# How Case Watchlist Tags and DMEs are Assigned Vault determines whether a Case should be tagged as a Designated Medical Event (DME) or with a preconfigured watchlist. You can maintain watchlists for Adverse Events of Special Interest (AESIs) and other Important Medical Events (IMEs) that require monitoring. Vault can tag _Cases_ for one or more watchlists, which can be specific to or independent of marketed _Products_ or _Studies_. For _Studies_ with _Unspecified Products_, Vault applies _Watchlist Tags_ to _Case Products_ with an eligible _Drug Role_ on _Cases_ for that _Study_. All Safety Vaults include an up-to-date official DME watchlist. By default, the DME watchlist monitors only _Cases_ with _Case Products_ or _Study Products_ referencing a _Product_ registered in a country under the jurisdiction of the European Medicines Agency (EMA). Your Admin can configure additional adverse event watchlists. Depending on your Admin's configuration, _Cases_ may be expedited when they are tagged for certain watchlists, regardless of expectedness or causality. ### Default Case Seriousness Your Admin can configure watchlists to assign a default Seriousnesss to an adverse event. Doing so will automatically assign the Case Seriousness for Inbox Items containing the respective adverse event after promoting it to a Case.

Note: If the Inbox Item being promoted already has a specified Seriousness (it is not blank), the watchlist will not update the Case Seriousness upon Case promotion.

The following diagram describes an example of a watchlist assigning Case Seriousness to an Inbox Item with an unspecified (blank) **Seriousness** field:

1. Watchlist A sets the Seriousness to "Other Medically Important Condition" for adverse event Cardiac Arrest. 2. After you promote an Inbox Item containing adverse event Cardiac Arrest and a blank **Seriousness** field to a Case, the Case Seriousness will be automatically set to "Other Medically Important Condition". If multiple watchlists are configured to set the Case Seriousness for the same adverse event, Vault will assign all specified Seriousness criteria to the Case with the respective adverse event. In other words, the Case Seriousness is cumulative. The following diagram describes an example of a watchlist assigning Case Seriousness to an Inbox Item with a specified (not blank) **Seriousness** field:

1. Watchlist A sets the Seriousness to "Other Medically Important Condition" for adverse event Cardiac Arrest. 2. After you promote an Inbox Item containing adverse event Cardiac Arrest and a specified Seriousness to a Case, the Inbox Item Seriousness will copy over to the Case. The Watchlist does not update the Case Seriousness. ## How to Trigger Watchlist Auto-Calculation Vault calculates and assigns watchlist tags on a _Case_ following: * _Case_ promotion. * _Case Adverse Event_ creation, update, or deletion. * _Case Product_ creation, update, or deletion. Vault calculates and assigns DME watchlist tags following: * _Case_ promotion. * _Case Adverse Event_ creation, update, or deletion. * _Case Product_ creation. * _Product_ or _Drug Role_ update on a _Case Product_.