<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-2025-837
Date of Submission: 2025-03-15

This report was submitted by a Patient from Gonzalez-Mckay Medical Center concerning patient ANON-PX-2719. The subject is a 49-year-old other with a significant medical history including hypertension, anxiety, osteoarthritis, atrial fibrillation. 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 407mg, initiated on 2025-02-11 for Type 2 diabetes and discontinued on 2025-03-04.

On approximately 2025-03-04, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Somnolence. The Stevens-Johnson syndrome was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed play and advised go. The current patient status regarding this symptom is 'Recovered'. The Somnolence was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. 

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: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Improve high study appear range inside least. Keep beat stand four significant everyone. Single talk prevent rise.</data>
report_id: ADR-2025-837
report_date: '2025-03-15'
patient_details:
  patient_id: ANON-PX-2719
  gender: Other
  relevant_history:
  - hypertension
  - anxiety
  - osteoarthritis
  - atrial fibrillation
  age_at_reaction: 49
suspected_drugs:
- drug_name: Metformin
  dosage: 407mg
  route_of_administration: Subcutaneous
  start_date: '2025-02-11'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
  end_date: '2025-03-04'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-03-04'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed play and advised go.
- symptom_name: Somnolence
  onset_date: '2025-03-04'
  severity: Mild
  outcome: Recovering
  intervention_required: true
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 1
reporting_facility: Gonzalez-Mckay Medical Center
reporter_type: Patient
notes: Improve high study appear range inside least. Keep beat stand four significant
  everyone. Single talk prevent rise.
