Instruction:
SUBJECT: Adverse event report Product A plus Levothyroxine concomitant medication only
Dear Pharmacovigilance Team,
I am the Consultant Neurologist at a pathology and diagnostics consortium and I am writing to formally report an adverse event involving a patient under my care.

I wish to report an adverse event. The patient experienced a 37 year old female patient initiated on Product A 8 weeks ago who developed severe headache, visual field defects, and magnetic resonance imaging confirmed cerebral venous sinus thrombosis. The neurologist and haematologist jointly concluded Product A was the likely precipitant and the drug was discontinued with anticoagulation therapy commenced.

Additionally, Levothyroxine has been used for epilepsy control for 5 years without breakthrough seizures or previous neuropsychiatric adverse events. The neurologist has reviewed the temporal association and explicitly excluded Levothyroxine as a suspect drug, confirming it should be continued without change.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

Thank you,
Dr. Linda Diaz, Consultant Neurologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 37 year old female patient initiated on Product A 8 weeks ago who developed severe headache, visual field defects, and magnetic resonance imaging confirmed cerebral venous sinus thrombosis, qualifying as an Adverse Event with Product A as the suspect drug. Levothyroxine is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Safety report Product A and both Product A and Omeprazole identified as suspect
Dear Corporate Drug Safety Department,
I am writing as the caregiver for my wife David Fox to report an adverse reaction they experienced with a recently started medication.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 62 year old male patient initiated on Product A 8 weeks ago for an autoimmune skin condition who has developed severely elevated liver enzymes confirmed on blood testing, persistent nausea, and mild jaundice. The treating hepatologist reviewed the case and determined that Product A is the most probable causative agent based on temporal relationship and known hepatic metabolism. Product A has been immediately withdrawn and the patient has been hospitalised under urgent hepatology review.

Additionally, the patient also experienced a 44 year old female patient on Omeprazole for 8 weeks who developed severe hypomagnesaemia with muscle spasms, tetany, and cardiac arrhythmias documented on electrocardiogram. The endocrinologist attributed the event to long-term proton pump inhibitor use and Omeprazole was stopped with magnesium replacement therapy commenced.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Omeprazole as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

Yours sincerely,
Mrs. Scott Nelson, Caregiver

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 62 year old male patient initiated on Product A 8 weeks ago for an autoimmune skin condition who has developed severely elevated liver enzymes confirmed on blood testing, persistent nausea, and mild jaundice, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 44 year old female patient on Omeprazole for 8 weeks who developed severe hypomagnesaemia with muscle spasms, tetany, and cardiac arrhythmias documented on electrocardiogram, qualifying as an Adverse Event with Omeprazole as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Omeprazole as the non-company suspect drug."}


Instruction:
SUBJECT: Adverse event notification for Product A with Product B maintained during event
Dear Global Safety Unit,
I am writing to report an adverse reaction I have experienced with a medication I was recently prescribed.

I wish to report an adverse event. The patient experienced a 76 year old female patient on Product A for 6 weeks who experienced syncopal episodes, documented bradycardia with heart rate 38 bpm, and dizziness requiring emergency department evaluation. The cardiologist identified complete heart block temporally related to Product A initiation. The drug was stopped and a temporary pacing wire inserted.

Additionally, Product B has been prescribed for rheumatoid arthritis for 2 years with sustained disease remission and no prior history of similar adverse events. The rheumatologist has reviewed the case and confirmed that Product B is not suspected and will be continued without dose adjustment.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

Appreciatively,
Mr. Michael Shaw

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "Analysis": "The email reports an adverse event a 76 year old female patient on Product A for 6 weeks who experienced syncopal episodes, documented bradycardia with heart rate 38 bpm, and dizziness requiring emergency department evaluation, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a concomitant drug."}


Instruction:
SUBJECT: Product A adverse reaction with dual suspect Product A and Atorvastatin
Good morning,
I am writing as the caregiver for my wife Justin Peterson to report an adverse reaction they experienced with a recently started medication.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 41 year old female patient on Product A for 11 weeks who experienced recurrent pancreatitis with severe epigastric pain, serum lipase 12 times upper limit of normal, and computed tomography showing pancreatic inflammation. The gastroenterologist determined Product A as the likely causative agent and the drug was stopped with supportive care initiated.

Additionally, the patient also experienced a 63 year old female patient on Atorvastatin for 12 weeks who developed new-onset type 2 diabetes with fasting glucose 9.8 mmol/L and HbA1c 7.4%. The endocrinologist identified statin-induced dysglycaemia related to Atorvastatin and the drug was stopped with lifestyle modification and metformin therapy commenced.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Atorvastatin as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

Appreciatively,
Mrs. Timothy Roberts, Caregiver

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 41 year old female patient on Product A for 11 weeks who experienced recurrent pancreatitis with severe epigastric pain, serum lipase 12 times upper limit of normal, and computed tomography showing pancreatic inflammation, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 63 year old female patient on Atorvastatin for 12 weeks who developed new-onset type 2 diabetes with fasting glucose 9, qualifying as an Adverse Event with Atorvastatin as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Atorvastatin as the non-company suspect drug."}


Instruction:
SUBJECT: Urgent adverse event Product A and Product B as background therapy
Dear Pharmacovigilance Team,
I am the Consultant Rheumatologist at a multi-site primary care network and I am writing to formally report an adverse event involving a patient under my care.

I wish to report an adverse event. The patient experienced a 55 year old female patient who was started on Product A 11 weeks ago for a chronic inflammatory condition. Over the past 6 weeks the patient has developed severe muscle weakness across both lower limbs, significant hair loss, and persistent nausea that have substantially affected quality of life. The treating specialist reviewed the case and is confident that Product A is responsible based on temporal association and clinical presentation. Product A has been withheld and the patient is under close specialist follow-up.

Additionally, The patient has taken Product B for hyperlipidaemia for over 4 years without any previous muscle symptoms or elevation in creatine kinase levels. The treating physician has documented that Product B is concomitant medication only and is not considered responsible for the current adverse presentation.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

Sincerely,
Dr. Brandon Hayes, Consultant Rheumatologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "Analysis": "The email reports an adverse event a 55 year old female patient who was started on Product A 11 weeks ago for a chronic inflammatory condition, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a concomitant drug."}


Instruction:
SUBJECT: Product A reaction report with suspect Product B also implicated
Dear Regional Pharmacovigilance Lead,
I am the Consultant Pulmonologist at an integrated care system and I am writing to formally report an adverse event involving a patient under my care.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 62 year old male patient initiated on Product A 8 weeks ago for an autoimmune skin condition who has developed severely elevated liver enzymes confirmed on blood testing, persistent nausea, and mild jaundice. The treating hepatologist reviewed the case and determined that Product A is the most probable causative agent based on temporal relationship and known hepatic metabolism. Product A has been immediately withdrawn and the patient has been hospitalised under urgent hepatology review.

Additionally, the patient also experienced a 71 year old male patient started on Product B 5 weeks ago for rheumatoid arthritis who developed acute confusion, fever to 39.2 C, and neutropenia with an absolute neutrophil count of 0.4 x10^9/L. The infectious disease team ruled out sepsis and the haematologist attributed the event to Product B. The drug was discontinued and granulocyte colony-stimulating factor administered.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Product B as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

Respectfully,
Dr. Samantha Gray, Consultant Pulmonologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 62 year old male patient initiated on Product A 8 weeks ago for an autoimmune skin condition who has developed severely elevated liver enzymes confirmed on blood testing, persistent nausea, and mild jaundice, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 71 year old male patient started on Product B 5 weeks ago for rheumatoid arthritis who developed acute confusion, fever to 39, qualifying as an Adverse Event with Product B as a suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A and Product B as dual suspect drugs."}


Instruction:
SUBJECT: Product A adverse event and dual suspect Product A and Ibuprofen report
Dear Clinical Safety and Regulatory Affairs,
I am the Consultant Neurologist at a geriatric medicine consortium and I am writing to formally report an adverse event involving a patient under my care.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 45 year old female patient initiated on Product A 10 weeks ago who developed severe depression with suicidal ideation, insomnia, and anhedonia requiring urgent psychiatric admission. The psychiatrist determined the temporal onset strongly implicated Product A and the drug was discontinued with antidepressant therapy and close psychiatric monitoring commenced.

Additionally, the patient also experienced a 74 year old female patient on Ibuprofen for 4 weeks who developed acute kidney injury with serum creatinine 298 umol/L and reduced urine output in the setting of concurrent dehydration. The nephrologist identified Ibuprofen as the causative agent and the drug was stopped with fluid resuscitation and renal monitoring arranged.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Ibuprofen as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

Regards,
Dr. Sharon Romero, Consultant Neurologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 45 year old female patient initiated on Product A 10 weeks ago who developed severe depression with suicidal ideation, insomnia, and anhedonia requiring urgent psychiatric admission, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 74 year old female patient on Ibuprofen for 4 weeks who developed acute kidney injury with serum creatinine 298 umol/L and reduced urine output in the setting of concurrent dehydration, qualifying as an Adverse Event with Ibuprofen as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Ibuprofen as the non-company suspect drug."}


Instruction:
SUBJECT: Formal adverse event notification Product A with Amlodipine excluded as causative agent
Dear Medical Affairs and Drug Safety,
I am writing to report an adverse reaction I have experienced with a medication I was recently prescribed.

I wish to report an adverse event. The patient experienced a 60 year old male patient on Product A for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis. The dermatologist concluded the reaction was induced by Product A and the drug was stopped with photoprotection and topical therapy commenced.

Additionally, Amlodipine was started 14 months ago and has provided stable disease management with no prior episodes of acute deterioration. The specialist has reviewed the temporal relationship and explicitly excluded Amlodipine from the differential diagnosis of the current event.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

Appreciatively,
Mr. Sharon Payne

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 60 year old male patient on Product A for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis, qualifying as an Adverse Event with Product A as the suspect drug. Amlodipine is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Product A suspected adverse reaction with concomitant Product B therapy
Hi,
I am writing as the caregiver for my mother David Gordon to report an adverse reaction they experienced with a recently started medication.

I wish to report an adverse event. The patient experienced a 64 year old male patient on Product A for 13 weeks who developed progressive dysphagia, odynophagia, and severe oesophageal ulceration on endoscopy. The gastroenterologist concluded Product A was the likely aetiological factor and the drug was withdrawn with proton pump inhibitor therapy and nutritional support initiated.

Additionally, Product B was initiated 22 months ago for atrial fibrillation rate control and has maintained stable heart rhythm without any previous episodes of bradycardia or syncope. The cardiologist has reviewed the electrophysiology and confirmed that Product B is not implicated and should be continued.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

Cordially,
Mr. Joyce Marshall, Caregiver

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "Analysis": "The email reports an adverse event a 64 year old male patient on Product A for 13 weeks who developed progressive dysphagia, odynophagia, and severe oesophageal ulceration on endoscopy, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a concomitant drug."}


Instruction:
SUBJECT: Product A adverse reaction with suspect Product A with suspect Levothyroxine
Dear Regional Pharmacovigilance Lead,
I am the Consultant Hepatologist at a community health partnership covering 12 clinics and I am writing to formally report an adverse event involving a patient under my care.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 45 year old female patient initiated on Product A 10 weeks ago who developed severe depression with suicidal ideation, insomnia, and anhedonia requiring urgent psychiatric admission. The psychiatrist determined the temporal onset strongly implicated Product A and the drug was discontinued with antidepressant therapy and close psychiatric monitoring commenced.

Additionally, the patient also experienced a 42 year old female patient on Levothyroxine for 3 months who developed osteoporosis with new vertebral compression fracture on imaging and bone mineral density T-score of -3.2. The endocrinologist identified exogenous thyrotoxicosis from Levothyroxine overdose as the causative factor and the dose was adjusted with bisphosphonate therapy initiated.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Levothyroxine as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

Respectfully,
Dr. Jennifer Palmer, Consultant Hepatologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 45 year old female patient initiated on Product A 10 weeks ago who developed severe depression with suicidal ideation, insomnia, and anhedonia requiring urgent psychiatric admission, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 42 year old female patient on Levothyroxine for 3 months who developed osteoporosis with new vertebral compression fracture on imaging and bone mineral density T-score of -3, qualifying as an Adverse Event with Levothyroxine as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Levothyroxine as the non-company suspect drug."}


Instruction:
SUBJECT: Adverse event notification for Product A with Product B excluded as cause
Dear Sir or Madam,
I am the Consultant Dermatologist at a private oncology clinic group and I am writing to formally report an adverse event involving a patient under my care.

I wish to report an adverse event. The patient experienced a 34 year old female patient on Product A for 10 weeks who experienced severe abdominal pain, bloody diarrhoea more than 8 episodes per day, and colitis confirmed on flexible sigmoidoscopy. The gastroenterologist assessed the histopathology and concluded the pattern was consistent with drug-induced colitis attributed to Product A. The patient was admitted for intravenous corticosteroids and bowel rest.

Additionally, Product B has been used for inflammatory bowel disease maintenance for 2 years with sustained mucosal healing and no prior episodes of acute gastrointestinal bleeding. The gastroenterologist has reviewed the case and documented that Product B is concomitant medication only and is not implicated in the current event.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

Best regards,
Dr. Helen Ford, Consultant Dermatologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "Analysis": "The email reports an adverse event a 34 year old female patient on Product A for 10 weeks who experienced severe abdominal pain, bloody diarrhoea more than 8 episodes per day, and colitis confirmed on flexible sigmoidoscopy, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a concomitant drug."}


Instruction:
SUBJECT: Product A reaction report with historical Product B use
Dear Regional Pharmacovigilance Lead,
I am the Medical Director at a paediatric outpatient service and I am formally notifying you of an adverse event report requiring pharmacovigilance review.

I wish to report an adverse event. The patient experienced a 73 year old male patient started on Product A 6 weeks ago who developed severe thrombocytopenia with platelet count 12 x10^9/L and mucosal bleeding. The haematologist excluded other causes and attributed the event to Product A. The drug was stopped and platelet transfusion administered with haematology follow-up arranged.

With regard to medication history, Product B was used for 5 months as part of a combination regimen and was discontinued 9 months ago when the regimen was simplified with no adverse events at any point. The treating physician has confirmed Product B as historical medication and excluded it from the current differential diagnosis.

Please formally record this report and confirm if any additional historical medication details are required for your assessment.

Cordially,
Dr. Victoria Soto, Medical Director

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "Analysis": "The email reports an adverse event a 73 year old male patient started on Product A 6 weeks ago who developed severe thrombocytopenia with platelet count 12 x10^9/L and mucosal bleeding, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as historical medication that was discontinued well before the onset of the current adverse event and is explicitly documented as not relevant to the current reaction by the treating physician, qualifying as a historical drug."}


Instruction:
SUBJECT: Safety report Product A and both Product A and Levothyroxine identified as suspect
Dear Post-Marketing Surveillance Unit,
I am the Consultant Rheumatologist at a geriatric medicine consortium and I am writing to formally report an adverse event involving a patient under my care.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 67 year old female patient initiated on Product A 9 weeks ago who developed a severe generalized maculopapular rash covering more than 50% of body surface area, facial swelling, and eosinophilia. The dermatologist diagnosed a severe cutaneous adverse reaction likely due to Product A and the drug was permanently discontinued with systemic steroids initiated.

Additionally, the patient also experienced a 42 year old female patient on Levothyroxine for 3 months who developed osteoporosis with new vertebral compression fracture on imaging and bone mineral density T-score of -3.2. The endocrinologist identified exogenous thyrotoxicosis from Levothyroxine overdose as the causative factor and the dose was adjusted with bisphosphonate therapy initiated.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Levothyroxine as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

Best regards,
Dr. Karen Robertson, Consultant Rheumatologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 67 year old female patient initiated on Product A 9 weeks ago who developed a severe generalized maculopapular rash covering more than 50% of body surface area, facial swelling, and eosinophilia, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 42 year old female patient on Levothyroxine for 3 months who developed osteoporosis with new vertebral compression fracture on imaging and bone mineral density T-score of -3, qualifying as an Adverse Event with Levothyroxine as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Levothyroxine as the non-company suspect drug."}


Instruction:
SUBJECT: Suspected adverse event with Product A and suspect Product A with suspect Ibuprofen
Dear Post-Marketing Surveillance Unit,
I am the Consultant Neurologist at a geriatric medicine consortium and I am writing to formally report an adverse event involving a patient under my care.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 76 year old female patient on Product A for 6 weeks who experienced syncopal episodes, documented bradycardia with heart rate 38 bpm, and dizziness requiring emergency department evaluation. The cardiologist identified complete heart block temporally related to Product A initiation. The drug was stopped and a temporary pacing wire inserted.

Additionally, the patient also experienced a 74 year old female patient on Ibuprofen for 4 weeks who developed acute kidney injury with serum creatinine 298 umol/L and reduced urine output in the setting of concurrent dehydration. The nephrologist identified Ibuprofen as the causative agent and the drug was stopped with fluid resuscitation and renal monitoring arranged.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Ibuprofen as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

Warm regards,
Dr. Andrew Ortiz, Consultant Neurologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 76 year old female patient on Product A for 6 weeks who experienced syncopal episodes, documented bradycardia with heart rate 38 bpm, and dizziness requiring emergency department evaluation, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 74 year old female patient on Ibuprofen for 4 weeks who developed acute kidney injury with serum creatinine 298 umol/L and reduced urine output in the setting of concurrent dehydration, qualifying as an Adverse Event with Ibuprofen as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Ibuprofen as the non-company suspect drug."}


Instruction:
SUBJECT: Product A suspected reaction with concomitant Product B therapy – formal report
Dear Pharmacovigilance Team,
I am writing on behalf of a patient group member to report an adverse event involving a medication that was recently initiated.

I wish to report an adverse event. The patient experienced a 37 year old female patient initiated on Product A 8 weeks ago who developed severe headache, visual field defects, and magnetic resonance imaging confirmed cerebral venous sinus thrombosis. The neurologist and haematologist jointly concluded Product A was the likely precipitant and the drug was discontinued with anticoagulation therapy commenced.

Additionally, Product B was started 26 months ago for Parkinson disease and has provided stable motor control without any previous episodes of dyskinesia or hallucination. The neurologist has reviewed the temporal association and confirmed that Product B is not suspected and should be continued without dose adjustment.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

Yours sincerely,
Mr. Brian Holmes, Patient Representative

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "Analysis": "The email reports an adverse event a 37 year old female patient initiated on Product A 8 weeks ago who developed severe headache, visual field defects, and magnetic resonance imaging confirmed cerebral venous sinus thrombosis, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a concomitant drug."}


Instruction:
SUBJECT: Product A reaction report with Lisinopril maintained as background medication
Dear Pharmacovigilance and Risk Management Team,
I am writing to report an adverse reaction I have experienced with a medication I was recently prescribed.

I wish to report an adverse event. The patient experienced a 60 year old male patient on Product A for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis. The dermatologist concluded the reaction was induced by Product A and the drug was stopped with photoprotection and topical therapy commenced.

Additionally, Lisinopril has been used for epilepsy control for 5 years without breakthrough seizures or previous neuropsychiatric adverse events. The neurologist has reviewed the temporal association and explicitly excluded Lisinopril as a suspect drug, confirming it should be continued without change.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

Yours faithfully,
Mr. Jeffrey Gibson

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 60 year old male patient on Product A for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis, qualifying as an Adverse Event with Product A as the suspect drug. Lisinopril is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Adverse event report Product A plus Product B discontinued prior to event
To Whom It May Concern,
I am the Head of Pharmacy Services at a geriatric medicine consortium and I am submitting this adverse event report on behalf of a patient who presented to our pharmacy services.

I wish to report an adverse event. The patient experienced a 34 year old female patient on Product A for 10 weeks who experienced severe abdominal pain, bloody diarrhoea more than 8 episodes per day, and colitis confirmed on flexible sigmoidoscopy. The gastroenterologist assessed the histopathology and concluded the pattern was consistent with drug-induced colitis attributed to Product A. The patient was admitted for intravenous corticosteroids and bowel rest.

With regard to medication history, The patient completed a 3 month tapering course of Product B 16 months ago for a withdrawal protocol with no rebound symptoms or delayed adverse events observed since then. The clinician has documented Product B as historical and confirmed no association with the current adverse event.

Please formally record this report and confirm if any additional historical medication details are required for your assessment.

With appreciation,
Ms. Katherine Russell, Head of Pharmacy Services

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "Analysis": "The email reports an adverse event a 34 year old female patient on Product A for 10 weeks who experienced severe abdominal pain, bloody diarrhoea more than 8 episodes per day, and colitis confirmed on flexible sigmoidoscopy, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as historical medication that was discontinued well before the onset of the current adverse event and is explicitly documented as not relevant to the current reaction by the treating physician, qualifying as a historical drug."}


Instruction:
SUBJECT: Product A adverse event and ongoing Levothyroxine use alongside Product A report
Dear Medical Affairs and Drug Safety,
I am writing on behalf of a patient group member to report an adverse event involving a medication that was recently initiated.

I wish to report an adverse event. The patient experienced a 60 year old male patient on Product A for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis. The dermatologist concluded the reaction was induced by Product A and the drug was stopped with photoprotection and topical therapy commenced.

Additionally, The patient has received Levothyroxine for osteoporosis for 16 months with stable bone mineral density and no prior history of fracture. The endocrinologist has assessed the current event and documented that Levothyroxine is concomitant only and is not considered causative.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

With best wishes,
Mr. George Bell, Patient Representative

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 60 year old male patient on Product A for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis, qualifying as an Adverse Event with Product A as the suspect drug. Levothyroxine is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Pharmacovigilance report Product A with Omeprazole stable during Product A reaction
Dear Regional Pharmacovigilance Lead,
I am the Chief of Medicine at a residential care home network managing over 400 elderly residents across 5 facilities and I am formally notifying you of an adverse event report requiring pharmacovigilance review.

I wish to report an adverse event. The patient experienced a 37 year old female patient initiated on Product A 8 weeks ago who developed severe headache, visual field defects, and magnetic resonance imaging confirmed cerebral venous sinus thrombosis. The neurologist and haematologist jointly concluded Product A was the likely precipitant and the drug was discontinued with anticoagulation therapy commenced.

Additionally, The patient has been on Omeprazole for chronic kidney disease for 30 months with stable renal parameters and no prior episodes of acute deterioration. The nephrologist has assessed the current event and explicitly stated that Omeprazole is not a contributing factor and should be maintained at the current dose.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

Yours faithfully,
Dr. Kenneth Henry, Chief of Medicine

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 37 year old female patient initiated on Product A 8 weeks ago who developed severe headache, visual field defects, and magnetic resonance imaging confirmed cerebral venous sinus thrombosis, qualifying as an Adverse Event with Product A as the suspect drug. Omeprazole is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Urgent adverse event Product A and suspect Product B also implicated
Dear Pharmacovigilance and Risk Management Team,
I am writing to report an adverse reaction I have experienced with a medication I was recently prescribed.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 60 year old male patient on Product A for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis. The dermatologist concluded the reaction was induced by Product A and the drug was stopped with photoprotection and topical therapy commenced.

Additionally, the patient also experienced a 48 year old female patient on Product B for 14 weeks who presented with new-onset shortness of breath, dry cough, and bilateral pulmonary infiltrates on chest imaging consistent with pneumonitis. The pulmonologist excluded infectious causes and concluded Product B is the likely culprit. Product B was stopped and high-dose corticosteroids commenced with planned repeat imaging in 4 weeks.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Product B as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

Regards,
Mr. Carolyn White

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 60 year old male patient on Product A for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 48 year old female patient on Product B for 14 weeks who presented with new-onset shortness of breath, dry cough, and bilateral pulmonary infiltrates on chest imaging consistent with pneumonitis, qualifying as an Adverse Event with Product B as a suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A and Product B as dual suspect drugs."}


Instruction:
SUBJECT: Formal adverse event notification Product A with Atorvastatin also suspected by physician
Dear Drug Safety Department,
I am the Attending Physician at a pathology and diagnostics consortium and I am formally notifying you of an adverse event report requiring pharmacovigilance review.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 50 year old female patient on Product A for 15 weeks who developed severe arthralgia involving multiple joints with morning stiffness exceeding 2 hours and elevated inflammatory markers. The rheumatologist assessed the presentation as drug-induced inflammatory arthritis attributed to Product A and the drug was discontinued with symptomatic management.

Additionally, the patient also experienced a 49 year old female patient on Atorvastatin for 8 weeks who developed cognitive impairment with memory loss, confusion, and disorientation confirmed on neuropsychological testing. The neurologist identified statin-associated cognitive decline related to Atorvastatin and the drug was stopped with cognitive rehabilitation and follow-up arranged.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Atorvastatin as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

Yours sincerely,
Dr. Anthony Armstrong, Attending Physician

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 50 year old female patient on Product A for 15 weeks who developed severe arthralgia involving multiple joints with morning stiffness exceeding 2 hours and elevated inflammatory markers, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 49 year old female patient on Atorvastatin for 8 weeks who developed cognitive impairment with memory loss, confusion, and disorientation confirmed on neuropsychological testing, qualifying as an Adverse Event with Atorvastatin as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Atorvastatin as the non-company suspect drug."}


Instruction:
SUBJECT: Adverse reaction report involving Product A and Ibuprofen not implicated in adverse event
Dear Pharmacovigilance and Risk Management Team,
I am the Ward Nurse Manager at a childrens hospital outpatient department and I am documenting this adverse event report on behalf of a patient under our ward care.

I wish to report an adverse event. The patient experienced a 67 year old female patient initiated on Product A 9 weeks ago who developed a severe generalized maculopapular rash covering more than 50% of body surface area, facial swelling, and eosinophilia. The dermatologist diagnosed a severe cutaneous adverse reaction likely due to Product A and the drug was permanently discontinued with systemic steroids initiated.

Additionally, Ibuprofen was initiated 22 months ago for atrial fibrillation rate control and has maintained stable heart rhythm without any previous episodes of bradycardia or syncope. The cardiologist has reviewed the electrophysiology and confirmed that Ibuprofen is not implicated and should be continued.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

Many thanks,
Ms. Paul Meyer, Ward Nurse Manager

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 67 year old female patient initiated on Product A 9 weeks ago who developed a severe generalized maculopapular rash covering more than 50% of body surface area, facial swelling, and eosinophilia, qualifying as an Adverse Event with Product A as the suspect drug. Ibuprofen is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Urgent adverse event Product A and Product B no longer taken
Dear Sir or Madam,
I am the Consultant Rheumatologist at a gastroenterology clinic partnership and I am writing to formally report an adverse event involving a patient under my care.

I wish to report an adverse event. The patient experienced a 38 year old male patient on Product A for 12 weeks who developed acute kidney injury with serum creatinine rising from baseline 89 umol/L to 312 umol/L and reduced urine output. The nephrologist performed renal biopsy revealing acute interstitial nephritis consistent with hypersensitivity to Product A. The drug was stopped and corticosteroid therapy commenced.

With regard to medication history, The patient completed a 3 month tapering course of Product B 16 months ago for a withdrawal protocol with no rebound symptoms or delayed adverse events observed since then. The clinician has documented Product B as historical and confirmed no association with the current adverse event.

Please formally record this report and confirm if any additional historical medication details are required for your assessment.

Cordially,
Dr. Rebecca Hawkins, Consultant Rheumatologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "Analysis": "The email reports an adverse event a 38 year old male patient on Product A for 12 weeks who developed acute kidney injury with serum creatinine rising from baseline 89 umol/L to 312 umol/L and reduced urine output, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as historical medication that was discontinued well before the onset of the current adverse event and is explicitly documented as not relevant to the current reaction by the treating physician, qualifying as a historical drug."}


Instruction:
SUBJECT: Serious adverse event report Product A and suspect Product B also implicated
Dear Regional Pharmacovigilance Lead,
I am the Consultant Cardiologist at a pain management clinic group and I am writing to formally report an adverse event involving a patient under my care.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 37 year old female patient initiated on Product A 8 weeks ago who developed severe headache, visual field defects, and magnetic resonance imaging confirmed cerebral venous sinus thrombosis. The neurologist and haematologist jointly concluded Product A was the likely precipitant and the drug was discontinued with anticoagulation therapy commenced.

Additionally, the patient also experienced a 55 year old female patient who was started on Product B 11 weeks ago for a chronic inflammatory condition. Over the past 6 weeks the patient has developed severe muscle weakness across both lower limbs, significant hair loss, and persistent nausea that have substantially affected quality of life. The treating specialist reviewed the case and is confident that Product B is responsible based on temporal association and clinical presentation. Product B has been withheld and the patient is under close specialist follow-up.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Product B as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

Yours sincerely,
Dr. Catherine Crawford, Consultant Cardiologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 37 year old female patient initiated on Product A 8 weeks ago who developed severe headache, visual field defects, and magnetic resonance imaging confirmed cerebral venous sinus thrombosis, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 55 year old female patient who was started on Product B 11 weeks ago for a chronic inflammatory condition, qualifying as an Adverse Event with Product B as a suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A and Product B as dual suspect drugs."}


Instruction:
SUBJECT: Safety report Product A and physician suspects both Product A and Atorvastatin
Dear Clinical Safety and Regulatory Affairs,
I am writing to report an adverse reaction I have experienced with a medication I was recently prescribed.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 60 year old male patient on Product A for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis. The dermatologist concluded the reaction was induced by Product A and the drug was stopped with photoprotection and topical therapy commenced.

Additionally, the patient also experienced a 49 year old female patient on Atorvastatin for 8 weeks who developed cognitive impairment with memory loss, confusion, and disorientation confirmed on neuropsychological testing. The neurologist identified statin-associated cognitive decline related to Atorvastatin and the drug was stopped with cognitive rehabilitation and follow-up arranged.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Atorvastatin as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

Yours sincerely,
Ms. Michael Walker

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 60 year old male patient on Product A for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 49 year old female patient on Atorvastatin for 8 weeks who developed cognitive impairment with memory loss, confusion, and disorientation confirmed on neuropsychological testing, qualifying as an Adverse Event with Atorvastatin as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Atorvastatin as the non-company suspect drug."}


Instruction:
SUBJECT: Adverse event report Product A plus Omeprazole continued without change
Dear Drug Safety Department,
I am the Pharmacy Operations Manager at a pharmaceutical benefit manager and I am submitting this adverse event report on behalf of a patient who presented to our pharmacy services.

I wish to report an adverse event. The patient experienced a 62 year old male patient initiated on Product A 8 weeks ago for an autoimmune skin condition who has developed severely elevated liver enzymes confirmed on blood testing, persistent nausea, and mild jaundice. The treating hepatologist reviewed the case and determined that Product A is the most probable causative agent based on temporal relationship and known hepatic metabolism. Product A has been immediately withdrawn and the patient has been hospitalised under urgent hepatology review.

Additionally, Omeprazole has been used for epilepsy control for 5 years without breakthrough seizures or previous neuropsychiatric adverse events. The neurologist has reviewed the temporal association and explicitly excluded Omeprazole as a suspect drug, confirming it should be continued without change.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

Warm regards,
Mr. Virginia Rice, Pharmacy Operations Manager

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 62 year old male patient initiated on Product A 8 weeks ago for an autoimmune skin condition who has developed severely elevated liver enzymes confirmed on blood testing, persistent nausea, and mild jaundice, qualifying as an Adverse Event with Product A as the suspect drug. Omeprazole is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Suspected adverse event with Product A and Product B as background therapy
Dear Post-Marketing Surveillance Unit,
I am writing as the caregiver for my husband Robert Bradley to report an adverse reaction they experienced with a recently started medication.

I wish to report an adverse event. The patient experienced a 55 year old female patient who was started on Product A 11 weeks ago for a chronic inflammatory condition. Over the past 6 weeks the patient has developed severe muscle weakness across both lower limbs, significant hair loss, and persistent nausea that have substantially affected quality of life. The treating specialist reviewed the case and is confident that Product A is responsible based on temporal association and clinical presentation. Product A has been withheld and the patient is under close specialist follow-up.

Additionally, Product B has been prescribed for rheumatoid arthritis for 2 years with sustained disease remission and no prior history of similar adverse events. The rheumatologist has reviewed the case and confirmed that Product B is not suspected and will be continued without dose adjustment.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

Yours sincerely,
Mr. Eric Wagner, Caregiver

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "Analysis": "The email reports an adverse event a 55 year old female patient who was started on Product A 11 weeks ago for a chronic inflammatory condition, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a concomitant drug."}


Instruction:
SUBJECT: Formal adverse event notification Product A with Product B historical medication only
Dear Sir or Madam,
I am writing to report an adverse reaction I have experienced with a medication I was recently prescribed.

I wish to report an adverse event. The patient experienced a 59 year old male patient on Product A for 16 weeks who developed progressive peripheral neuropathy affecting both hands and feet with numbness, tingling, and loss of proprioception impacting daily function. The neurologist performed nerve conduction studies showing axonal degeneration and concluded Product A is the probable cause. Product A was stopped and the patient referred for rehabilitation.

With regard to medication history, Product B was administered for 4 weeks as prophylaxis 18 months ago and was not continued beyond the recommended duration with no adverse events during or after the course. The specialist has confirmed Product B as historical medication with no temporal relationship to the current symptoms.

Please formally record this report and confirm if any additional historical medication details are required for your assessment.

In professional solidarity,
Ms. Nathan Hart

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "Analysis": "The email reports an adverse event a 59 year old male patient on Product A for 16 weeks who developed progressive peripheral neuropathy affecting both hands and feet with numbness, tingling, and loss of proprioception impacting daily function, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as historical medication that was discontinued well before the onset of the current adverse event and is explicitly documented as not relevant to the current reaction by the treating physician, qualifying as a historical drug."}


Instruction:
SUBJECT: Adverse event notification for Product A with Levothyroxine concomitant medication only
Dear Patient Safety Team,
I am writing on behalf of a patient group member to report an adverse event involving a medication that was recently initiated.

I wish to report an adverse event. The patient experienced a 48 year old female patient on Product A for 14 weeks who presented with new-onset shortness of breath, dry cough, and bilateral pulmonary infiltrates on chest imaging consistent with pneumonitis. The pulmonologist excluded infectious causes and concluded Product A is the likely culprit. Product A was stopped and high-dose corticosteroids commenced with planned repeat imaging in 4 weeks.

Additionally, Levothyroxine was initiated 22 months ago for atrial fibrillation rate control and has maintained stable heart rhythm without any previous episodes of bradycardia or syncope. The cardiologist has reviewed the electrophysiology and confirmed that Levothyroxine is not implicated and should be continued.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

Cordially,
Mr. Henry Alvarez, Patient Representative

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 48 year old female patient on Product A for 14 weeks who presented with new-onset shortness of breath, dry cough, and bilateral pulmonary infiltrates on chest imaging consistent with pneumonitis, qualifying as an Adverse Event with Product A as the suspect drug. Levothyroxine is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Product A reaction report with Product B historical medication only
Dear Sir or Madam,
I am the Pharmacy Operations Manager at a community health partnership covering 12 clinics and I am submitting this adverse event report on behalf of a patient who presented to our pharmacy services.

I wish to report an adverse event. The patient experienced a 62 year old male patient initiated on Product A 8 weeks ago for an autoimmune skin condition who has developed severely elevated liver enzymes confirmed on blood testing, persistent nausea, and mild jaundice. The treating hepatologist reviewed the case and determined that Product A is the most probable causative agent based on temporal relationship and known hepatic metabolism. Product A has been immediately withdrawn and the patient has been hospitalised under urgent hepatology review.

With regard to medication history, The patient received Product B for 4 months as part of a treatment trial and stopped it 11 months ago upon completion of the protocol. The investigator has documented that Product B is historical and there is no temporal relationship to the current adverse event.

Please formally record this report and confirm if any additional historical medication details are required for your assessment.

Yours faithfully,
Mr. Stephen Stevens, Pharmacy Operations Manager

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "Analysis": "The email reports an adverse event a 62 year old male patient initiated on Product A 8 weeks ago for an autoimmune skin condition who has developed severely elevated liver enzymes confirmed on blood testing, persistent nausea, and mild jaundice, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as historical medication that was discontinued well before the onset of the current adverse event and is explicitly documented as not relevant to the current reaction by the treating physician, qualifying as a historical drug."}


Instruction:
SUBJECT: Pharmacovigilance report Product A with both Product A and Levothyroxine identified as suspect
Dear Pharmacovigilance Team,
I am the Chief of Medicine at a pharmaceutical benefit manager and I am formally notifying you of an adverse event report requiring pharmacovigilance review.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 64 year old male patient on Product A for 13 weeks who developed progressive dysphagia, odynophagia, and severe oesophageal ulceration on endoscopy. The gastroenterologist concluded Product A was the likely aetiological factor and the drug was withdrawn with proton pump inhibitor therapy and nutritional support initiated.

Additionally, the patient also experienced a 29 year old female patient on Levothyroxine for 2 months who developed symptoms of thyrotoxicosis including palpitations, weight loss, heat intolerance, and atrial fibrillation with suppressed thyroid-stimulating hormone. The endocrinologist identified dose-related Levothyroxine toxicity and the dose was reduced with beta-blocker therapy initiated.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Levothyroxine as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

Cordially,
Dr. Heather Snyder, Chief of Medicine

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 64 year old male patient on Product A for 13 weeks who developed progressive dysphagia, odynophagia, and severe oesophageal ulceration on endoscopy, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 29 year old female patient on Levothyroxine for 2 months who developed symptoms of thyrotoxicosis including palpitations, weight loss, heat intolerance, and atrial fibrillation with suppressed thyroid-stimulating hormone, qualifying as an Adverse Event with Levothyroxine as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Levothyroxine as the non-company suspect drug."}


Instruction:
SUBJECT: Product A adverse reaction with suspected Methotrexate co-reaction
Dear Global Safety Unit,
I am writing as the caregiver for my elderly aunt Brian Jackson to report an adverse reaction they experienced with a recently started medication.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 29 year old female patient started on Product A 4 weeks ago who experienced anaphylaxis within 30 minutes of dosing including urticaria, angioedema, bronchospasm, and hypotension requiring emergency adrenaline administration and intensive care admission. The allergist confirmed Product A as the trigger and the drug was permanently contraindicated.

Additionally, the patient also experienced a 36 year old female patient on Methotrexate for 16 weeks who developed acute hepatitis with alanine aminotransferase 1,240 U/L, bilirubin 68 umol/L, and right upper quadrant pain. The hepatologist attributed the event to Methotrexate and the drug was stopped with hepatology follow-up and liver function monitoring arranged.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Methotrexate as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

With best wishes,
Mrs. Emily Morales, Caregiver

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 29 year old female patient started on Product A 4 weeks ago who experienced anaphylaxis within 30 minutes of dosing including urticaria, angioedema, bronchospasm, and hypotension requiring emergency adrenaline administration and intensive care admission, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 36 year old female patient on Methotrexate for 16 weeks who developed acute hepatitis with alanine aminotransferase 1,240 U/L, bilirubin 68 umol/L, and right upper quadrant pain, qualifying as an Adverse Event with Methotrexate as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Methotrexate as the non-company suspect drug."}


Instruction:
SUBJECT: Adverse event notification for Product A with Product A and Levothyroxine both implicated
Dear Adverse Events Reporting Centre,
I am the Pharmacy Operations Manager at a surgical day case unit group and I am submitting this adverse event report on behalf of a patient who presented to our pharmacy services.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 53 year old female patient started on Product A 7 weeks ago who developed profound fatigue, pallor, and symptomatic anaemia with haemoglobin of 7.2 g/dL. The haematologist identified bone marrow suppression attributed to Product A and the drug was immediately discontinued. The patient required packed red blood cell transfusion and close monitoring.

Additionally, the patient also experienced a 42 year old female patient on Levothyroxine for 3 months who developed osteoporosis with new vertebral compression fracture on imaging and bone mineral density T-score of -3.2. The endocrinologist identified exogenous thyrotoxicosis from Levothyroxine overdose as the causative factor and the dose was adjusted with bisphosphonate therapy initiated.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Levothyroxine as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

Sincerely,
Mr. Victoria Washington, Pharmacy Operations Manager

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 53 year old female patient started on Product A 7 weeks ago who developed profound fatigue, pallor, and symptomatic anaemia with haemoglobin of 7, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 42 year old female patient on Levothyroxine for 3 months who developed osteoporosis with new vertebral compression fracture on imaging and bone mineral density T-score of -3, qualifying as an Adverse Event with Levothyroxine as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Levothyroxine as the non-company suspect drug."}


Instruction:
SUBJECT: Suspected adverse event with Product A and Product B implicated only as concomitant
Dear Adverse Events Reporting Centre,
I am writing on behalf of a patient group member to report an adverse event involving a medication that was recently initiated.

I wish to report an adverse event. The patient experienced a 55 year old female patient who was started on Product A 11 weeks ago for a chronic inflammatory condition. Over the past 6 weeks the patient has developed severe muscle weakness across both lower limbs, significant hair loss, and persistent nausea that have substantially affected quality of life. The treating specialist reviewed the case and is confident that Product A is responsible based on temporal association and clinical presentation. Product A has been withheld and the patient is under close specialist follow-up.

Additionally, Product B was started 20 months ago for depression and has provided sustained symptom remission without any previous episodes of mood alteration or behavioural change. The psychiatrist has reviewed the case and documented that Product B is concomitant medication only and is not considered a causative agent.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

In professional solidarity,
Mr. Brenda Robertson, Patient Representative

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "Analysis": "The email reports an adverse event a 55 year old female patient who was started on Product A 11 weeks ago for a chronic inflammatory condition, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a concomitant drug."}


Instruction:
SUBJECT: Adverse event report Product A plus Metformin excluded as causative agent
Dear Patient Safety Team,
I am the Consultant Rheumatologist at a corporate occupational health provider and I am writing to formally report an adverse event involving a patient under my care.

I wish to report an adverse event. The patient experienced a 58 year old male patient on Product A for 18 weeks who developed new-onset atrial fibrillation with rapid ventricular response, palpitations, and dyspnoea requiring electrical cardioversion and anticoagulation. The cardiologist identified Product A as a probable contributing factor and the drug was stopped with appropriate cardiac therapy instituted.

Additionally, The patient has been on Metformin for over 2 years without any adverse effects and continues to take it without any change in dose or regimen. The treating physician has explicitly confirmed that Metformin is not considered a contributing factor to the current adverse event and will remain unchanged in the treatment plan.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

With best wishes,
Dr. Richard Bennett, Consultant Rheumatologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 58 year old male patient on Product A for 18 weeks who developed new-onset atrial fibrillation with rapid ventricular response, palpitations, and dyspnoea requiring electrical cardioversion and anticoagulation, qualifying as an Adverse Event with Product A as the suspect drug. Metformin is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Formal adverse event notification Product A with suspect Product B also implicated
Dear Patient Safety Team,
I am writing as the caregiver for my elderly aunt Patrick Arnold to report an adverse reaction they experienced with a recently started medication.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 67 year old female patient initiated on Product A 9 weeks ago who developed a severe generalized maculopapular rash covering more than 50% of body surface area, facial swelling, and eosinophilia. The dermatologist diagnosed a severe cutaneous adverse reaction likely due to Product A and the drug was permanently discontinued with systemic steroids initiated.

Additionally, the patient also experienced a 53 year old female patient started on Product B 7 weeks ago who developed profound fatigue, pallor, and symptomatic anaemia with haemoglobin of 7.2 g/dL. The haematologist identified bone marrow suppression attributed to Product B and the drug was immediately discontinued. The patient required packed red blood cell transfusion and close monitoring.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Product B as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

Many thanks,
Mr. Jennifer Romero, Caregiver

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 67 year old female patient initiated on Product A 9 weeks ago who developed a severe generalized maculopapular rash covering more than 50% of body surface area, facial swelling, and eosinophilia, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 53 year old female patient started on Product B 7 weeks ago who developed profound fatigue, pallor, and symptomatic anaemia with haemoglobin of 7, qualifying as an Adverse Event with Product B as a suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A and Product B as dual suspect drugs."}


Instruction:
SUBJECT: Adverse event notification for Product A with Omeprazole continued without change
Hi,
I am the Director of Clinical Services at a paediatric outpatient service and I am formally notifying you of an adverse event report requiring pharmacovigilance review.

I wish to report an adverse event. The patient experienced a 50 year old female patient on Product A for 15 weeks who developed severe arthralgia involving multiple joints with morning stiffness exceeding 2 hours and elevated inflammatory markers. The rheumatologist assessed the presentation as drug-induced inflammatory arthritis attributed to Product A and the drug was discontinued with symptomatic management.

Additionally, Omeprazole was started 14 months ago and has provided stable disease management with no prior episodes of acute deterioration. The specialist has reviewed the temporal relationship and explicitly excluded Omeprazole from the differential diagnosis of the current event.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

Kind regards,
Dr. Susan Miller, Director of Clinical Services

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 50 year old female patient on Product A for 15 weeks who developed severe arthralgia involving multiple joints with morning stiffness exceeding 2 hours and elevated inflammatory markers, qualifying as an Adverse Event with Product A as the suspect drug. Omeprazole is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Product A reaction and Product A and Amlodipine jointly suspected formal notification
Dear Corporate Drug Safety Department,
I am the Clinical Pharmacy Director at a childrens hospital outpatient department and I am submitting this adverse event report on behalf of a patient who presented to our pharmacy services.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 60 year old male patient on Product A for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis. The dermatologist concluded the reaction was induced by Product A and the drug was stopped with photoprotection and topical therapy commenced.

Additionally, the patient also experienced a 69 year old male patient on Amlodipine for 7 weeks who developed severe gingival hyperplasia with bleeding gums and difficulty eating confirmed on dental examination. The dentist and cardiologist jointly identified Amlodipine as the causative agent and the drug was stopped with dental debridement and alternative antihypertensive therapy commenced.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Amlodipine as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

Appreciatively,
Dr. Emily Smith, Clinical Pharmacy Director

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 60 year old male patient on Product A for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 69 year old male patient on Amlodipine for 7 weeks who developed severe gingival hyperplasia with bleeding gums and difficulty eating confirmed on dental examination, qualifying as an Adverse Event with Amlodipine as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Amlodipine as the non-company suspect drug."}


Instruction:
SUBJECT: Product A adverse event and Metformin stable during Product A reaction report
Dear Sir or Madam,
I am writing to report an adverse reaction I have experienced with a medication I was recently prescribed.

I wish to report an adverse event. The patient experienced a 67 year old female patient initiated on Product A 9 weeks ago who developed a severe generalized maculopapular rash covering more than 50% of body surface area, facial swelling, and eosinophilia. The dermatologist diagnosed a severe cutaneous adverse reaction likely due to Product A and the drug was permanently discontinued with systemic steroids initiated.

Additionally, Metformin was initiated 22 months ago for atrial fibrillation rate control and has maintained stable heart rhythm without any previous episodes of bradycardia or syncope. The cardiologist has reviewed the electrophysiology and confirmed that Metformin is not implicated and should be continued.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

Kind regards,
Ms. Brian James

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 67 year old female patient initiated on Product A 9 weeks ago who developed a severe generalized maculopapular rash covering more than 50% of body surface area, facial swelling, and eosinophilia, qualifying as an Adverse Event with Product A as the suspect drug. Metformin is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Pharmacovigilance report Product A with suspect Product B also implicated
Dear Medical Affairs and Drug Safety,
I am writing to report an adverse reaction I have experienced with a medication I was recently prescribed.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 53 year old female patient started on Product A 7 weeks ago who developed profound fatigue, pallor, and symptomatic anaemia with haemoglobin of 7.2 g/dL. The haematologist identified bone marrow suppression attributed to Product A and the drug was immediately discontinued. The patient required packed red blood cell transfusion and close monitoring.

Additionally, the patient also experienced a 29 year old female patient started on Product B 4 weeks ago who experienced anaphylaxis within 30 minutes of dosing including urticaria, angioedema, bronchospasm, and hypotension requiring emergency adrenaline administration and intensive care admission. The allergist confirmed Product B as the trigger and the drug was permanently contraindicated.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Product B as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

Yours sincerely,
Ms. Melissa Holmes

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 53 year old female patient started on Product A 7 weeks ago who developed profound fatigue, pallor, and symptomatic anaemia with haemoglobin of 7, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 29 year old female patient started on Product B 4 weeks ago who experienced anaphylaxis within 30 minutes of dosing including urticaria, angioedema, bronchospasm, and hypotension requiring emergency adrenaline administration and intensive care admission, qualifying as an Adverse Event with Product B as a suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A and Product B as dual suspect drugs."}


Instruction:
SUBJECT: Adverse event notification for Product A with Product B unchanged during reaction
Dear Corporate Drug Safety Department,
I am writing as the caregiver for my mother Sharon Delgado to report an adverse reaction they experienced with a recently started medication.

I wish to report an adverse event. The patient experienced a 64 year old male patient on Product A for 13 weeks who developed progressive dysphagia, odynophagia, and severe oesophageal ulceration on endoscopy. The gastroenterologist concluded Product A was the likely aetiological factor and the drug was withdrawn with proton pump inhibitor therapy and nutritional support initiated.

Additionally, The patient has been on Product B for glaucoma for 3 years with stable intraocular pressure and no prior history of visual disturbance or ocular adverse events. The ophthalmologist has assessed the current presentation and confirmed that Product B is not suspected and should be continued.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

With best wishes,
Mrs. Melissa Watson, Caregiver

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "Analysis": "The email reports an adverse event a 64 year old male patient on Product A for 13 weeks who developed progressive dysphagia, odynophagia, and severe oesophageal ulceration on endoscopy, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a concomitant drug."}


Instruction:
SUBJECT: Pharmacovigilance report Product A with suspect Product B also implicated
Dear Regional Pharmacovigilance Lead,
I am writing on behalf of a patient group member to report an adverse event involving a medication that was recently initiated.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 42 year old male patient on Product A for 20 weeks who presented with new visual disturbances, blurred vision, and bilateral optic disc swelling on ophthalmic examination. The neuro-ophthalmologist identified the findings as consistent with drug-induced papilloedema related to Product A. The drug was stopped and lumbar puncture performed to exclude intracranial hypertension.

Additionally, the patient also experienced a 60 year old male patient on Product B for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis. The dermatologist concluded the reaction was induced by Product B and the drug was stopped with photoprotection and topical therapy commenced.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Product B as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

With best wishes,
Ms. Michael Hoffman, Patient Advocate

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 42 year old male patient on Product A for 20 weeks who presented with new visual disturbances, blurred vision, and bilateral optic disc swelling on ophthalmic examination, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 60 year old male patient on Product B for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis, qualifying as an Adverse Event with Product B as a suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A and Product B as dual suspect drugs."}


Instruction:
SUBJECT: Adverse event notification for Product A with Lisinopril stable during Product A reaction
Dear Regional Pharmacovigilance Lead,
I am the Attending Physician at a surgical day case unit group and I am formally notifying you of an adverse event report requiring pharmacovigilance review.

I wish to report an adverse event. The patient experienced a 34 year old female patient on Product A for 10 weeks who experienced severe abdominal pain, bloody diarrhoea more than 8 episodes per day, and colitis confirmed on flexible sigmoidoscopy. The gastroenterologist assessed the histopathology and concluded the pattern was consistent with drug-induced colitis attributed to Product A. The patient was admitted for intravenous corticosteroids and bowel rest.

Additionally, The patient has been on Lisinopril for chronic kidney disease for 30 months with stable renal parameters and no prior episodes of acute deterioration. The nephrologist has assessed the current event and explicitly stated that Lisinopril is not a contributing factor and should be maintained at the current dose.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

Cordially,
Dr. Patricia Smith, Attending Physician

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 34 year old female patient on Product A for 10 weeks who experienced severe abdominal pain, bloody diarrhoea more than 8 episodes per day, and colitis confirmed on flexible sigmoidoscopy, qualifying as an Adverse Event with Product A as the suspect drug. Lisinopril is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Product A reaction report with Product B historical medication only
Dear Adverse Events Reporting Centre,
I am the Consultant Cardiologist at a specialist dermatology centre and I am writing to formally report an adverse event involving a patient under my care.

I wish to report an adverse event. The patient experienced a 45 year old female patient initiated on Product A 10 weeks ago who developed severe depression with suicidal ideation, insomnia, and anhedonia requiring urgent psychiatric admission. The psychiatrist determined the temporal onset strongly implicated Product A and the drug was discontinued with antidepressant therapy and close psychiatric monitoring commenced.

With regard to medication history, Product B was used for 2 months as a short-term bridging therapy and was stopped 12 months ago with no complications during treatment or follow-up. The treating physician has confirmed Product B as historical medication and excluded it from consideration in the current adverse event.

Please formally record this report and confirm if any additional historical medication details are required for your assessment.

Many thanks,
Dr. Stephanie Santos, Consultant Cardiologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "Analysis": "The email reports an adverse event a 45 year old female patient initiated on Product A 10 weeks ago who developed severe depression with suicidal ideation, insomnia, and anhedonia requiring urgent psychiatric admission, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as historical medication that was discontinued well before the onset of the current adverse event and is explicitly documented as not relevant to the current reaction by the treating physician, qualifying as a historical drug."}


Instruction:
SUBJECT: Product A adverse event and Amlodipine stable during Product A reaction report
Dear Regional Pharmacovigilance Lead,
I am the Consultant Neurologist at a pathology and diagnostics consortium and I am writing to formally report an adverse event involving a patient under my care.

I wish to report an adverse event. The patient experienced a 55 year old female patient who was started on Product A 11 weeks ago for a chronic inflammatory condition. Over the past 6 weeks the patient has developed severe muscle weakness across both lower limbs, significant hair loss, and persistent nausea that have substantially affected quality of life. The treating specialist reviewed the case and is confident that Product A is responsible based on temporal association and clinical presentation. Product A has been withheld and the patient is under close specialist follow-up.

Additionally, Amlodipine has been prescribed for rheumatoid arthritis for 2 years with sustained disease remission and no prior history of similar adverse events. The rheumatologist has reviewed the case and confirmed that Amlodipine is not suspected and will be continued without dose adjustment.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

Sincerely,
Dr. Angela Russell, Consultant Neurologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 55 year old female patient who was started on Product A 11 weeks ago for a chronic inflammatory condition, qualifying as an Adverse Event with Product A as the suspect drug. Amlodipine is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Formal adverse event notification Product A with suspect Product B also implicated
Dear Clinical Safety and Regulatory Affairs,
I am writing on behalf of a patient group member to report an adverse event involving a medication that was recently initiated.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 41 year old female patient on Product A for 11 weeks who experienced recurrent pancreatitis with severe epigastric pain, serum lipase 12 times upper limit of normal, and computed tomography showing pancreatic inflammation. The gastroenterologist determined Product A as the likely causative agent and the drug was stopped with supportive care initiated.

Additionally, the patient also experienced a 41 year old female patient on Product B for 11 weeks who experienced recurrent pancreatitis with severe epigastric pain, serum lipase 12 times upper limit of normal, and computed tomography showing pancreatic inflammation. The gastroenterologist determined Product B as the likely causative agent and the drug was stopped with supportive care initiated.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Product B as causative agents. Both drugs have been stopped and the patient is under close monitoring.

Please investigate this dual suspect drug report urgently.

With best wishes,
Mr. Michelle Young, Patient Representative

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 41 year old female patient on Product A for 11 weeks who experienced recurrent pancreatitis with severe epigastric pain, serum lipase 12 times upper limit of normal, and computed tomography showing pancreatic inflammation, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 41 year old female patient on Product B for 11 weeks who experienced recurrent pancreatitis with severe epigastric pain, serum lipase 12 times upper limit of normal, and computed tomography showing pancreatic inflammation, qualifying as an Adverse Event with Product B as a suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A and Product B as dual suspect drugs."}


Instruction:
SUBJECT: Product A reaction and Ibuprofen concomitant medication only formal notification
Dear Regional Pharmacovigilance Lead,
I am writing as the caregiver for my sister Nancy Webb to report an adverse reaction they experienced with a recently started medication.

I wish to report an adverse event. The patient experienced a 34 year old female patient on Product A for 10 weeks who experienced severe abdominal pain, bloody diarrhoea more than 8 episodes per day, and colitis confirmed on flexible sigmoidoscopy. The gastroenterologist assessed the histopathology and concluded the pattern was consistent with drug-induced colitis attributed to Product A. The patient was admitted for intravenous corticosteroids and bowel rest.

Additionally, The patient has received Ibuprofen for osteoporosis for 16 months with stable bone mineral density and no prior history of fracture. The endocrinologist has assessed the current event and documented that Ibuprofen is concomitant only and is not considered causative.

Please formally record this report in your pharmacovigilance database and advise on any additional documentation required.

Regards,
Mrs. Dennis Williams, Caregiver

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 34 year old female patient on Product A for 10 weeks who experienced severe abdominal pain, bloody diarrhoea more than 8 episodes per day, and colitis confirmed on flexible sigmoidoscopy, qualifying as an Adverse Event with Product A as the suspect drug. Ibuprofen is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}