<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-2024-867
Date of Submission: 2024-11-13

This report was submitted by a Nurse from Rogers-Clay Medical Center concerning patient ANON-PX-5926. The subject is a 77-year-old male with a significant medical history including hypertension, 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 88mg, initiated on 2024-09-04 for Type 2 diabetes and discontinued on 2024-10-24.

On approximately 2024-09-18, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Nausea, Anaphylaxis. The Maculopapular Rash was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Nausea was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Anaphylaxis was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 2 was calculated, The assessment concluded the relationship was 'Possible'. 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: Laugh none life rise general material enjoy. Throughout community return knowledge evidence possible specific.</data>
report_id: ADR-2024-867
report_date: '2024-11-13'
patient_details:
  patient_id: ANON-PX-5926
  gender: Male
  relevant_history:
  - hypertension
  - type 2 diabetes
  age_at_reaction: 77
suspected_drugs:
- drug_name: Metformin
  dosage: 88mg
  route_of_administration: Intravenous
  start_date: '2024-09-04'
  indication_for_use: Type 2 diabetes
  end_date: '2024-10-24'
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2024-09-18'
  severity: Moderate
  outcome: Recovering
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2024-09-18'
  severity: Mild
  outcome: Unknown
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2024-09-18'
  severity: Mild
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 2
reporting_facility: Rogers-Clay Medical Center
reporter_type: Nurse
notes: Laugh none life rise general material enjoy. Throughout community return knowledge
  evidence possible specific.
