<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-2025-652
Date of Submission: 2025-01-18

This report was submitted by a Other Healthcare Professional from Payne, Morse and Garcia Medical Center concerning patient ANON-PX-4082. The subject is a 84-year-old male 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): Metformin (Biguanide) administered via the Intramuscular route at a dosage of 347mg, initiated on 2024-11-08 for Type 2 diabetes and discontinued on 2025-01-12.

On approximately 2024-12-21, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Stevens-Johnson syndrome, Headache. The Dizziness was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed player and advised outside. The current patient status regarding this symptom is 'Not Recovered'. The Stevens-Johnson syndrome was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Headache was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not 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: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2025-652
report_date: '2025-01-18'
patient_details:
  patient_id: ANON-PX-4082
  gender: Male
  relevant_history:
  - migraines
  - asthma
  age_at_reaction: 84
suspected_drugs:
- drug_name: Metformin
  dosage: 347mg
  route_of_administration: Intramuscular
  start_date: '2024-11-08'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
  end_date: '2025-01-12'
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2024-12-21'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed player and advised outside.
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-12-21'
  severity: Mild
  outcome: Recovering
  intervention_required: false
- symptom_name: Headache
  onset_date: '2024-12-21'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 1
reporting_facility: Payne, Morse and Garcia Medical Center
reporter_type: Other Healthcare Professional
