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MedWatch Online Voluntary Reporting Form
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To enable your JavaScript please <a href="index.cfm?action=reporting.enableJavascript" target="_blank" > adjust your browser settings </a>. </span> </div> </div> </div> </noscript> <div id="homepage" class='mainPagePadding'> <div class="row"> <div class="col-md-12 padBottom20"> <h2 class="marginTop0">Welcome</h2> </div> <div class="col-md-12 padBottom20" style="text-align:center"> <strong> If this is a medical emergency, please call 911.<br/> If you have a mental health crisis, please call 988.<br/> </strong> </div> </div> <div class="row"> <div class="col-md-12 padBottom20 alignPara"> <p>Health professionals, consumers and patients can voluntarily report observed or suspected adverse events for human medical products to FDA. Voluntary reporting can help FDA identify unknown risk for approved medical products. Reporting can be done through our online reporting portal or by downloading, completing and then submitting FDA Form 3500 (Health Professional) or 3500B (Consumer/Patient) to MedWatch: The FDA Safety Information and Adverse Event Reporting Program.</p> <p><strong>While not mandatory, FDA encourages reporters to provide their contact information in case FDA needs to gather more information. Note that reporters can request, within the report, FDA not release their contact information to the manufacturer.</strong></p> </div> <div class="col-md-12"> <div class="col-md-12 col-sm-12 col-xs-12 padBottom20 itemBtn"> <div class="reportBtns"> <h3 class="marginTop0">Begin Online Report</h3> <div class="col-md-4 col-sm-4 btnsDiv"> <a class="btn" href="index.cfm?action=professional.reporting1"> <img width="100%" height="100%" src="includes/images/health-professionals.jpg" alt="medical staff smiling" class="hidden-xs" aria-hidden="true"> <span class="btn btn-primary btn-lg"> <span><strong>Health Professional</strong></span> <br> <span><small>(FDA Form 3500)</small></span> </span> </a> </div> <div class="col-md-4 col-sm-4 btnsDiv"> <a class="btn" href="index.cfm?action=consumer.reporting1"> <img width="100%" height="100%" src="includes/images/consumer-patient.jpg" alt="people smiling" class="hidden-xs" aria-hidden="true"> <span class="btn btn-primary btn-lg"> <span><strong>Consumer/Patient</strong></span> <br> <span><small>(FDA Form 3500B)</small></span> </span> </a> - <div class="col-md-12 col-sm-12 btnsDivEs"> <a onclick="loadSpanishSection();" href="javascript:void(0);" rel="noopener noreferrer" hreflang="es" id="spanishGeneralInstructions" >Click aquí para instrucciones generales En español</a> </div> </div> <div class="col-md-4 col-sm-4 btnsDiv"> <a class="btn" href="index.cfm?action=reporting.search" id="newBtn"> <img height="100%" src="includes/images/retrieve_report.png" alt="Retrieve Report" class="hidden-xs" aria-hidden="true"> <span class="btn btn-default btn-sm btnSM" style=""><span style="white-space:normal">Continue an incomplete report</span> </span> </a> <p class="incompleteText col-sm-4">Click here to continue filling out an incomplete report. You will need Report ID and Report Date. You will have 3 days to complete this report from the start date.</p> </p> </div> </div> </div><!-- itembtn --> </div> <div class='col-md-12 infoText alignPara padBottom20'> <strong>Thank you for taking the time to submit a MedWatch report. If you wish to download and print a copy of your report please review the <a href="index.cfm?action=reporting.faqs" style='border-bottom: 1px dotted;' target="_blank" title="MedWatch Volunatry Report Frequently Asked Questions">MedWatch Voluntary Report Frequently Asked Questions.</a><br><br>MedWatch Online allows reporters to start a report and complete it within 3 days. Reporters can save an incomplete report and provide an email address to receive instructions on how to complete & submit a report with Report ID and Report Date.</strong></div> <div class='col-md-12 infoText alignPara'> Note that after submitting, you cannot retrieve the report and edit it. However, you can start a new report and supply more information about the case. Please include the suspect product and a brief summary of the adverse events, medical/product use errors, or product quality issues. Other information such as the reporter and the patient characteristics (if available) should also be provided again. This may appear repetitive, but it helps the FDA connect the new report with the previously submitted one. </div> <div class="col-md-12 padBottom20"><h2 style='text-align:center'>Information You Should Report to MedWatch</h2> <ul> <li><strong>Unexpected side effects or adverse events</strong> can include everything from skin rashes to more serious complications.</li> <li><strong>Product quality problems</strong> such as information if a product isn't working properly or if it has a defect.</li> <li class='alignPara'><strong>Product Use/Medication Errors that can be prevented.</strong> These can be caused by various issues, including choosing the wrong product because of labels or packaging that look alike or have similar brand or generic names. Mistakes also can be caused by difficulty with a device due to hard-to-read controls or displays, which may cause you to record a test result that is not correct.</li> <li><strong>Therapeutic failures.</strong> These problems can include when a medical product does not seem to work as well when you switch from one generic to another.</li> </ul> </div> <div class="col-md-12 padBottom20"><h2 style='text-align:center'>Types of FDA Regulated Products You Can Report Through MedWatch</h2> <ul class='alignPara'> <li><strong>Prescription and over-the-counter medicines</strong> including those administered in a hospital or outpatient infusion centers. </li> <li><strong>Biologics</strong> such as blood components, blood/plasma derivatives, blood transfusions, gene therapies, and human cells and tissue transplants.</li> <li><strong>Medical devices</strong> such as diabetes glucose-test kit, hearing aids, breast pumps, and many more products.</li> <li><strong>Combination products</strong> such as prefilled drug syringe, auto-injectors, metered-dose inhalers, contact lens coated with a drug and nasal-spray.</li> <li><strong>Special nutritional products</strong> such as dietary supplements, medical foods and infant formulas.</li> <li><strong>Cosmetics</strong> such as moisturizers, makeup, shampoos, conditioners, hair dyes and tattoos.</li> <li><strong>Food</strong> such as beverages and ingredients added to foods. </li> </ul> </div> <div class="col-md-12 padBottom20"><h2 style='text-align:center'>Where to Report Other FDA Regulated Product Safety Information</h2> <p class='alignPara'>Other products that the FDA regulates such as Tobacco Products, Vaccines and Animal/Livestock medicine and feed utilize different reporting pathways. It is recommended that reports concerning these products be submitted directly to the appropriate portals below.</p> <ul> <li class='alignPara'><strong>Tobacco, E-cigarettes or Vaping:</strong> Report problems or adverse health events and tobacco product problems, include problems with e-cigarettes (also known as "vapes"), e-liquids, heated tobacco products, cigarettes, roll-your-own cigarettes, cigars, little cigars, pipes, waterpipes (also known as hookah), chewing tobacco, snuff, or snus. Report issues to the <a href="https://www.safetyreporting.hhs.gov/SRP2/" target="_blank">Safety Reporting Portal</a>.</li> <li><strong>Vaccines:</strong> Report vaccine events to the Vaccine Adverse Event Reporting System (VAERS) online at <a href="https://vaers.hhs.gov/reportevent.html" target="_blank">https://vaers.hhs.gov/reportevent.html.</a></li> <li><strong>Animal Drug, Device, Pet Food and Livestock Feed Problems (pet food and livestock feed):</strong> For information on how to report visit <a href="https://www.fda.gov/vetproductreporting" target="_blank">www.fda.gov/vetproductreporting.</a></li> </ul> Note that submissions for these products through MedWatch will be accepted and directed to the correct center or office. </div> <div class="col-md-12"> <div class='col-md-2'></div> <div class='col-md-8 col-xs-12 col-sm-8'> <div class="panel-header"> <a class="btn btn-default btn-sm" href="#mainLinks-md" data-toggle="collapse" role="button" aria-expanded="false" 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