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2. Serious Adverse Events

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Serious Adverse Events

This section will be helpful for CRAs who need to report a Serious Adverse Event for a subject. 

  1. Begin on Home Page > Subjects menu > CRA Console
  2. Select a protocol by entering the protocol number in the Select Protocol field
  3. Find Subject and click on Subject "Epic MRN" hyperlink
  4. Click the SAEs vertical tab
  5. Create a new SAE record
    1. Click "New"
    2. Enter the following Required Fields into the "Subject SAE Update" block
      1. Event Date
        1. Date the event became reportable
      2. Event End Date (Required for Oncology only)
        1. Date the Serious event ended
      3. Reported Date
        1. Date the research team found out about the SAE. The research team includes all WUSM faculty and staff listed in myIRB
      4. PI Comments (Required for Oncology only)
        1. This is a free-text field where the SAE reporting timeframe must be entered for Oncology studies
      5. Outcome
        1. Outcome is the status of the subject in regard to the SAE
      6. Adverse Event Details (Required for Oncology only)
        1. Details of the actual AE including CTCAE SystemTermGrade, and whether or not it is Unexpected
    3. Enter the following Oncology Required Fields in the "Tracking Details" block
      1. Notified Regulatory (date)
      2. Notified Sponsor (date)
      3. Team Reviewed (date)
    4. Click the "Submit" and "Close" button
  6. If needed, create a Follow-Up SAE record
    1. Find the SAE record associated with the one you are updating and click on its "Event No. hyperlink"
    2. Click the "Create Follow-Up" button
    3. Enter updated information for the following Required Fields:
      1. Event Date
      2. Reported Date
      3. Outcome
      4. Notified Regulatory (date) (Required for Oncology only)
    4. Make any other updates to the original SAE
    5. Click the "Submit" and "Close" button
    6. For Oncology studies, in the "Supporting Documents" block, click Add
      1. Upload the PI Signed SAE Report
  7. To Complete SAE Record:
    1. Find the SAE record associated with the one you are updating and click on its "Event No. hyperlink"
    2. Click "Update"
    3. Enter the following Oncology Required Fields into the "Adverse Event Details" block
      1. Category
        1. The category option list is dependent upon the coding scheme associated with the protocol. For protocols using CTC V4, the category list corresponds to System Organ Class
      2. AE Detail
        1. The AE Detail option list is dependent upon the coding scheme associated with the protocol. For protocols using CTC V4, the category list corresponds to the System Organ Class
      3. Grade
        1. Grade is the severity of the AE. For protocols using CTC V4, grades 1 through 5 will display
      4. Unexpected
        1. An SAE is unexpected if its nature or severity is not consistent with information relevant source document(s) (e.g. investigator's brochure, consent, protocol)
    4. Click the "Add" button
    5. Click the "Submit" and "Close" button
    6. Navigate back to the SAE record associated with the one you are updating and click on its "Event No. hyperlink"
    7. Click "Update"
    8. Ensure SAE information is Complete
    9. In the "Tracking Details" block, enter the Notified Sponsor Action Date
    10. In the "Supporting Documents" block, click add and upload the PI Signed SAE Report
    11. Click the "Complete and Lock" button
    12. The Regulatory Coordinator should complete the SAE Record according to the instructions on the "Updating Regulatory Reportable Event Information" Work Instruction

*Required fields marked in red, bold font, required for all unless Oncology specifically called out

Common Terminology Criteria for Adverse Events (CTCAE):

  •  Set of criteria for the standardized classification of adverse effects of drugs used in cancer therapy.
  • Each oncology protocol should specify which version of the CTCAE should be utilized.
  • The CTCAE version can be updated/changed in the management tab of the PC console by the regulatory coordinator as long as no SAEs have been documented. 


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