Abnormal ECG Report

[Pages:2]Abnormal ECG Report

Sponsor: DEMO SPONSOR

Protocol: PROTOCOL DEMO2 (Active) Location: Philadelphia Country: United States of America

Investigator: BLUE, C

IDMs Value

ID1

rand

Initials Date of Birth Transmittal Visit

Lead HR RR PR QRS QT QTcB QTcF Reviewer

Number

222BB S0001

ABCD

BAB 20-JUL-1966 ANN 15-MAY-1970

63174 BASELINE / V5 HOUR 1

63176* TREATMENT V5 1 / DOSE 1

60 1000 170 66 916 285

88 384 81 361

384 384 Nelson, Julie 377 372 Diaz, Marisa

S0001

ANN 15-MAY-1970 63173

Number of Abnormal Transmittals for SiteID (2015):

BASELINE / HOUR 2

II 68 885 173 107 489 520 510 Diaz, Marisa

3

Compound: Mean Comparator Workflow

eRT Account: 051715

Data Type: ECG

Sponsor SiteID: 2015

Review Item(s)

Collection Date and Time

ST Segment : Depressed T Waves : Biphasic

Conduction : First Degree AV Block Clinical Alerts : Marked PR Prolongation

Conduction : Prolonged QTc Clinical Alerts : Prolonged QTc

08-SEP-2006 10:20:10 20-FEB-2009 10:18:18

16-FEB-2008 16:43:40

Generated on: 24-MAR-2010 15:26:50 Filters: Protocol=PROTOCOL DEMO2; Data Type=ECG

Totals reflect the applied filter.

Page 1 of 2

Abnormal ECG Report

Sponsor: DEMO SPONSOR

Protocol: PROTOCOL DEMO2 (Active) Location: Philadelphia Country: United States of America

Investigator: GREEN, A

IDMs Value

ID1

rand

Initials Date of Birth Transmittal Visit

Lead HR RR PR QRS QT QTcB QTcF Reviewer

Number

666FF 666FF

FEDC

FFF 11-NOV-1966 FFF 11-NOV-1966

63182 63175

TREATMENT II 1 / DOSE 1

BASELINE / II HOUR 1

72 831 195 134 414 454 440 Diaz, Marisa 39 1532 180 81 393 318 341 Jacobs, Robert

Number of Abnormal Transmittals for SiteID (2011):

2

Number of Abnormal Transmittals for Protocol (PROTOCOL DEMO2):

5

Number of Abnormal Transmittals for Report:

5

Compound: Mean Comparator Workflow

eRT Account: 051715

Data Type: ECG

Sponsor SiteID: 2011

Review Item(s)

Conduction : Other Finding

Rhythm : Sinus Bradycardia Clinical Alerts : Marked Bradycardia

Collection Date and Time

16-MAY-2007 03:13:26 02-OCT-2006 10:20:10

Generated on: 24-MAR-2010 15:26:50 Filters: Protocol=PROTOCOL DEMO2; Data Type=ECG

Totals reflect the applied filter.

Page 2 of 2

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