Instruction:
SUBJECT: Pharmacovigilance report Product A with Product B not currently administered
Good morning,
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 an adverse event. The patient experienced a 38 year old male patient on Product A for 12 weeks who developed acute kidney injury with serum creatinine rising from baseline 89 umol/L to 312 umol/L and reduced urine output. The nephrologist performed renal biopsy revealing acute interstitial nephritis consistent with hypersensitivity to Product A. The drug was stopped and corticosteroid therapy commenced.

With regard to medication history, The patient completed a 3 month 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.

Yours faithfully,
Dr. Laura Nelson, Director of Clinical Services

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


Instruction:
SUBJECT: Product A reaction and Product B completed treatment historically formal notification
Dear Pharmacovigilance and Risk Management Team,
I am writing on behalf of a patient group member to report an adverse event involving a medication that was recently initiated.

I wish to report an adverse event. The patient experienced a 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 administered for 20 weeks as part of a rehabilitation protocol and was completed 5 months ago with sustained functional improvement and no complications on follow-up. The specialist has confirmed Product B as historical medication with no temporal or causal relationship to the current symptoms.

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

Sincerely,
Ms. Carolyn Wagner, Patient Advocate

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

Additionally, the patient also experienced a 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.

Many thanks,
Mr. Brandon Carter, Patient Representative

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 76 year old female patient on Product A for 6 weeks who experienced syncopal episodes, documented bradycardia with heart rate 38 bpm, and dizziness requiring emergency department evaluation, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 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: Adverse event report Product A plus Product B taken alongside
Dear Post-Marketing Surveillance Unit,
I am writing as the caregiver for my father Timothy Lopez to report an adverse reaction they experienced with a recently started medication.

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

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

Best regards,
Mr. David Ramos, Caregiver

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: Suspected adverse event with Product A and concurrent Product B use
Good morning,
I am the Senior Nurse Practitioner at a private cardiology practice group 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 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 22 months ago for atrial fibrillation rate control and has maintained stable heart rhythm without any previous episodes of bradycardia or syncope. The cardiologist has reviewed the electrophysiology and confirmed that Product B is not implicated and should be continued.

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

Yours faithfully,
Ms. Ronald Arnold, Senior Nurse Practitioner

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: Safety report Product A and suspect Product B also implicated
Dear Sir or Madam,
I am writing as the caregiver for my wife Virginia Santos to report an adverse reaction they experienced with a recently started medication.

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

Additionally, the patient also experienced a 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.

Yours faithfully,
Mrs. Victoria Castro, Caregiver

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 41 year old female patient on Product A for 11 weeks who experienced recurrent pancreatitis with severe epigastric pain, serum lipase 12 times upper limit of normal, and computed tomography showing pancreatic inflammation, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 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: Product A adverse reaction with historical Product B use
Dear Medical Affairs and Drug Safety,
I am writing as the caregiver for my wife Susan Ruiz 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 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.

Thank you,
Mr. Margaret Vazquez, 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: Adverse reaction report involving Product A and Amoxicillin not implicated in adverse event
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 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.

Additionally, The patient has been on Amoxicillin 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 Amoxicillin 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.

In professional solidarity,
Mr. Jerry Watson

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 the suspect drug. Amoxicillin is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Formal adverse event notification Product A with Product B taken alongside
Dear Patient Safety Team,
I am the Chief of Medicine 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.

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 sincerely,
Dr. Julie Ortiz, Chief of Medicine

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


Instruction:
SUBJECT: Product A reaction report with suspect Product B also implicated
Dear Pharmacovigilance and Risk Management Team,
I am the Chief of Medicine at a pharmaceutical benefit manager and I am formally notifying you of an adverse event report requiring pharmacovigilance review.

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

Additionally, the patient also experienced a 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.

Kind regards,
Dr. Scott Lee, Chief of Medicine

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 64 year old male patient on Product A for 13 weeks who developed progressive dysphagia, odynophagia, and severe oesophageal ulceration on endoscopy, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 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: Product A adverse reaction with ongoing Product B treatment
Hi,
I am the Chief of Medicine at a group of private outpatient clinics 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 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, Product B was started 26 months ago for Parkinson disease and has provided stable motor control without any previous episodes of dyskinesia or hallucination. The neurologist has reviewed the temporal association and confirmed that Product B is not suspected and should be continued without dose adjustment.

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

Sincerely,
Dr. William Grant, Chief of Medicine

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "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 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 event and both Product A and Levothyroxine identified as suspect report
Dear Corporate Drug Safety Department,
I am the Consultant Pulmonologist 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 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 42 year old female patient on Levothyroxine for 3 months who developed osteoporosis with new vertebral compression fracture on imaging and bone mineral density T-score of -3.2. The endocrinologist identified exogenous thyrotoxicosis from Levothyroxine overdose as the causative factor and the dose was adjusted with bisphosphonate therapy initiated.

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

Please investigate this dual suspect drug report urgently.

Yours sincerely,
Dr. Samuel Brooks, Consultant Pulmonologist

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 42 year old female patient on Levothyroxine for 3 months who developed osteoporosis with new vertebral compression fracture on imaging and bone mineral density T-score of -3, qualifying as an Adverse Event with Levothyroxine as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Levothyroxine as the non-company suspect drug."}


Instruction:
SUBJECT: Product A suspected adverse reaction with Omeprazole unchanged during event onset
To Whom It May Concern,
I am writing as the caregiver for my husband Edward Andrews to report an adverse reaction they experienced with a recently started medication.

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.

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

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

Kind regards,
Mr. George Hansen, Caregiver

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 the suspect drug. Omeprazole is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


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

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

Additionally, the patient also experienced a 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.

Warm regards,
Mrs. Helen Robinson, Caregiver

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 62 year old male patient initiated on Product A 8 weeks ago for an autoimmune skin condition who has developed severely elevated liver enzymes confirmed on blood testing, persistent nausea, and mild jaundice, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 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: Urgent adverse event Product A and Product B completed treatment historically
Dear Regional Pharmacovigilance Lead,
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 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.

With regard to medication history, The patient was previously on Product B for 8 months but completed the course and stopped it 6 months ago with no adverse events during or after treatment. The treating physician has explicitly documented 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.

Appreciatively,
Dr. Carolyn Stevens, Chief of Medicine

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "Analysis": "The email reports an adverse event a 55 year old female patient who was started on Product A 11 weeks ago for a chronic inflammatory condition, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as 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 previous Product B therapy
Dear Drug Safety Department,
I am writing as the caregiver for my father Jacob Martin to report an adverse reaction they experienced with a recently started medication.

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 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.

Appreciatively,
Mrs. Mary Cooper, Caregiver

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: Product A reaction and Amoxicillin concomitant medication only formal notification
Dear Medical Affairs and Drug Safety,
I am writing as the caregiver for my wife Henry Cook 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, The patient has been on Amoxicillin 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 Amoxicillin 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.

Respectfully,
Mrs. Timothy Coleman, 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. Amoxicillin 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 notification for Product A with Omeprazole stable during Product A reaction
Dear Corporate Drug Safety Department,
I am the Chief of Medicine at a residential care home network managing over 400 elderly residents across 5 facilities and I am formally notifying you of an adverse event report requiring pharmacovigilance review.

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

Additionally, The patient has received Omeprazole 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 Omeprazole is concomitant only and is not considered causative.

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

With best wishes,
Dr. Carol Rodriguez, Chief of Medicine

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 76 year old female patient on Product A for 6 weeks who experienced syncopal episodes, documented bradycardia with heart rate 38 bpm, and dizziness requiring emergency department evaluation, qualifying as an Adverse Event with Product A as the suspect drug. Omeprazole is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Adverse reaction report involving Product A and suspect Product B also implicated
Dear Global Safety Unit,
I am writing as the caregiver for my father Adam Hicks 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 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 53 year old female patient started on Product B 7 weeks ago who developed profound fatigue, pallor, and symptomatic anaemia with haemoglobin of 7.2 g/dL. The haematologist identified bone marrow suppression attributed to Product B and the drug was immediately discontinued. The patient required packed red blood cell transfusion and close monitoring.

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

Please investigate this dual suspect drug report urgently.

With best wishes,
Mr. Helen Davis, Caregiver

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 53 year old female patient started on Product B 7 weeks ago who developed profound fatigue, pallor, and symptomatic anaemia with haemoglobin of 7, qualifying as an Adverse Event with Product B as a suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A and Product B as dual suspect drugs."}


Instruction:
SUBJECT: Safety report Product A and suspected combined effect Product A and Amlodipine
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 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 65 year old male patient on Amlodipine for 9 weeks who developed severe bilateral peripheral oedema extending to the thighs, weight gain of 8 kg, and pitting oedema confirmed clinically. The cardiologist attributed the event to Amlodipine and the drug was stopped with diuretic therapy and close follow-up arranged.

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

Please investigate this dual suspect drug report urgently.

Cordially,
Ms. Shirley Stewart, Patient Advocate

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 65 year old male patient on Amlodipine for 9 weeks who developed severe bilateral peripheral oedema extending to the thighs, weight gain of 8 kg, and pitting oedema confirmed clinically, qualifying as an Adverse Event with Amlodipine as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Amlodipine as the non-company suspect drug."}


Instruction:
SUBJECT: Adverse reaction report involving Product A and suspected Amlodipine co-reaction
Dear Clinical Safety and Regulatory Affairs,
I am writing on behalf of a patient group member to report an adverse event involving a medication that was recently initiated.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 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 65 year old male patient on Amlodipine for 9 weeks who developed severe bilateral peripheral oedema extending to the thighs, weight gain of 8 kg, and pitting oedema confirmed clinically. The cardiologist attributed the event to Amlodipine and the drug was stopped with diuretic therapy and close follow-up arranged.

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

Please investigate this dual suspect drug report urgently.

Regards,
Mr. Amanda Long, Patient Representative

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 65 year old male patient on Amlodipine for 9 weeks who developed severe bilateral peripheral oedema extending to the thighs, weight gain of 8 kg, and pitting oedema confirmed clinically, qualifying as an Adverse Event with Amlodipine as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Amlodipine as the non-company suspect drug."}


Instruction:
SUBJECT: Product A reaction report with suspect Product B also implicated
Dear Post-Marketing Surveillance Unit,
I am writing on behalf of a patient group member to report an adverse event involving a medication that was recently initiated.

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

Cordially,
Ms. Richard Arnold, Patient Advocate

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 64 year old male patient on Product B for 13 weeks who developed progressive dysphagia, odynophagia, and severe oesophageal ulceration on endoscopy, 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 Amoxicillin excluded as causative agent – formal report
Dear Global Safety Unit,
I am the Consultant Gastroenterologist at a community health partnership covering 12 clinics and I am writing to formally report an adverse event involving a patient under my care.

I wish to report 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, The patient has received Amoxicillin 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 Amoxicillin is concomitant only and is not considered causative.

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

Appreciatively,
Dr. Robert Guzman, Consultant Gastroenterologist

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. Amoxicillin is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Suspected adverse event with Product A and Amlodipine concomitant medication only
Dear Regional Pharmacovigilance Lead,
I am the Clinical Pharmacist at a rehabilitation and long-term care facility 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 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 received Amlodipine 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 Amlodipine is concomitant only and is not considered causative.

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

Cordially,
Dr. Jennifer Boyd, Clinical Pharmacist

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. 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: Urgent adverse event Product A and Amlodipine concomitant medication only
Hi,
I am writing as the caregiver for my mother Kenneth Roberts to report an adverse reaction they experienced with a recently started medication.

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

Additionally, 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.

Appreciatively,
Mr. Gary Robinson, Caregiver

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. Amlodipine is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Formal adverse event notification Product A with Product B unchanged during reaction
Good morning,
I am the Consultant Haematologist at a multi-site primary care network and I am writing to formally report an adverse event involving a patient under my care.

I wish to report an adverse event. The patient experienced a 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 has been used for epilepsy control for 5 years without breakthrough seizures or previous neuropsychiatric adverse events. The neurologist has reviewed the temporal association and explicitly excluded Product B as a suspect drug, confirming it should be continued without change.

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

With appreciation,
Dr. Samantha Tran, Consultant Haematologist

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: Pharmacovigilance report Product A with Product B not currently administered
Dear Pharmacovigilance Team,
I am writing on behalf of a patient group member to report an adverse event involving a medication that was recently initiated.

I wish to report an adverse event. The patient experienced a 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 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.

Appreciatively,
Mr. Gregory Cooper, 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 adverse reaction with suspect Product B also implicated
Dear Sir or Madam,
I am the Pharmacy Operations Manager at a community health partnership covering 12 clinics and I am submitting this adverse event report on behalf of a patient who presented to our pharmacy services.

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

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

Please investigate this dual suspect drug report urgently.

Cordially,
Mr. Nathan Lopez, Pharmacy Operations Manager

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 71 year old male patient started on Product B 5 weeks ago for rheumatoid arthritis who developed acute confusion, fever to 39, qualifying as an Adverse Event with Product B as a suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A and Product B as dual suspect drugs."}


Instruction:
SUBJECT: Product A reaction report with Omeprazole continued without change
Hi,
I am the Consultant Dermatologist at a private cardiology practice group and I am writing to formally report an adverse event involving a patient under my care.

I wish to report an adverse event. The patient experienced a 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, Omeprazole was started 14 months ago and has provided stable disease management with no prior episodes of acute deterioration. The specialist has reviewed the temporal relationship and explicitly excluded Omeprazole from the differential diagnosis of the current event.

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

Kind regards,
Dr. Katherine Bailey, Consultant Dermatologist

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. Omeprazole is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Safety report Product A and past Product B exposure
Dear Corporate 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 73 year old male patient started on Product A 6 weeks ago who developed severe thrombocytopenia with platelet count 12 x10^9/L and mucosal bleeding. The haematologist excluded other causes and attributed the event to Product A. The drug was stopped and platelet transfusion administered with haematology follow-up arranged.

With regard to medication history, Product B was used 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.

Warm regards,
Mr. Alexander Hoffman, Patient Representative

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: Product A adverse reaction with Product B not suspected
Dear Patient Safety Team,
I am the Senior Consultant 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 an adverse event. The patient experienced a 45 year old female patient initiated on Product A 10 weeks ago who developed severe depression with suicidal ideation, insomnia, and anhedonia requiring urgent psychiatric admission. The psychiatrist determined the temporal onset strongly implicated Product A and the drug was discontinued with antidepressant therapy and close psychiatric monitoring commenced.

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

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

Yours faithfully,
Dr. Donald Kennedy, Senior Consultant

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "Analysis": "The email reports an adverse event a 45 year old female patient initiated on Product A 10 weeks ago who developed severe depression with suicidal ideation, insomnia, and anhedonia requiring urgent psychiatric admission, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a concomitant drug."}


Instruction:
SUBJECT: Formal adverse event notification Product A with Ibuprofen maintained as background medication
Dear Corporate Drug Safety Department,
I am the Consultant Dermatologist at a group of private outpatient clinics 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 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, Ibuprofen was initiated 22 months ago for atrial fibrillation rate control and has maintained stable heart rhythm without any previous episodes of bradycardia or syncope. The cardiologist has reviewed the electrophysiology and confirmed that Ibuprofen is not implicated and should be continued.

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

Sincerely,
Dr. Ronald Lewis, Consultant Dermatologist

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 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 both Product A and Amlodipine identified as suspect report
Dear Post-Marketing Surveillance Unit,
I am the Senior Nurse Practitioner at a private cardiology practice group and I am documenting this adverse event report on behalf of a patient under our ward care.

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

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

Please investigate this dual suspect drug report urgently.

Regards,
Ms. Emily Mendez, Senior Nurse Practitioner

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 69 year old male patient on Amlodipine for 7 weeks who developed severe gingival hyperplasia with bleeding gums and difficulty eating confirmed on dental examination, qualifying as an Adverse Event with Amlodipine as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Amlodipine as the non-company suspect drug."}


Instruction:
SUBJECT: Product A reaction and Lisinopril excluded as causative agent formal notification
To Whom It May Concern,
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 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, Lisinopril has been used for epilepsy control for 5 years without breakthrough seizures or previous neuropsychiatric adverse events. The neurologist has reviewed the temporal association and explicitly excluded Lisinopril as a suspect drug, confirming it should be continued without change.

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

Best regards,
Mr. Susan Vazquez, Patient Representative

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 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: Pharmacovigilance report Product A with suspected Metformin co-reaction
Hi,
I am writing as the caregiver for my mother Linda Gordon 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 42 year old male patient on Product A for 20 weeks who presented with new visual disturbances, blurred vision, and bilateral optic disc swelling on ophthalmic examination. The neuro-ophthalmologist identified the findings as consistent with drug-induced papilloedema related to Product A. The drug was stopped and lumbar puncture performed to exclude intracranial hypertension.

Additionally, the patient also experienced a 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 faithfully,
Mr. Laura Jones, 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 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 historical Product B use
Dear Medical Affairs and Drug Safety,
I am writing to report an adverse reaction I have experienced with a medication I was recently prescribed.

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

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.

Respectfully,
Ms. Andrew Daniels

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "Analysis": "The email reports an adverse event a 53 year old female patient started on Product A 7 weeks ago who developed profound fatigue, pallor, and symptomatic anaemia with haemoglobin of 7, qualifying as an Adverse Event with Product A as 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 Pharmacovigilance Team,
I am writing on behalf of a patient group member to report an adverse event involving a medication that was recently initiated.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. 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 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.

Thank you,
Ms. Sarah Baker, Patient Advocate

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 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: Product A suspected reaction with Product B not currently administered – formal report
Dear Adverse Events Reporting Centre,
I am the Clinical Pharmacy Director at a pain management clinic group 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 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 13 months and stopped it 6 months ago upon relocation with stable disease maintained on alternative therapy since then. 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.

Appreciatively,
Dr. Gregory Andrews, Clinical Pharmacy Director

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 suspect Product B also implicated – formal report
To Whom It May Concern,
I am writing as the caregiver for my mother Anthony Delgado 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 42 year old male patient on Product A for 20 weeks who presented with new visual disturbances, blurred vision, and bilateral optic disc swelling on ophthalmic examination. The neuro-ophthalmologist identified the findings as consistent with drug-induced papilloedema related to Product A. The drug was stopped and lumbar puncture performed to exclude intracranial hypertension.

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

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

Please investigate this dual suspect drug report urgently.

In professional solidarity,
Mr. Nicole Robinson, 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 a suspect drug. The email additionally reports another adverse event a 53 year old female patient started on Product B 7 weeks ago who developed profound fatigue, pallor, and symptomatic anaemia with haemoglobin of 7, qualifying as an Adverse Event with Product B as a suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A and Product B as dual suspect drugs."}


Instruction:
SUBJECT: Adverse reaction report involving Product A and Product B historical medication only
Dear Pharmacovigilance Team,
I am the Chief of Medicine at a private oncology clinic group and I am formally notifying you of an adverse event report requiring pharmacovigilance review.

I wish to report an adverse event. The patient experienced a 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, 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.

With best wishes,
Dr. Nathan Elliott, 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 reaction report with previous Product B therapy
Dear Drug Safety Department,
I am the Senior Nurse Practitioner at a rheumatology clinic group 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 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 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.

Regards,
Ms. Timothy Vargas, Senior Nurse Practitioner

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: Adverse event report Product A plus Ibuprofen also suspected by physician
Dear Medical Affairs and Drug Safety,
I am the Director of Clinical Services at a hepatology referral 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 45 year old female patient initiated on Product A 10 weeks ago who developed severe depression with suicidal ideation, insomnia, and anhedonia requiring urgent psychiatric admission. The psychiatrist determined the temporal onset strongly implicated Product A and the drug was discontinued with antidepressant therapy and close psychiatric monitoring commenced.

Additionally, the patient also experienced a 68 year old male patient on Ibuprofen 800 mg three times daily for 6 weeks who developed severe gastrointestinal bleeding with haematemesis, melaena, and haemoglobin drop from 13.2 g/dL to 7.1 g/dL. The gastroenterologist identified Ibuprofen as the probable cause and the drug was stopped with blood transfusion and urgent endoscopy arranged.

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

Please investigate this dual suspect drug report urgently.

Sincerely,
Dr. Rebecca Roberts, Director of Clinical Services

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 45 year old female patient initiated on Product A 10 weeks ago who developed severe depression with suicidal ideation, insomnia, and anhedonia requiring urgent psychiatric admission, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 68 year old male patient on Ibuprofen 800 mg three times daily for 6 weeks who developed severe gastrointestinal bleeding with haematemesis, melaena, and haemoglobin drop from 13, qualifying as an Adverse Event with Ibuprofen as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Ibuprofen as the non-company suspect drug."}


Instruction:
SUBJECT: Adverse event notification for Product A with Omeprazole excluded as causative agent
Dear Corporate Drug Safety Department,
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 55 year old female patient who was started on Product A 11 weeks ago for a chronic inflammatory condition. Over the past 6 weeks the patient has developed severe muscle weakness across both lower limbs, significant hair loss, and persistent nausea that have substantially affected quality of life. The treating specialist reviewed the case and is confident that Product A is responsible based on temporal association and clinical presentation. Product A has been withheld and the patient is under close specialist follow-up.

Additionally, The patient has been on Omeprazole 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 Omeprazole 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.

Yours faithfully,
Ms. Julie Payne

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. Omeprazole is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a non-company concomitant drug."}


Instruction:
SUBJECT: Product A adverse reaction with Product B implicated only as concomitant
Dear Pharmacovigilance Team,
I am the Clinical Pharmacist 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 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 Product B for hyperlipidaemia for over 4 years without any previous muscle symptoms or elevation in creatine kinase levels. The treating physician has documented that Product B is concomitant medication only and is not considered responsible for the current adverse presentation.

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

With best wishes,
Dr. Debra Wells, Clinical Pharmacist

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


Instruction:
SUBJECT: Pharmacovigilance report Product A with Levothyroxine stable during Product A reaction
Dear Adverse Events Reporting Centre,
I am writing as the caregiver for my father Maria Elliott to report an adverse reaction they experienced with a recently started medication.

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

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

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

Sincerely,
Mrs. Aaron Porter, Caregiver

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 53 year old female patient started on Product A 7 weeks ago who developed profound fatigue, pallor, and symptomatic anaemia with haemoglobin of 7, qualifying as an Adverse Event with Product A as 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: Adverse event report Product A plus both Product A and Lisinopril identified as suspect
Dear Medical Affairs and Drug Safety,
I am the Consultant Neurologist at a regional hospital trust 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 42 year old male patient on Product A for 20 weeks who presented with new visual disturbances, blurred vision, and bilateral optic disc swelling on ophthalmic examination. The neuro-ophthalmologist identified the findings as consistent with drug-induced papilloedema related to Product A. The drug was stopped and lumbar puncture performed to exclude intracranial hypertension.

Additionally, the patient also experienced a 82 year old female patient on Lisinopril for 5 weeks who developed symptomatic hypotension with blood pressure 78/42 mmHg, dizziness, and syncopal episodes leading to a fall and hip fracture. The geriatrician identified Lisinopril as the causative agent and the drug was stopped with orthostatic blood pressure monitoring and fracture management commenced.

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

Please investigate this dual suspect drug report urgently.

In professional solidarity,
Dr. Brandon Williams, Consultant Neurologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 42 year old male patient on Product A for 20 weeks who presented with new visual disturbances, blurred vision, and bilateral optic disc swelling on ophthalmic examination, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 82 year old female patient on Lisinopril for 5 weeks who developed symptomatic hypotension with blood pressure 78/42 mmHg, dizziness, and syncopal episodes leading to a fall and hip fracture, qualifying as an Adverse Event with Lisinopril 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 Lisinopril as the non-company suspect drug."}


Instruction:
SUBJECT: Suspected adverse event with Product A and past Product B exposure
Dear Clinical Safety and Regulatory Affairs,
I am the Consultant Dermatologist at a geriatric medicine consortium and I am writing to formally report an adverse event involving a patient under my care.

I wish to report 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, 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.

Yours sincerely,
Dr. Benjamin Simpson, Consultant Dermatologist

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: Product A suspected adverse reaction with Product B as background therapy
Dear Corporate Drug Safety Department,
I am the Attending Physician at a surgical day case unit group and I am formally notifying you of an adverse event report requiring pharmacovigilance review.

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

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

Many thanks,
Dr. Lisa Ruiz, Attending Physician

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."}