FDA Adverse Event and Products Experience Reports; Electronic Submissions

Forms and Documents

Document Name	Status
0645 Nonsub Change to include 0672 320 reg.pdf Justification for No Material/Nonsubstantive Change	2020-01-15
0645 MedWatch eReporting SSA 2019.pdf Supporting Statement A	2019-05-29

IC Document Collections

IC ID	Document Title	Status
192363	Mandatory and voluntary RFR (human and animal) via SRP	Unchanged
192362	Mandatory Adverse Event Reporting via ESG (Gateway-to-Gateway transmission)	Unchanged
192361	Mandatory Adverse Event Reporting via the SRP (other than RFR reports) Other-(Screen shots for CVM collection)	Unchanged
192360	Voluntary Adverse Event Reporting via the SRP (other than RFR reports) Other-eForm Submission	Unchanged

ICR Details

OMB Control No: 0910-0645	ICR Reference No: 202001-0910-007
Status: Historical Active	Previous ICR Reference No: 201905-0910-008
Agency/Subagency: HHS/FDA	Agency Tracking No: CROSS CENTER
Title: FDA Adverse Event and Products Experience Reports; Electronic Submissions
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/16/2020
	Date Received in OIRA: 01/15/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2022	06/30/2022	06/30/2022
Responses	3,013,420	0	3,013,420
Time Burden (Hours)	1,809,396	0	1,809,396
Cost Burden (Dollars)	141,386,203	0	141,386,203

---

Abstract: This ICR collects both mandatory and voluntary information regarding adverse events associated with FDA-regulated products that are submitted electronically using agency data-collection applications. Because the agency continues to move from a paper/manual submissions process for reporting adverse events to an electronic systems process, the scope of the ICR is limited to those product areas for which an electronic portal has been developed. Respondents include both manufacturers and distributors of FDA products, as well as individual consumers. The information collected enables FDA to identify potential public health threats and implement mitigation strategies as appropriate.

---

Authorizing Statute(s): PL: Pub.L. 109 - 462 120 Name of Law: DSNDCPA
   PL: Pub.L. 110 - 85 1005 Name of Law: FDAAA
   US Code: 21 USC 301 et. seq. Name of Law: FFDCA
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 61653	11/30/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 24798	05/29/2019
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
Voluntary Adverse Event Reporting via the SRP (other than RFR reports)
Mandatory Adverse Event Reporting via ESG (Gateway-to-Gateway transmission)
Mandatory and voluntary RFR (human and animal) via SRP
Mandatory Adverse Event Reporting via the SRP (other than RFR reports)

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	3,013,420	3,013,420	0	0	0	0
Annual Time Burden (Hours)	1,809,396	1,809,396	0	0	0	0
Annual Cost Burden (Dollars)	141,386,203	141,386,203	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Our estimated burden for the information collection reflects an overall increase of 688,547 hours and a corresponding increase of 1,145,763 responses. The majority of these adjustments is attributed to the shift in mandatory reports associated with medical devices (mandatory reports via the ESG), which had previously been counted under OMB Control 0910-0291.

---

Annual Cost to Federal Government: $35,485,483

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/15/2020

---