68%

IACUC Protocol # (If Known):
PI or Personnel involved in the Adverse Event (if applicable):
Date the Event Occurred:
Location Event Occurred (area, building, room, etc):
Is the possibility that this type of event could occur noted in the protocol?
Does this event exceed the noted level of such an event (i.e. 10% mortality expected but experienced 15%)?
Provide a description (include dates and details of the adverse/unanticipated problem):
Has this type of event been previously reported on this study or associated with this PI?
In your judgement, is a change in procedure or handling methodology necessary to reduce or eliminate future reoccurrence of this type of adverse event/unanticipated problem?
Provide a complete description of how this event/problem was managed, including all personnel alerted and dates of contact (if known):
Provide a complete description of the corrective actions taken to ensure that this type of event/problem does not occur in the future (if known):
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