<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-2025-394
Date of Submission: 2025-07-11

This report was submitted by a Physician from Ferguson Inc Medical Center concerning patient ANON-PX-7559. The subject is a 44-year-old male with a significant medical history including seasonal allergies, chronic kidney disease, osteoarthritis. 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 73mg, initiated on 2025-04-24 for Type 2 diabetes with the course ongoing; Omeprazole (Proton-pump inhibitor) administered via the Intravenous route at a dosage of 53mg, initiated on 2025-04-24 for Gastroesophageal reflux disease with the course ongoing.

On approximately 2025-05-05, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Maculopapular Rash, Nausea. The Anaphylaxis was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Maculopapular Rash was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed left and advised deep. The current patient status regarding this symptom is 'Fatal'. The Nausea was classified as Moderate 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. The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Pressure improve power data somebody watch measure matter. Building party push box.</data>
report_id: ADR-2025-394
report_date: '2025-07-11'
patient_details:
  patient_id: ANON-PX-7559
  gender: Male
  relevant_history:
  - seasonal allergies
  - chronic kidney disease
  - osteoarthritis
  age_at_reaction: 44
suspected_drugs:
- drug_name: Metformin
  dosage: 73mg
  route_of_administration: Oral
  start_date: '2025-04-24'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
- drug_name: Omeprazole
  dosage: 53mg
  route_of_administration: Intravenous
  start_date: '2025-04-24'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2025-05-05'
  severity: Moderate
  outcome: Recovered
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2025-05-05'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed left and advised deep.
- symptom_name: Nausea
  onset_date: '2025-05-05'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
reporting_facility: Ferguson Inc Medical Center
reporter_type: Physician
notes: Pressure improve power data somebody watch measure matter. Building party push
  box.
