Information Collection Request

Undetermined cause of Serratia marcescens infections - Emergency

ICR 201804-0920-013 · OMB 0920-1226 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Records abstraction form for patients who suffered from Serratia marcescens infection Form and Instruction New Available
Emergency SSB Serratia BSI Multiple States.docx Supporting Statement B Uploaded 2018-04-26 Available
Emergency SSA Serratia BSI Multiple States.docx Supporting Statement A Uploaded 2018-04-26 Available
Emergency Review Request Memo.pdf Supplementary Document Uploaded 2018-04-26 Available
Att 4 - Non-research determination.pdf Supplementary Document Uploaded 2018-04-26 Available
Att 1 - Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document Uploaded 2018-04-26 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
231226 Records abstraction form for patients who suffered from Serratia marcescens infection Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
07/31/2018 6 Months From Approved
100 0 0
200 0 0
0 0 0





Reginfo record details
1
table that charts list of burden
IC Title Form No. Form Name
Records abstraction form for patients who suffered from Serratia marcescens infection NA Undetermined cause of Serratia marcescens infections - Multiple States,2018 Records Abstraction Tool

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 100 0 0 100 0 0
Annual Time Burden (Hours) 200 0 0 200 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No