Adverse events typically do not need to be reported to the IRB. If the adverse event was expected and fits within the foreseeable/anticipated risks described in the IRB application, protocol, and consent, it is likely not reportable. The nature, rate of occurrence, and severity would be in line with expectations. Also, adverse events that are caused by an underlying health condition not related to the study or its procedures are not reportable to the IRB. Certain adverse events may need to be reported to a sponsor, clinical research organization acting on behalf of the sponsor, or another entity, but the IRB does not need to be notified. When in doubt, consult the PI and/or IRB.
If the PI determines an adverse event resulted in an unanticipated problem, that’s when it needs to be reported to the IRB. Unanticipated problems are (1) unexpected, (2) related or possibly related to the research, AND (3) suggest the research places subjects or others at greater risk of harm than was previously known or recognized. The adverse event, as determined by the PI or qualified and delegated research staff, can make the determination whether it meets the 3 criteria of an unanticipated problem. Documentation of this assessment should be included in the study binder. If it meets all, it is reportable to the IRB. Final determinations whether the adverse event resulted in an unanticipated problem are made by the convened board. Most unanticipated problems are reportable within 5 business days on the Event Report found within eCompliance under “IRB Forms,” but some require quicker reporting as outlined in the Unanticipated Problems SOP (i.e. deaths).
Examples of unanticipated problems can be found in the OHRP Guidance on Reviewing and Reporting Unanticipated Risks to Subjects or Others and Adverse Events (page 22). Please see our Unanticipated Problems SOP for additional examples (page 3).