Instruction:
SUBJECT: Product A suspected adverse reaction with Amoxicillin also suspected by physician
Hi,
I am writing as the caregiver for my father Nathan Lopez 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 58 year old male patient on Product A for 18 weeks who developed new-onset atrial fibrillation with rapid ventricular response, palpitations, and dyspnoea requiring electrical cardioversion and anticoagulation. The cardiologist identified Product A as a probable contributing factor and the drug was stopped with appropriate cardiac therapy instituted.

Additionally, the patient also experienced a 31 year old female patient treated with Amoxicillin for 5 days who developed a severe widespread erythematous rash with mucosal involvement and target lesions consistent with Stevens-Johnson syndrome. The allergist attributed the reaction to Amoxicillin and the drug was stopped with immediate dermatology and ophthalmology referral.

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

Please investigate this dual suspect drug report urgently.

Cordially,
Mr. Melissa Nguyen, Caregiver

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 58 year old male patient on Product A for 18 weeks who developed new-onset atrial fibrillation with rapid ventricular response, palpitations, and dyspnoea requiring electrical cardioversion and anticoagulation, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 31 year old female patient treated with Amoxicillin for 5 days who developed a severe widespread erythematous rash with mucosal involvement and target lesions consistent with Stevens-Johnson syndrome, qualifying as an Adverse Event with Amoxicillin as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Amoxicillin as the non-company suspect drug."}


Instruction:
SUBJECT: Urgent adverse event Product A and ongoing Omeprazole use alongside Product A
Dear Regional Pharmacovigilance Lead,
I am writing to report an adverse reaction I have experienced with a medication I was recently prescribed.

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

Warm regards,
Ms. Jonathan Hall

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 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 concomitant Product B therapy
Dear Adverse Events Reporting Centre,
I am the Consultant Endocrinologist at a childrens hospital outpatient department and I am writing to formally report an adverse event involving a patient under my care.

I wish to report an adverse event. The patient experienced a 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 Product B for benign prostatic hyperplasia for 3 years with stable urinary symptoms and no prior history of orthostatic hypotension. The urologist has assessed the current presentation and confirmed that Product B is not suspected and will remain unchanged.

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

Cordially,
Dr. Alexander Dixon, Consultant Endocrinologist

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


Instruction:
SUBJECT: Urgent adverse event Product A and Product A and Omeprazole both implicated
Dear Pharmacovigilance and Risk Management Team,
I am the Consultant Rheumatologist at a respiratory medicine centre and I am writing to formally report an adverse event involving a patient under my care.

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

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

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

Please investigate this dual suspect drug report urgently.

Thank you,
Dr. James Meyer, Consultant Rheumatologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 67 year old female patient initiated on Product A 9 weeks ago who developed a severe generalized maculopapular rash covering more than 50% of body surface area, facial swelling, and eosinophilia, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 44 year old female patient on Omeprazole for 8 weeks who developed severe hypomagnesaemia with muscle spasms, tetany, and cardiac arrhythmias documented on electrocardiogram, qualifying as an Adverse Event with Omeprazole as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Omeprazole as the non-company suspect drug."}


Instruction:
SUBJECT: Adverse event notification for Product A with suspect Product B also implicated
Dear Adverse Events Reporting Centre,
I am the Head of Pharmacy Services at a clinical research site network 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 58 year old male patient on Product B 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 B as a probable contributing factor and the drug was stopped with appropriate cardiac therapy instituted.

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

Please investigate this dual suspect drug report urgently.

Appreciatively,
Ms. Ryan Ryan, Head of Pharmacy Services

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 58 year old male patient on Product B 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 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 Lisinopril concomitant medication only
Hi,
I am the Consultant Haematologist 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 an adverse event. The patient experienced a 60 year old male patient on Product A for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis. The dermatologist concluded the reaction was induced by Product A and the drug was stopped with photoprotection and topical therapy commenced.

Additionally, The patient has taken Lisinopril for over 4 years without any previous adverse events of this nature. The treating physician has documented that Lisinopril is concomitant medication only and is not considered responsible for the current adverse presentation.

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

In professional solidarity,
Dr. Nathan Coleman, Consultant Haematologist

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


Instruction:
SUBJECT: Adverse event report Product A plus suspect Product B also implicated
Good morning,
I am the Clinical Nurse Specialist at a chain of retail pharmacies 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 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 38 year old male patient on Product B 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 B. The drug was stopped and corticosteroid therapy commenced.

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

Please investigate this dual suspect drug report urgently.

Sincerely,
Mr. Jacob Taylor, Clinical Nurse Specialist

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 38 year old male patient on Product B 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 B as a suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A and Product B as dual suspect drugs."}


Instruction:
SUBJECT: Safety report Product A and Metformin excluded as causative agent
Dear Drug Safety Department,
I am the Director of Clinical Services 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 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 Metformin for 3 years with good control and no history of similar adverse events. The treating physician has assessed the current symptoms and confirmed that Metformin 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.

Appreciatively,
Dr. Nathan Mitchell, Director of Clinical Services

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


Instruction:
SUBJECT: Pharmacovigilance report Product A with concomitant Product B exposure
Hi,
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 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 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.

Many thanks,
Mr. Charles Castro

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: Product A suspected reaction with dual suspect Product A and Ibuprofen – formal report
Dear Corporate Drug Safety Department,
I am writing as the caregiver for my sister Aaron Hamilton 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 74 year old female patient on Ibuprofen for 4 weeks who developed acute kidney injury with serum creatinine 298 umol/L and reduced urine output in the setting of concurrent dehydration. The nephrologist identified Ibuprofen as the causative agent and the drug was stopped with fluid resuscitation and renal monitoring arranged.

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

Please investigate this dual suspect drug report urgently.

Sincerely,
Mrs. Laura Freeman, 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 74 year old female patient on Ibuprofen for 4 weeks who developed acute kidney injury with serum creatinine 298 umol/L and reduced urine output in the setting of concurrent dehydration, qualifying as an Adverse Event with Ibuprofen as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Ibuprofen as the non-company suspect drug."}


Instruction:
SUBJECT: Product A reaction report with previous Product B therapy
Dear Patient Safety Team,
I am writing as the caregiver for my elderly aunt Scott Dixon 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, Product B was prescribed for 10 weeks for a seasonal condition and was last used 15 months ago with full resolution of the original indication. The clinician has reviewed the history and confirmed Product B as historical medication with no bearing on the current adverse event.

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

Sincerely,
Mr. Deborah Owens, 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 event report Product A plus ongoing Product B treatment
Dear Clinical Safety and Regulatory Affairs,
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 an adverse event. The patient experienced a 41 year old female patient on Product A for 11 weeks who experienced recurrent pancreatitis with severe epigastric pain, serum lipase 12 times upper limit of normal, and computed tomography showing pancreatic inflammation. The gastroenterologist determined Product A as the likely causative agent and the drug was stopped with supportive care initiated.

Additionally, 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,
Dr. Nathan Porter, Consultant Pulmonologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "Analysis": "The email reports an adverse event a 41 year old female patient on Product A for 11 weeks who experienced recurrent pancreatitis with severe epigastric pain, serum lipase 12 times upper limit of normal, and computed tomography showing pancreatic inflammation, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a concomitant drug."}


Instruction:
SUBJECT: Suspected adverse event with Product A and historical Product B use
Dear Global Safety Unit,
I am the Pharmacy Operations Manager 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 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.

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.

Best regards,
Mr. Donald Patterson, Pharmacy Operations Manager

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "Analysis": "The email reports an adverse event a 64 year old male patient on Product A for 13 weeks who developed progressive dysphagia, odynophagia, and severe oesophageal ulceration on endoscopy, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as historical medication that was discontinued well before the onset of the current adverse event and is explicitly documented as not relevant to the current reaction by the treating physician, qualifying as a historical drug."}


Instruction:
SUBJECT: Formal adverse event notification Product A with suspect Product B also implicated
Dear Clinical Safety and Regulatory Affairs,
I am the Consultant Endocrinologist at a respiratory medicine centre and I am writing to formally report an adverse event involving a patient under my care.

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

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

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

Please investigate this dual suspect drug report urgently.

With best wishes,
Dr. Brenda Knight, Consultant Endocrinologist

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


Instruction:
SUBJECT: Safety report Product A and Product B as background therapy
Dear Patient Safety Team,
I am writing on behalf of a patient group member to report an adverse event involving a medication that was recently initiated.

I wish to report an adverse event. The patient experienced a 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, Product B was initiated 10 months ago for multiple sclerosis relapse prevention and has maintained stable disease activity on magnetic resonance imaging surveillance. The neurologist has reviewed the case and explicitly excluded Product B from the list of suspect medications for the current adverse event.

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

Cordially,
Mr. Daniel Cooper, Patient Representative

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "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 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 and Product B historical exposure documented formal notification
Hi,
I am the Consultant Nephrologist at a pharmaceutical benefit manager and I am writing to formally report an adverse event involving a patient under my care.

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

With regard to medication history, Product B was prescribed for 10 weeks for a seasonal condition and was last used 15 months ago with full resolution of the original indication. The clinician has reviewed the history and confirmed Product B as historical medication with no bearing on the current adverse event.

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

In professional solidarity,
Dr. Samantha Castro, Consultant Nephrologist

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 suspected Atorvastatin co-reaction report
Dear Medical Affairs and Drug Safety,
I am the Ward Nurse Manager at a rural district hospital 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 53 year old female patient started on Product A 7 weeks ago who developed profound fatigue, pallor, and symptomatic anaemia with haemoglobin of 7.2 g/dL. The haematologist identified bone marrow suppression attributed to Product A and the drug was immediately discontinued. The patient required packed red blood cell transfusion and close monitoring.

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

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

Please investigate this dual suspect drug report urgently.

Yours sincerely,
Ms. Heather Cox, Ward Nurse Manager

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 53 year old female patient started on Product A 7 weeks ago who developed profound fatigue, pallor, and symptomatic anaemia with haemoglobin of 7, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 63 year old female patient on Atorvastatin for 12 weeks who developed new-onset type 2 diabetes with fasting glucose 9, qualifying as an Adverse Event with Atorvastatin as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Atorvastatin as the non-company suspect drug."}


Instruction:
SUBJECT: Adverse event notification for Product A with Product B excluded as cause
Dear Drug Safety Department,
I am the Chief of Medicine at a chain of retail pharmacies 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.

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

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

Sincerely,
Dr. Patricia Torres, Chief of Medicine

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


Instruction:
SUBJECT: Product A suspected reaction with dual suspect Product A and Omeprazole – formal report
Hi,
I am the Consultant Hepatologist at a chain of retail pharmacies 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 58 year old male patient on Product A for 18 weeks who developed new-onset atrial fibrillation with rapid ventricular response, palpitations, and dyspnoea requiring electrical cardioversion and anticoagulation. The cardiologist identified Product A as a probable contributing factor and the drug was stopped with appropriate cardiac therapy instituted.

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

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

Please investigate this dual suspect drug report urgently.

Respectfully,
Dr. Brian Peters, Consultant Hepatologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 58 year old male patient on Product A for 18 weeks who developed new-onset atrial fibrillation with rapid ventricular response, palpitations, and dyspnoea requiring electrical cardioversion and anticoagulation, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 44 year old female patient on Omeprazole for 8 weeks who developed severe hypomagnesaemia with muscle spasms, tetany, and cardiac arrhythmias documented on electrocardiogram, qualifying as an Adverse Event with Omeprazole as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Omeprazole as the non-company suspect drug."}


Instruction:
SUBJECT: Suspected adverse event with Product A and suspected Methotrexate co-reaction
Dear Sir or Madam,
I am the Consultant Hepatologist at a community health partnership covering 12 clinics and I am writing to formally report an adverse event involving a patient under my care.

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

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

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

Please investigate this dual suspect drug report urgently.

Yours sincerely,
Dr. Eric Peters, Consultant Hepatologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 37 year old female patient initiated on Product A 8 weeks ago who developed severe headache, visual field defects, and magnetic resonance imaging confirmed cerebral venous sinus thrombosis, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 36 year old female patient on Methotrexate for 16 weeks who developed acute hepatitis with alanine aminotransferase 1,240 U/L, bilirubin 68 umol/L, and right upper quadrant pain, qualifying as an Adverse Event with Methotrexate as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Methotrexate as the non-company suspect drug."}


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

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

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

With best wishes,
Mr. Stephen Hunter, Patient Representative

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


Instruction:
SUBJECT: Adverse event report Product A plus Product B unchanged during reaction
Dear Clinical Safety and Regulatory Affairs,
I am the Consultant Neurologist at a tertiary referral 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 29 year old female patient started on Product A 4 weeks ago who experienced anaphylaxis within 30 minutes of dosing including urticaria, angioedema, bronchospasm, and hypotension requiring emergency adrenaline administration and intensive care admission. The allergist confirmed Product A as the trigger and the drug was permanently contraindicated.

Additionally, The patient has 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.

With best wishes,
Dr. Joseph Jordan, Consultant Neurologist

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: Adverse reaction report involving Product A and suspect Product B also implicated
Hi,
I am the Consultant Cardiologist at an immunology and allergy clinic and I am writing to formally report an adverse event involving a patient under my care.

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

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

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

Please investigate this dual suspect drug report urgently.

Best regards,
Dr. Joseph Reyes, Consultant Cardiologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 37 year old female patient initiated on Product A 8 weeks ago who developed severe headache, visual field defects, and magnetic resonance imaging confirmed cerebral venous sinus thrombosis, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 60 year old male patient on Product B for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis, qualifying as an Adverse Event with Product B as a suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A and Product B as dual suspect drugs."}


Instruction:
SUBJECT: Safety report Product A and physician suspects both Product A and Levothyroxine
Good morning,
I am writing to report an adverse reaction I have experienced with a medication I was recently prescribed.

I wish to report a serious adverse event where the treating physician suspects both medications as contributory factors. The patient experienced a 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 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,
Mr. Richard Munoz

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

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

Additionally, the patient also experienced a 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.

Warm regards,
Mr. Jonathan Chen, Patient Representative

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 53 year old female patient started on Product A 7 weeks ago who developed profound fatigue, pallor, and symptomatic anaemia with haemoglobin of 7, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 50 year old female patient on Product B for 15 weeks who developed severe arthralgia involving multiple joints with morning stiffness exceeding 2 hours and elevated inflammatory markers, qualifying as an Adverse Event with Product B as a suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A and Product B as dual suspect drugs."}


Instruction:
SUBJECT: Adverse event notification for Product A with Product B stable throughout event
Dear Medical Affairs and Drug Safety,
I am the Consultant Neurologist at a geriatric medicine consortium and I am writing to formally report an adverse event involving a patient under my care.

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

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

Many thanks,
Dr. Rachel Marshall, Consultant Neurologist

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: Safety report Product A and Product B discontinued prior to event
Dear Post-Marketing Surveillance Unit,
I am the Consultant Haematologist at a mental health trust 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 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.

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.

Kind regards,
Dr. Michelle Torres, Consultant Haematologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "95%"}, "Analysis": "The email reports an adverse event a 64 year old male patient on Product A for 13 weeks who developed progressive dysphagia, odynophagia, and severe oesophageal ulceration on endoscopy, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as 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 Product B taken alongside
Dear Clinical Safety and Regulatory Affairs,
I am the Consultant Nephrologist at a pain management clinic group and I am writing to formally report an adverse event involving a patient under my care.

I wish to report 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, The patient has been maintained on Product B for hypothyroidism for 6 years with stable thyroid function tests and no previous episodes of thyrotoxicosis or related symptoms. The endocrinologist has documented that Product B is concomitant only and is not considered responsible for the current presentation.

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

With best wishes,
Dr. Heather Fox, Consultant Nephrologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "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 concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a concomitant drug."}


Instruction:
SUBJECT: Formal adverse event notification Product A with Product B taken alongside
Good morning,
I am the Clinical Pharmacist at a large endocrinology centre 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 60 year old male patient on Product A for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis. The dermatologist concluded the reaction was induced by Product A and the drug was stopped with photoprotection and topical therapy commenced.

Additionally, 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. Cynthia Clark, Clinical Pharmacist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "Analysis": "The email reports an adverse event a 60 year old male patient on Product A for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis, qualifying as an Adverse Event with Product A as the suspect drug. Product B is described as concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a concomitant drug."}


Instruction:
SUBJECT: Product A suspected adverse reaction with both Product A and Metformin identified as suspect
Dear Clinical Safety and Regulatory Affairs,
I am the Consultant Endocrinologist at a mental health 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 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 61 year old male patient on Metformin for 24 months who developed vitamin B12 deficiency with megaloblastic anaemia, peripheral neuropathy, and serum B12 level 98 pg/mL. The haematologist identified Metformin as the causative agent and the drug was stopped with intramuscular B12 replacement therapy initiated.

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.

Sincerely,
Dr. Donna Walker, Consultant Endocrinologist

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 61 year old male patient on Metformin for 24 months who developed vitamin B12 deficiency with megaloblastic anaemia, peripheral neuropathy, and serum B12 level 98 pg/mL, 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: Suspected adverse event with Product A and concomitant Product B therapy
Hi,
I am the Head of Pharmacy Services at a clinical research site network 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 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 taken Product B for chronic pain for 15 months with stable analgesic response and no prior history of similar neurological symptoms. The pain specialist has assessed the current adverse event and explicitly stated that Product B is not a contributing factor and will remain unchanged.

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

Best regards,
Ms. Victoria Carroll, Head of Pharmacy Services

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


Instruction:
SUBJECT: Product A adverse reaction with Levothyroxine excluded as causative agent
To Whom It May Concern,
I am the Ward Nurse Manager at a large endocrinology centre and I am documenting this adverse event report on behalf of a patient under our ward care.

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

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

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

With appreciation,
Ms. Timothy Ortiz, Ward Nurse Manager

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


Instruction:
SUBJECT: Product A suspected reaction with concomitant Product B therapy – formal report
To Whom It May Concern,
I am writing as the caregiver for my wife Raymond Boyd 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, 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.

Appreciatively,
Mr. Jose Arnold, 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: Adverse event report Product A plus Product B unchanged during reaction
Good morning,
I am the Consultant Hepatologist at a rehabilitation and long-term care facility and I am writing to formally report an adverse event involving a patient under my care.

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

Additionally, The patient 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.

Appreciatively,
Dr. Emma Gray, Consultant Hepatologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "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 concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a concomitant drug."}


Instruction:
SUBJECT: Adverse event notification for Product A with Amoxicillin excluded as causative agent
Dear Adverse Events Reporting Centre,
I am the Consultant Haematologist at a metropolitan ambulance service medical liaison office 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 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 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.

Regards,
Dr. Maria Reed, Consultant Haematologist

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. 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 Product B stopped months ago
Dear Patient Safety Team,
I am the Clinical Pharmacist at a womens health 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 58 year old male patient on Product A for 18 weeks who developed new-onset atrial fibrillation with rapid ventricular response, palpitations, and dyspnoea requiring electrical cardioversion and anticoagulation. The cardiologist identified Product A as a probable contributing factor and the drug was stopped with appropriate cardiac therapy instituted.

With regard to medication history, Product B was prescribed for 10 weeks for a seasonal condition and was last used 15 months ago with full resolution of the original indication. The clinician has reviewed the history and confirmed Product B as historical medication with no bearing on the current adverse event.

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

Many thanks,
Dr. Debra Reed, Clinical Pharmacist

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: Formal adverse event notification Product A with Omeprazole excluded as causative agent
Dear Pharmacovigilance and Risk Management Team,
I am writing to report an adverse reaction I have experienced with a medication I was recently prescribed.

I wish to report an adverse event. The patient experienced a 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 has been maintained on Omeprazole for 3 years with good control and no history of similar adverse events. The treating physician has assessed the current symptoms and confirmed that Omeprazole 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.

With appreciation,
Mr. Stephanie Evans

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

Additionally, the patient also experienced a 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,
Ms. Nancy Salazar, Patient Advocate

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 67 year old female patient initiated on Product A 9 weeks ago who developed a severe generalized maculopapular rash covering more than 50% of body surface area, facial swelling, and eosinophilia, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 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: Product A reaction report with Product B excluded as cause
Dear Pharmacovigilance and Risk Management Team,
I am writing to report an adverse reaction I have experienced with a medication I was recently prescribed.

I wish to report an adverse event. The patient experienced a 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, Product B was started 14 months ago for chronic obstructive pulmonary disease and has provided stable respiratory function with no prior episodes of acute exacerbation. The pulmonologist has reviewed the temporal relationship and explicitly excluded Product B from the differential diagnosis of the current event.

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

With appreciation,
Mr. Joseph Wallace

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "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 concomitant medication that has been used for an extended period without prior adverse events and is explicitly excluded as a causative factor by the treating physician, qualifying as a concomitant drug."}


Instruction:
SUBJECT: Product A suspected adverse reaction with suspect Product B also implicated
Dear Adverse Events Reporting Centre,
I am the Consultant Hepatologist at a mental health 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 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 62 year old male patient initiated on Product B 8 weeks ago for an autoimmune skin condition who has developed severely elevated liver enzymes confirmed on blood testing, persistent nausea, and mild jaundice. The treating hepatologist reviewed the case and determined that Product B is the most probable causative agent based on temporal relationship and known hepatic metabolism. Product B has been immediately withdrawn and the patient has been hospitalised under urgent hepatology review.

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

Please investigate this dual suspect drug report urgently.

Yours faithfully,
Dr. Jonathan Butler, Consultant Hepatologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 34 year old female patient on Product A for 10 weeks who experienced severe abdominal pain, bloody diarrhoea more than 8 episodes per day, and colitis confirmed on flexible sigmoidoscopy, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 62 year old male patient initiated on Product B 8 weeks ago for an autoimmune skin condition who has developed severely elevated liver enzymes confirmed on blood testing, persistent nausea, and mild jaundice, qualifying as an Adverse Event with Product B as a suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A and Product B as dual suspect drugs."}


Instruction:
SUBJECT: Adverse event notification for Product A with suspect Product A with suspect Omeprazole
Good morning,
I am writing to report an adverse reaction I have experienced with a medication I was recently prescribed.

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

Additionally, the patient also experienced a 58 year old male patient on Omeprazole for 6 months who developed community-acquired pneumonia with increased frequency and severity compared to his baseline. The pulmonologist identified evidence linking long-term proton pump inhibitor use to increased infection risk and Omeprazole was stopped with antibiotic therapy initiated.

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

Please investigate this dual suspect drug report urgently.

In professional solidarity,
Mr. Betty Mason

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 58 year old male patient on Omeprazole for 6 months who developed community-acquired pneumonia with increased frequency and severity compared to his baseline, qualifying as an Adverse Event with Omeprazole as a non-company suspect drug. The treating physician explicitly suspects both medications as contributory factors and has stopped both drugs, identifying Product A as the company suspect drug and Omeprazole as the non-company suspect drug."}


Instruction:
SUBJECT: Product A suspected adverse reaction with Product B historical medication only
To Whom It May Concern,
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 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, The patient completed a standard 6 month course of Product B 4 months ago for a chronic condition and has been off the drug since with no withdrawal effects or delayed adverse events. The specialist has documented Product B as historical and stated it is not relevant to the current presentation.

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

Kind regards,
Ms. Stephanie Reyes

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 reaction report with dual suspect Product A and Amlodipine
Dear Adverse Events Reporting Centre,
I am the Medical Director at a private oncology clinic group 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 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 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.

With appreciation,
Dr. Angela Owens, Medical Director

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 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 suspected reaction with suspect Product B also implicated – formal report
Hi,
I am the Consultant Rheumatologist at a surgical day case unit group and I am writing to formally report an adverse event involving a patient under my care.

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

Additionally, the patient also experienced a 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.

Appreciatively,
Dr. Angela Murray, Consultant Rheumatologist

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 60 year old male patient on Product A for 9 weeks who developed severe photosensitivity with blistering sunburn-like reaction on sun-exposed skin and skin biopsy showing vacuolar interface dermatitis, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 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: Formal adverse event notification Product A with Product B not suspected
Hi,
I am writing as the caregiver for my elderly aunt John White to report an adverse reaction they experienced with a recently started medication.

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

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,
Mr. Mary Peters, Caregiver

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


Instruction:
SUBJECT: Product A reaction and Product B as background therapy formal notification
Dear Pharmacovigilance Team,
I am the Clinical Pharmacy Director at a group of private outpatient clinics and I am submitting this adverse event report on behalf of a patient who presented to our pharmacy services.

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

Cordially,
Dr. Michelle Kennedy, Clinical Pharmacy Director

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "98%"}, "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 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 Amlodipine taken concurrently not suspected
Good morning,
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 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 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,
Ms. Melissa Sanchez, Patient Advocate

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. 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: Suspected adverse event with Product A and suspect Product B also implicated
Dear Corporate Drug Safety Department,
I am the Medical Director at a paediatric outpatient service and I am formally notifying you of an adverse event report requiring pharmacovigilance review.

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

Additionally, the patient also experienced a 42 year old male patient on Product B 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 B. The drug was stopped and lumbar puncture performed to exclude intracranial hypertension.

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

Please investigate this dual suspect drug report urgently.

Warm regards,
Dr. Elizabeth Ellis, Medical Director

Output: {"Classification_of_request": {"Classification": "Adverse Event", "Confidence_percentage": "96%"}, "Analysis": "The email reports an adverse event a 53 year old female patient started on Product A 7 weeks ago who developed profound fatigue, pallor, and symptomatic anaemia with haemoglobin of 7, qualifying as an Adverse Event with Product A as a suspect drug. The email additionally reports another adverse event a 42 year old male patient on Product B 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 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."}