Initial case entry—fields descriptions

Field Description

Initial Receipt Date

Enter the complete date on which your company became aware of the case. The Receipt Date cannot be entered as a partial date.

Central Receipt Date

Enter the date on which this information was received by Central Safety.

Country of Incidence

Select the country where the adverse event occurred. This may or may not be the reporter's or the patient's country of residence.

Report Type

Select the item that best describes the type of report. This determines the fields that are made available for entering case information.

The report type also impacts duplicate search. For example, selecting Sponsored Trial makes the Study ID and Protocol ID fields available. The Administrator can adjust the information in this list.

Study ID(applicable to clinical trial cases only)

Click Select to choose the study ID from the Clinical Trial Selection dialog box.

Center ID

(applicable to clinical trial cases only)

Click Select to choose the Center ID from the Clinical Trial Selection dialog box.

Initial Justification

The values of this field are configurable through the standard Justifications dialog box. This field is reflected in the General tab of the Case Form and is also available for duplicate searching for cases.

Click the green dot to view and select justifications from the Justification dialog box.

Product Name

If the adverse event(s) are associated with more than one product, each additional product can be added from the Case Form.

Enter the most suspect product here. Click Select to search for a product from the Trade Name Product Lookup dialog box. Several items are automatically entered on the Case Form based on the product selected here.

Generic Name

This field can be used to enter the generic name of the product. This field is automatically entered when a product is selected from the Trade Name Product Lookup dialog box.

Description as Reported

Enter a brief verbatim description from the reporter describing the event that is most clinically important in the case. The icon denotes that the event is encoded. Click the icon to populate the MedDRA hierarchy dialog box.

Onset Date/Time

Enter the date/time for the onset of adverse event symptoms.

ID

Enter the value to search for a Reporter Reference number, Case Reference, and Case number.

Journal and/or Title

These items are applicable to literature cases only. Click Select to choose a journal and/or title from the Literature Reference dialog box. The Administrator can adjust this list.