Instruction:
SUBJECT: Safety report Product A and Product B taken alongside
Dear Post-Marketing Surveillance Unit,
I am the Attending Physician at a university hospital department 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 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, Product B was initiated 10 months ago for multiple sclerosis relapse prevention and has maintained stable disease activity on magnetic resonance imaging surveillance. The neurologist has reviewed the case and explicitly excluded Product B from the list of suspect medications for the current adverse event.

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

With appreciation,
Dr. Douglas Webb, Attending Physician

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "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. 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 notification for Product A with Product A and Amoxicillin jointly suspected
Dear Pharmacovigilance Team,
I am the Clinical Pharmacy Director at a specialist dermatology centre 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 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, the patient also experienced a 31 year old female patient treated with Amoxicillin for 5 days who developed a severe widespread erythematous rash with mucosal involvement and target lesions consistent with Stevens-Johnson syndrome. The allergist attributed the reaction to Amoxicillin and the drug was stopped with immediate dermatology and ophthalmology referral.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Amoxicillin 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. Lisa Kelley, Clinical Pharmacy Director

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 a suspect drug. The email additionally reports another adverse event a 31 year old female patient treated with Amoxicillin for 5 days who developed a severe widespread erythematous rash with mucosal involvement and target lesions consistent with Stevens-Johnson syndrome, qualifying as an Adverse Event with Amoxicillin 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 Amoxicillin as the non-company suspect drug."}


Instruction:
SUBJECT: Product A suspected reaction with suspect Product B also implicated – formal report
Dear Corporate Drug Safety Department,
I am the Consultant Dermatologist at a rural district hospital 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 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 73 year old male patient started on Product B 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 B. The drug was stopped and platelet transfusion administered with haematology follow-up arranged.

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.

Appreciatively,
Dr. Jerry Hicks, Consultant Dermatologist

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 73 year old male patient started on Product B 6 weeks ago who developed severe thrombocytopenia with platelet count 12 x10^9/L and mucosal bleeding, 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: Serious adverse event report Product A and suspect Product B also implicated
Dear Adverse Events Reporting Centre,
I am the Medical Director at a Veterans Affairs medical centre 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 68 year old male patient started on Product A 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 A. The drug was discontinued and granulocyte colony-stimulating factor administered.

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.

Regards,
Dr. Kimberly Sanders, Medical Director

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 68 year old male patient started on Product A 5 weeks ago for rheumatoid arthritis who developed acute confusion, fever to 39, 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 reaction report involving Product A and dual drug reaction Product A and Atorvastatin
Dear Adverse Events Reporting Centre,
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 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 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.

Kind regards,
Mr. Jason Nelson

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 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: Suspected adverse event with Product A and suspect Product B also implicated
Dear Post-Marketing Surveillance Unit,
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 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 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.

Kind regards,
Ms. Douglas Carroll

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 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: Product A adverse reaction with Product B prior use not relevant
Dear Drug Safety Department,
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 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.

With regard to medication history, Product B was prescribed for 6 months but was stopped by the patient 7 months ago due to perceived lack of efficacy with no adverse events reported during use. The treating physician has confirmed Product B as historical medication and excluded it from the current causality assessment.

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

Cordially,
Mr. Joyce Marshall, Patient Representative

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "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. 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 suspected reaction with ongoing Methotrexate use alongside Product A – formal report
Dear Drug Safety Department,
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 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, Methotrexate 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 Methotrexate from the differential diagnosis of the current event.

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

Yours faithfully,
Mr. Emily Robertson, Patient Representative

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. Methotrexate 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 Levothyroxine taken concurrently not suspected formal notification
Dear Corporate Drug Safety Department,
I am the Ward Nurse Manager at a university hospital 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 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 Levothyroxine 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 Levothyroxine 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,
Ms. Joshua Morris, Ward Nurse Manager

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 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 suspected adverse reaction with Product B stopped months ago
To Whom It May Concern,
I am the Director of Clinical Services at a childrens hospital outpatient department 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.

With regard to medication history, The patient completed a 3 month course of Product B 14 months ago for an acute infection and has not taken it since. The infectious disease specialist has reviewed the history and explicitly documented Product B as historical with no relevance to the current symptoms.

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

Best regards,
Dr. Karen Perry, Director of Clinical 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 reaction and Amlodipine concomitant medication only formal notification
Dear Regional Pharmacovigilance Lead,
I am writing as the caregiver for my husband Kimberly Robertson 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, Amlodipine 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 Amlodipine 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,
Mr. Katherine Lewis, Caregiver

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: Product A adverse event and Ibuprofen not implicated in adverse event report
Dear Global Safety Unit,
I am the Consultant Endocrinologist at a childrens hospital outpatient department 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 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, Ibuprofen was initiated 18 months ago for a chronic condition and has been well tolerated throughout with stable parameters documented on serial follow-ups. The specialist has reviewed the case and explicitly stated that Ibuprofen is not implicated in the current presentation and should be continued without interruption.

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

With best wishes,
Dr. Joyce Allen, Consultant Endocrinologist

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. 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 suspect Product B also implicated
Dear Post-Marketing Surveillance Unit,
I am the Pharmacy Operations Manager at a specialist neurology centre 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 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 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.

With appreciation,
Mr. Brian Bell, Pharmacy Operations Manager

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 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: Adverse event report Product A plus concurrent Product B use
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 an adverse event. 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, Product B was initiated 10 months ago for multiple sclerosis relapse prevention and has maintained stable disease activity on magnetic resonance imaging surveillance. The neurologist has reviewed the case and explicitly excluded Product B from the list of suspect medications for the current adverse event.

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

Regards,
Mr. Katherine Ford

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "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 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 suspected adverse reaction with suspect Product B also implicated
Dear Regional Pharmacovigilance Lead,
I am the Director of Clinical Services at a multi-site primary care network 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 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.

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.

Sincerely,
Dr. Anna Duncan, Director of Clinical Services

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "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 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: Product A suspected reaction with Lisinopril concomitant medication only – formal report
Dear Pharmacovigilance Team,
I am the Consultant Hepatologist at a childrens hospital outpatient department 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, The patient has taken Lisinopril for over 4 years without any previous adverse events of this nature. The treating physician has documented that Lisinopril 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.

Yours faithfully,
Dr. Brenda Henderson, Consultant Hepatologist

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: Adverse event report Product A plus Product B stopped before symptoms began
Dear Adverse Events Reporting Centre,
I am the Consultant Neurologist at a rehabilitation and long-term care facility 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 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.

With regard to medication history, Product B was prescribed for 8 weeks for an acute exacerbation and was completed 11 months ago with full recovery and no delayed complications on long-term follow-up. The clinician has confirmed Product B as historical medication with no relevance to the current adverse event.

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

Warm regards,
Dr. Timothy James, Consultant Neurologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "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 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 reaction and Lisinopril taken concurrently not suspected formal notification
Dear Sir or Madam,
I am writing as the caregiver for my father Linda Rose to report an adverse reaction they experienced with a recently started medication.

I wish to report an adverse event. 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, Lisinopril 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 Lisinopril is not implicated and should be continued.

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

With best wishes,
Mrs. Margaret Henderson, Caregiver

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 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 suspected adverse reaction with Product B no current exposure
Dear Pharmacovigilance and Risk Management Team,
I am the Clinical Pharmacist at a pathology and diagnostics 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 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 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.

Thank you,
Dr. Rebecca Lee, Clinical Pharmacist

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: Product A reaction report with suspect Product A with suspect Methotrexate
Dear Corporate Drug Safety Department,
I am writing as the caregiver for my mother Deborah Nichols 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 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 also experienced a 51 year old female patient on Methotrexate for 11 weeks who developed pancytopenia with white blood cell count 1.2 x10^9/L, haemoglobin 6.8 g/dL, and platelet count 18 x10^9/L with mucosal ulceration. The haematologist attributed the event to Methotrexate toxicity and the drug was stopped with folinic acid rescue and blood product support initiated.

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. Frank Green, Caregiver

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 a suspect drug. The email additionally reports another adverse event a 51 year old female patient on Methotrexate for 11 weeks who developed pancytopenia with white blood cell count 1, 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: Urgent adverse event Product A and suspect Product B also implicated
Dear Global Safety Unit,
I am the Consultant Nephrologist at a university hospital department 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 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 34 year old female patient on Product B 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 B. The patient was admitted for intravenous corticosteroids and bowel rest.

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.

Warm regards,
Dr. Larry Russell, Consultant Nephrologist

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 34 year old female patient on Product B 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 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 Metformin also suspected by physician
Dear Corporate Drug Safety Department,
I am the Director of Clinical Services 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 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 72 year old female patient on Metformin for 14 months who presented with new-onset severe lactic acidosis with blood lactate 8.4 mmol/L, abdominal pain, and altered mental status. The nephrologist attributed the event to Metformin given the temporal association and the patient was immediately taken off the drug with urgent haemodialysis commenced.

The treating physician has reviewed both temporal associations and clinical presentations and explicitly suspects both Product A and Metformin 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. Rebecca Ramirez, Director of Clinical Services

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 72 year old female patient on Metformin for 14 months who presented with new-onset severe lactic acidosis with blood lactate 8, qualifying as an Adverse Event with Metformin 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 Metformin as the non-company suspect drug."}


Instruction:
SUBJECT: Formal adverse event notification Product A with Product B no longer taken
Dear Regional Pharmacovigilance Lead,
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 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.

With regard to medication history, Product B was used intermittently over a 5 month period and was last taken 10 months ago with no adverse events at any point during exposure. The clinician has confirmed that Product B is historical medication and is not considered in the differential diagnosis of the current event.

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

Cordially,
Mr. Christine Murphy

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "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. 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 dual suspect Product A and Atorvastatin
Dear Post-Marketing Surveillance Unit,
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 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 56 year old male patient started on Atorvastatin 7 weeks ago who developed severe myalgia, creatine kinase levels of 12,400 U/L, and dark urine consistent with rhabdomyolysis. The cardiologist identified Atorvastatin as the causative agent and the drug was permanently discontinued with aggressive fluid resuscitation initiated.

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.

Regards,
Mr. Daniel Powell

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 56 year old male patient started on Atorvastatin 7 weeks ago who developed severe myalgia, creatine kinase levels of 12,400 U/L, and dark urine consistent with rhabdomyolysis, 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 historical exposure documented
Dear Pharmacovigilance Team,
I am writing as the caregiver for my elderly aunt Joshua Schmidt to report an adverse reaction they experienced with a recently started medication.

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.

With regard to medication history, The patient was maintained on Product B for 15 months and was switched to a newer agent 7 months ago due to updated guidelines with no adverse events during the transition. The specialist has documented Product B as historical and stated it is not implicated in the current presentation.

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

Best regards,
Mr. Susan Thomas, Caregiver

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "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 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 reaction with ongoing Product B treatment
Dear Corporate Drug Safety Department,
I am the Consultant Dermatologist at a large endocrinology 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 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 has received Product B 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 Product B 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 appreciation,
Dr. Katherine Knight, Consultant Dermatologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "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 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 Atorvastatin not implicated in adverse event
Dear Regional Pharmacovigilance Lead,
I am the Ward Nurse Manager at a hepatology referral centre 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 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 has been on Atorvastatin 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 Atorvastatin 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.

Cordially,
Ms. Nicholas Patel, Ward Nurse Manager

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 the suspect drug. Atorvastatin 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 adverse event and suspect Product B also implicated report
Dear Post-Marketing Surveillance Unit,
I am the Medical Director at a tertiary referral hospital 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 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 67 year old female patient initiated on Product B 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 B and the drug was permanently discontinued with systemic steroids 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.

Kind regards,
Dr. Michelle Freeman, Medical Director

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 67 year old female patient initiated on Product B 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 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: Suspected adverse event with Product A and Lisinopril excluded as causative agent
Dear Corporate Drug Safety Department,
I am the Clinical Pharmacy Director at an immunology and allergy clinic 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 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 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.

Respectfully,
Dr. Joyce Holmes, Clinical Pharmacy Director

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 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 adverse event and Lisinopril concomitant medication only report
Dear Pharmacovigilance Team,
I am the Medical Director at a specialist neurology centre 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 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.

Additionally, Lisinopril 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 Lisinopril is not implicated and should be continued.

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

Yours faithfully,
Dr. Anthony Knight, Medical Director

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "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. 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 reaction report involving Product A and previous Product B therapy
Dear Clinical Safety and Regulatory Affairs,
I am the Chief of Medicine at a mental health trust 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 prescribed for 6 months but was stopped by the patient 7 months ago due to perceived lack of efficacy with no adverse events reported during use. The treating physician has confirmed Product B as historical medication and excluded it from the current causality assessment.

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

Thank you,
Dr. Kathleen Munoz, Chief of Medicine

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: Serious adverse event report Product A and Atorvastatin stable during Product A reaction
Dear Adverse Events Reporting Centre,
I am the Director of Clinical Services at a mental health trust 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, The patient has received Atorvastatin 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 Atorvastatin is concomitant only and is not considered causative.

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

Sincerely,
Dr. Carol Vargas, 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. Atorvastatin 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 stopped before symptoms began
Dear Patient Safety Team,
I am the Chief of Medicine at a corporate occupational health provider 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 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.

With regard to medication history, Product B was administered for 16 weeks as part of a chemotherapy regimen and was completed 13 months ago with no long-term complications observed on follow-up. The oncologist has confirmed Product B as historical medication with no temporal or biological relationship to the current presentation.

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

With appreciation,
Dr. Richard Vazquez, Chief of Medicine

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "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. 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 suspect Product B also implicated
Dear Sir or Madam,
I am writing as the caregiver for my father Andrew Castro 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 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.

Additionally, the patient also experienced a 59 year old male patient on Product B 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 B is the probable cause. Product B was stopped and the patient referred for rehabilitation.

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 faithfully,
Mrs. Julie Hudson, Caregiver

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "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 a suspect drug. The email additionally reports another adverse event a 59 year old male patient on Product B 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 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 report Product A plus Product B not currently administered
Dear Pharmacovigilance Team,
I am the Attending Physician at a specialist dermatology centre 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.

With regard to medication history, Product B was prescribed for 8 weeks for an acute exacerbation and was completed 11 months ago with full recovery and no delayed complications on long-term follow-up. The clinician has confirmed Product B as historical medication with no relevance to the current adverse event.

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

Yours sincerely,
Dr. Paul Porter, Attending Physician

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "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. 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: Formal adverse event notification Product A with ongoing Product B treatment
Dear Sir or Madam,
I am writing as the caregiver for my sister Jacob Kelly to report an adverse reaction they experienced with a recently started medication.

I wish to report an adverse event. 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 has been maintained on Product B for type 2 diabetes for 3 years with good glycaemic control and no history of hypoglycaemic episodes. The endocrinologist has assessed the current symptoms and confirmed that Product B is not suspected as a causative agent and should be continued as prescribed.

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

Yours faithfully,
Mr. Scott Rodriguez, Caregiver

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "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 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: Urgent adverse event Product A and past Product B exposure
Dear Patient Safety Team,
I am the Consultant Hepatologist at a respiratory medicine 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 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, The patient used Product B for 7 months but switched to an alternative agent 8 months ago due to formulary change with no adverse events during or after the switch. The treating physician has documented Product B as historical and explicitly excluded it from the current causality assessment.

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

Best regards,
Dr. Jessica Bell, Consultant Hepatologist

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: Formal adverse event notification Product A with Product B completed course before reaction
Dear Medical Affairs and Drug Safety,
I am writing as the caregiver for my father Charles Vargas to report an adverse reaction they experienced with a recently started medication.

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.

With regard to medication history, The patient completed a standard 6 month course of Product B 4 months ago for a chronic condition and has been off the drug since with no withdrawal effects or delayed adverse events. The specialist has documented Product B as historical and stated it is not relevant to the current presentation.

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

Thank you,
Mrs. Nathan Kelley, Caregiver

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "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. 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 reaction and previous Product B therapy formal notification
Hi,
I am the Chief of Medicine at a Veterans Affairs medical centre 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 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.

With regard to medication history, The patient used Product B for 7 months but switched to an alternative agent 8 months ago due to formulary change with no adverse events during or after the switch. The treating physician has documented Product B as historical and explicitly excluded it from the current causality assessment.

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

With appreciation,
Dr. Douglas Edwards, Chief of Medicine

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "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 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 suspected adverse reaction with Product B no current exposure
Dear Sir or Madam,
I am the Senior Consultant at a managed care organisation 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 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.

With regard to medication history, The patient was on Product B for 11 months and self-discontinued it 3 months ago after symptom resolution with no medical advice to the contrary and no adverse events reported. The clinician has documented Product B as historical and stated there is no association with the current event.

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

In professional solidarity,
Dr. Paul Stewart, Senior Consultant

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "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 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 suspected reaction with Product B completed treatment historically – formal report
To Whom It May Concern,
I am the Consultant Pulmonologist at a home healthcare nursing agency 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 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.

With regard to medication history, The patient was maintained on Product B for 15 months and was switched to a newer agent 7 months ago due to updated guidelines with no adverse events during the transition. The specialist has documented Product B as historical and stated it is not implicated in the current presentation.

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

Appreciatively,
Dr. Michael Elliott, Consultant Pulmonologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "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. 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 reaction report with Product B stopped months ago
Dear Global Safety Unit,
I am the Senior Nurse Practitioner at a respiratory medicine centre 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 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, Product B was administered for 16 weeks as part of a chemotherapy regimen and was completed 13 months ago with no long-term complications observed on follow-up. The oncologist has confirmed Product B as historical medication with no temporal or biological relationship to the current presentation.

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

Yours faithfully,
Ms. Emma Medina, Senior Nurse Practitioner

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: Serious adverse event report Product A and Ibuprofen 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 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 has taken Ibuprofen for over 4 years without any previous adverse events of this nature. The treating physician has documented that Ibuprofen 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.

Yours faithfully,
Mr. Ryan Allen

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 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: Product A adverse event and continued Product B administration report
Dear Regional Pharmacovigilance Lead,
I am the Clinical Nurse Specialist at a geriatric medicine consortium 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 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 has been maintained on Product B for hypothyroidism for 6 years with stable thyroid function tests and no previous episodes of thyrotoxicosis or related symptoms. The endocrinologist has documented that Product B is concomitant only and is not considered responsible for the current presentation.

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

Warm regards,
Mr. Heather Roberts, Clinical Nurse Specialist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "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 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: Urgent adverse event Product A and suspect Product B also implicated
Dear Adverse Events Reporting Centre,
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 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.

Additionally, the patient also experienced a 50 year old female patient on Product B 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 B and the drug was discontinued with symptomatic management.

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.

Cordially,
Mr. Paul Hunter

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "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 a suspect drug. The email additionally reports another adverse event a 50 year old female patient on Product B 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 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 reaction report involving Product A and Lisinopril taken concurrently not suspected
Dear Global Safety Unit,
I am the Consultant Rheumatologist at a specialist neurology 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 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, The patient has taken Lisinopril for over 4 years without any previous adverse events of this nature. The treating physician has documented that Lisinopril 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.

With appreciation,
Dr. Aaron Ortiz, Consultant Rheumatologist

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. 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 suspected reaction with Product B prior use not relevant – formal report
Dear Drug Safety Department,
I am the Senior Nurse Practitioner at a Veterans Affairs medical centre 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 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, 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.

With appreciation,
Ms. Robert Castillo, Senior Nurse Practitioner

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: Safety report Product A and suspect Product B also implicated
Dear Sir or Madam,
I am the Attending Physician at a dialysis centre network 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 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 62 year old male patient initiated on Product B 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 B is the most probable causative agent based on temporal relationship and known hepatic metabolism. Product B has been immediately withdrawn and the patient has been hospitalised under urgent hepatology review.

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 appreciation,
Dr. Victoria Ruiz, Attending Physician

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 62 year old male patient initiated on Product B 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 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."}