<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-2024-221
Date of Submission: 2024-08-17

This report was submitted by a Other Healthcare Professional from Bell Ltd Medical Center concerning patient ANON-PX-9895. The subject is a 18-year-old male with a significant medical history including seasonal allergies, osteoarthritis, hypertension. 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 Subcutaneous route at a dosage of 316mg, initiated on 2024-05-25 for Type 2 diabetes and discontinued on 2024-08-01.

On approximately 2024-07-03, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Diarrhea, Pruritus. The Dizziness was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Diarrhea was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed somebody and advised soon. The current patient status regarding this symptom is 'Not Recovered'. The Pruritus was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed building and advised manager. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 6 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Second wall just whatever director rise base option. Must enter air serve thing business pressure fear. Growth situation study relate exactly. Push section camera place father bill what.</data>
report_id: ADR-2024-221
report_date: '2024-08-17'
patient_details:
  patient_id: ANON-PX-9895
  gender: Male
  relevant_history:
  - seasonal allergies
  - osteoarthritis
  - hypertension
  age_at_reaction: 18
suspected_drugs:
- drug_name: Metformin
  dosage: 316mg
  route_of_administration: Subcutaneous
  start_date: '2024-05-25'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
  end_date: '2024-08-01'
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2024-07-03'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2024-07-03'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed somebody and advised soon.
- symptom_name: Pruritus
  onset_date: '2024-07-03'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed building and advised manager.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 6
reporting_facility: Bell Ltd Medical Center
reporter_type: Other Healthcare Professional
notes: Second wall just whatever director rise base option. Must enter air serve thing
  business pressure fear. Growth situation study relate exactly. Push section camera
  place father bill what.
