GMRAFN5.m

GMRAFN5 ;HIRMFO/WAA-FDA MEDWATCH FORM ;11/30/95  15:36

 ;;4.0;Adverse Reaction Tracking;;Mar 29, 1996

 S GMRAX=$G(^GMR(120.85,GMRAPA1,"RPT"))

 W ?66,"|1. Name, address & phone #: " I GMRAPG1=1 W $P(GMRAX,U)

 W !,$E(LINE2,1,66),"|" I GMRAPG1=1 W $E($P(GMRAX,U,2)_"  "_$P(GMRAX,U,3)_"  "_$P(GMRAX,U,4),1,63)

 W !,?66,"|" I GMRAPG1=1 W $E($P(GMRAX,U,5),1,63) W:$P(GMRAX,U,6)'="" ", ",$P(^DIC(5,$P(GMRAX,U,6),0),U)," " W:$P(GMRAX,U,7)'="" $P(GMRAX,U,7) W "     ",$P(GMRAX,U,8)

 W !,"Mail to: MedWatch                      or FAX to:",?66,"|",$E(LINE1,68,131)

 W !,"         5600 Fishers Lane                1-800-FDA-0178",?66,"|2. Health professional? |3. Occupation |4. Reported to Mfr."

 W !,"         Rockville, MD 20852-9787",?66,"|"

 I GMRAPG1=1 W ?70,"[",$S($P(GMRAX,U,9)="n":"NO",$P(GMRAX,U,9)="y":"YES",1:" "),"]"

 W ?91,"|" I GMRAPG1=1 W $E($P(GMRAX,U,11),1,14)

 W ?106,"|" I GMRAPG1=1 W ?110,"[",$S($P($G(^GMR(120.85,GMRAPA1,"PTC1")),U,7)'="":"YES",1:"NO"),"]"

 W !,?66,"|",$E(LINE1,68,131)

 W !,?66,"|5. If you don't want your identity disclosed to the Manufacturer,"

 W !,?66,"|   place an ""X"" in the box.["

 I GMRAPG1=1 W $S($P(GMRAX,U,10)="n":"X",1:" "),"]"

 I GMRAPG1'=1 W " ]"

 W !,"FDA Form 3500",?66,"|",$E(LINE2,68,131)

 W !!,"Submission of a report does not constitute an admission that medical personnel or the product caused or contributed to the event."

 W @IOF

 Q

CONCO ;PRINT CONCOMITANT DRUG DATA

 S GMRAX=$G(^TMP($J,"GMR","C",GMRACCT)) K ^TMP($J,"GMR","C",GMRACCT)

 W "    ",$P(GMRAX,U)," " I $P(GMRAX,U,2)'="" W $E($P(GMRAX,U,2),4,5),"/",$E($P(GMRAX,U,2),6,7),"/",$E($P(GMRAX,U,2),2,3)

 I $P(GMRAX,U,3)'="" W "-",$E($P(GMRAX,U,3),4,5),"/",$E($P(GMRAX,U,3),6,7),"/",$E($P(GMRAX,U,3),2,3)

 K GMRAX

 I '$D(^TMP($J,"GMR","C",(GMRACCT+1))) S GMRANOC=0

 Q

--- Routine Detail   --- with STRUCTURED ROUTINE LISTING ---GMRAFN5   1805     printed  Feb 18, 2025@23:05:36                                                                                                                                                                                                     Page 2

GMRAFN5   ;HIRMFO/WAA-FDA MEDWATCH FORM ;11/30/95  15:36

 +1       ;;4.0;Adverse Reaction Tracking;;Mar 29, 1996

 +2        SET GMRAX=$GET(^GMR(120.85,GMRAPA1,"RPT"))

 +3        WRITE ?66,"|1. Name, address & phone #: "

           IF GMRAPG1=1

               WRITE $PIECE(GMRAX,U)

 +4        WRITE !,$EXTRACT(LINE2,1,66),"|"

           IF GMRAPG1=1

               WRITE $EXTRACT($PIECE(GMRAX,U,2)_"  "_$PIECE(GMRAX,U,3)_"  "_$PIECE(GMRAX,U,4),1,63)

 +5        WRITE !,?66,"|"

           IF GMRAPG1=1

               WRITE $EXTRACT($PIECE(GMRAX,U,5),1,63)

               if $PIECE(GMRAX,U,6)'=""

                   WRITE ", ",$PIECE(^DIC(5,$PIECE(GMRAX,U,6),0),U)," "

               if $PIECE(GMRAX,U,7)'=""

                   WRITE $PIECE(GMRAX,U,7)

               WRITE "     ",$PIECE(GMRAX,U,8)

 +6        WRITE !,"Mail to: MedWatch                      or FAX to:",?66,"|",$EXTRACT(LINE1,68,131)

 +7        WRITE !,"         5600 Fishers Lane                1-800-FDA-0178",?66,"|2. Health professional? |3. Occupation |4. Reported to Mfr."

 +8        WRITE !,"         Rockville, MD 20852-9787",?66,"|"

 +9        IF GMRAPG1=1

               WRITE ?70,"[",$SELECT($PIECE(GMRAX,U,9)="n":"NO",$PIECE(GMRAX,U,9)="y":"YES",1:" "),"]"

 +10       WRITE ?91,"|"

           IF GMRAPG1=1

               WRITE $EXTRACT($PIECE(GMRAX,U,11),1,14)

 +11       WRITE ?106,"|"

           IF GMRAPG1=1

               WRITE ?110,"[",$SELECT($PIECE($GET(^GMR(120.85,GMRAPA1,"PTC1")),U,7)'="":"YES",1:"NO"),"]"

 +12       WRITE !,?66,"|",$EXTRACT(LINE1,68,131)

 +13       WRITE !,?66,"|5. If you don't want your identity disclosed to the Manufacturer,"

 +14       WRITE !,?66,"|   place an ""X"" in the box.["

 +15       IF GMRAPG1=1

               WRITE $SELECT($PIECE(GMRAX,U,10)="n":"X",1:" "),"]"

 +16       IF GMRAPG1'=1

               WRITE " ]"

 +17       WRITE !,"FDA Form 3500",?66,"|",$EXTRACT(LINE2,68,131)

 +18       WRITE !!,"Submission of a report does not constitute an admission that medical personnel or the product caused or contributed to the event."

 +19       WRITE @IOF

 +20       QUIT 

CONCO     ;PRINT CONCOMITANT DRUG DATA

 +1        SET GMRAX=$GET(^TMP($JOB,"GMR","C",GMRACCT))

           KILL ^TMP($JOB,"GMR","C",GMRACCT)

 +2        WRITE "    ",$PIECE(GMRAX,U)," "

           IF $PIECE(GMRAX,U,2)'=""

               WRITE $EXTRACT($PIECE(GMRAX,U,2),4,5),"/",$EXTRACT($PIECE(GMRAX,U,2),6,7),"/",$EXTRACT($PIECE(GMRAX,U,2),2,3)

 +3        IF $PIECE(GMRAX,U,3)'=""

               WRITE "-",$EXTRACT($PIECE(GMRAX,U,3),4,5),"/",$EXTRACT($PIECE(GMRAX,U,3),6,7),"/",$EXTRACT($PIECE(GMRAX,U,3),2,3)

 +4        KILL GMRAX

 +5        IF '$DATA(^TMP($JOB,"GMR","C",(GMRACCT+1)))

               SET GMRANOC=0

 +6        QUIT