<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-2024-564
Date of Submission: 2024-12-24

This report was submitted by a Nurse from Sawyer, Jones and Young Medical Center concerning patient ANON-PX-3365. The subject is a 63-year-old other with a significant medical history including anxiety, 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 Intramuscular route at a dosage of 412mg, initiated on 2024-12-07 for Type 2 diabetes with the course ongoing; Warfarin (Anticoagulant) administered via the Intravenous route at a dosage of 55mg, initiated on 2024-12-07 for Thromboembolism prevention with the course ongoing.

On approximately 2024-12-09, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Hepatotoxicity, Stevens-Johnson syndrome, Somnolence. The Hepatotoxicity was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Stevens-Johnson syndrome was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Somnolence was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. 

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. 

Reporter's Narrative Summary: North kid fall campaign. Science successful exist near front. Reason military international probably several meeting.</data>
report_id: ADR-2024-564
report_date: '2024-12-24'
patient_details:
  patient_id: ANON-PX-3365
  gender: Other
  relevant_history:
  - anxiety
  - atrial fibrillation
  age_at_reaction: 63
suspected_drugs:
- drug_name: Metformin
  dosage: 412mg
  route_of_administration: Intramuscular
  start_date: '2024-12-07'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
- drug_name: Warfarin
  dosage: 55mg
  route_of_administration: Intravenous
  start_date: '2024-12-07'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
adverse_reactions:
- symptom_name: Hepatotoxicity
  onset_date: '2024-12-09'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-12-09'
  severity: Mild
  outcome: Fatal
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2024-12-09'
  severity: Mild
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
reporting_facility: Sawyer, Jones and Young Medical Center
reporter_type: Nurse
notes: North kid fall campaign. Science successful exist near front. Reason military
  international probably several meeting.
