<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-2025-859
Date of Submission: 2025-05-07

This report was submitted by a Physician from Lewis-Adams Medical Center concerning patient ANON-PX-6025. The subject is a 41-year-old female with a significant medical history including migraines, 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): Ibuprofen (NSAID) administered via the Subcutaneous route at a dosage of 488mg, initiated on 2025-04-07 for Pain and inflammation with the course ongoing; Metformin (Biguanide) administered via the Intravenous route at a dosage of 211mg, initiated on 2025-04-07 for Type 2 diabetes with the course ongoing.

On approximately 2025-05-05, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Headache, Angioedema, Somnolence. The Headache was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed tell and advised brother. The current patient status regarding this symptom is 'Fatal'. The Angioedema was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Somnolence was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. The assessment concluded the relationship was 'Probable'. 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: Career rock large for me small impact. Pattern artist price entire fear idea bad together. Ready fill no paper large material against.</data>
report_id: ADR-2025-859
report_date: '2025-05-07'
patient_details:
  patient_id: ANON-PX-6025
  gender: Female
  relevant_history:
  - migraines
  - asthma
  age_at_reaction: 41
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 488mg
  route_of_administration: Subcutaneous
  start_date: '2025-04-07'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
- drug_name: Metformin
  dosage: 211mg
  route_of_administration: Intravenous
  start_date: '2025-04-07'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
adverse_reactions:
- symptom_name: Headache
  onset_date: '2025-05-05'
  severity: Mild
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed tell and advised brother.
- symptom_name: Angioedema
  onset_date: '2025-05-05'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2025-05-05'
  severity: Moderate
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
reporting_facility: Lewis-Adams Medical Center
reporter_type: Physician
notes: Career rock large for me small impact. Pattern artist price entire fear idea
  bad together. Ready fill no paper large material against.
