As well as deciding whether an event is serious, we will also ask if the event classifies as an event of special interest (ESI).
There are currently 19 types of events that we require a little more specific information on, with each event having a separate form.
You can view and download any of our ESI forms below.
- Aplastic anaemia, Pancytopaenia, Serious Neutropenia (PDF, 127KB)
- Cerebrovascular accident (CVA) (PDF, 114KB)
- Serious Congestive heart failure (PDF, 144KB)
- Death (PDF, 246KB)
- Demyelination/Optic neuritis (PDF, 85KB)
- Lymphoproliferative Malignancy (PDF, 172KB)
- Malignancy including skin cancer/Bowen’s disease (PDF, 116KB)
- Myocardial Infarction/Serious Acute Coronary Syndrome (PDF, 130KB)
- Pregnancy (PDF, 52KB)
- Pulmonary Embolism (PDF, 130KB)
- Serious Infection (PDF, 209KB)
- Tuberculosis (PDF, 73KB)
- Serious Lupus/Lupus-like illness (PDF, 116KB)
- Hepatitis B Reactivation (PDF, 59KB)
- Serious Haemorrhage (PDF, 115KB)
- Serious skin reaction (eg Stevens Johnson syndrome, erythema multiforme, toxic epidermal necrosis) (PDF, 172KB)
- Serious lower GI ulcer/bleed/perforation (PDF, 110KB)
- Serious hepatic dysfunction/failure (PDF, 151KB)
- Serious Hypersensitivity Reaction (PDF, 206KB)