Causality Assessment Template

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ADVERSE DRUG REACTION MONITORING CENTRE

Govt. Kilpauk Medical College & Hospital.


Pharmacovigilance Programme of India (PVPI)
Minutes Of Meeting for Causality Assessment Committee Meeting (CAC)
Date : Time:

Place:
CAC Members;

1.Dr.T. Aruna - Coordinator, HOD& Professor Of Pharmacology.


2.Dr. Paranthaman - HOD& Pro Professor Of General Medicine-Clinician
3.Dr. Keerthana Brattiyya - Pharmacologist
4.Mrs.T. Lakshmi Prasanna - Jr. Pharmacovigilance Associate

List Of ICSRs is as follows

S.NO AMC Report ID Causality


1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
Total ICSRs:

No. Of ICSRs………Discussed in detail for the index month………………….2022

CAC Member’s Signature

1.

2.
3. Signature of the Coordinator
Copy to:1.All CAC members 2.NCC-PvPI

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