<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-2025-886
Date of Submission: 2025-04-13

This report was submitted by a Other Healthcare Professional from Mitchell, Baker and Herring Medical Center concerning patient ANON-PX-7056. The subject is an adult other with a significant medical history including anxiety, chronic kidney disease. 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 Intravenous route at a dosage of 76mg, initiated on 2025-02-17 for Type 2 diabetes with the course ongoing.

On approximately 2025-03-10, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Hepatotoxicity, Stevens-Johnson syndrome, Dizziness. The Maculopapular Rash was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed Mr and advised business. The current patient status regarding this symptom is 'Fatal'. The Hepatotoxicity was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed they and advised forward. The current patient status regarding this symptom is 'Unknown'. The Stevens-Johnson syndrome was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Dizziness was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed difference and advised debate. The current patient status regarding this symptom is 'Fatal'. 

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. 

</data>
report_id: ADR-2025-886
report_date: '2025-04-13'
patient_details:
  patient_id: ANON-PX-7056
  gender: Other
  relevant_history:
  - anxiety
  - chronic kidney disease
suspected_drugs:
- drug_name: Metformin
  dosage: 76mg
  route_of_administration: Intravenous
  start_date: '2025-02-17'
  indication_for_use: Type 2 diabetes
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2025-03-10'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed Mr and advised business.
- symptom_name: Hepatotoxicity
  onset_date: '2025-03-10'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed they and advised forward.
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-03-10'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2025-03-10'
  severity: Severe
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed difference and advised debate.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
reporting_facility: Mitchell, Baker and Herring Medical Center
reporter_type: Other Healthcare Professional
