<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-2025-930
Date of Submission: 2025-03-19

This report was submitted by a Patient from Barber Group Medical Center concerning patient ANON-PX-1602. The subject is a 36-year-old other with a significant medical history including osteoarthritis, chronic kidney disease. 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): Atorvastatin (Statin) administered via the Intramuscular route at a dosage of 276mg, initiated on 2025-01-31 for Hypercholesterolemia and discontinued on 2025-03-18; Metformin (Biguanide) administered via the Intravenous route at a dosage of 449mg, initiated on 2025-01-31 for Type 2 diabetes and discontinued on 2025-03-18.

On approximately 2025-03-08, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Anaphylaxis, Hepatotoxicity. The Stevens-Johnson syndrome was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed suffer and advised someone. The current patient status regarding this symptom is 'Unknown'. The Anaphylaxis was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. The Hepatotoxicity was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 6 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Red on least. Girl present cell add issue itself. Machine recognize or apply church.</data>
report_id: ADR-2025-930
report_date: '2025-03-19'
patient_details:
  patient_id: ANON-PX-1602
  gender: Other
  relevant_history:
  - osteoarthritis
  - chronic kidney disease
  age_at_reaction: 36
suspected_drugs:
- drug_name: Atorvastatin
  dosage: 276mg
  route_of_administration: Intramuscular
  start_date: '2025-01-31'
  indication_for_use: Hypercholesterolemia
  drug_class: Statin
  end_date: '2025-03-18'
- drug_name: Metformin
  dosage: 449mg
  route_of_administration: Intravenous
  start_date: '2025-01-31'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
  end_date: '2025-03-18'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-03-08'
  severity: Severe
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed suffer and advised someone.
- symptom_name: Anaphylaxis
  onset_date: '2025-03-08'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: true
- symptom_name: Hepatotoxicity
  onset_date: '2025-03-08'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 6
reporting_facility: Barber Group Medical Center
reporter_type: Patient
notes: Red on least. Girl present cell add issue itself. Machine recognize or apply
  church.
