Information Collection

57.113 Pediatric Ventilator-Associated Event (PedVAE)

IC 222890 under ICR 202408-0920-016 · OMB 0920-0666.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0666 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 57.113 57.113 Pediatric Ventilator-Associated Event (PedVAE)	Form and Instruction
57.113 Pediatric Ventilator-Associated Event (PedVAE) 57.113_Pediatric VAE_November_2022.docx	Form and Instruction
57.113 Pediatric Ventilator-Associated Event (PedVAE) 57.113_Pediatric VAE_November_2022.docx	Form and Instruction
57.113_Pediatric VAE_November_2022.docx 57.113 PedVAE with GISAB edits in tracked changes	IC Document
57.113_Pediatric VAE_November_2022.docx 57.113 PedVAE with GISAB edits in tracked changes	IC Document

IC Title:

57.113 Pediatric Ventilator-Associated Event (PedVAE)

Agency IC Tracking Number:

0920-0666

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	57.113	Pediatric Ventilator-Associated Event (PedVAE)	57.113_Pediatric VAE_November_2022.docx	NA	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 334

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	334	334
Annual IC Time Burden (Hours)	173	173
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
57.113 PedVAE with GISAB edits in tracked changes	57.113_Pediatric VAE_November_2022.docx	04/25/2023

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.