<format type="yaml">{report_id: string, report_date: date, patient_details: {patient_id: string, age_at_reaction: number optional, gender: string, relevant_history: list[string]}, suspected_drugs: list[{drug_name: string, drug_class: string optional, dosage: string, route_of_administration: string, start_date: date, end_date: date optional, indication_for_use: string}], adverse_reactions: list[{symptom_name: string, onset_date: date, severity: string, outcome: string, intervention_required: boolean, intervention_details: string optional}], causality_assessment: {naranjo_score: number optional, assessment_conclusion: string, dechallenge_rechallenge: string}, reporting_facility: string, reporter_type: string, notes: string optional}</format> <data>PHARMACOVIGILANCE CASE REPORT - CONFIDENTIAL
Report Identifier: ADR-2024-435
Date of Submission: 2024-11-28

This report was submitted by a Patient from Thompson Ltd Medical Center concerning patient ANON-PX-2084. The subject is an adult other with a significant medical history including asthma, chronic kidney disease. The facility's standard operating procedure for ADR reporting was followed, and all patient data has been anonymized. The patient chart was reviewed for comorbidities. 

Current medication review revealed the following suspected agent(s): Lisinopril administered via the Intramuscular route at a dosage of 228mg, initiated on 2024-09-10 for Hypertension with the course ongoing; Metformin (Biguanide) administered via the Topical route at a dosage of 302mg, initiated on 2024-09-10 for Type 2 diabetes with the course ongoing.

On approximately 2024-11-12, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Diarrhea, Anaphylaxis, Vomiting. The Diarrhea was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. The Anaphylaxis was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. The Vomiting was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed great and advised south. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Expect necessary ten catch. Too data general easy apply site. Only positive buy marriage investment room one run.</data>
report_id: ADR-2024-435
report_date: '2024-11-28'
patient_details:
  patient_id: ANON-PX-2084
  gender: Other
  relevant_history:
  - asthma
  - chronic kidney disease
suspected_drugs:
- drug_name: Lisinopril
  dosage: 228mg
  route_of_administration: Intramuscular
  start_date: '2024-09-10'
  indication_for_use: Hypertension
- drug_name: Metformin
  dosage: 302mg
  route_of_administration: Topical
  start_date: '2024-09-10'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
adverse_reactions:
- symptom_name: Diarrhea
  onset_date: '2024-11-12'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
- symptom_name: Anaphylaxis
  onset_date: '2024-11-12'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: true
- symptom_name: Vomiting
  onset_date: '2024-11-12'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed great and advised south.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
reporting_facility: Thompson Ltd Medical Center
reporter_type: Patient
notes: Expect necessary ten catch. Too data general easy apply site. Only positive
  buy marriage investment room one run.
