<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-2025-788
Date of Submission: 2025-06-11

This report was submitted by a Other Healthcare Professional from Garner LLC Medical Center concerning patient ANON-PX-1784. The subject is a 59-year-old male with a significant medical history including seasonal allergies, type 2 diabetes, anxiety, atrial fibrillation. 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 Intravenous route at a dosage of 169mg, initiated on 2025-04-03 for Type 2 diabetes with the course ongoing; Lisinopril (ACE inhibitor) administered via the Intravenous route at a dosage of 105mg, initiated on 2025-04-03 for Hypertension with the course ongoing.

On approximately 2025-04-22, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Pruritus, Vomiting, Stevens-Johnson syndrome. The Anaphylaxis was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Pruritus was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Vomiting was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed prepare and advised exactly. The current patient status regarding this symptom is 'Recovered'. The Stevens-Johnson syndrome was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed study and advised than. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Say education social we no management particularly really. Push address story offer.</data>
report_id: ADR-2025-788
report_date: '2025-06-11'
patient_details:
  patient_id: ANON-PX-1784
  gender: Male
  relevant_history:
  - seasonal allergies
  - type 2 diabetes
  - anxiety
  - atrial fibrillation
  age_at_reaction: 59
suspected_drugs:
- drug_name: Metformin
  dosage: 169mg
  route_of_administration: Intravenous
  start_date: '2025-04-03'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
- drug_name: Lisinopril
  dosage: 105mg
  route_of_administration: Intravenous
  start_date: '2025-04-03'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2025-04-22'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2025-04-22'
  severity: Severe
  outcome: Recovered
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-04-22'
  severity: Mild
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed prepare and advised exactly.
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-04-22'
  severity: Mild
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed study and advised than.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
reporting_facility: Garner LLC Medical Center
reporter_type: Other Healthcare Professional
notes: Say education social we no management particularly really. Push address story
  offer.
