Sections in This Article
- I. Reaction Information
- II. Suspect Drug(s) Information
- III. Concomitant Drug(s) and History
- IV. Manufacturer Information
- Footer
- Additional (Overflow) Pages
The following list describes how the system handles certain data while generating a CIOMS I form:
- For events, diagnoses, indications, test names, and medical conditions, Vault Safety always populates the MedDRA lower-level term (LLT) when there is a coded value available. If there is no MedDRA term available, the reported term is used.
Note You can opt to populate the MedDRA preferred term (PT) for adverse events instead of the LLT. This feature is available by request only. Contact Veeva Support to request this feature.
- Dates are populated using the format
dd-mmm-yyyy
.
Blank dates are populated as dashes (---). - Certain fields may be masked, depending on the blinding settings on the Case or masking settings on the Distribution. Generate Masked Distributions describes the fields that may be masked.
I. Reaction Information

CIOMS I Field | Populated Value |
---|---|
1 Patient Initials | The value entered in the Patient Initials / ID field on the Case. |
1a. Country | The two-letter country code and name of the country selected in the Event Country field on the primary Case Adverse Event. |
2. Date of Birth | The date entered in the Date of Birth field on the Case. |
2a. Age | The value is mapped from one of the following Case fields, ordered by priority:
|
3. Sex | The value from the Gender field on the Case. |
3a. Weight | The value is mapped from one of the following Case fields, ordered by priority:
|
4-6 Reaction Onset | The earliest Onset Date for any Case Adverse Event associated with the Case version. |
7 + 13 Describe Reaction(s) | This field is populated with the following information:
|
8-12 Check All | The appropriate check boxes are selected, based on the Seriousness criteria for each Case Adverse Event associated with the Case. If there are multiple seriousness values selected for a Case Adverse Event, the system populates the checkbox corresponding to the most severe value, according to the following order (from most severe to least):
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II. Suspect Drug(s) Information

CIOMS I Field | Populated Value | ||||||||||||||||||||||||||||||||
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14. Suspect Drug(s) | The following information is populated for Case Products assigned a Drug Role of Suspect or Interacting:
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15. Daily Doses | The values and units in the Dose and Frequency fields on the primary Case Product Dosage. If there is no value in the Dose field, the value is taken from the Dose Text field. | ||||||||||||||||||||||||||||||||
16. Route(s) of Administration | The value entered in either the Patient RoA or Patient RoA (Reported) field on the associated Case Product Dosage.
For parent-child cases, the routes of administration are listed for both the patient (child) and the parent. |
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17. Indication(s) for Use | The value entered in either the Name (MedDRA) or Indication (Reported) field on the associated Case Product Indication record. | ||||||||||||||||||||||||||||||||
18. Therapy Date(s) | This field is populated with the following fields for each associated Case Product Dosage record: [First Admin Date or --- or unk] to [Last Admin Date or --- or unk] |
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19. Therapy Duration | The value and unit entered in the Duration field on the associated Case Product Dosage record. The system updates the Duration field value to “Ongoing” if any of the following values are in the Action(s) Taken field:
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20. Did Reaction Abate After Stopping Drug? | The system uses the following fields to calculate whether a dechallenge test occurred and populate the appropriate checkbox:
The following table outlines how different values in these fields populate this field on the CIOMS I form:
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21. Did Reaction Reappear After Reintroduction? | The system uses the Reaction Recurrence field on the primary Case Assessment to determine whether a rechallenge test occurred and populate the appropriate checkbox. If the Reaction Recurrence field is set to no - n/a, then the Not Applicable check box is selected. |
III. Concomitant Drug(s) and History

CIOMS I Field | Populated Value |
---|---|
22. Concomitant Drug(s) and Dates of Administration | The following information is repeated for each associated Case Product record, populated from the following fields:
|
23. Other Relevant History | The following information is populated:
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IV. Manufacturer Information

CIOMS I Field | Populated Value | ||||||||
---|---|---|---|---|---|---|---|---|---|
24a. Name and Address of Manufacturer | The contact information is populated from the user selected in the Sender User field on the associated Transmission (Submission or Distribution) record. When generating a form preview from the Case, the contact information is populated with the contact details for the Case Organization. |
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24b. MFR Control No. | The value from the UID field on the Case. | ||||||||
24c. Date Received by Manufacturer | Initial Cases: The date is mapped from the Case New Info Date field. If the New Info Date is not populated, the date is mapped from the Case Receipt Date field.
A Case is considered initial when it meets one of the following conditions:
Follow-Up: The date is mapped from the Case New Info Date field. A Case is considered follow-up when it meets one of the following conditions:
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24d. Report Source | The appropriate Report Source check boxes are selected, depending on the following logic:
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25a. Report Type | The appropriate check box is selected, depending on whether the Case is initial or follow-up. The Report Type is determined with the following logic:
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25b. Name and Address of Reporter | This field is populated using the name and address on the primary Case Reporter record. | ||||||||
Date of This Report | The date when the report was generated, according to the Vault's Timezone. | ||||||||
26. Remarks | The text entered in the CIOMS Remarks field on the Case. |
Footer
The left-side of the CIOMS I footer is timestamped with the date and time when the form was generated, according to the Vault’s Timezone.
The right-side of the footer is populated with the Case UID, appended with the value in the Follow-up Number field on the associated Transmission (Submission or Distribution) record. Note that the follow-up number will be appended when present on the Transmission, even when the Case type is not a Follow-Up Case.
Additional (Overflow) Pages
When Vault Safety generates the CIOMS I form, any text that exceeds field character limits is overflowed to additional pages. The indicator “(…)” and/or “(Continued)” is appended to any field or section that continues on additional pages. Any text on the additional pages is identified with the relevant section and field. Any Case Assessment Results associated with the Case are also listed in the overflow pages.
Assessment Results in Overflow Pages
Any Case Assessment Results associated with the Case are listed in the overflow pages. For example:
- Cholecap⇄Yellow Fever, Healthcare Professional, EU Method of Assessment, Reasonable Possibility
- *****⇄Yellow Fever, Sponsor, EU Method of Assessment, Reasonable Possibility
Each record is listed in the following format:

For unblinded double-blinded Studies, if there is a specified value in the Assessment Result (Override) field, the system uses this value instead of the Assessment Result value for unmasked CIOMS I Transmissions and previews. An administrator must perform configurations and contact Veeva Support to request this feature be made available in your vault.
Note There is a limitation where if there is a specified value in the Assessment Result (Override) field, the system will always generate the masked version of aggregate reports. This limitation will be addressed in a future release.
*Product Name Mapping
The way the system maps the product name during report generation depends on the product blinding settings:
- If the Case is a non-study or an open-label study Case, the product name is mapped from the Name (
product_name_v
) field on the Case Product record. - If the Case is a blinded study Case, the system uses the following logic to map the product name:
Criteria (Inputs) Form Generation Does the Study Arms? (study_has_arms_v) Is the Case Blinded? (blinded_v) Document Masking Product Name Mapping Example No No Unblinded Case Product > Name ( product_name_v
)Cholecap No No Blinded ***** ***** No Yes or Blank Unblinded N/A: Document not generated No Yes or Blank Blinded ***** ***** Yes No Unblinded Case Product > Name ( product_name_v
)Cholecap Yes No Blinded Case Product > Blinded Name (Placeholder) ( study_product_placeholder__v
)Cholecap vs. Placebo Yes Yes or Blank Unblinded N/A: Document not generated Yes Yes or Blank Blinded Case Product > Blinded Name (Placeholder) ( study_product_placeholder__v
)Cholecap vs. Placebo