<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-2025-943
Date of Submission: 2025-02-20

This report was submitted by a Patient from Beck-Harris Medical Center concerning patient ANON-PX-4229. The subject is an adult other with a significant medical history including seasonal allergies, coronary artery disease, 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 Topical route at a dosage of 133mg, initiated on 2025-02-06 for Pain and inflammation and discontinued on 2025-02-14; Metformin (Biguanide) administered via the Intramuscular route at a dosage of 169mg, initiated on 2025-02-06 for Type 2 diabetes and discontinued on 2025-02-14.

On approximately 2025-02-10, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Anaphylaxis. The Dizziness was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed shoulder and advised away. The current patient status regarding this symptom is 'Fatal'. The Anaphylaxis was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. 

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. 

</data>
report_id: ADR-2025-943
report_date: '2025-02-20'
patient_details:
  patient_id: ANON-PX-4229
  gender: Other
  relevant_history:
  - seasonal allergies
  - coronary artery disease
  - asthma
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 133mg
  route_of_administration: Topical
  start_date: '2025-02-06'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2025-02-14'
- drug_name: Metformin
  dosage: 169mg
  route_of_administration: Intramuscular
  start_date: '2025-02-06'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
  end_date: '2025-02-14'
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2025-02-10'
  severity: Mild
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed shoulder and advised away.
- symptom_name: Anaphylaxis
  onset_date: '2025-02-10'
  severity: Mild
  outcome: Recovered
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 6
reporting_facility: Beck-Harris Medical Center
reporter_type: Patient
