<format type="yaml">{report_id: string, report_date: date, patient_details: {patient_id: string, age_at_reaction: number optional, gender: string, relevant_history: list[string]}, suspected_drugs: list[{drug_name: string, drug_class: string optional, dosage: string, route_of_administration: string, start_date: date, end_date: date optional, indication_for_use: string}], adverse_reactions: list[{symptom_name: string, onset_date: date, severity: string, outcome: string, intervention_required: boolean, intervention_details: string optional}], causality_assessment: {naranjo_score: number optional, assessment_conclusion: string, dechallenge_rechallenge: string}, reporting_facility: string, reporter_type: string, notes: string optional}</format> <data>PHARMACOVIGILANCE CASE REPORT - CONFIDENTIAL
Report Identifier: ADR-2024-420
Date of Submission: 2024-09-29

This report was submitted by a Physician from Blevins, Murphy and King Medical Center concerning patient ANON-PX-3067. The subject is a 30-year-old male with a significant medical history including atrial fibrillation, chronic kidney disease, osteoarthritis. The facility's standard operating procedure for ADR reporting was followed, and all patient data has been anonymized. The patient chart was reviewed for comorbidities. 

Current medication review revealed the following suspected agent(s): Metformin administered via the Subcutaneous route at a dosage of 162mg, initiated on 2024-07-31 for Type 2 diabetes and discontinued on 2024-09-15.

On approximately 2024-09-11, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Headache, Stevens-Johnson syndrome, Hepatotoxicity. The Headache was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed especially and advised southern. The current patient status regarding this symptom is 'Recovering'. The Stevens-Johnson syndrome was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Hepatotoxicity was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 5 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Write road you yes education fall. Move event person reflect wait seven.</data>
report_id: ADR-2024-420
report_date: '2024-09-29'
patient_details:
  patient_id: ANON-PX-3067
  gender: Male
  relevant_history:
  - atrial fibrillation
  - chronic kidney disease
  - osteoarthritis
  age_at_reaction: 30
suspected_drugs:
- drug_name: Metformin
  dosage: 162mg
  route_of_administration: Subcutaneous
  start_date: '2024-07-31'
  indication_for_use: Type 2 diabetes
  end_date: '2024-09-15'
adverse_reactions:
- symptom_name: Headache
  onset_date: '2024-09-11'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed especially and advised southern.
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-09-11'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2024-09-11'
  severity: Mild
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 5
reporting_facility: Blevins, Murphy and King Medical Center
reporter_type: Physician
notes: Write road you yes education fall. Move event person reflect wait seven.
