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Re: Global ID / Local ID: TH201501004781/ TH150101476 FU (1)
Thank you for reporting to us an adverse event related to Lilly product(s).
We would like to collect more information to better understanding the reported event.
Please respond to following question regarding the adverse event – numbness in both hands, involving a female patient, aged 75, who was subscribed Forteo, reported the event to Lilly on 12-Jan-2015.
Please provide the informatoin for following:
1. Did the patient have any other medical history besides diabetes?
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2. What was the medication she took for diabetes? Please provide dosage regimen.
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3. What was the cause of the numbness in hands?
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4. Did she receive any treatment?
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5. What was the outcome of the event?
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6. In your, opinion was the event related to Forteo? Please provide rationale.
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HCP’s signature:
Date:
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For Eli Lilly internal use only
Date of Confirmation of FU request sent to HCP:
Name and Designation: