<?xml version=“1.0” encoding=“UTF-8”?> <AdverseEvent xmlns=“hl7.org/fhir”>

<id value="example"/>

<!--   an identifier used for this allergic propensity (adverse reaction risk)   -->
<meta>
  <security>
    <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
    <code value="HTEST"/>
    <display value="test health data"/>
  </security>
</meta>
<identifier>
  <system value="http://acme.com/ids/patients/risks"/>
  <value value="49476534"/>
</identifier>

<!--   this was an actual adverse event, not just a potential one   -->
<actuality value="actual"/>

<!--   high level categorizion. The "event" below will say more   -->
<category> 
  <coding> 
    <system value="http://terminology.hl7.org/CodeSystem/adverse-event-category"/> 
    <code value="product-use-error"/> 
    <display value="Product Use Error"/> 
  </coding> 
</category> 

<!--   more precise details of the event   -->
<event>
  <coding>
    <!--   example uses SNOMED CT. Other likely possibilities include MedDRA   -->
    <system value="http://snomed.info/sct"/>
    <code value="304386008"/>
    <display value="O/E - itchy rash"/>
  </coding>
      <text value="This was a mild rash on the left forearm"/>
</event>

<!--   the patient that actually had the adverse event   -->
<subject>
  <reference value="Patient/example"/>
</subject>

<!--   when the event happened   --> 
<date value="2017-01-29T12:34:56+00:00"/>

<!--   This was a rash, so overall not serious   -->
<seriousness>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/adverse-event-seriousness"/>
      <code value="Non-serious"/>
      <display value="Non-serious"/>
  </coding>
</seriousness>

<!--   In overall terms even if it was a severe rash it is a relatively mild event overall   --> 
<severity>
  <coding>
    <system value="http://terminology.hl7.org/CodeSystem/adverse-event-severity"/>
    <code value="mild"/>
    <display value="Mild"/>
  </coding>
</severity>

<!--   who made the record / last updated it   -->
<recorder>
  <reference value="Practitioner/example"/>
</recorder>

<!--   may have been for cream to treat sunburn on that arm, reference to that medication   -->
<suspectEntity>
  <instance>
    <reference value="Medication/example"/>
  </instance>
</suspectEntity>

</AdverseEvent>