# EU MIR Generation Data Mapping

Learn how Vault maps _Case_ details to generate the European Commission's Manufacturer Incident Report (MIR) for Serious Incidents (MDR/IVDR) and Incidents (AIMDD/MDD/IVDD), Version 7.3.1. Depending on your _Transmission Document Type_ selection during _Transmission_ generation, Vault formats the document as a PDF (_EU MIR_) or an XML file (_EU MIR XML_). When generating XML files, Vault truncates values to fit within data element character limits.

In the sections below, images of the form represent the PDF format, but the data mapping descriptions in the tables apply to both the PDF and the XML formats.

## Prerequisite

Your Admin must <a href="/en/gr/872185/">enable European Union Manufacturer Incident Report (EU MIR) PDF Generation</a>.

## Section 1: Administrative information

Section 1 captures information about the responsible competent authority, details about the incident report, information on the report submitter, device manufacturer, and authorized representative.

### 1.1 Responsible competent authority in which country the incident occurred

<a href="https://platform.veevavault.help/assets/images/saf-mir-1.1.png" data-lightbox="saf-mir-1.1.png" data-title="" data-alt="EU MIR Form: 1.1 Corresponding competent authority section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-1.1.png" alt="EU MIR Form: 1.1 Corresponding competent authority section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr> 
    </thead>
    <tbody>
        <tr>
            <td>a. Name of receiving national competent authority (NCA)</td>
            <td>The <em>Name</em> of the <em>Agency</em> in the <em>Destination</em> field of the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>b. EUDAMED number of NCA</td>
            <td>The <em>EUDAMED Number</em> of the <em>Agency</em> in the <em>Destination</em> field of the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>c. Reference number assigned by NCA for this incident</td>
            <td>The <em>NCA Reference Number</em> on the <em>Device Incident Report</em> of the <em>Device</em>-type <em>Case Product</em>. If blank, Vault populates <code>Not Known</code>.</td>
        </tr>
        <tr>
            <td>d. Reference number assigned by EUDAMED for this incident</td>
            <td>The <em>EUDAMED Reference Number</em> on the <em>Device Incident Report</em> of the <em>Device</em>-type <em>Case Product</em>. If blank, Vault populates <code>Not Known</code>.</td>
        </tr>
    </tbody>
</table>

### 1.2 Date, type, and classification of incident report

<a href="https://platform.veevavault.help/assets/images/saf-mir-1.2.png" data-lightbox="saf-mir-1.2.png" data-title="" data-alt="EU MIR Form: 1.2 Date, type, and classification of incident report section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-1.2.png" alt="EU MIR Form: 1.2 Date, type, and classification of incident report section" style=""  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr>
    </thead>
    <tbody>
        <tr>
            <td>a. Date of report submission</td>
            <td>The <em>Transmission Date</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>b. Date of incident</td>
            <td>Vault populates a date range for when the onset of the event could have occurred based on the <em>Onset</em> date of the primary <em>Case Adverse Event</em>:
            <ul>
            <li>If the <em>Onset</em> date includes the day, month, and year, Vault populates from <code>yyyy-mm-dd</code> to <code>yyyy-mm-dd</code>.</li>
            <li>If the <em>Onset</em> date includes only the  month and year, Vault populates from the first to the last day of the month. For example, if the <em>Onset</em> date is <em>April 2026</em>, Vault populates from <code>2026-04-01</code> to <code>2026-04-30</code>.</li>
            <li>If the <em>Onset</em> date includes only the year, Vault populates from the first to the last day of the year. For example, if the <em>Onset</em> date is <em>2026</em>, Vault populates from <code>2026-01-01</code> to <code>2026-12-31</code>.</li>
            </ul>
            <div class="note-border alert-info">
  <div class="alert alert-info" role="alert">
    <div><i class="far fa-info-circle"></i></div>
    <div class="alert-text">
      <p><strong>Note</strong>: If the <em>Receipt Date</em> is before the last date of the range, Vault exports the <em>Receipt Date</em> in the second field. For example, if the <em>Onset</em> date is <em>2025</em> and the <em>Receipt Date</em> is <em>September 23, 2025</em>, Vault populates from <code>2025-01-01</code> to <code>2025-09-23</code>.</p>
    </div>
  </div>
</div>


            If the <em>Onset</em> date is blank, Vault populates the <em>Receipt Date</em>.
            </td>
        </tr>
        <tr>
            <td>c. Manufacturer awareness date of the incident</td>
            <td>For initial <em>Cases</em>, Vault exports the <em>Receipt Date</em>. For follow-up <em>Cases</em>, Vault exports the <em>New Info Date</em>.</td>
        </tr>
        <tr>
            <td>d. Manufacturer awareness date of reportability <a id="eu-mir-12d"></a></td>
            <td>The <em>Manufacturer Reportable Awareness Date</em> on the <em>Case</em>.</td>
        </tr>
        <tr>
            <td>e. Type of report</td>
            <td>The <em>Type of Incident Report</em> on the <em>Device Incident Report</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>f. In case of initial and follow-up reports, please indicate the expected date of the next report</td>
            <td>The <em>Expected Date of Next Report</em> on the <em>Device Incident Report</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>g. Classification of serious incident</td>
            <td>Vault selects an option using the following priority:
                <ol><li><strong>Death</strong>: If the <em>Seriousness</em> of the <em>Case Adverse Event</em> includes <em>Results in Death</em></li>
                    <li><strong>Serious public health threat</strong>: If the <em>Device Report Type</em> of the <em>Device</em>-type <em>Case Product</em> includes <em>Public Health Risk</em> and the <em>Case Adverse Event</em> includes a <em>Seriousness</em> value</li>
                    <li><strong>Unanticipated serious deterioration in state of health</strong>: If the <em>Device Report Type</em> of the <em>Device</em>-type <em>Case Product</em> does not include <em>Public Health Risk</em> and a <em>Case Assessment Expectedness</em> record for the <em>Case Product</em> on the <em>Transmission</em> has <em>No</em> in the <em>Expected</em> field and the <em>Case Adverse Event</em> includes a <em>Seriousness</em> value</li>
                    <li><strong>All other reportable incidents</strong>: In all other scenarios</li>
                </ol></td>
        </tr>
    </tbody>
</table>

### 1.3 Submitter information

This includes information about the report submitter, manufacturer, and additional sections that Vault may populate depending on the type of report submitter.

#### 1.3.1 Submitter of the report

<a href="https://platform.veevavault.help/assets/images/saf-mir-1.3.1.png" data-lightbox="saf-mir-1.3.1.png" data-title="" data-alt="EU MIR Form: 1.3.1 Submitter of the report section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-1.3.1.png" alt="EU MIR Form: 1.3.1 Submitter of the report section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr>
    </thead>
    <tbody>
        <tr>
            <td>a. Submitter of the report</td>
            <td><p>The <em>Submitter of Report</em> on the <em>Device Incident Report</em> of the <em>Device</em>-type <em>Case Product</em>.</p>
            <p>When the <em>Submitter of Report</em> is <em>Other</em>, Vault also exports the <em>Submitter of Report (Other)</em> text.</p></td>
        </tr>
        <tr>
            <td>b. Manufacturer's reference number for this incident</td>
            <td>The <em>Manufacturer Reference Number</em> on the <em>Device Incident Report</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>c. NCA's local reference number</td>
            <td>If any other <em>Case Products</em> include an <em>NCA Reference Number</em>, Vault exports the value. Vault comma-separates multiple values.</td>
        </tr>
        <tr>
            <td>c. EUDAMED's reference number</td>
            <td>If any other <em>Case Products</em> include a <em>EUDAMED Number</em>, Vault exports the value. Vault comma-separates multiple values.</td>
        </tr>
        <tr>
            <td>c. Manufacturer's reference number</td>
            <td>If any other <em>Case Products</em> include a <em>Manufacturer Reference Number</em>, Vault exports the value. Vault comma-separates multiple values.</td>
        </tr>
        <tr>
            <td>d. NCA's local FSCA reference number</td>
            <td>The <em>NCA FSCA Reference Number</em> on the <em>Device Incident Report</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>d. EUDAMED's FSCA reference number</td>
            <td>The <em>EUDAMED FSCA Reference Number</em> on the <em>Device Incident Report</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>d. Manufacturer's FSCA reference number</td>
            <td>The <em>Manufacturer FSCA Reference Number</em> on the <em>Device Incident Report</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>e. Periodic Summary Report (PSR) ID <a id="eu-mir-13e"></a></td>
            <td>The <em>Periodic Summary Report (PSR) ID</em> from the <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>f. The incident occurred within a PMCF/PMPF investigation</td>
            <td>For study <em>Cases</em> with a <em>Study Type</em> of <em>Other</em> and a <em>Registration Type</em> that corresponds to E2B code <code>7</code>, Vault selects yes. Otherwise, Vault selects no.</td>
        </tr>
        </tbody>
    </table>

#### 1.3.2 Manufacturer information

<a href="https://platform.veevavault.help/assets/images/saf-mir-1.3.2.png" data-lightbox="saf-mir-1.3.2.png" data-title="" data-alt="EU MIR Form: 1.3.2 Manufacturer information section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-1.3.2.png" alt="EU MIR Form: 1.3.2 Manufacturer information section" style="max-width: 80%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr>
    </thead>
    <tbody>
        <tr>
            <td>a. Manufacturer organisation name</td>
            <td>The <em>Name</em> of the <em>Organization</em> linked in the <em>Manufacturer</em> field of the corresponding <em>Product</em> record.</td>
        </tr>
        <tr>
            <td>b. Single registration number</td>
            <td>The <em>Single Registration Number (SRN)</em> of the <em>Organization</em> linked in the <em>Manufacturer</em> field of the corresponding <em>Product</em> record.</td>
        </tr>
        <tr>
            <td>c. Contact's first name</td>
            <td>The <em>First Name</em> of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>d. Contact's last name</td>
            <td>The <em>Last Name</em> of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>e. Email</td>
            <td>The <em>Email</em> of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>f. Phone</td>
            <td>The value in the <em>Telephone</em> field of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>g. Country</td>
            <td>The two-letter ISO code associated with the <em>Country</em> of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>h. Street</td>
            <td>The value, excluding leading numbers, in the <em>Street</em> field of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>. Vault does not populate this field if the street address includes a PO Box.</td>
        </tr>
        <tr>
            <td>i. Street number</td>
            <td>The leading numbers in the <em>Street</em> field of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>j. Address complement</td>
            <td>Vault does not populate this field.</td>
        </tr>
        <tr>
            <td>k. PO Box</td>
            <td>If the <em>Street</em> field of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em> includes a PO Box, Vault populates the <em>Street</em> value.</td>
        </tr>
        <tr>
            <td>l. City name</td>
            <td>The <em>City</em> of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>m. Postal code</td>
            <td>The <em>Postal Code</em> of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
    </tbody>
</table>

#### 1.3.3 Authorised representative information

Vault populates this section only if the _Submitter of Report_ is _Authorised Representative_.

<a href="https://platform.veevavault.help/assets/images/saf-mir-1.3.3.png" data-lightbox="saf-mir-1.3.3.png" data-title="" data-alt="EU MIR Form: 1.3.2 Manufacturer information section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-1.3.3.png" alt="EU MIR Form: 1.3.2 Manufacturer information section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr>
    </thead>
    <tbody>
        <tr>
            <td>a. Authorised representative organisation name</td>
            <td>The <em>Name</em> of the <em>Organization</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>b. Single Registration Number</td>
            <td>The <em>Single Registration Number (SRN)</em> of the <em>Organization</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>c. Contact's first name</td>
            <td>The <em>First Name</em> of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>d. Contact's last name</td>
            <td>The <em>Last Name</em> of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>e. Email</td>
            <td>The <em>Email</em> of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>f. Phone</td>
            <td>The value in the <em>Telephone</em> field of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>g. Country</td>
            <td>The two-letter ISO code associated with the <em>Country</em> of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>h. Street</td>
            <td>The value, excluding leading numbers, in the <em>Street</em> field of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>. Vault does not populate this field if the street address includes a PO Box.</td>
        </tr>
        <tr>
            <td>i. Street number</td>
            <td>The leading numbers in the <em>Street</em> field of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>j. Address complement</td>
            <td>Vault does not populate this field.</td>
        </tr>
        <tr>
            <td>k. PO Box</td>
            <td>If the <em>Street</em> field of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em> includes a PO Box, Vault populates the <em>Street</em> value.</td>
        </tr>
        <tr>
            <td>l. City name</td>
            <td>The <em>City</em> of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>m. Postal code</td>
            <td>The <em>Postal Code</em> of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
    </tbody>
</table>

#### 1.3.4 Submitter's details if not also manufacturer or authorised representative

Vault populates this section only if the _Submitter of Report_ is _Other_.

<a href="https://platform.veevavault.help/assets/images/saf-mir-1.3.4.png" data-lightbox="saf-mir-1.3.4.png" data-title="" data-alt="EU MIR Form: 1.3.4 Submitter's details if not also manufacturer or authorised representative section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-1.3.4.png" alt="EU MIR Form: 1.3.4 Submitter's details if not also manufacturer or authorised representative section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr>
    </thead>
    <tbody>
        <tr>
            <td>a. Registered commercial name of company</td>
            <td>The <em>Name</em> of the <em>Organization</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>b. Contact's first name</td>
            <td>The <em>First Name</em> of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>c. Contact's last name</td>
            <td>The <em>Last Name</em> of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>d. Email</td>
            <td>The <em>Email</em> of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>e. Phone</td>
            <td>The value in the <em>Telephone</em> field of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>f. Country</td>
            <td>The two-letter ISO code associated with the <em>Country</em> of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>g. Street</td>
            <td>The value, excluding leading numbers, in the <em>Street</em> field of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>. Vault does not populate this field if the street address includes a PO Box.</td>
        </tr>
        <tr>
            <td>h. Street number</td>
            <td>The leading numbers in the <em>Street</em> field of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>i. Address complement</td>
            <td>Vault does not populate this field.</td>
        </tr>
        <tr>
            <td>j. PO Box</td>
            <td>If the <em>Street</em> field of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em> includes a PO Box, Vault populates the <em>Street</em> value.</td>
        </tr>
        <tr>
            <td>k. City name</td>
            <td>The <em>City</em> of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
        <tr>
            <td>l. Postal code</td>
            <td>The <em>Postal Code</em> of the <em>User</em> associated with the <em>Sender (User)</em> on the <em>Transmission</em>.</td>
        </tr>
    </tbody>
</table>

## Section 2: Medical device information

Section 2 includes device identification, categorization, description, and risk class information, as well as identifies the market distribution of the device and the use of relevant related accessories and devices.

### 2.1 Unique Device Identification (UDI)

<a href="https://platform.veevavault.help/assets/images/saf-mir-2.1.png" data-lightbox="saf-mir-2.1.png" data-title="" data-alt="EU MIR Form: 2.1 Unique Device Identification (UDI) section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-2.1.png" alt="EU MIR Form: 2.1 Unique Device Identification (UDI) section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr> 
    </thead>
    <tbody>
        <tr>
            <td>a. (Master) UDI-DI/Eudamed ID <a id="eu-mir-21a"></a></td>
            <td>The <em>Unique Identifier</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>a. Issuing entity <a id="eu-mir-21a2"></a></td>
            <td>The <em>Unique Identifier Issuing Entity</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>b. UDI production identifier</td>
            <td>The <em>UDI Production Identifier</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>c. Basic UDI-DI/Eudamed-DI <a id="eu-mir-21c"></a></td>
            <td>Vault populates a value using the following priority order:
                <ol>
                    <li>The <em>Basic UDI-DI</em> on the <em>Device</em>-type <em>Case Product</em>.</li>
                    <li>The <em>Basic UDI-DI</em> on the <em>Product</em>  related to the <em>Device</em>-type <em>Case Product</em>.</li>
                </ol>
            </td>
        </tr>
        <tr>
            <td>c. Issuing entity <a id="eu-mir-21c2"></a></td>
            <td>The <em>Basic UDI-DI Issuing Entity</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>d. Unit of use UDI-DI <a id="eu-mir-21d"></a></td>
            <td>The <em>Unit of Use UDI-DI</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>d. Issuing entity <a id="eu-mir-21d2"></a></td>
            <td>The <em>Unit of Use UDI-DI Issuing Entity</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>

    </tbody>
</table>

### 2.2 Categorisation of device

<a href="https://platform.veevavault.help/assets/images/saf-mir-2.2.png" data-lightbox="saf-mir-2.2.png" data-title="" data-alt="EU MIR Form: 2.2 Categorisation of device section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-2.2.png" alt="EU MIR Form: 2.2 Categorisation of device section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr> 
    </thead>
    <tbody>
        <tr>
            <td>a. Medical device nomenclature</td>
            <td>The <em>Medical Device Terminology</em> on the <em>Device Incident Report</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>a. if other, please specify</td>
            <td>When the <em>Medical Device Terminology</em> is <em>Other</em>, Vault also exports the <em>Medical Device Terminology (Other)</em> text.</td>
        </tr>
        <tr>
            <td>b. Medical device nomenclature code <a id="eu-mir-22b"></a></td>
            <td>Vault populates a value using the following priority:
            <ol>
            <li>The <em>Device Nomenclature Code</em> on the <em>Product</em> related to the <em>Case Product</em>.</li>
            <li>The <em>Device Nomenclature Code</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</li>
        </ol></td>
        </tr>
    </tbody>
</table>

### 2.3 Description of device and commercial information

<a href="https://platform.veevavault.help/assets/images/saf-mir-2.3.png" data-lightbox="saf-mir-2.3.png" data-title="" data-alt="EU MIR Form: 2.3 Description of device and commercial information section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-2.3.png" alt="EU MIR Form: 2.3 Description of device and commercial information section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr> 
    </thead>
    <tbody>
        <tr>
            <td>a. Medical device name (brand/trade /proprietary or common name)</td>
            <td>The <em>Brand Name</em> on the <em>Product</em> related to the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>b. Description of the device and its intended purpose</td>
            <td>The <em>Description of Device</em> on the <em>Product</em> related to the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>b. Nomenclature text</td>
            <td>The <em>Nomenclature Text</em> on the <em>Product</em> related to the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>c. Model</td>
            <td>The <em>Model Number</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>d. Catalogue/reference number</td>
            <td>The <em>Catalog Number</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>e. Serial number</td>
            <td>The <em>Serial Number</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>f. Lot/batch number</td>
            <td>Vault populates a value using the following priority:
                <ol>
                    <li>The <em>Batch/Lot Number</em> of the <em>Case Product Dosage</em></li>
                    <li>The <em>Lot Number</em> in the <em>Device Information</em> section of the <em>Device</em>-type <em>Case Product</em></li>
                </ol></td>
        </tr>
        <tr>
            <td>g. Software version</td>
            <td>The <em>Software Version</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>h. Firmware version</td>
            <td>The <em>Firmware Version</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>i. Device manufacturing date</td>
            <td>The <em>Manufacture Date</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>j. Device expiry date</td>
            <td>The <em>Expiration Date</em> on the <em>Device</em>-type <em>Case Product</em>.  If blank, Vault exports the earliest <em>Expiration Date</em> on any <em>Case Product Dosage</em> record on the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>k. Date when device was implanted</td>
            <td>The <em>Date Implanted</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>. If only a partial date exists, Vault populates <code>01</code> for the missing month and day as needed. For example, if the <em>Onset</em> date includes only the year <code>2025</code>, Vault populates <code>2025-01-01</code>.</td>
        </tr>
        <tr>
            <td>l. Date when device was explanted</td>
            <td>The <em>Date Explanted</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>. If only a partial date exists, Vault populates <code>01</code> for the missing month and day as needed. For example, if the <em>Onset</em> date includes only the year <code>2025</code>, Vault populates <code>2025-01-01</code>.</td>
        </tr>
        <tr>
            <td>m. If precise implant/explant dates are unknown, provide the duration of implantation</td>
            <td>If both the <em>Date Implanted</em> and <em>Date Explanted</em> are available and include exact dates, Vault populates the date range of implantation. Vault does not export partial dates.</td>
        </tr>
        <tr>
            <td>n. Implant facility</td>
            <td>The <em>Implant Facility</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>o. Explant facility</td>
            <td>The <em>Explant Facility</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>p. Notified body (NB) ID number(s) Notified body (NB) certificate number(s) of device <a id="eu-mir-23p"></a></td>
            <td>The <em>Notified Body ID</em> and <em>Notified Body Certificate Number</em> on the <em>Product Registration</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>q. Please indicate the date of one of the following <a id="eu-mir-23q"></a></td>
            <td>The <em>Device Market Date Type</em> and <em>Device Market Date</em> on the <em>Product Registration</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
    </tbody>
</table>

### 2.4 Risk class of device when placed on market

<a href="https://platform.veevavault.help/assets/images/saf-mir-2.4.png" data-lightbox="saf-mir-2.4.png" data-title="" data-alt="EU MIR Form: 2.4 Risk class of device when placed on market section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-2.4.png" alt="EU MIR Form: 2.4 Risk class of device when placed on market section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr> 
    </thead>
    <tbody>
        <tr>
            <td>a. Applicable legislation unknown <a id="eu-mir-24a-legislation"></a></td>
            <td>If the <em>Applicable Legislation Unknown</em> value is <em>Yes</em> on the <em>Product Registration</em>, Vault selects this option.</td>
        </tr>
        <tr>
            <td>b. This device has been placed on the market before the implementation of the MDD/AIMDD/IVDD <a id="eu-mir-24a"></a></td>
            <td>Vault selects the option if the <em>Product Registration</em> of the <em>Device</em>-type <em>Case Product</em> meets both criteria: 
            <ul>
            <li>The <em>MDD/AIMDD Risk Class</em> is <em>Marketed Before MDD/AIMDD</em>.</li>
            <li>The <em>IVDD Risk Class</em> is <em>Marketed Before IVDD</em>.</li>
            </ul></td>
        </tr>
        <tr>
            <td>c. MDD/AIMDD <a id="eu-mir-24c-mdd"></a></td>
            <td>The <em>MDD/AIMDD Risk Class</em> on a <em>Product Registration</em> using the following priority: 
            <ol>
            <li>The <em>MDD/AIMDD Risk Class</em> of a <em>Product Registration</em> linked to the <em>Case Product</em>.</li>
            <li>The <em>MDD/AIMDD Risk Class</em> of a <em>Product Registration</em> in a country where the <em>Case Adverse Event</em> occurred. Vault exports the first found record with a value.</li>
            <li>The <em>MDD/AIMDD Risk Class</em> of a <em>Product Registration</em> in a country under the jurisdiction of the EMA. Vault exports the first found record with a value.</li>
            </ol>
            <p>Vault does not populate this field when the <em>MDD/AIMDD Risk Class</em> is <em>Marketed Before MDD/AIMDD</em>.</p></td>
        </tr>
        <tr>
            <td>c. IVDD <a id="eu-mir-24c-ivdd"></a></td>
            <td>The <em>IVDD Risk Class</em> on a <em>Product Registration</em> using the following priority: 
            <ol>
            <li>The <em>IVDD Risk Class</em> of a <em>Product Registration</em> linked to the <em>Case Product</em>.</li>
            <li>The <em>IVDD Risk Class</em> of a <em>Product Registration</em> in a country where the <em>Case Adverse Event</em> occurred. Vault exports the first found record with a value.</li>
            <li>The <em>IVDD Risk Class</em> of a <em>Product Registration</em> in a country under the jurisdiction of the EMA. Vault exports the first found record with a value.</li>
            </ol>
            <p>Vault does not populate this field when the <em>IVDD Risk Class</em> is <em>Marketed Before IVDD</em>.</p></td>
        </tr>
        <tr>
            <td>d. MDR <a id="eu-mir-24d-class"></a></td>
            <td>The <em>MDR Class</em> on a <em>Product Registration</em> using the following priority: 
            <ol>
            <li>The <em>MDR Class</em> of a <em>Product Registration</em> linked to the <em>Case Product</em>.</li>
            <li>The <em>MDR Class</em> of a <em>Product Registration</em> in a country where the <em>Case Adverse Event</em> occurred. Vault exports the first found record with a value.</li>
            <li>The <em>MDR Class</em> of a <em>Product Registration</em> in a country under the jurisdiction of the EMA. Vault exports the first found record with a value.</li>
            </ol>
            </td>
        </tr>
        <tr>
            <td>d. Type <a id="eu-mir-24d-type"></a></td>
            <td>The <em>MDR Type</em> on a <em>Product Registration</em> using the following priority: 
            <ol>
            <li>The <em>MDR Type</em> of a <em>Product Registration</em> linked to the <em>Case Product</em>.</li>
            <li>The <em>MDR Type</em> of a <em>Product Registration</em> in a country where the <em>Case Adverse Event</em> occurred. Vault exports the first found record with a value.</li>
            <li>The <em>MDR Type</em> of a <em>Product Registration</em> in a country under the jurisdiction of the EMA. Vault exports the first found record with a value.</li>
            </ol>
            </td>
        </tr>
        <tr>
            <td>d. IVDR <a id="eu-mir-24d-class-ivdr"></a></td>
            <td>The <em>IVDR Class</em> on a <em>Product Registration</em> using the following priority: 
            <ol>
            <li>The <em>IVDR Class</em> of a <em>Product Registration</em> linked to the <em>Case Product</em>.</li>
            <li>The <em>IVDR Class</em> of a <em>Product Registration</em> in a country where the <em>Case Adverse Event</em> occurred. Vault exports the first found record with a value.</li>
            <li>The <em>IVDR Class</em> of a <em>Product Registration</em> in a country under the jurisdiction of the EMA. Vault exports the first found record with a value.</li>
            </ol>
            </td>
        </tr>
        <tr>
            <td>d. Type <a id="eu-mir-24d-type-ivdr"></a></td>
            <td>The <em>IVDR Type</em> on a <em>Product Registration</em> using the following priority: 
            <ol>
            <li>The <em>IVDR Type</em> of a <em>Product Registration</em> linked to the <em>Case Product</em>.</li>
            <li>The <em>IVDR Type</em> of a <em>Product Registration</em> in a country where the <em>Case Adverse Event</em> occurred. Vault exports the first found record with a value.</li>
            <li>The <em>IVDR Type</em> of a <em>Product Registration</em> in a country under the jurisdiction of the EMA. Vault exports the first found record with a value.</li>
            </ol>
            </td>
        </tr>
        <tr>
            <td>e. Did this device continue to be placed on the EU market after MDR / IVDR date of application? <a id="eu-mir-24e"></a></td>
            <td>The <em>EU Market after application date</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>. If blank, Vault exports the <em>EU Market After Application Date</em> from the <em>Product Registration</em>.</td>
        </tr>
        <tr>
            <td>f. Does the device fulfil any of the following cases: <a id="eu-mir-24f-fulfill"></a></td>
            <td>If either of the <em>Scientific Opinion Asked</em> or <em>Competent Authority Consulted</em> fields on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em> is <em>Yes</em>, Vault selects Yes. Otherwise Vault selects No.</td>
        </tr>
        <tr>
            <td>f. Competent authority name or European Medicines Agency which delivered the scientific opinion or was consulted by the notified body <a id="eu-mir-24f-name"></a></td>
            <td>The <em>Competent Authority Consulted Name</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>f. Name(s) of the medicinal substance(s) / product(s), tissue(s), cell(s) of human origin or their derivative(s) associated with the device <a id="eu-mir-24f-associated"></a></td>
            <td>The <em>Associated Products</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
    </tbody>
</table>

### 2.5 Market distribution of device (region/country)

<a href="https://platform.veevavault.help/assets/images/saf-mir-2.5.png" data-lightbox="saf-mir-2.5.png" data-title="" data-alt="EU MIR Form: 2.5 Market distribution of device (region/country) section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-2.5.png" alt="EU MIR Form: 2.5 Market distribution of device (region/country) section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr> 
    </thead>
    <tbody>
        <tr>
            <td>a. Market distribution of device (region/country)</td>
            <td>Vault selects each country code where the <em>Case Product</em> has a <em>Product Registration</em>. If the <em>Case Product</em> is registered in all countries, Vault selects the All EEA, Switzerland and Turkey checkbox. If the <em>Case Product</em> is registered in additional countries, Vault populates the country codes in the Others field, separating values with a semicolon (;).</td>
        </tr>
    </tbody>
</table>

### 2.6 Use of accessories, associated devices or other devices

<a href="https://platform.veevavault.help/assets/images/saf-mir-2.6.png" data-lightbox="saf-mir-2.6.png" data-title="" data-alt="EU MIR Form: 2.6 Use of accessories, associated devices or other devices section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-2.6.png" alt="EU MIR Form: 2.6 Use of accessories, associated devices or other devices section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr> 
    </thead>
    <tbody>
        <tr>
            <td>a. Relevant accessories used with the device being reported on</td>
            <td>The <em>Relevant Accessories</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>b. Relevant associated devices used with the device being reported on</td>
            <td>The <em>Relevant Associated Devices</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
    </tbody>
</table>

## Section 3: Incident information derived from initial reporter (healthcare professional/facility/patient/lay user/other)

Section 3 includes details about the nature of the incident, medical device problem, patient, and  initial reporter.

### 3.1 Nature of incident

<a href="https://platform.veevavault.help/assets/images/saf-mir-3.1.png" data-lightbox="saf-mir-3.1.png" data-title="" data-alt="EU MIR Form: 3.1 Nature of incident section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-3.1.png" alt="EU MIR Form: 3.1 Nature of incident section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr> 
    </thead>
    <tbody>
        <tr>
            <td>a. Provide a comprehensive description of the incident</td>
            <td>The <em>Additional Device Manufacturer Narrative</em> on the <em>Case Product</em>.</td>
        </tr>
    </tbody>
</table>

### 3.2 Medical device problem information

<a href="https://platform.veevavault.help/assets/images/saf-mir-3.2.png" data-lightbox="saf-mir-3.2.png" data-title="" data-alt="EU MIR Form: 3.2 Medical device problem information section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-3.2.png" alt="EU MIR Form: 3.2 Medical device problem information section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr> 
    </thead>
    <tbody>
        <tr>
            <td>a. IMDRF Medical device problem codes (Annex A)</td>
            <td>If the <em>Device Type Code</em> of the <em>Device</em>-type <em>Case Product</em> is <em>Medical Device Problem</em>, Vault exports an IMDRF code using the following priority:
                <ol><li>Level 3</li>
                    <li>Level 2</li>
                    <li>Level 1</li>
                </ol></td>
        </tr>
        <tr>
            <td>b. Number of patients involved <a id="eu-mir-32b"></a></td>
            <td>The <em>Number of Patients Involved</em> from the <em>Case Product</em>. If blank, Vault populates <code>1</code>.</td>
        </tr>
        <tr>
            <td>c. What is the current location of the device?</td>
            <td>The <em>Current Device Location</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.
            <p>When the <em>Current Device Location</em> is <em>Other</em>, Vault also exports the <em>Current Device Location (Other)</em> text.</p></td>
        </tr>
        <tr>
            <td>d. Operator of device at the time of the incident</td>
            <td>The <em>Operator of Device</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.
            <p>When the <em>Operator of Device</em> is <em>Other</em>, Vault also exports the <em>Operator of Device (Other)</em> text.</p></td>
        </tr>
        <tr>
            <td>e. Usage of device (as intended)</td>
            <td>The <em>Device Usage Type</em> value and the <em>Usage of Device (Other)</em> text on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>f. Remedial actions taken by healthcare facility, patient or user subsequent to the incident</td>
            <td>The <em>Remedial Action</em> and <em>Remedial Action (Other)</em> values from the <em>Case Product</em>. Vault comma-separates multiple values.</td>
        </tr>
    </tbody>
</table>

### 3.3 Clinical information

<a href="https://platform.veevavault.help/assets/images/saf-mir-3.3.png" data-lightbox="saf-mir-3.3.png" data-title="" data-alt="EU MIR Form: 3.3 Patient information section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-3.3.png" alt="EU MIR Form: 3.3 Patient information section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr> 
    </thead>
    <tbody>
        <tr>
            <td>a. IMDRF 'Health Effect' terms and codes (Annex E, F)</td>
            <td>If the <em>Device Type Code</em> of the <em>Device</em>-type <em>Case Product</em> is <em>Health Effects - Clinical signs and Symptoms or Conditions</em> or <em>Health Effects - Health Impact</em>, Vault exports an IMDRF code based on the <em>Rank</em> field of the <em>Case Product Device Code</em>, if populated. Otherwise, Vault exports a code using the following priority:
                <ol><li>Level 3</li>
                    <li>Level 2</li>
                    <li>Level 1</li>
                </ol></td>
        </tr>
        <tr>
            <td>b. Age of patient at the time of the incident</td>
            <td>The <em>Age (normalized)</em> of the <em>Case Patient</em>. If the age value is two (2) years or less, Vault exports the age in years, months, and days. Otherwise, Vault populates only the year, rounding down to the nearest year.</td>
        </tr>
        <tr>
            <td>c. Gender</td>
            <td>The value in the <em>Sex</em> field on the <em>Case</em> as follows:
            <ul><li>If <em>Female</em>, Vault selects Female.</li>
                <li>If <em>Male</em>, Vault selects Male.</li>
                <li>In either of the following instances, Vault selects Other:
                <ul><li><em>Sex</em> is blank, but <em>Gender</em> includes a value.</li>
                <li>Both <em>Gender</em> and <em>Gender (reason omitted)</em> include values.</li></ul>
                </li>
                <li>If blank and <em>Gender (reason omitted)</em> is blank, <em>Not Asked</em>, <em>Unknown</em>, or <em>Asked But Unknown</em>, Vault selects Not specified.</li>
            </ul>
        </td>
        </tr>
        <tr>
            <td>d. Body weight</td>
            <td>The <em>Weight (normalized)</em> of the <em>Case Patient</em>.</td>
        </tr>
        <tr>
            <td>e. Height (cm)</td>
            <td>The <em>Height (normalized)</em> of the <em>Case Patient</em>.</td>
        </tr>
        <tr>
            <td>f. List any of the patient's prior health condition or medication that may be relevant to this incident</td>
            <td>The <em>Device Usage Type</em> value and the <em>Usage of Device (Other)</em> text on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
    </tbody>
</table>


### 3.4 Initial reporter (can be healthcare professional of facility, patient, lay user)

<a href="https://platform.veevavault.help/assets/images/saf-mir-3.4.png" data-lightbox="saf-mir-3.4.png" data-title="" data-alt="EU MIR Form: 3.4 Initial reporter (can be healthcare professional of facility, patient, lay user) section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-3.4.png" alt="EU MIR Form: 3.4 Initial reporter (can be healthcare professional of facility, patient, lay user) section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr> 
    </thead>
    <tbody>
        <tr>
            <td>a. Role of initial reporter</td>
            <td>The <em>Qualification</em> of the primary <em>Reporter</em>-type <em>Case Contact</em>.</td>
        </tr>
        <tr>
            <td>b. Name of healthcare facility where incident occurred</td>
            <td>The <em>Facility Name</em> or <em>Facility Name (Reason Omitted)</em> of the primary <em>Reporter</em>-type <em>Case Contact</em>.</td>
        </tr>
        <tr>
            <td>c. Healthcare facility report number</td>
            <td>Vault does not populate this field.</td>
        </tr>
        <tr>
            <td>d. Contact's first name</td>
            <td>The <em>First Name</em> of the primary <em>Reporter</em>-type <em>Case Contact</em>.</td>
        </tr>
        <tr>
            <td>e. Contact's last name</td>
            <td>The <em>Last Name</em> of the primary <em>Reporter</em>-type <em>Case Contact</em>.</td>
        </tr>
        <tr>
            <td>f. Email</td>
            <td>The <em>Email Address</em> of the primary <em>Reporter</em>-type <em>Case Contact</em>.</td>
        </tr>
        <tr>
            <td>g. Phone</td>
            <td>The <em>Telephone</em> value of the primary <em>Reporter</em>-type <em>Case Contact</em>.</td>
        </tr>
        <tr>
            <td>h. Country</td>
            <td>The <em>Country</em> of the primary <em>Reporter</em>-type <em>Case Contact</em>. If the country is not in the drop-down list, Vault:
                <ul>
                    <li>Populates Other in the Country field.</li>
                    <li>Selects the if other, please specify checkbox.</li>
                    <li>Exports the name of the Country in the text box.</li>
                </ul></td>
        </tr>
        <tr>
            <td>i. Street</td>
            <td>The <em>Street</em> of the primary <em>Reporter</em>-type <em>Case Contact</em>.</td>
        </tr>
        <tr>
            <td>j. Street number</td>
            <td>The <em>Street Number</em> of the primary <em>Reporter</em>-type <em>Case Contact</em>.</td>
        </tr>
        <tr>
            <td>k. Address complement</td>
            <td>The <em>Street Line 2</em> value of the primary <em>Reporter</em>-type <em>Case Contact</em>.</td>
        </tr>
        <tr>
            <td>l. PO Box</td>
            <td>The <em>PO Box</em> of the primary <em>Reporter</em>-type <em>Case Contact</em>.</td>
        </tr>
        <tr>
            <td>m. City name</td>
            <td>The <em>City</em> of the primary <em>Reporter</em>-type <em>Case Contact</em>.</td>
        </tr>
        <tr>
            <td>n. Postal code</td>
            <td>The <em>Postal Code</em> of the primary <em>Reporter</em>-type <em>Case Contact</em>.</td>
        </tr>
    </tbody>
</table>

## Section 4: Manufacturer analysis

Section 4 includes the manufacturer's preliminary comments, cause investigation and conclusion details, and similar incident information.

### 4.1 Manufacturer's preliminary comments

<a href="https://platform.veevavault.help/assets/images/saf-mir-4.1.png" data-lightbox="saf-mir-4.1.png" data-title="" data-alt="EU MIR Form: 4.1 Manufacturer's preliminary comments section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-4.1.png" alt="EU MIR Form: 4.1 Manufacturer's preliminary comments section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr> 
    </thead>
    <tbody>
        <tr>
            <td>a. For initial and follow-up reports: preliminary results and conclusions of manufacturer's investigation</td>
            <td>The <em>Preliminary Results and Conclusions</em> text on the <em>Manufacturer Analysis</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>b. Suspicion of a relationship between the incident and the medicinal substance(s) / product(s), tissue(s), cell(s) of human origin or their derivative(s) associated with the device? <a id="eu-mir-41b"></a></td>
            <td>The <em>Initial Product and Incident Assessment</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>c. Initial actions (corrective and/or preventive) implemented by the manufacturer</td>
            <td>The <em>Initial (Corrective/Preventative) Actions</em> text on the <em>Manufacturer Analysis</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>d. What further investigations do you intend in view of reaching final conclusions?</td>
            <td>The <em>Further Investigations</em> text on the <em>Manufacturer Analysis</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
    </tbody>
</table>

### 4.2 Cause investigation and conclusion

<a href="https://platform.veevavault.help/assets/images/saf-mir-4.2.png" data-lightbox="saf-mir-4.2.png" data-title="" data-alt="EU MIR Form: 4.2 Cause investigation and conclusion section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-4.2.png" alt="EU MIR Form: 4.2 Cause investigation and conclusion section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr> 
    </thead>
    <tbody>
        <tr>
            <td>a. For Final (Serious incident): Description of the manufacturer's evaluation concerning possible root causes/causative factors and conclusion</td>
            <td>The <em>Root Cause Description</em> and <em>Conclusion</em> text on the <em>Manufacturer Analysis</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>b. For Final (Non-reportable incident): Fill out rationale for why this is considered not reportable <a id="eu-mir-42b"></a></td>
            <td>The <em>Not Reportable Rationale</em> on the <em>Device Incident Report</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>c. Is root cause confirmed?</td>
            <td>The <em>Is root cause confirmed?</em> value on the <em>Manufacturer Analysis</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>c. Suspicion or confirmation of a relationship between the serious incident and the medicinal substance(s)/product(s), tissue(s), cell(s) of human origin or their derivative(s) associated with the device</td>
            <td>The <em>Final Product and Incident Assessment</em> on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>d. Has the risk assessment been reviewed? <a id="eu-mir-42d"></a></td>
            <td>The <em>Risk assessment reviewed?</em> value on the <em>Manufacturer Analysis</em> of the <em>Device</em>-type <em>Case Product</em>. If the risk assessment has not been reviewed, Vault populates the <em>Rationale for no review required</em> value.</td>
        </tr>
        <tr>
            <td>d. If the risk assessment has been reviewed, is it still adequate? <a id="eu-mir-42d2"></a></td>
            <td>The <em>Is reviewed assessment still adequate?</em> value on the <em>Device Information</em> record of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>d. Results of the assessment <a id="eu-mir-42d3"></a></td>
            <td>The <em>Risk Assessment Results</em> from the <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>e. IMDRF 'Cause Investigation' terms and codes (Annex B, C, D)</td>
            <td>If the <em>Device Type Code</em> of the <em>Device</em>-type <em>Case Product</em> is <em>Type of Investigation, Investigation Finding, or Investigation Conclusion</em>, Vault exports an IMDRF code using the following priority:
                <ol><li>Level 3</li>
                    <li>Level 2</li>
                    <li>Level 1</li>
                </ol></td>
        </tr>
        <tr>
            <td>f. IMDRF Component codes (Annex G)</td>
            <td>If the <em>Device Type Code</em> of the <em>Device</em>-type <em>Case Product</em> is <em>Medical Device Component</em>, Vault exports an IMDRF code using the following priority:
                <ol><li>Level 3</li>
                    <li>Level 2</li>
                    <li>Level 1</li>
                </ol></td>
        </tr>
        <tr>
            <td>g. Description of remedial action/corrective action/preventive action/field safety corrective action (FSCA)</td>
            <td>The <em>Corrective/Preventative Action</em> text on the <em>Manufacturer Analysis</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>h. Time schedule for the implementation of the identified actions</td>
            <td>The <em>Corrective/Preventative Action Schedule</em> text on the <em>Manufacturer Analysis</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>i. Final comments from the manufacturer on cause investigation and conclusion</td>
            <td>The <em>Investigation Summary and Conclusion</em> text on the <em>Manufacturer Analysis</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
    </tbody>
</table>

### 4.3 Similar serious incidents (for Final serious incidents)

This includes additional information about similar incidents and the codes and terms used to identify them.

#### 4.3.1 Use of IMDRF terms and codes for identifying similar incidents

<a href="https://platform.veevavault.help/assets/images/saf-mir-4.3.1.png" data-lightbox="saf-mir-4.3.1.png" data-title="" data-alt="EU MIR Form: 4.3.1 Use of IMDRF terms and codes for identifying similar incidents section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-4.3.1.png" alt="EU MIR Form: 4.3.1 Use of IMDRF terms and codes for identifying similar incidents section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr> 
    </thead>
    <tbody>
        <tr>
            <td>a. Identification of similar serious incidents using IMDRF Adverse Event Reporting terms and codes</td>
            <td><p>The <em>IMDRF Similar Incident Identification</em> on the <em>Device Incident Report</em> of the <em>Device</em>-type <em>Case Product</em>. Depending on the selected values, Vault may select one or both of the checkboxes for Medical device problem and Investigation finding.</p>
            <p>When the <em>IMDRF Similar Incident Identification (Other)</em> field includes a value, Vault selects only the Other checkbox and exports the <em>IMDRF Similar Incident (Other)</em> text.</p></td>
        </tr>
    </tbody>
</table>

#### 4.3.2 Use of in-house terms/codes for identifying similar incidents

<a href="https://platform.veevavault.help/assets/images/saf-mir-4.3.2.png" data-lightbox="saf-mir-4.3.2.png" data-title="" data-alt="EU MIR Form: 4.3.2 Use of in-house terms/codes for identifying similar incidents section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-4.3.2.png" alt="EU MIR Form: 4.3.2 Use of in-house terms/codes for identifying similar incidents section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr> 
    </thead>
    <tbody>
        <tr>
            <td>a. If similar serious incident were not identified by IMDRF codes but by in-house codes, please provide the codes and terms below.</td>
            <td>Vault does not populate this field.</td>
        </tr>
    </tbody>
</table>

#### 4.3.3 Number of similar serious incidents and devices on the market

<a href="https://platform.veevavault.help/assets/images/saf-mir-4.3.3.png" data-lightbox="saf-mir-4.3.3.png" data-title="" data-alt="EU MIR Form: 4.3.3 Number of similar incidents and devices on the market section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-4.3.3.png" alt="EU MIR Form: 4.3.3 Number of similar incidents and devices on the market section" style="max-width: 50%;"  />
</a>

The form fields include:

<table>
    <thead>
        <tr>
            <th>MIR Form Field</th>
            <th>Data Source</th>
        </tr> 
    </thead>
    <tbody>
        <tr>
            <td>a. Indicate on which basis similar serious incidents were identified regarding the device or device variant:</td>
            <td>The <em>Similar Incident Basis</em> selection and the <em>Similar Incident Basis Details</em> text on the <em>Device Incident Report</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
        <tr>
            <td>b. Indicate on which criteria the number of devices on the market (also known as denominator data) is based on</td>
            <td>The <em>Devices Marketed Criteria</em> on the <em>Device Incident Report</em> of the <em>Device</em>-type <em>Case Product</em>.
            <p>When the <em>Devices Marketed Criteria</em> is <em>Other</em>, Vault also exports the <em>Devices Marketed Criteria (Other)</em> text.</p></td>
        </tr>
        <tr>
            <td>c. Enter the number of similar serious incidents (SI) and devices on the market for the indicated time periods</td>
            <td>For each <a href="/en/gr/01287/#similar-incident-fields">time period and region</a>, Vault exports the <em>Start Date</em> and <em>End Date</em> from each <em>Case Product Similar Incident</em> record.</td>
        </tr>
        <tr>
            <td>d. Comments on how similar (serious) incidents and associated number of devices on the market were determined</td>
            <td>The <em>Similar Incident Comments</em> text on the <em>Device Incident Report</em> of the <em>Device</em>-type <em>Case Product</em>.</td>
        </tr>
    </tbody>
</table>

## Section 5: General Comments {#general-comments}

<a href="https://platform.veevavault.help/assets/images/saf-mir-5.png" data-lightbox="saf-mir-5.png" data-title="" data-alt="EU MIR Form: 5: General Comments section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-5.png" alt="EU MIR Form: 5: General Comments section" style="max-width: 50%;"  />
</a>

Vault populates the _Device Comments_ on the _Case Product_.

## Coded summary of report

<a href="https://platform.veevavault.help/assets/images/saf-mir-coded-summary.png" data-lightbox="saf-mir-coded-summary.png" data-title="" data-alt="EU MIR Form: Coded summary of report section">
  <img class="docimage" src="https://platform.veevavault.help/assets/images/saf-mir-coded-summary.png" alt="EU MIR Form: Coded summary of report section" style="max-width: 50%;"  />
</a>

In the Coded summary of report section, Vault populates a summary of the _Case_ using the information from the rest of the form.
