|
  
    fhir:
      fhir:
      fhir:
      fhir:
      fhir:
    ], ...;

    # AdverseEvent.suspectEntity.instance[x] : 1..1 Refers to the specific entity that caused the adverse event. One of these 2
      fhir:AdverseEvent.suspectEntity.instanceCodeableConcept [ CodeableConcept ]
      fhir:AdverseEvent.suspectEntity.instanceReference [ Reference(Device|Immunization|Medication|MedicationAdministration|MedicationUsage|
  Procedure|Substance) ]

    fhir:AdverseEvent.suspectEntity.causality [ # 0..1 Information on the possible cause of the event
      fhir:AdverseEvent.suspectEntity.causality.assessmentMethod [ CodeableConcept ]; # 0..1 Method of evaluating the relatedness of the suspected entity to the event
      fhir:AdverseEvent.suspectEntity.causality.entityRelatedness [ CodeableConcept ]; # 0..1 Result of the assessment regarding the relatedness of the suspected entity to the event
      fhir:AdverseEvent.suspectEntity.causality.author [ Reference(Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Author of the information on the possible cause of the event
    ];

  ], ...;
  fhir:|
  
  fhir:
  fhir:

  fhir:AdverseEvent.contributingFactor [ # 0..* Contributing factors suspected to have increased the probability or severity of the adverse event
    # AdverseEvent.contributingFactor.item[x] : 1..1 Item suspected to have increased the probability or severity of the adverse event. One of these 2
      fhir:AdverseEvent.contributingFactor.itemReference [ Reference(AllergyIntolerance|Condition|DocumentReference|FamilyMemberHistory|Immunization|
  Observation|Procedure) ]

      fhir:AdverseEvent.contributingFactor.itemCodeableConcept [ CodeableConcept ]
  ], ...;
  fhir:AdverseEvent.preventiveAction [ # 0..* Preventive actions that contributed to avoiding the adverse event
    # AdverseEvent.preventiveAction.item[x] : 1..1 Action that contributed to avoiding the adverse event. One of these 2
      fhir:AdverseEvent.preventiveAction.itemReference [ Reference(DocumentReference|Immunization|MedicationAdministration|MedicationRequest|
  Procedure) ]

      fhir:AdverseEvent.preventiveAction.itemCodeableConcept [ CodeableConcept ]
  ], ...;
  fhir:AdverseEvent.mitigatingAction [ # 0..* Ameliorating actions taken after the adverse event occured in order to reduce the extent of harm
    # AdverseEvent.mitigatingAction.item[x] : 1..1 Ameliorating action taken after the adverse event occured in order to reduce the extent of harm. One of these 2
      fhir:AdverseEvent.mitigatingAction.itemReference [ Reference(DocumentReference|MedicationAdministration|MedicationRequest|Procedure) ]
      fhir:AdverseEvent.mitigatingAction.itemCodeableConcept [ CodeableConcept ]
  ], ...;
  fhir:AdverseEvent.supportingInfo [ # 0..* Supporting information relevant to the event
    # AdverseEvent.supportingInfo.item[x] : 1..1 Subject medical history or document relevant to this adverse event. One of these 2
      fhir:AdverseEvent.supportingInfo.itemReference [ Reference(AllergyIntolerance|Condition|DocumentReference|FamilyMemberHistory|Immunization|
  Observation|Procedure) ]

      fhir:AdverseEvent.supportingInfo.itemCodeableConcept [ CodeableConcept ]
  ], ...;
  fhir:AdverseEvent.study [ Reference(ResearchStudy) ], ... ; # 0..* Research study that the subject is enrolled in

]

Changes since R3

AdverseEvent
AdverseEvent.identifier
  • Max Cardinality changed from 1 to *
AdverseEvent.actuality AdverseEvent.status
  • Added Mandatory Element
AdverseEvent.category AdverseEvent.actuality
  • Max Cardinality changed from 1 to * Type changed from code to CodeableConcept Change binding strength value set from required http://hl7.org/fhir/ValueSet/adverse-event-actuality|4.0.0 to extensible http://hl7.org/fhir/ValueSet/adverse-event-actuality|4.2.0
AdverseEvent.event AdverseEvent.code
  • Added Element
AdverseEvent.subject AdverseEvent.occurrence[x]
  • Min Cardinality changed from 0 to 1 Type Reference: Added Target Types Group, Practitioner, RelatedPerson Type Reference: Removed Target Types ResearchSubject, Medication, Device Element
AdverseEvent.encounter AdverseEvent.outcome
  • Added Element Remove Binding http://hl7.org/fhir/ValueSet/adverse-event-outcome|4.0.0 (required)
AdverseEvent.detected AdverseEvent.participant
  • Added Element
AdverseEvent.recordedDate AdverseEvent.participant.function
  • Added Element
AdverseEvent.resultingCondition AdverseEvent.participant.actor
  • Added Mandatory Element
AdverseEvent.severity AdverseEvent.suspectEntity.instance[x]
  • Added Mandatory Element
AdverseEvent.outcome AdverseEvent.suspectEntity.causality
  • Change value set Max Cardinality changed from http://hl7.org/fhir/ValueSet/adverse-event-outcome * to http://hl7.org/fhir/ValueSet/adverse-event-outcome|4.0.1 1
AdverseEvent.recorder AdverseEvent.suspectEntity.causality.assessmentMethod
  • Type Reference: Added Target Type PractitionerRole Element
AdverseEvent.contributor AdverseEvent.suspectEntity.causality.entityRelatedness
  • Added Element
AdverseEvent.suspectEntity.instance AdverseEvent.suspectEntity.causality.author
  • Type Reference: Added Target Types Immunization, Procedure Patient, RelatedPerson
AdverseEvent.suspectEntity.causality AdverseEvent.contributingFactor
  • Max Cardinality changed from 1 to * Added Element
AdverseEvent.contributingFactor.item[x]
  • Type changed from code to BackboneElement Added Mandatory Element
AdverseEvent.preventiveAction
  • Remove Binding http://hl7.org/fhir/ValueSet/adverse-event-causality (required) Added Element
AdverseEvent.suspectEntity.causality.assessment AdverseEvent.preventiveAction.item[x]
  • Added Mandatory Element
AdverseEvent.suspectEntity.causality.productRelatedness AdverseEvent.mitigatingAction
  • Added Element
AdverseEvent.suspectEntity.causality.author AdverseEvent.mitigatingAction.item[x]
  • Added Mandatory Element
AdverseEvent.suspectEntity.causality.method AdverseEvent.supportingInfo
  • Added Element
AdverseEvent.subjectMedicalHistory AdverseEvent.supportingInfo.item[x]
  • Type Reference: Added Target Types Media, DocumentReference Mandatory Element
AdverseEvent.type AdverseEvent.event
  • deleted
AdverseEvent.reaction AdverseEvent.date
  • deleted
AdverseEvent.eventParticipant AdverseEvent.severity
  • deleted
AdverseEvent.description AdverseEvent.contributor
  • deleted
AdverseEvent.suspectEntity.causalityAssessment AdverseEvent.suspectEntity.instance
  • deleted
AdverseEvent.suspectEntity.causalityProductRelatedness AdverseEvent.suspectEntity.causality.assessment
  • deleted
AdverseEvent.suspectEntity.causalityMethod AdverseEvent.suspectEntity.causality.productRelatedness
  • deleted
AdverseEvent.suspectEntity.causalityAuthor AdverseEvent.suspectEntity.causality.method
  • deleted
AdverseEvent.suspectEntity.causalityResult AdverseEvent.subjectMedicalHistory
  • deleted
AdverseEvent.referenceDocument
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

See R3 <--> R4 Conversion Maps (status = 1 test that all execute ok. 1 fail round-trip testing and 1 r3 resources are invalid (0 errors). )

Structure

Type of the event itself in relation to the subject Refers to the specific entity that caused the adverse event 0..* 0..1
Name Flags Card. Type Description & Constraints doco
. . AdverseEvent Σ TU DomainResource Medical care, research study or other healthcare event causing physical injury
Elements defined in Ancestors: id , meta , implicitRules , language , text , contained , extension , modifierExtension
. . . identifier Σ 0..1 0..* Identifier Business identifier for the event
. . . actuality status ?! Σ 1..1 code in-progress | completed | entered-in-error | unknown
Adverse Event Status ( Required )
... actuality ?! Σ 1..1 code actual | potential
AdverseEventActuality ( Required )
. . event . code Σ 0..1 CodeableConcept Event or incident that occurred or was averted
SNOMED CT Clinical Findings AdverseEvent Type ( Example )
. . . subject Σ 1..1 Reference ( Patient | Group | Practitioner | RelatedPerson ) Subject impacted by event
. . . encounter Σ 0..1 Reference ( Encounter ) The Encounter during which this AdverseEvent was created as part of
. . date . occurrence[x] Σ 0..1 When the event occurred
.... occurrenceDateTime dateTime When the event occurred
. . . . occurrencePeriod Period
.... occurrenceTiming Timing
. . . detected Σ 0..1 dateTime When the event was detected
. . . recordedDate Σ 0..1 dateTime When the event was recorded
. . . resultingCondition Σ 0..* Reference ( Condition ) Effect on the subject due to this event
. . . location Σ 0..1 Reference ( Location ) Location where adverse event occurred
. . . seriousness Σ 0..1 CodeableConcept Seriousness or gravity of the event
AdverseEventSeriousness ( Example )
. . . severity outcome Σ 0..1 CodeableConcept mild | moderate | severe Type of outcome from the adverse event
AdverseEventSeverity AdverseEvent Outcome ( Required Preferred )
. . outcome . recorder Σ 0..1 CodeableConcept Reference ( Patient resolved | recovering | ongoing | resolvedWithSequelae | fatal Practitioner | unknown AdverseEventOutcome PractitionerRole ( Required | RelatedPerson ) Who recorded the adverse event
. . recorder . participant Σ 0..1 0..* Reference ( Patient | Practitioner | PractitionerRole | RelatedPerson BackboneElement ) Who recorded was involved in the adverse event or the potential adverse event and what they did
. . . contributor . function Σ 0..* 0..1 CodeableConcept Type of involvement
AdverseEvent Participant Function ( Example )
.... actor Σ 1..1 Reference ( Practitioner | PractitionerRole | Organization | CareTeam | Patient | Device | RelatedPerson ) Who was involved in the adverse event or the potential adverse event
. . . suspectEntity Σ 0..* BackboneElement The suspected agent causing the adverse event
. . . instance . instance[x] Σ 1..1 Refers to the specific entity that caused the adverse event
..... instanceCodeableConcept CodeableConcept
..... instanceReference Reference ( Immunization | Procedure | Substance | Medication | MedicationAdministration | MedicationStatement MedicationUsage | Device )
. . . . causality Σ 0..1 BackboneElement Information on the possible cause of the event
. . . . . assessmentMethod Σ 0..1 CodeableConcept Method of evaluating the relatedness of the suspected entity to the event
AdverseEventCausalityMethod ( Example )
. . . . . assessment entityRelatedness Σ 0..1 CodeableConcept Assessment Result of the assessment regarding the relatedness of if the suspected entity caused to the event
AdverseEventCausalityAssessment ( Example )
. . . . productRelatedness . author Σ 0..1 string Reference ( Practitioner | PractitionerRole | Patient | RelatedPerson ) Author of the information on the possible cause of the event
... contributingFactor Σ 0..* BackboneElement Contributing factors suspected to have increased the probability or severity of the adverse event
.... item[x] AdverseEvent.suspectEntity.causalityProductRelatedness Σ 1..1 Item suspected to have increased the probability or severity of the adverse event
AdverseEvent Contributing Factor ( Example )
. . . . . author itemReference Reference ( Condition | Observation | AllergyIntolerance | FamilyMemberHistory | Immunization | Procedure | DocumentReference )
. . . . . itemCodeableConcept CodeableConcept
... preventiveAction Σ 0..1 0..* BackboneElement Preventive actions that contributed to avoiding the adverse event
.... item[x] Σ 1..1 Action that contributed to avoiding the adverse event
AdverseEvent Preventive Action ( Example )
..... itemReference Reference ( Practitioner Immunization | PractitionerRole Procedure | DocumentReference | MedicationAdministration | MedicationRequest ) AdverseEvent.suspectEntity.causalityAuthor
. . . . . method itemCodeableConcept CodeableConcept
. . . mitigatingAction Σ 0..* BackboneElement Ameliorating actions taken after the adverse event occured in order to reduce the extent of harm
.... item[x] CodeableConcept Σ ProbabilityScale | Bayesian | Checklist 1..1 Ameliorating action taken after the adverse event occured in order to reduce the extent of harm
AdverseEventCausalityMethod AdverseEvent Mitigating Action ( Example )
. . . . . subjectMedicalHistory itemReference Reference ( Procedure | DocumentReference | MedicationAdministration | MedicationRequest )
. . . . . itemCodeableConcept CodeableConcept
... supportingInfo Σ 0..* BackboneElement Supporting information relevant to the event
.... item[x] Σ 1..1 Subject medical history or document relevant to this adverse event
AdverseEvent Supporting Information ( Example )
..... itemReference Reference ( Condition | Observation | AllergyIntolerance | FamilyMemberHistory | Immunization | Procedure | Media | DocumentReference ) AdverseEvent.subjectMedicalHistory
. . referenceDocument . . . itemCodeableConcept Σ 0..* Reference ( DocumentReference CodeableConcept ) AdverseEvent.referenceDocument
. . . study Σ 0..* Reference ( ResearchStudy ) AdverseEvent.study Research study that the subject is enrolled in

doco Documentation for this format

UML Diagram ( Legend )

AdverseEvent ( DomainResource ) Business identifiers assigned to this adverse event by the performer or other systems which remain constant as the resource is updated and propagates from server to server identifier : Identifier [0..1] [0..*] The current state of the data entry of the adverse event or potential adverse event (this element modifies the meaning of other elements) status : code [1..1] « Codes identifying the lifecycle stage of an event. (Strength=Required) AdverseEventStatus ! » Whether the event actually happened, or just had the potential to. Note that this is independent of whether anyone was affected or harmed or how severely (this element modifies the meaning of other elements) actuality : code [1..1] « Overall nature of the adverse event, e.g. real or potential. (Strength=Required) AdverseEventActuality ! » The overall type of event, intended for search and filtering purposes category : CodeableConcept [0..*] « Overall categorization of the event, e.g. product-related or situational. (Strength=Extensible) AdverseEventCategory + » This element defines the specific type of Specific event that occurred or that was prevented from occurring averted, such as patient fall, wrong organ removed, or wrong blood transfused event code : CodeableConcept [0..1] « Detailed type of event. (Strength=Example) SNOMEDCTClinicalFindings AdverseEvent Type ?? » This subject or group impacted by the event subject : Reference [1..1] « Patient | Group | Practitioner | RelatedPerson » The Encounter during which AdverseEvent was created or to which the creation of this record is tightly associated encounter : Reference [0..1] « Encounter » The date (and perhaps time) when the adverse event occurred date occurrence[x] : dateTime DataType [0..1] « dateTime | Period | Timing » Estimated or actual date the AdverseEvent began, in the opinion of the reporter detected : dateTime [0..1] The date on which the existence of the AdverseEvent was first recorded recordedDate : dateTime [0..1] Includes information about the reaction that occurred as a result of exposure to a substance (for example, a drug or a chemical) resultingCondition : Reference [0..*] « Condition » The information about where the adverse event occurred location : Reference [0..1] « Location » Assessment whether this event event, or averted event, was of real clinical importance seriousness : CodeableConcept [0..1] « Overall seriousness of this event for the patient. (Strength=Example) AdverseEventSeriousness ?? » Describes the severity type of outcome from the adverse event, in relation to the subject. Contrast to AdverseEvent.seriousness - a severe rash might not be serious, but a mild heart problem is such as resolved, recovering, ongoing, resolved-with-sequelae, or fatal severity outcome : CodeableConcept [0..1] « The severity of the adverse event itself, in direct relation to the subject. (Strength=Required) AdverseEventSeverity ! » Describes Codes describing the type of outcome from the adverse event event. (Strength=Preferred) outcome : CodeableConcept AdverseEvent Outcome [0..1] « TODO (and should this be required?). (Strength=Required) AdverseEventOutcome ! ? » Information on who recorded the adverse event. May be the patient or a practitioner recorder : Reference [0..1] « Patient | Practitioner | PractitionerRole | RelatedPerson » Parties that may or should contribute or have contributed information to the adverse event, which can consist of one or more activities. Such information includes information leading to the decision to perform the activity and how to perform the activity (e.g. consultant), information The research study that the activity itself seeks to reveal (e.g. informant of clinical history), or information about what activity was performed (e.g. informant witness) subject is enrolled in contributor study : Reference [0..*] « Practitioner | PractitionerRole ResearchStudy | » Device » Participant AdverseEvent.subjectMedicalHistory Distinguishes the type of involvement of the actor in the adverse event, such as contributor or informant subjectMedicalHistory function : Reference CodeableConcept [0..*] [0..1] « Condition | Observation | AllergyIntolerance | FamilyMemberHistory | Immunization | Procedure | Media | DocumentReference Codes describing the type of involvement of the actor in the adverse event. (Strength=Example) AdverseEvent Participant Func... ?? » AdverseEvent.referenceDocument Indicates who or what participated in the event referenceDocument actor : Reference [0..*] [1..1] « DocumentReference Practitioner » | PractitionerRole | AdverseEvent.study study Organization : Reference | CareTeam [0..*] « ResearchStudy | Patient | Device | RelatedPerson » SuspectEntity Identifies the actual instance of what caused the adverse event. May be a substance, medication, medication administration, medication statement or a device instance instance[x] : Reference DataType [1..1] « CodeableConcept | Reference ( Immunization | Procedure | Substance | Medication | MedicationAdministration | MedicationStatement MedicationUsage | Device ) » Causality Assessment The method of evaluating the relatedness of if the suspected entity caused to the event assessmentMethod : CodeableConcept [0..1] « TODO. (Strength=Example) AdverseEventCausalityMethod ?? » The result of the assessment regarding the relatedness of the suspected entity to the event entityRelatedness : CodeableConcept [0..1] « Codes for the assessment of whether the entity caused the event. (Strength=Example) AdverseEventCausalityAssessme... ?? » AdverseEvent.suspectEntity.causalityProductRelatedness The author of the information on the possible cause of the event productRelatedness author : string Reference [0..1] « Practitioner | PractitionerRole | Patient | RelatedPerson » ContributingFactor AdverseEvent.suspectEntity.causalityAuthor The item that is suspected to have increased the probability or severity of the adverse event author item[x] : Reference DataType [0..1] [1..1] « Practitioner Reference ( Condition | PractitionerRole Observation | AllergyIntolerance | FamilyMemberHistory | Immunization | Procedure | DocumentReference )| CodeableConcept ; Codes describing the contributing factors suspected to have increased the probability or severity of the adverse event. (Strength=Example) AdverseEvent Contributing Fac... ?? » PreventiveAction ProbabilityScale The action that contributed to avoiding the adverse event item[x] : DataType [1..1] « Reference ( Immunization | Bayesian Procedure | Checklist DocumentReference | MedicationAdministration | MedicationRequest )| CodeableConcept ; Codes describing the preventive actions that contributed to avoiding the adverse event. (Strength=Example) method AdverseEvent Preventive Action ?? » MitigatingAction The ameliorating action taken after the adverse event occured in order to reduce the extent of harm item[x] : DataType [1..1] « Reference ( Procedure | DocumentReference | MedicationAdministration | MedicationRequest )| CodeableConcept [0..1] ; Codes describing the ameliorating actions taken after the adverse event occured in order to reduce the extent of harm. (Strength=Example) AdverseEvent Mitigating Action ?? » SupportingInfo Relevant past history for the subject. In a clinical care context, an example being a patient had an adverse event following a pencillin administration and the patient had a previously documented penicillin allergy. In a clinical trials context, an example is a bunion or rash that was present prior to the study. Additionally, the supporting item can be a document that is relevant to this instance of the adverse event that is not part of the subject's medical history. For example, a clinical note, staff list, or material safety data sheet (MSDS). Supporting information is not a contributing factor, preventive action, or mitigating action item[x] : DataType [1..1] « Reference ( Condition | Observation | TODO. AllergyIntolerance | FamilyMemberHistory | Immunization | Procedure | DocumentReference )| CodeableConcept ; Codes describing the supporting information relevant to the event. (Strength=Example) AdverseEventCausalityMethod AdverseEvent Supporting Infor... ?? » Indicates who or what participated in the adverse event and how they were involved participant [0..*] Information on the possible cause of the event causality [0..*] [0..1] Describes the entity that is suspected to have caused the adverse event suspectEntity [0..*] The contributing factors suspected to have increased the probability or severity of the adverse event contributingFactor [0..*] Preventive actions that contributed to avoiding the adverse event preventiveAction [0..*] The ameliorating action taken after the adverse event occured in order to reduce the extent of harm mitigatingAction [0..*] Supporting information relevant to the event supportingInfo [0..*]

XML Template 

<

<AdverseEvent xmlns="http://hl7.org/fhir"> doco

 <!-- from Resource: id, meta, implicitRules, and language -->
 <!-- from DomainResource: text, contained, extension, and modifierExtension -->
 <</identifier>

 <identifier><!-- 0..* Identifier Business identifier for the event --></identifier>
 <status value="[code]"/><!-- 1..1 in-progress | completed | entered-in-error | unknown -->

 <actuality value="[code]"/><!-- 1..1 actual | potential -->
 <category><!-- 0..* CodeableConcept product-problem | product-quality | product-use-error | wrong-dose | incorrect-prescribing-information | wrong-technique | wrong-route-of-administration | wrong-rate | wrong-duration | wrong-time | expired-drug | medical-device-use-error | problem-different-manufacturer | unsafe-physical-environment --></category>
 <</event>
 <</subject>
 <</encounter>
 <

 <code><!-- 0..1 CodeableConcept Event or incident that occurred or was averted --></code>
 <subject><!-- 1..1 Reference(Group|Patient|Practitioner|RelatedPerson) Subject impacted by event --></subject>
 <encounter><!-- 0..1 Reference(Encounter) The Encounter during which this AdverseEvent was created --></encounter>
 <occurrence[x]><!-- 0..1 dateTime|Period|Timing When the event occurred --></occurrence[x]>

 <detected value="[dateTime]"/><!-- 0..1 When the event was detected -->
 <recordedDate value="[dateTime]"/><!-- 0..1 When the event was recorded -->
 <resultingCondition><!-- 0..* Reference(Condition) Effect on the subject due to this event --></resultingCondition>
 <location><!-- 0..1 Reference(Location) Location where adverse event occurred --></location>
 <</seriousness>
 <</severity>
 <</outcome>

 <seriousness><!-- 0..1 CodeableConcept Seriousness or gravity of the event --></seriousness>
 <outcome><!-- 0..1 CodeableConcept Type of outcome from the adverse event --></outcome>

 <recorder><!-- 0..1 Reference(Patient|Practitioner|PractitionerRole|
   RelatedPerson) Who recorded the adverse event --></recorder>
 <</contributor>

 <participant>  <!-- 0..* Who was involved in the adverse event or the potential adverse event and what they did -->
  <function><!-- 0..1 CodeableConcept Type of involvement --></function>
  <actor><!-- 1..1 Reference(CareTeam|Device|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) Who was involved in the adverse event or the potential adverse event --></actor>

 </participant>

 <suspectEntity>  <!-- 0..* The suspected agent causing the adverse event -->
  <|
    </instance>
  <
   <</assessment>
   <
   <</author>
   <</method>

  <instance[x]><!-- 1..1 CodeableConcept|Reference(Device|Immunization|Medication|
    MedicationAdministration|MedicationUsage|Procedure|Substance) Refers to the specific entity that caused the adverse event --></instance[x]>

  <causality>  <!-- 0..1 Information on the possible cause of the event -->
   <assessmentMethod><!-- 0..1 CodeableConcept Method of evaluating the relatedness of the suspected entity to the event --></assessmentMethod>
   <entityRelatedness><!-- 0..1 CodeableConcept Result of the assessment regarding the relatedness of the suspected entity to the event --></entityRelatedness>
   <author><!-- 0..1 Reference(Patient|Practitioner|PractitionerRole|
     RelatedPerson) Author of the information on the possible cause of the event --></author>
  </causality>
 </suspectEntity>
 <|
   |
   </subjectMedicalHistory>
 <</referenceDocument>
 <</study>

 <contributingFactor>  <!-- 0..* Contributing factors suspected to have increased the probability or severity of the adverse event -->
  <item[x]><!-- 1..1 Reference(AllergyIntolerance|Condition|DocumentReference|
    FamilyMemberHistory|Immunization|Observation|Procedure)|CodeableConcept Item suspected to have increased the probability or severity of the adverse event --></item[x]>

 </contributingFactor>
 <preventiveAction>  <!-- 0..* Preventive actions that contributed to avoiding the adverse event -->
  <item[x]><!-- 1..1 Reference(DocumentReference|Immunization|
    MedicationAdministration|MedicationRequest|Procedure)|CodeableConcept Action that contributed to avoiding the adverse event --></item[x]>

 </preventiveAction>
 <mitigatingAction>  <!-- 0..* Ameliorating actions taken after the adverse event occured in order to reduce the extent of harm -->
  <item[x]><!-- 1..1 Reference(DocumentReference|MedicationAdministration|
    MedicationRequest|Procedure)|CodeableConcept Ameliorating action taken after the adverse event occured in order to reduce the extent of harm --></item[x]>

 </mitigatingAction>
 <supportingInfo>  <!-- 0..* Supporting information relevant to the event -->
  <item[x]><!-- 1..1 Reference(AllergyIntolerance|Condition|DocumentReference|
    FamilyMemberHistory|Immunization|Observation|Procedure)|CodeableConcept Subject medical history or document relevant to this adverse event --></item[x]>

 </supportingInfo>
 <study><!-- 0..* Reference(ResearchStudy) Research study that the subject is enrolled in --></study>

</AdverseEvent>

JSON Template 

{doco
  "resourceType" : "",

  "resourceType" : "AdverseEvent",

  // from Resource: id, meta, implicitRules, and language
  // from DomainResource: text, contained, extension, and modifierExtension
  "

  "identifier" : [{ Identifier }], // Business identifier for the event
  "status" : "<code>", // R!  in-progress | completed | entered-in-error | unknown

  "actuality" : "<code>", // R!  actual | potential
  "category" : [{ CodeableConcept }], // product-problem | product-quality | product-use-error | wrong-dose | incorrect-prescribing-information | wrong-technique | wrong-route-of-administration | wrong-rate | wrong-duration | wrong-time | expired-drug | medical-device-use-error | problem-different-manufacturer | unsafe-physical-environment
  "
  "
  "
  "

  "code" : { CodeableConcept }, // Event or incident that occurred or was averted
  "subject" : { Reference(Group|Patient|Practitioner|RelatedPerson) }, // R!  Subject impacted by event
  "encounter" : { Reference(Encounter) }, // The Encounter during which this AdverseEvent was created
  // occurrence[x]: When the event occurred. One of these 3:

  "occurrenceDateTime" : "<dateTime>",
  "occurrencePeriod" : { Period },
  "occurrenceTiming" : { Timing },

  "detected" : "<dateTime>", // When the event was detected
  "recordedDate" : "<dateTime>", // When the event was recorded
  "resultingCondition" : [{ Reference(Condition) }], // Effect on the subject due to this event
  "location" : { Reference(Location) }, // Location where adverse event occurred
  "
  "
  "

  "seriousness" : { CodeableConcept }, // Seriousness or gravity of the event
  "outcome" : { CodeableConcept }, // Type of outcome from the adverse event

  "recorder" : { Reference(Patient|Practitioner|PractitionerRole|
   RelatedPerson) }, // Who recorded the adverse event
  "

  "participant" : [{ // Who was involved in the adverse event or the potential adverse event and what they did
    "function" : { CodeableConcept }, // Type of involvement
    "actor" : { Reference(CareTeam|Device|Organization|Patient|Practitioner|
    PractitionerRole|RelatedPerson) } // R!  Who was involved in the adverse event or the potential adverse event

  }],

  "suspectEntity" : [{ // The suspected agent causing the adverse event
    "|
    
    "
      "
      "
      "
      "
    }]

    // instance[x]: Refers to the specific entity that caused the adverse event. One of these 2:
    "instanceCodeableConcept" : { CodeableConcept },
    "instanceReference" : { Reference(Device|Immunization|Medication|
    MedicationAdministration|MedicationUsage|Procedure|Substance) },

    "causality" : { // Information on the possible cause of the event
      "assessmentMethod" : { CodeableConcept }, // Method of evaluating the relatedness of the suspected entity to the event
      "entityRelatedness" : { CodeableConcept }, // Result of the assessment regarding the relatedness of the suspected entity to the event
      "author" : { Reference(Patient|Practitioner|PractitionerRole|
     RelatedPerson) } // Author of the information on the possible cause of the event

    }

  }],
  "|
   |
   
  "
  "

  "contributingFactor" : [{ // Contributing factors suspected to have increased the probability or severity of the adverse event
    // item[x]: Item suspected to have increased the probability or severity of the adverse event. One of these 2:

    "itemReference" : { Reference(AllergyIntolerance|Condition|DocumentReference|
    FamilyMemberHistory|Immunization|Observation|Procedure) }

    "itemCodeableConcept" : { CodeableConcept }
  }],
  "preventiveAction" : [{ // Preventive actions that contributed to avoiding the adverse event
    // item[x]: Action that contributed to avoiding the adverse event. One of these 2:

    "itemReference" : { Reference(DocumentReference|Immunization|
    MedicationAdministration|MedicationRequest|Procedure) }

    "itemCodeableConcept" : { CodeableConcept }
  }],
  "mitigatingAction" : [{ // Ameliorating actions taken after the adverse event occured in order to reduce the extent of harm
    // item[x]: 

      Ameliorating action taken after the adverse event occured in order to reduce the extent of harm. One of these 2:
    "itemReference" : { Reference(DocumentReference|MedicationAdministration|
    MedicationRequest|Procedure) }

    "itemCodeableConcept" : { CodeableConcept }
  }],
  "supportingInfo" : [{ // Supporting information relevant to the event
    // item[x]: Subject medical history or document relevant to this adverse event. One of these 2:

    "itemReference" : { Reference(AllergyIntolerance|Condition|DocumentReference|
    FamilyMemberHistory|Immunization|Observation|Procedure) }

    "itemCodeableConcept" : { CodeableConcept }
  }],
  "study" : [{ Reference(ResearchStudy) }] // Research study that the subject is enrolled in

}

Turtle Template 

@prefix fhir: <http://hl7.org/fhir/> .doco


[ a fhir:;

[ a fhir:AdverseEvent;

  fhir:nodeRole fhir:treeRoot; # if this is the parser root

  # from Resource: .id, .meta, .implicitRules, and .language
  # from DomainResource: .text, .contained, .extension, and .modifierExtension
  fhir:

  fhir:AdverseEvent.identifier [ Identifier ], ... ; # 0..* Business identifier for the event
  fhir:AdverseEvent.status [ code ]; # 1..1 in-progress | completed | entered-in-error | unknown

  fhir:AdverseEvent.actuality [ code ]; # 1..1 actual | potential
  fhir:AdverseEvent.category [ CodeableConcept ], ... ; # 0..* product-problem | product-quality | product-use-error | wrong-dose | incorrect-prescribing-information | wrong-technique | wrong-route-of-administration | wrong-rate | wrong-duration | wrong-time | expired-drug | medical-device-use-error | problem-different-manufacturer | unsafe-physical-environment
  fhir:
  fhir:
  fhir:
  fhir:

  fhir:AdverseEvent.code [ CodeableConcept ]; # 0..1 Event or incident that occurred or was averted
  fhir:AdverseEvent.subject [ Reference(Group|Patient|Practitioner|RelatedPerson) ]; # 1..1 Subject impacted by event
  fhir:AdverseEvent.encounter [ Reference(Encounter) ]; # 0..1 The Encounter during which this AdverseEvent was created
  # AdverseEvent.occurrence[x] : 0..1 When the event occurred. One of these 3
    fhir:AdverseEvent.occurrenceDateTime [ dateTime ]
    fhir:AdverseEvent.occurrencePeriod [ Period ]
    fhir:AdverseEvent.occurrenceTiming [ Timing ]

  fhir:AdverseEvent.detected [ dateTime ]; # 0..1 When the event was detected
  fhir:AdverseEvent.recordedDate [ dateTime ]; # 0..1 When the event was recorded
  fhir:AdverseEvent.resultingCondition [ Reference(Condition) ], ... ; # 0..* Effect on the subject due to this event
  fhir:AdverseEvent.location [ Reference(Location) ]; # 0..1 Location where adverse event occurred
  fhir:
  fhir:
  fhir:

  fhir:AdverseEvent.seriousness [ CodeableConcept ]; # 0..1 Seriousness or gravity of the event
  fhir:AdverseEvent.outcome [ CodeableConcept ]; # 0..1 Type of outcome from the adverse event

  fhir:AdverseEvent.recorder [ Reference(Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Who recorded the adverse event
  fhir:

  fhir:AdverseEvent.participant [ # 0..* Who was involved in the adverse event or the potential adverse event and what they did
    fhir:AdverseEvent.participant.function [ CodeableConcept ]; # 0..1 Type of involvement
    fhir:AdverseEvent.participant.actor [ Reference(CareTeam|Device|Organization|Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 1..1 Who was involved in the adverse event or the potential adverse event
  ], ...;

  fhir:AdverseEvent.suspectEntity [ # 0..* The suspected agent causing the adverse event
    fhir:|
  
    fhir:
      fhir:
      fhir:
      fhir:
      fhir:
    ], ...;

    # AdverseEvent.suspectEntity.instance[x] : 1..1 Refers to the specific entity that caused the adverse event. One of these 2
      fhir:AdverseEvent.suspectEntity.instanceCodeableConcept [ CodeableConcept ]
      fhir:AdverseEvent.suspectEntity.instanceReference [ Reference(Device|Immunization|Medication|MedicationAdministration|MedicationUsage|
  Procedure|Substance) ]

    fhir:AdverseEvent.suspectEntity.causality [ # 0..1 Information on the possible cause of the event
      fhir:AdverseEvent.suspectEntity.causality.assessmentMethod [ CodeableConcept ]; # 0..1 Method of evaluating the relatedness of the suspected entity to the event
      fhir:AdverseEvent.suspectEntity.causality.entityRelatedness [ CodeableConcept ]; # 0..1 Result of the assessment regarding the relatedness of the suspected entity to the event
      fhir:AdverseEvent.suspectEntity.causality.author [ Reference(Patient|Practitioner|PractitionerRole|RelatedPerson) ]; # 0..1 Author of the information on the possible cause of the event
    ];

  ], ...;
  fhir:|
  
  fhir:
  fhir:

  fhir:AdverseEvent.contributingFactor [ # 0..* Contributing factors suspected to have increased the probability or severity of the adverse event
    # AdverseEvent.contributingFactor.item[x] : 1..1 Item suspected to have increased the probability or severity of the adverse event. One of these 2
      fhir:AdverseEvent.contributingFactor.itemReference [ Reference(AllergyIntolerance|Condition|DocumentReference|FamilyMemberHistory|Immunization|
  Observation|Procedure) ]

      fhir:AdverseEvent.contributingFactor.itemCodeableConcept [ CodeableConcept ]
  ], ...;
  fhir:AdverseEvent.preventiveAction [ # 0..* Preventive actions that contributed to avoiding the adverse event
    # AdverseEvent.preventiveAction.item[x] : 1..1 Action that contributed to avoiding the adverse event. One of these 2
      fhir:AdverseEvent.preventiveAction.itemReference [ Reference(DocumentReference|Immunization|MedicationAdministration|MedicationRequest|
  Procedure) ]

      fhir:AdverseEvent.preventiveAction.itemCodeableConcept [ CodeableConcept ]
  ], ...;
  fhir:AdverseEvent.mitigatingAction [ # 0..* Ameliorating actions taken after the adverse event occured in order to reduce the extent of harm
    # AdverseEvent.mitigatingAction.item[x] : 1..1 Ameliorating action taken after the adverse event occured in order to reduce the extent of harm. One of these 2
      fhir:AdverseEvent.mitigatingAction.itemReference [ Reference(DocumentReference|MedicationAdministration|MedicationRequest|Procedure) ]
      fhir:AdverseEvent.mitigatingAction.itemCodeableConcept [ CodeableConcept ]
  ], ...;
  fhir:AdverseEvent.supportingInfo [ # 0..* Supporting information relevant to the event
    # AdverseEvent.supportingInfo.item[x] : 1..1 Subject medical history or document relevant to this adverse event. One of these 2
      fhir:AdverseEvent.supportingInfo.itemReference [ Reference(AllergyIntolerance|Condition|DocumentReference|FamilyMemberHistory|Immunization|
  Observation|Procedure) ]

      fhir:AdverseEvent.supportingInfo.itemCodeableConcept [ CodeableConcept ]
  ], ...;
  fhir:AdverseEvent.study [ Reference(ResearchStudy) ], ... ; # 0..* Research study that the subject is enrolled in

]

Changes since Release 3

AdverseEvent
AdverseEvent.identifier
  • Max Cardinality changed from 1 to *
AdverseEvent.actuality AdverseEvent.status
  • Added Mandatory Element
AdverseEvent.category AdverseEvent.actuality
  • Max Cardinality changed from 1 to * Type changed from code to CodeableConcept Change binding strength value set from required http://hl7.org/fhir/ValueSet/adverse-event-actuality|4.0.0 to extensible http://hl7.org/fhir/ValueSet/adverse-event-actuality|4.2.0
AdverseEvent.event AdverseEvent.code
  • Added Element
AdverseEvent.subject AdverseEvent.occurrence[x]
  • Min Cardinality changed from 0 to 1 Type Reference: Added Target Types Group, Practitioner, RelatedPerson Type Reference: Removed Target Types ResearchSubject, Medication, Device Element
AdverseEvent.encounter AdverseEvent.outcome
  • Added Element Remove Binding http://hl7.org/fhir/ValueSet/adverse-event-outcome|4.0.0 (required)
AdverseEvent.detected AdverseEvent.participant
  • Added Element
AdverseEvent.recordedDate AdverseEvent.participant.function
  • Added Element
AdverseEvent.resultingCondition AdverseEvent.participant.actor
  • Added Mandatory Element
AdverseEvent.severity AdverseEvent.suspectEntity.instance[x]
  • Added Mandatory Element
AdverseEvent.outcome AdverseEvent.suspectEntity.causality
  • Change value set Max Cardinality changed from http://hl7.org/fhir/ValueSet/adverse-event-outcome * to http://hl7.org/fhir/ValueSet/adverse-event-outcome|4.0.1 1
AdverseEvent.recorder AdverseEvent.suspectEntity.causality.assessmentMethod
  • Type Reference: Added Target Type PractitionerRole Element
AdverseEvent.contributor AdverseEvent.suspectEntity.causality.entityRelatedness
  • Added Element
AdverseEvent.suspectEntity.instance AdverseEvent.suspectEntity.causality.author
  • Type Reference: Added Target Types Immunization, Procedure Patient, RelatedPerson
AdverseEvent.suspectEntity.causality AdverseEvent.contributingFactor
  • Max Cardinality changed from 1 to * Added Element
AdverseEvent.contributingFactor.item[x]
  • Type changed from code to BackboneElement Added Mandatory Element
AdverseEvent.preventiveAction
  • Remove Binding http://hl7.org/fhir/ValueSet/adverse-event-causality (required) Added Element
AdverseEvent.suspectEntity.causality.assessment AdverseEvent.preventiveAction.item[x]
  • Added Mandatory Element
AdverseEvent.suspectEntity.causality.productRelatedness AdverseEvent.mitigatingAction
  • Added Element
AdverseEvent.suspectEntity.causality.author AdverseEvent.mitigatingAction.item[x]
  • Added Mandatory Element
AdverseEvent.suspectEntity.causality.method AdverseEvent.supportingInfo
  • Added Element
AdverseEvent.subjectMedicalHistory AdverseEvent.supportingInfo.item[x]
  • Type Reference: Added Target Types Media, DocumentReference Mandatory Element
AdverseEvent.type AdverseEvent.event
  • deleted
AdverseEvent.reaction AdverseEvent.date
  • deleted
AdverseEvent.eventParticipant AdverseEvent.severity
  • deleted
AdverseEvent.description AdverseEvent.contributor
  • deleted
AdverseEvent.suspectEntity.causalityAssessment AdverseEvent.suspectEntity.instance
  • deleted
AdverseEvent.suspectEntity.causalityProductRelatedness AdverseEvent.suspectEntity.causality.assessment
  • deleted
AdverseEvent.suspectEntity.causalityMethod AdverseEvent.suspectEntity.causality.productRelatedness
  • deleted
AdverseEvent.suspectEntity.causalityAuthor AdverseEvent.suspectEntity.causality.method
  • deleted
AdverseEvent.suspectEntity.causalityResult AdverseEvent.subjectMedicalHistory
  • deleted
AdverseEvent.referenceDocument
  • deleted

See the Full Difference for further information

This analysis is available as XML or JSON .

See R3 <--> R4 Conversion Maps (status = 1 test that all execute ok. 1 fail round-trip testing and 1 r3 resources are invalid (0 errors). )

 

See the Profiles & Extensions and the alternate definitions: Master Definition XML + JSON , XML Schema / Schematron + JSON Schema , ShEx (for Turtle ) + see the extensions , the spreadsheet version & the dependency analysis a

9.9.3.1 9.9.4.1 Terminology Bindings

AdverseEvent.event AdverseEvent.severity AdverseEvent.outcome AdverseEvent.suspectEntity.causality.method
Path Definition Type Reference
AdverseEvent.status Codes identifying the lifecycle stage of an event. Required AdverseEventStatus
AdverseEvent.actuality Overall nature of the adverse event, e.g. real or potential. Required AdverseEventActuality
AdverseEvent.category Overall categorization of the event, e.g. product-related or situational. Extensible AdverseEventCategory
AdverseEvent.code Detailed type of event. Example SNOMEDCTClinicalFindings AdverseEvent Type
AdverseEvent.seriousness Overall seriousness of this event for the patient. Example AdverseEventSeriousness
AdverseEvent.outcome The severity Codes describing the type of outcome from the adverse event itself, event. Preferred AdverseEvent Outcome
AdverseEvent.participant.function Codes describing the type of involvement of the actor in direct relation to the subject. adverse event. Required Example AdverseEventSeverity AdverseEvent Participant Function
AdverseEvent.suspectEntity.causality.assessmentMethod TODO (and should this be required?). TODO. Required Example AdverseEventOutcome AdverseEventCausalityMethod
AdverseEvent.suspectEntity.causality.assessment AdverseEvent.suspectEntity.causality.entityRelatedness Codes for the assessment of whether the entity caused the event. Example AdverseEventCausalityAssessment
AdverseEvent.contributingFactor.item[x] TODO. Codes describing the contributing factors suspected to have increased the probability or severity of the adverse event. Example AdverseEventCausalityMethod AdverseEvent Contributing Factor
AdverseEvent.preventiveAction.item[x] Codes describing the preventive actions that contributed to avoiding the adverse event. Example AdverseEvent Preventive Action
AdverseEvent.mitigatingAction.item[x] Codes describing the ameliorating actions taken after the adverse event occured in order to reduce the extent of harm. Example AdverseEvent Mitigating Action
AdverseEvent.supportingInfo.item[x] Codes describing the supporting information relevant to the event. Example AdverseEvent Supporting Inforation

9.9.4 9.9.5 Search Parameters

Search parameters for this resource. The common parameters also apply. See Searching for more information about searching in REST, messaging, and services.

Name Type Description Expression In Common
actuality N token actual | potential AdverseEvent.actuality
category token product-problem | product-quality | product-use-error | wrong-dose | incorrect-prescribing-information | wrong-technique | wrong-route-of-administration | wrong-rate | wrong-duration | wrong-time | expired-drug | medical-device-use-error | problem-different-manufacturer | unsafe-physical-environment AdverseEvent.category
code token Event or incident that occurred or was averted AdverseEvent.code
date date When the event occurred AdverseEvent.date AdverseEvent.occurrence
event identifier token Type of Business identifier for the event itself in relation to the subject AdverseEvent.event AdverseEvent.identifier
location reference Location where adverse event occurred AdverseEvent.location
( Location )
patient reference Subject impacted by event AdverseEvent.subject
( Practitioner , Group , Patient , RelatedPerson )
recorder reference Who recorded the adverse event AdverseEvent.recorder
( Practitioner , Patient , PractitionerRole , RelatedPerson )
resultingcondition reference Effect on the subject due to this event AdverseEvent.resultingCondition
( Condition )
seriousness token Seriousness or gravity of the event AdverseEvent.seriousness
severity status N token mild in-progress | moderate completed | severe entered-in-error | unknown AdverseEvent.severity AdverseEvent.status
study reference AdverseEvent.study Research study that the subject is enrolled in AdverseEvent.study
( ResearchStudy )
subject reference Subject impacted by event AdverseEvent.subject
( Practitioner , Group , Patient , RelatedPerson )
substance reference Refers to the specific entity that caused the adverse event AdverseEvent.suspectEntity.instance (AdverseEvent.suspectEntity.instance as Reference)
( Immunization , Device , Medication , Procedure , Substance , MedicationAdministration , MedicationStatement MedicationUsage )