{
  "resourceType": "AdverseEvent",
  "id": "VAERSExampleEvent",
  "meta": {
    "profile": [
      "http://hl7.org/fhir/us/icsr-ae-reporting/StructureDefinition/ibm-fda-vaers-adverseevent"
    ]
  },
  "text": {
    "status": "generated",
    "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>actuality</b>: actual</p><p><b>event</b>: <span title=\"Codes: {http://meddra.org 10004223}\">Bell's Palsy</span></p><p><b>subject</b>: <a href=\"Patient-VAERSPatient.html\">Generated Summary: id: 123456789; FNAME LNAME ; gender: male; birthDate: 1955-07-22</a></p><p><b>date</b>: 2017-04-23</p><p><b>seriousness</b>: <span title=\"Codes: {urn:oid:2.16.840.1.113883.3.989.2.1.1.19 26}\">26</span></p><p><b>outcome</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/adverse-event-outcome recovering}\">Recovering</span></p><blockquote><p><b>suspectEntity</b></p><p><b>instance</b>: <a href=\"Immunization-VAERSExampleImmunization.html\">Generated Summary: status: completed; <span title=\"Codes: {http://hl7.org/fhir/sid/ndc 7046101903}\">7046101903</span>; occurrence: 2017-04-23; </a></p><h3>Causalities</h3><table class=\"grid\"><tr><td>-</td><td><b>ProductRelatedness</b></td></tr><tr><td>*</td><td>Suspect</td></tr></table></blockquote><blockquote><p><b>suspectEntity</b></p><p><b>instance</b>: <a href=\"MedicationAdministration-VAERSHydrocortisoneAdministration.html\">Generated Summary: status: completed; <span title=\"Codes: {http://www.nlm.nih.gov/research/umls/rxnorm 197782}\">hydrocortisone 10 MG Oral Tablet</span>; effective: 2017-04-23</a></p><h3>Causalities</h3><table class=\"grid\"><tr><td>-</td><td><b>ProductRelatedness</b></td></tr><tr><td>*</td><td>Concomitant</td></tr></table></blockquote></div>"
  },
  "actuality": "actual",
  "event": {
    "coding": [
      {
        "system": "http://meddra.org",
        "code": "10004223",
        "display": "Bell's Palsy"
      }
    ]
  },
  "subject": {
    "reference": "Patient/VAERSPatient"
  },
  "date": "2017-04-23",
  "seriousness": {
    "coding": [
      {
        "system": "urn:oid:2.16.840.1.113883.3.989.2.1.1.19",
        "code": "26"
      }
    ]
  },
  "outcome": {
    "coding": [
      {
        "system": "http://terminology.hl7.org/CodeSystem/adverse-event-outcome",
        "code": "recovering"
      }
    ]
  },
  "suspectEntity": [
    {
      "instance": {
        "reference": "Immunization/VAERSExampleImmunization"
      },
      "causality": [
        {
          "productRelatedness": "Suspect"
        }
      ]
    },
    {
      "instance": {
        "reference": "MedicationAdministration/VAERSHydrocortisoneAdministration"
      },
      "causality": [
        {
          "productRelatedness": "Concomitant"
        }
      ]
    }
  ]
}