| 
     | 
     | 
    AE Case ID  | 
    This field is populated with the adverse event case ID when the case is accepted by the safety system.  | 
    No  | 
    Awareness Date  | 
    The date the company was made aware of the event.  | 
    Yes  | 
    Country of Incidence  | 
    This list of values displays the countries that are configured in Siebel CRM.  | 
    Yes  | 
    Description  | 
    Detailed description of the adverse event.  | 
    Yes  | 
    Event Type  | 
    Describes the type of event, such as adverse drug event or adverse, medical-device event.  | 
    Yes  | 
    Event Severity  | 
    This field captures the severity of the product issue. The following list of values is provided: 
 | 
    No  | 
    Last Follow Up Date  | 
    This field displays the date that follow-up information on the adverse event was last recorded.  | 
    No  | 
    Product  | 
    The name of the product associated with the adverse event.  | 
    Yes  | 
    Received Date  | 
    The date when a company representative became aware of the event.  | 
    No  | 
    Reportable  | 
    Set this field to one of the following values: 
- Yes
 - No
 - Potential
 - Follow Up
 - Void
  
 | 
    Yes  | 
    Reported Outcome  | 
    This field captures the reported outcome for the product issue. The following list of values is provided: 
- Recovered
 - Recovering
 - Not Recovered
 - Resolved with Sequelae
 - Fatal
 - Unknown
  
 | 
    No  | 
    Reporter Qualification  | 
    This field captures whether the reporter is a health professional, lawyer, or consumer. The following list of values is provided: 
- Physician
 - Pharmacist
 - Other Health Professional
 - Lawyer
 - Consumer or Non-Health Professional
  
 | 
    No  | 
    Report Type  | 
    This field captures whether or not the product issue was reported during a study. The following list of values is provided: 
- Spontaneous 	
 - Study 	
 - Other 	
 - Not available to Sender
  
 | 
    Yes  | 
    Safety System Received Date  | 
    This field is populated with the date when the case was accepted by the safety system.  | 
    No  |