<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-2024-555
Date of Submission: 2024-12-12

This report was submitted by a Nurse from Richard-Mitchell Medical Center concerning patient ANON-PX-1650. The subject is a 56-year-old other with a significant medical history including migraines, hypertension. 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 Oral route at a dosage of 290mg, initiated on 2024-11-06 for Type 2 diabetes and discontinued on 2024-12-03.

On approximately 2024-11-10, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Somnolence, Nausea. The Somnolence was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Nausea was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 9 was calculated, The assessment concluded the relationship was 'Highly Probable'. Dechallenge/Rechallenge status was noted as: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Type quite can represent ask. Until current reality the. Worker conference space.</data>
report_id: ADR-2024-555
report_date: '2024-12-12'
patient_details:
  patient_id: ANON-PX-1650
  gender: Other
  relevant_history:
  - migraines
  - hypertension
  age_at_reaction: 56
suspected_drugs:
- drug_name: Metformin
  dosage: 290mg
  route_of_administration: Oral
  start_date: '2024-11-06'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
  end_date: '2024-12-03'
adverse_reactions:
- symptom_name: Somnolence
  onset_date: '2024-11-10'
  severity: Mild
  outcome: Fatal
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2024-11-10'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 9
reporting_facility: Richard-Mitchell Medical Center
reporter_type: Nurse
notes: Type quite can represent ask. Until current reality the. Worker conference
  space.
