<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-2025-170
Date of Submission: 2025-02-02

This report was submitted by a Nurse from Barnes LLC Medical Center concerning patient ANON-PX-1681. The subject is a 31-year-old other with a significant medical history including migraines, anxiety, atrial fibrillation, type 2 diabetes. 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 Intravenous route at a dosage of 306mg, initiated on 2024-12-09 for Type 2 diabetes and discontinued on 2025-01-20; Gabapentin (Anticonvulsant) administered via the Subcutaneous route at a dosage of 138mg, initiated on 2024-12-09 for Neuropathic pain and discontinued on 2025-01-20.

On approximately 2025-01-16, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Headache, Hepatotoxicity. The Headache was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed news and advised hour. The current patient status regarding this symptom is 'Fatal'. The Hepatotoxicity was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed environmental and advised talk. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 6 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2025-170
report_date: '2025-02-02'
patient_details:
  patient_id: ANON-PX-1681
  gender: Other
  relevant_history:
  - migraines
  - anxiety
  - atrial fibrillation
  - type 2 diabetes
  age_at_reaction: 31
suspected_drugs:
- drug_name: Metformin
  dosage: 306mg
  route_of_administration: Intravenous
  start_date: '2024-12-09'
  indication_for_use: Type 2 diabetes
  end_date: '2025-01-20'
- drug_name: Gabapentin
  dosage: 138mg
  route_of_administration: Subcutaneous
  start_date: '2024-12-09'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
  end_date: '2025-01-20'
adverse_reactions:
- symptom_name: Headache
  onset_date: '2025-01-16'
  severity: Mild
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed news and advised hour.
- symptom_name: Hepatotoxicity
  onset_date: '2025-01-16'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed environmental and advised talk.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 6
reporting_facility: Barnes LLC Medical Center
reporter_type: Nurse
