<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-2025-739
Date of Submission: 2025-06-09

This report was submitted by a Pharmacist from Perry, Huang and Griffin Medical Center concerning patient ANON-PX-7124. The subject is a 26-year-old other with a significant medical history including type 2 diabetes, 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 Subcutaneous route at a dosage of 40mg, initiated on 2025-05-29 for Type 2 diabetes and discontinued on 2025-06-06; Atorvastatin administered via the Intravenous route at a dosage of 156mg, initiated on 2025-05-29 for Hypercholesterolemia and discontinued on 2025-06-06.

On approximately 2025-06-05, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Vomiting, Anaphylaxis, Stevens-Johnson syndrome, Hepatotoxicity. The Dizziness was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed threat and advised ground. The current patient status regarding this symptom is 'Recovered'. The Vomiting was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Anaphylaxis was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Stevens-Johnson syndrome was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Hepatotoxicity was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed low and advised agree. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 4 was calculated, The assessment concluded the relationship was 'Possible'. 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-2025-739
report_date: '2025-06-09'
patient_details:
  patient_id: ANON-PX-7124
  gender: Other
  relevant_history:
  - type 2 diabetes
  - osteoarthritis
  age_at_reaction: 26
suspected_drugs:
- drug_name: Metformin
  dosage: 40mg
  route_of_administration: Subcutaneous
  start_date: '2025-05-29'
  indication_for_use: Type 2 diabetes
  end_date: '2025-06-06'
- drug_name: Atorvastatin
  dosage: 156mg
  route_of_administration: Intravenous
  start_date: '2025-05-29'
  indication_for_use: Hypercholesterolemia
  end_date: '2025-06-06'
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2025-06-05'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed threat and advised ground.
- symptom_name: Vomiting
  onset_date: '2025-06-05'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2025-06-05'
  severity: Mild
  outcome: Unknown
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-06-05'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2025-06-05'
  severity: Mild
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed low and advised agree.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 4
reporting_facility: Perry, Huang and Griffin Medical Center
reporter_type: Pharmacist
