Structure the ICSR message using the HL7 v3 transmission wrapper as specified in the ICH E2B(R3) Implementation Guide (updated July 18, 2025); the root element is MCCI_IN200100UV01 wrapping the PORR_IN049016UV message
Populate required E2B(R3) data elements: C.1 (sender/receiver identification), C.2 (case safety report identifiers, senderSafetyReportId, receive date, transmission date), D (patient characteristics), E (reactions/events with MedDRA-coded preferred terms and LLTs), F (results of tests and procedures), G (drug information with WHO Drug Dictionary coded suspect/concomitant medications)
Assign the correct reportType: 1 for spontaneous, 2 for study report (clinical trial cases), 3 for other; clinical trial ICSRs require additional fields including the study registration identifier from ClinicalTrials.gov
Validate the XML against the E2B(R3) schema and code lists using an E2B validation tool; check codesystem version values in each coded element against the FDA-accepted codesystem versions published in the FAERS submission guide
Submit via the FDA ESG (Electronic Submissions Gateway) using the B2B gateway or AS2 protocol; include the message in the correct folder structure per FDA gateway technical specifications
For 15-day expedited reports (unexpected serious adverse reactions), confirm the clock starts on the date of first receipt of the case and submit within 15 calendar days; non-expedited periodic reports must follow the IND annual report schedule
Known gotchas
MedDRA coding must use the version specified in the E2B(R3) message header; submitting with a MedDRA version that differs from what the FDA has loaded causes processing rejections
The E2B(R3) format uses ISO / HL7 27953-2 XML with complex namespace declarations; using an E2B-specific authoring tool or library is strongly recommended over hand-crafting the XML to avoid namespace errors that fail schema validation
Clinical trial ICSRs must include the study's IND number and ClinicalTrials.gov NCT ID in the appropriate E2B data elements; omitting these identifiers causes the case to be processed as a spontaneous report, affecting signal detection
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