<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-2024-630
Date of Submission: 2024-10-09

This report was submitted by a Pharmacist from Tanner-Anderson Medical Center concerning patient ANON-PX-5552. The subject is a 62-year-old male with a significant medical history including migraines, type 2 diabetes. 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 Oral route at a dosage of 373mg, initiated on 2024-09-27 for Type 2 diabetes and discontinued on 2024-10-05; Warfarin (Anticoagulant) administered via the Topical route at a dosage of 180mg, initiated on 2024-09-27 for Thromboembolism prevention and discontinued on 2024-10-05.

On approximately 2024-10-03, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Somnolence, Angioedema, Stevens-Johnson syndrome, Pruritus. The Somnolence was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Angioedema was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Stevens-Johnson syndrome was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Pruritus was classified as Moderate 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. 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: Wonder catch season everyone. Town answer firm institution society summer. Stock foot debate Mrs moment part look.</data>
report_id: ADR-2024-630
report_date: '2024-10-09'
patient_details:
  patient_id: ANON-PX-5552
  gender: Male
  relevant_history:
  - migraines
  - type 2 diabetes
  age_at_reaction: 62
suspected_drugs:
- drug_name: Metformin
  dosage: 373mg
  route_of_administration: Oral
  start_date: '2024-09-27'
  indication_for_use: Type 2 diabetes
  end_date: '2024-10-05'
- drug_name: Warfarin
  dosage: 180mg
  route_of_administration: Topical
  start_date: '2024-09-27'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2024-10-05'
adverse_reactions:
- symptom_name: Somnolence
  onset_date: '2024-10-03'
  severity: Moderate
  outcome: Recovered
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2024-10-03'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-10-03'
  severity: Mild
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2024-10-03'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Negative dechallenge
reporting_facility: Tanner-Anderson Medical Center
reporter_type: Pharmacist
notes: Wonder catch season everyone. Town answer firm institution society summer.
  Stock foot debate Mrs moment part look.
