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Notification for study UMBRELLA

Sae (F8)
Form completed by : Guibelalde
Form completion date: 11 Jun 2021 at 13:38:38
Clinician: Guibelalde
Institute: Hospital Universitari Son Espases
1 Event description: Other, specify
2 Specify other febrile upper respiratory infection
3 Please comment briefly on nature of SAE Infection Paraionfluenza 3 virus
4 Toxicity grade according CTCAE 2
5 Classification Unplanned Hospitalisation (or prolongation of planned
hospitalisation)
6 Start date 08 Jun 2021
7 Ongoing No
8 Stop date 10 Jun 2021
9 Could the patient's original condition or other illness Probably
account for this event?
10 Do you think the event was related to the treatment? Possibly

Patient has been assigned patient number: 72418002

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