<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-2024-410
Date of Submission: 2024-09-11

This report was submitted by a Patient from Mckinney Ltd Medical Center concerning patient ANON-PX-2762. The subject is an adult other with a significant medical history including seasonal allergies, chronic kidney disease, asthma, osteoarthritis. 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 Intramuscular route at a dosage of 399mg, initiated on 2024-07-08 for Type 2 diabetes with the course ongoing; Levothyroxine (Thyroid hormone) administered via the Subcutaneous route at a dosage of 32mg, initiated on 2024-07-08 for Hypothyroidism with the course ongoing.

On approximately 2024-08-21, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Nausea, Anaphylaxis. The Nausea was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed decade and advised life. The current patient status regarding this symptom is 'Fatal'. The Anaphylaxis was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed training and advised type. 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: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Lead decade owner nice while. Window security past interesting item development positive staff.</data>
report_id: ADR-2024-410
report_date: '2024-09-11'
patient_details:
  patient_id: ANON-PX-2762
  gender: Other
  relevant_history:
  - seasonal allergies
  - chronic kidney disease
  - asthma
  - osteoarthritis
suspected_drugs:
- drug_name: Metformin
  dosage: 399mg
  route_of_administration: Intramuscular
  start_date: '2024-07-08'
  indication_for_use: Type 2 diabetes
- drug_name: Levothyroxine
  dosage: 32mg
  route_of_administration: Subcutaneous
  start_date: '2024-07-08'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
adverse_reactions:
- symptom_name: Nausea
  onset_date: '2024-08-21'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed decade and advised life.
- symptom_name: Anaphylaxis
  onset_date: '2024-08-21'
  severity: Mild
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed training and advised type.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 1
reporting_facility: Mckinney Ltd Medical Center
reporter_type: Patient
notes: Lead decade owner nice while. Window security past interesting item development
  positive staff.
