Ecganalysisreport 3

ECG Analysis Report with Mean Comparator Change
Sponsor:
Protocol:
Account:
Transmittal Number:
Array BioPharma Inc.

CLGX818X2109
746874
12947868
Subject Information
Date of Birth:
7 Digit Subject Number:
5009
Chmielowski, Bartosz
924 Westwood Blvd.
Suite 200
Los Angeles CA 90024
United States of America
PART 1 CYCLE 5 / DAY 15 / PRE DOSE
19-NOV-2015
12:17:32
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
24-JAN-1948
5009001
Interval Duration Measurements

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
63
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
947
N/A
N/A
PR Interval (ms) :
148
N/A
N/A
75
N/A
N/A
405
N/A
N/A
412
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
QTc Fridericia's (ms) :
Evaluation
Interpretation:
Abnormal
Evaluation By:
Evaluation Date/Time:
Muhammad Iqbal
07-JUL-2016 17:18 ET
Findings
Conduction:
Left Anterior Hemiblock
For Site Use Only.

Investigator Signature: __________________________________________________
Date: ____________________________
Generated on: 07-JUL-2016 17:23:45

1818 Market Street
Philadelphia, PA 19103
Page 1 of 2
Peterborough Business Park
Lynch Wood
Peterborough, Cambridgeshire PE2 6FZ
PROTOCOL:
Array BioPharma Inc. - CLGX818X2109
SITE:
5009
INVESTIGATOR: Chmielowski, Bartosz
ERT
ACCOUNT: 746874
TRANSMITTAL: 12947868
COLLECTED: 19-NOV-2015
12:17:32
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12947826
Subject Information
5009
924 Westwood Blvd.
Suite 200
PART 2 CYCLE 1 / DAY 21 / LEE011_PRE
DOSE
27-APR-2016
11:00:41
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
05-OCT-1939
5009003

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
74
RR Interval (ms) :
PR Interval (ms) :
Comparator
(3 of 3)
Mean
81
Change
-7
812
738
74
190
183
85
97
-12
QT Interval (ms) :
404
369
35
433
409
24
QRS Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
For Site Use Only.

Robert Kleiman
07-JUL-2016 08:44 ET
Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
COLLECTED: 27-APR-2016
11:00:41
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12947829
Subject Information
5009
924 Westwood Blvd.
Suite 200
PART 2 CYCLE 1 / DAY 8 / LEE011 4 POST
DOSE
13-APR-2016
14:24:42
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
05-OCT-1939
5009003

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
78
RR Interval (ms) :
PR Interval (ms) :
Comparator
(3 of 3)
Mean
81
Change
-3
765
738
27
195
183
12
91
97
-6
QT Interval (ms) :
408
369
39
446
409
37
QRS Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
For Site Use Only.

Robert Kleiman
07-JUL-2016 08:44 ET
Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
14:24:42
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12947824
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
02-MAY-2016
08:42:10
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
05-OCT-1939
5009003

Palmer, Jane
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
74
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
813
N/A
N/A
PR Interval (ms) :
191
N/A
N/A
93
N/A
N/A
397
N/A
N/A
425
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
Robert Kleiman
07-JUL-2016 08:44 ET
Remarks: >> The following demography or visit name was modified from the original source ECG.
>> Please review the modified data listed above and notify ERT of any required changes
>> using the data correction instructions in your study guide.
Visit: PART 2 CYCLE 1 / DAY 15 / PRE DOSE
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
COLLECTED: 02-MAY-2016
08:42:10
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12947822
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
16-MAY-2016
10:25:26
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
05-OCT-1939
5009003

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
80
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
750
N/A
N/A
PR Interval (ms) :
187
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
77
N/A
N/A
369
N/A
N/A
407
N/A
N/A
Evaluation
Interpretation:
Normal
Evaluation By:
For Site Use Only.

Robert Kleiman
07-JUL-2016 08:44 ET
Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
10:25:26
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12947827
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
PART 2 CYCLE 1 / DAY 21 / LEE011_1.5 POST
DOSE
27-APR-2016
13:05:27
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
05-OCT-1939
5009003

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
71
RR Interval (ms) :
PR Interval (ms) :
Comparator
(3 of 3)
Mean
81
Change
-10
850
738
112
202
183
19
89
97
-8
QT Interval (ms) :
415
369
46
438
409
29
QRS Interval (ms) :
Evaluation
Interpretation:
Abnormal
Evaluation By:
Robert Kleiman
07-JUL-2016 08:44 ET
Findings
Conduction:
First Degree AV Block
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
13:05:27
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12947823
Subject Information
5009
924 Westwood Blvd.
Suite 200
DOSE
02-MAY-2016
13:10:13
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
05-OCT-1939
5009003

Palmer, Jane
Good Tracing
Collected By:
Tracing Quality:
Comparator
Mean
N/A
Change
N/A
747
N/A
N/A
179
N/A
N/A
90
N/A
N/A
QT Interval (ms) :
414
N/A
N/A
456
N/A
N/A
Lead Analyzed: II
Heart Rate (bpm) :
Mean
80
RR Interval (ms) :
PR Interval (ms) :
QRS Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
Robert Kleiman
07-JUL-2016 08:44 ET
Visit: PART 2 CYCLE 1 / DAY 15 / LEE011 4 POST DOSE
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
13:10:13
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12947825
Subject Information
5009
924 Westwood Blvd.
Suite 200
PART 2 CYCLE 2 / DAY 1 / 1.5 POST DOSE
02-MAY-2016
10:40:08
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
05-OCT-1939
5009003

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
80
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
754
N/A
N/A
PR Interval (ms) :
204
N/A
N/A
85
N/A
N/A
412
N/A
N/A
453
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
Evaluation
Interpretation:
Abnormal
Evaluation By:
Robert Kleiman
07-JUL-2016 08:44 ET
Findings
Conduction:
First Degree AV Block
Visit: PART 2 CYCLE 1 / DAY 15 / 1.5 POST DOSE
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
10:40:08
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12947821
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
UNSCHEDULED 1.5 POSTDOSE
16-MAY-2016
12:01:29
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
05-OCT-1939
5009003

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
84
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
713
N/A
N/A
PR Interval (ms) :
185
N/A
N/A
83
N/A
N/A
389
N/A
N/A
435
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
Robert Kleiman
07-JUL-2016 08:44 ET
Visit: PART 2 CYCLE 2 / DAY 15 / 1.5 POST DOSE
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
12:01:29
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12947828
Subject Information
5009
924 Westwood Blvd.
Suite 200
20-APR-2016
14:48:12
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
05-OCT-1939
5009003

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
94
Comparator
(3 of 3)
Mean
81
Change
13
RR Interval (ms) :
639
738
-99
PR Interval (ms) :
182
183
-1
QRS Interval (ms) :

QT Interval (ms) :
75
97
-22
313
369
-56
364
409
-45
Evaluation
Interpretation:
Normal
Evaluation By:
Robert Kleiman
07-JUL-2016 08:44 ET
Visit: PART 2 CYCLE 1 / DAY 8 / PRE DOSE
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
14:48:12
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12947820
Subject Information
5009
924 Westwood Blvd.
Suite 200
DOSE
16-MAY-2016
16:10:27
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
05-OCT-1939
5009003

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Comparator
Mean
N/A
Change
N/A
718
N/A
N/A
185
N/A
N/A
79
N/A
N/A
QT Interval (ms) :
371
N/A
N/A
414
N/A
N/A
Lead Analyzed: II
Heart Rate (bpm) :
Mean
84
RR Interval (ms) :
PR Interval (ms) :
QRS Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
For Site Use Only.

Robert Kleiman
07-JUL-2016 08:44 ET
Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
16:10:27
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707298
Subject Information
5009
924 Westwood Blvd.
Suite 200
RUNIN CYCLE 1 / DAY 15 / PRE DOSE
23-NOV-2015
10:50:43
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
05-OCT-1939
5009003

Jackson, Hannah
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
80
Comparator
(3 of 3)
Mean
81
Change
-1
RR Interval (ms) :
748
735
13
PR Interval (ms) :
191
182
QRS Interval (ms) :

QT Interval (ms) :
83
91
-8
362
368
-6
399
407
-8
Evaluation
Interpretation:
Normal
Evaluation By:
A Nagamani
06-JUL-2016 11:09 ET
Visit: / /
7 Digit Subject Number *UNIDENTIFIED*
Date of Birth --/--/----
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009
DATE OF BIRTH: --/--/---7 DIGIT SUBJECT NUMBER: *UNIDENTIFIED*

/
80 bpm
748 ms
197 ms
88 ms
373 ms
431 ms
410 ms
409 ms
27/72/41
10:50:43
SINUS RHYTHM
SEPTAL INFARCT, AGE UNDETERMINED
ABNORMAL ECG
CAUTION:
WAVEFORM QUALITY AND SCALING MAY BE AFFECTED BY THE RECEIVING FAX MACHINE
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707472
Subject Information
5009
924 Westwood Blvd.
Suite 200
13-JAN-2016
13:17:01
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
13-MAR-1958
5009002

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
65
Comparator
(3 of 3)
Mean
66
Change
-1
RR Interval (ms) :
926
913
13
PR Interval (ms) :
168
177
-9
85
82
QT Interval (ms) :
425
432
-7
436
445
-9
QRS Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
Svetlana Nikitina
15-JUN-2016 14:07 ET
Remarks: The mean comparison information has been updated.
For Site Use Only.

Date: ____________________________
Generated on: 30-JUN-2016 11:46:43

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009
DATE OF BIRTH: 03/13/1958

7 DIGIT SUBJECT NUMBER: 5009002
P2C1 / 8 / PD
64 bpm
927 ms
169 ms
82 ms
422 ms
438 ms
432 ms
432 ms
43/49/22
COLLECTED: 13-JAN-2016
13:17:01
SINUS RHYTHM
LOW QRS VOLTAGE IN CHEST LEADS
ATYPICAL ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707506
Subject Information
5009
924 Westwood Blvd.
Suite 200
20-JAN-2016
08:14:38
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
13-MAR-1958
5009002

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
67
Comparator
(3 of 3)
Mean
66
Change
1
RR Interval (ms) :
892
913
-21
PR Interval (ms) :
173
177
-4
86
82
QT Interval (ms) :
413
432
-19
429
445
-16
QRS Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
Svetlana Nikitina
15-JUN-2016 14:22 ET
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

P2C1 / 15 / P
66 bpm
897 ms
175 ms
86 ms
410 ms
432 ms
425 ms
424 ms
46/55/8
08:14:38
SINUS RHYTHM
ATYPICAL ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707530
Subject Information
5009
924 Westwood Blvd.
Suite 200
DOSE
20-JAN-2016
12:33:33
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
13-MAR-1958
5009002

Philips, Neil
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
63
RR Interval (ms) :
PR Interval (ms) :
Comparator
(3 of 3)
Mean
66
Change
-3
953
913
40
179
177
86
82
QT Interval (ms) :
437
432
444
445
-1
QRS Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
Svetlana Nikitina
15-JUN-2016 13:35 ET
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

P2C1 / 15 / 4PD
63 bpm
951 ms
170 ms
90 ms
435 ms
446 ms
442 ms
442 ms
42/45/12
12:33:33
SINUS RHYTHM
ATYPICAL ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707518
Subject Information
5009
924 Westwood Blvd.
Suite 200
20-JAN-2016
10:08:20
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
13-MAR-1958
5009002

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
64
Comparator
(3 of 3)
Mean
66
Change
-2
RR Interval (ms) :
934
913
21
PR Interval (ms) :
176
177
-1
QRS Interval (ms) :

QT Interval (ms) :
85
82
435
432
445
445
Evaluation
Interpretation:
Normal
Evaluation By:
Svetlana Nikitina
15-JUN-2016 14:22 ET
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

P2C1 / 15 / PD
65 bpm
920 ms
176 ms
84 ms
429 ms
447 ms
441 ms
440 ms
34/36/11
10:08:20
SINUS RHYTHM
ATYPICAL ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707484
Subject Information
5009
924 Westwood Blvd.
Suite 200
DOSE
13-JAN-2016
17:18:09
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
13-MAR-1958
5009002

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
67
RR Interval (ms) :
PR Interval (ms) :
Comparator
(3 of 3)
Mean
66
Change
1
896
913
-17
163
177
-14
84
82
QT Interval (ms) :
419
432
-13
435
445
-10
QRS Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
Svetlana Nikitina
15-JUN-2016 14:07 ET
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

P2C1 / 8 / 4PD
67 bpm
892 ms
166 ms
82 ms
425 ms
449 ms
441 ms
440 ms
5/-2/20
17:18:09
SINUS RHYTHM
ATYPICAL ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12947851
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
PART 2 CYCLE 1 / DAY 1 / PRE DOSE C
08-JAN-2016
10:06:06
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
13-MAR-1958
5009002

Cunningham, Michael
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
68
Comparator
Mean
N/A
Change
N/A
RR Interval (ms) :
879
N/A
N/A
PR Interval (ms) :
181
N/A
N/A
QRS Interval (ms) :

QT Interval (ms) :
72
N/A
N/A
429
N/A
N/A
448
N/A
N/A
Evaluation
Interpretation:
Normal
Evaluation By:
For Site Use Only.

Muhammad Iqbal
30-JUN-2016 11:40 ET
Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:
5009
ERT
ACCOUNT: 746874
10:06:06
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707270
Subject Information
Date of Birth:
5009
924 Westwood Blvd.
Suite 200
UNSCHEDULED PREDOSE
12-NOV-2015
11:34:33
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
13-MAR-1958
5009002

Crockett, Hayley
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
61
Comparator
(3 of 3)
Mean
63
Change
-2
RR Interval (ms) :
985
948
37
PR Interval (ms) :
163
170
-7
90
86
QT Interval (ms) :
413
420
-7
415
427
-12
QRS Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
Muhammad Iqbal
08-JUN-2016 05:36 ET
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

R1C1 / 1 / A
64 bpm
932 ms
169 ms
84 ms
419 ms
434 ms
428 ms
428 ms
56/50/47
11:34:33
SINUS RHYTHM
NORMAL ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Sponsor:
Protocol:
Account:
Transmittal Number:

CLGX818X2109
746874
12707312
Subject Information
5009
924 Westwood Blvd.
Suite 200
RUNIN CYCLE 1 / DAY 15 / PRE DOSE
25-NOV-2015
14:43:30
Site ID:
Investigator Name:
Address:
Visit:
Collection Date:
Collection Time:
Date of Birth:
13-MAR-1958
5009002

Warren, Dominic
Good Tracing
Collected By:
Tracing Quality:
Lead Analyzed: II
Heart Rate (bpm) :
Mean
56
Comparator
(3 of 3)
Mean
63
Change
-7
RR Interval (ms) :
1078
948
130
PR Interval (ms) :
183
170
13
87
86
QT Interval (ms) :
419
420
-1
409
427
-18
QRS Interval (ms) :
Evaluation
Interpretation:
Normal
Evaluation By:
Svetlana Nikitina
15-JUN-2016 14:07 ET
For Site Use Only.

Date: ____________________________

1818 Market Street
Page 1 of 2
Lynch Wood
PROTOCOL:
SITE:

5009

RC1 / 15 / P
56 bpm
1058 ms
179 ms
89 ms
423 ms
411 ms
415 ms
415 ms
58/60/36
14:43:30
SINUS BRADYCARDIA
NORMAL ECG
CAUTION:
VISIT:
HR_GL:
RR_GL:
PR_GL:
QRS_GL:
QT_GL:
QTcB_GL:
QTcF_GL:
QTcL_GL:
P-R-T axes:
ACCOUNT: 746874
ERT
Page 2 of 2

Ecganalysisreport 3

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ECG Analysis Report with Mean Comparator Change

Array BioPharma Inc.

Interval Duration Measurements

QRS Interval (ms) :

Left Anterior Hemiblock

For Site Use Only.

Generated on: 07-JUL-2016 17:23:45

Array BioPharma Inc. - CLGX818X2109

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 17:23:45

ECG Analysis Report with Mean Comparator Change

Array BioPharma Inc.

Interval Duration Measurements

QTc Fridericia's (ms) :

QRS Interval (ms) :

For Site Use Only.

Generated on: 07-JUL-2016 08:52:36

Array BioPharma Inc. - CLGX818X2109

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 08:52:36

ECG Analysis Report with Mean Comparator Change

Array BioPharma Inc.

Interval Duration Measurements

QTc Fridericia's (ms) :

QRS Interval (ms) :

For Site Use Only.

Generated on: 07-JUL-2016 08:52:12

Array BioPharma Inc. - CLGX818X2109

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 08:52:12

ECG Analysis Report with Mean Comparator Change

Array BioPharma Inc.

Interval Duration Measurements

QRS Interval (ms) :

For Site Use Only.

Generated on: 07-JUL-2016 08:52:00

Array BioPharma Inc. - CLGX818X2109

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 08:52:00

ECG Analysis Report with Mean Comparator Change

Array BioPharma Inc.

Interval Duration Measurements

QRS Interval (ms) :

For Site Use Only.

Generated on: 07-JUL-2016 08:51:37

Array BioPharma Inc. - CLGX818X2109

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 08:51:37

ECG Analysis Report with Mean Comparator Change

Array BioPharma Inc.

Interval Duration Measurements

QTc Fridericia's (ms) :

QRS Interval (ms) :

First Degree AV Block

For Site Use Only.

Generated on: 07-JUL-2016 08:51:20

Array BioPharma Inc. - CLGX818X2109

INVESTIGATOR: Chmielowski, Bartosz

Generated on: 07-JUL-2016 08:51:20

ECG Analysis Report with Mean Comparator Change

Array BioPharma Inc.

Interval Duration Measurements

QTc Fridericia's (ms) :

DATE OF BIRTH: --/--/---7 DIGIT SUBJECT NUMBER: UNIDENTIFIED