<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-2025-394
Date of Submission: 2025-04-01

This report was submitted by a Physician from Goodman, Huang and Jordan Medical Center concerning patient ANON-PX-7404. The subject is an adult other with a significant medical history including hypertension, atrial fibrillation, asthma. 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 (Biguanide) administered via the Intramuscular route at a dosage of 128mg, initiated on 2025-03-08 for Type 2 diabetes and discontinued on 2025-03-18.

On approximately 2025-03-13, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Maculopapular Rash, Angioedema, Dizziness. The Stevens-Johnson syndrome was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed marriage and advised allow. The current patient status regarding this symptom is 'Recovered'. The Maculopapular Rash was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Angioedema was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Dizziness was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 1 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Grow evening especially read star. Question none process long collection ok matter light. Baby most inside church like card.</data>
report_id: ADR-2025-394
report_date: '2025-04-01'
patient_details:
  patient_id: ANON-PX-7404
  gender: Other
  relevant_history:
  - hypertension
  - atrial fibrillation
  - asthma
suspected_drugs:
- drug_name: Metformin
  dosage: 128mg
  route_of_administration: Intramuscular
  start_date: '2025-03-08'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
  end_date: '2025-03-18'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-03-13'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed marriage and advised allow.
- symptom_name: Maculopapular Rash
  onset_date: '2025-03-13'
  severity: Mild
  outcome: Recovering
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2025-03-13'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2025-03-13'
  severity: Mild
  outcome: Recovered
  intervention_required: true
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Not applicable
  naranjo_score: 1
reporting_facility: Goodman, Huang and Jordan Medical Center
reporter_type: Physician
notes: Grow evening especially read star. Question none process long collection ok
  matter light. Baby most inside church like card.
