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Narrative

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Source1

{
  "resourceType": "AdverseEvent",
  "id": "clinicalcareexample2phlebotomist",
  "meta": {
    "versionId": "2",
    "lastUpdated": "2021-12-15T21:05:01.812+00:00",
    "profile": [
      "http://hl7.org/fhir/uv/adverseeventclinicalcare/StructureDefinition/AdverseEvent-clinical-care"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<!-- snip (see above) -->"
  },
  "identifier": [
    {
      "system": "http://acme.com/ids/patients/risks",
      "value": "001"
    }
  ],
  "status": "completed",
  "actuality": "actual",
  "category": [
    {
      "coding": [
        {
          "system": "http://terminology.hl7.org/CodeSystem/adverse-event-category",
          "code": "unsafe-physical-environment",
          "display": "Unsafe Physical Environment"
        }
      ]
    }
  ],
  "code": {
    "coding": [
      {
        "system": "http://snomed.info/sct",
        "code": "370927008",
        "display": "Death or significant injury of a patient or staff member resulting from a physical assault (i.e., battery) that occurs within or on the grounds of the healthcare facility (event)"
      }
    ]
  },
  "subject": {
    "type": "Practitioner",
    "display": "phlebotomist"
  },
  "encounter": {
    "display": "Inpatient encounter of event that was initiated with ER visit"
  },
  "detected": "2021-12-10T13:28:17-05:00",
  "recordedDate": "2021-12-15T13:28:17-05:00",
  "resultingEffect": [
    {
      "display": "Condition with Diagnosis category, 3.5 cm laceration on left forearm"
    }
  ],
  "location": {
    "display": "Hospital, Inpatient"
  },
  "outcome": [
    {
      "coding": [
        {
          "system": "http://snomed.info/sct",
          "code": "398056004",
          "display": "Transient abnormality with full recovery (finding)"
        }
      ]
    }
  ],
  "recorder": {
    "display": "The person entering in the information"
  },
  "suspectEntity": [
    {
      "instanceReference": {
        "type": "MedicationAdministration",
        "display": "14 year-old patient had increase in Levetiracetam"
      },
      "causality": {
        "entityRelatedness": {
          "coding": [
            {
              "system": "http://terminology.hl7.org/CodeSystem/adverse-event-causality-assess",
              "code": "probably-likely",
              "display": "Probably/Likely"
            }
          ]
        }
      }
    }
  ],
  "mitigatingAction": [
    {
      "itemReference": {
        "type": "MedicationRequest",
        "display": "for 14 year-old patient dose reduced to pre-admission dose for the remainder of his hospital stay."
      }
    }
  ],
  "note": [
    {
      "authorString": "Practitioner",
      "text": "There was no clinical or electrographic seizure episode or recurrence of fever since admission in the 14 year-old patient."
    }
  ]
}