<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-2025-756
Date of Submission: 2025-03-08

This report was submitted by a Pharmacist from Turner, Parker and Myers Medical Center concerning patient ANON-PX-8075. The subject is a 22-year-old female with a significant medical history including osteoarthritis, migraines. 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 Intramuscular route at a dosage of 223mg, initiated on 2025-02-23 for Type 2 diabetes and discontinued on 2025-03-03; Omeprazole administered via the Oral route at a dosage of 268mg, initiated on 2025-02-23 for Gastroesophageal reflux disease and discontinued on 2025-03-03.

On approximately 2025-02-25, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Dizziness, Diarrhea, Nausea, Anaphylaxis. The Vomiting was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed someone and advised challenge. The current patient status regarding this symptom is 'Not Recovered'. The Dizziness was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Diarrhea was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Nausea was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed each and advised up. The current patient status regarding this symptom is 'Recovered'. The Anaphylaxis was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 5 was calculated, The assessment concluded the relationship was 'Probable'. 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: Return goal turn allow they. Guy open for movie other.</data>
report_id: ADR-2025-756
report_date: '2025-03-08'
patient_details:
  patient_id: ANON-PX-8075
  gender: Female
  relevant_history:
  - osteoarthritis
  - migraines
  age_at_reaction: 22
suspected_drugs:
- drug_name: Metformin
  dosage: 223mg
  route_of_administration: Intramuscular
  start_date: '2025-02-23'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
  end_date: '2025-03-03'
- drug_name: Omeprazole
  dosage: 268mg
  route_of_administration: Oral
  start_date: '2025-02-23'
  indication_for_use: Gastroesophageal reflux disease
  end_date: '2025-03-03'
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2025-02-25'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed someone and advised challenge.
- symptom_name: Dizziness
  onset_date: '2025-02-25'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2025-02-25'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2025-02-25'
  severity: Mild
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed each and advised up.
- symptom_name: Anaphylaxis
  onset_date: '2025-02-25'
  severity: Severe
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 5
reporting_facility: Turner, Parker and Myers Medical Center
reporter_type: Pharmacist
notes: Return goal turn allow they. Guy open for movie other.
