# Adverse Event Chart Review Sample (PDF)

> Adverse event chart review sample for a fictional PCA oversedation: every order, vital and note in time order, gaps and contradictions flagged. Free PDF.

Canonical page: https://medrecords.ai/content-hub/samples/adverse-event-chart-review-sample/

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## Adverse Event Chart Review Sample

Adverse event chart review sample for a fictional opioid oversedation on a med-surg unit: every order, PCA entry, vital sign and nursing note in time order with its page, a 3 hour 10 minute gap in charted vitals, 1 late entry and 1 contradiction between the 01:15 nursing note and its 06:52 late entry. A hand-built illustration.

By [Ahmed Jemaa](https://medrecords.ai/authors/ahmed-jemaa/), Co-Founder & CEO of Medrecords AI · Published 3 Nov 2026

Riverbend General (fictional) — Med-surg, post-op day 1 — Hand-built illustration

### What’s inside this adverse event chart review

- Every order, PCA pump entry, vital sign and note in time order, each with its page
- Gaps in charting, late entries and contradictions flagged, not judged
- A source table that shows where 2 records disagree
- A list of records to request before the root cause analysis meets

| Record set | Fictional post-op PCA oversedation: orders, MAR, PCA pump log, vitals flowsheet, nursing notes, rapid response record, 412 pages |
| --- | --- |
| Clock | EHR time; both PCA programming events follow their orders |
| Flags | 1 gap in charting of 3 hours 10 minutes, 1 late entry, 1 contradiction |
| Not included | No cause, no policy finding, no standard of care opinion; those are for the risk team and counsel |

This is a hand-built illustration of the Medrecords AI output format on a fictional inpatient event, written for [hospital risk management chart review](https://medrecords.ai/solutions/hospital-risk-management/). It was not generated from a real file. Medrecords AI does not decide what caused an event (that is the job of the [root cause analysis](https://psnet.ahrq.gov/primer/root-cause-analysis) ); it cites and flags the chart entries around it. You review, you revise, you sign.

[](https://medrecords.ai/assets/samples/pdf/medical-chronology/adverse-event-chart-review-sample.pdf)
[Download the PDF ](https://medrecords.ai/assets/samples/pdf/medical-chronology/adverse-event-chart-review-sample.pdf)

### Sources

The patient, the hospital and every entry in this sample are fictional. The review steps it leaves to the risk team are described here, checked 2026-11-03.

- [AHRQ PSNet: Root Cause Analysis primer](https://psnet.ahrq.gov/primer/root-cause-analysis)
- [The Joint Commission: Sentinel Event Policy and Procedures](https://www.jointcommission.org/en-us/knowledge-library/support-center/standards-interpretation/sentinel-event-policy-and-procedures)
- [Hospital risk management chart review](https://medrecords.ai/solutions/hospital-risk-management/), the service this sample illustrates

### How Medrecords AI does this work

See how Medrecords AI lays out an inpatient adverse event: every entry cited, gaps and contradictions flagged for the risk team that decides what they mean.

[Solution — **Hospital risk management chart review** — Adverse event charts read into 1 cited timeline for risk, quality and counsel. Read more →](https://medrecords.ai/solutions/hospital-risk-management/) [Product — **Missing records identification** — Periods the chart describes with no matching entries, each flag cited to the pages that imply them. Read more →](https://medrecords.ai/product/missing-records-identification/) [Browse — **All 50 samples and tools** — Reports, chronologies, expert opinions, plus free templates and tools. Read more →](https://medrecords.ai/content-hub/samples/)
Test it on a file you already have.
Send 1 real record set. You get back a cited draft and decide for yourself whether the read holds up. No obligation either way.
[Book a demo](https://medrecords.ai/demo/) [See pricing](https://medrecords.ai/pricing/)

### More from Medical Chronologies

[Bates-Stamped Medical Chronology Sample](https://medrecords.ai/content-hub/samples/bates-stamped-medical-chronology-sample/) [Birth Injury Chronology Sample: HIE](https://medrecords.ai/content-hub/samples/birth-injury-hie-medical-chronology-sample/) [Birth Injury Chronology Sample: Shoulder Dystocia](https://medrecords.ai/content-hub/samples/shoulder-dystocia-birth-injury-chronology-sample/) [Medical Chronology With Bills Sample](https://medrecords.ai/content-hub/samples/medical-chronology-with-bills-sample/)
Last verified: 2026-11-03 · [← All samples](https://medrecords.ai/content-hub/samples/)

### More sample deliverables

- [**Hospital risk management chart review** — How Medrecords AI reads adverse event charts for risk, quality and counsel.](https://medrecords.ai/solutions/hospital-risk-management/)
- [**Post-op Infection Chronology Sample** — A surgical complication file, cited page by page.](https://medrecords.ai/content-hub/samples/post-op-infection-med-mal-chronology-sample/)
- [**Peer review record preparation** — Chart timelines for peer review committees.](https://medrecords.ai/solutions/peer-review/)
- [**Fetal Monitoring Timeline Sample** — Labor records and tracing pages on 1 clock, gaps flagged.](https://medrecords.ai/content-hub/samples/fetal-monitoring-birth-injury-timeline-sample/)