Part A Rapid Notification Format for Serious Adverse Events
United Kingdom
Reporting establishment
Report identification
Reporting date (year/month/day)
Date of serious adverse event (year/month/day)
| Serious adverse event, which may affect quality and safety of blood component due to a deviation in: | Specification | |||
|---|---|---|---|---|
| Product defect | Equipment failure | Human error | Other(specify) | |
| Whole blood collection | ||||
| Apheresis collection | ||||
| Testing of donations | ||||
| Processing | ||||
| Storage | ||||
| Distribution | ||||
| Materials | ||||
| Others (specify) | ||||