Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Investigation of Multistate Outbreak of Severe Illness related to consumption of Diamond ShruumzTM Brand products-United States_2024 New 100 83 0 Form and Instruction 0920-1011 Diamond Shruumz Outbreak Investigation Case Report Form
Post-product recall investigation of a multistate cluster of VIM-producing carbapenem resistant Pseudomonas aeruginosa associated with artificial tear use New 60 45 0 Form and Instruction 0920-1011 VIM-CRPA Outbreak Chart Abstraction Form]
Serious adverse events, including deaths, of unknown etiology following ceftriaxone administration among patients in multiple healthcare facility types, AL and multiple states, September 2024-Present New 120 60 0 Form and Instruction 0920-1011 CDC Case Report Form: Serious Adverse Events Following Ceftriaxone Injection in Healthcare Settings
VIM-Carbapenem Resistant Pseudomonas aeruginosa (VIM-CRPA) Outbreak Investigation Abstraction Form New 105 105 0 Form 0920-1011 Chart Abstraction Form
Form 0920-1011 Facility Product List
[NCEZID] Multistate investigation of serious adverse events, including deaths, of unknown etiology following ceftriaxone administration_Sep 2024-Present New 90 45 0 Form and Instruction 0920-1011 Case Report Form - Ceftriaxone Injection in Healthcare Settings - Public Health Departments
Form and Instruction 0920-1011 Case Report Form - Ceftriaxone Injection in Healthcare Settings - Healthcare Providers
[NCEZID] Undetermined Risk Factors for carbapenemase-producing carbapenem-resistant Enterobacterales (CP-CRE) among Children in Healthcare Settings New 204 204 0 Form and Instruction 0920-1011 Case Report Form - (CP-CRE) among Children in U.S. Healthcare Settings
[NCEZID] Undetermined Risk Ractors for Carbapenemase-producing Carbapenem-resistant Enterobacterales (CP-CRE) Among Children in Healthcare Settings - United States New 204 204 0 Form and Instruction n/a Case Report Form
Total Burden Actually Used for Information Collections Under Currently Approved ICR: 883 746 0  
Total Burden Currently Requested for Information Collections Under Currently Approved ICR: 0 0 0  
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