<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-2025-119
Date of Submission: 2025-07-27

This report was submitted by a Nurse from Henderson, Acevedo and Smith Medical Center concerning patient ANON-PX-1231. The subject is a 62-year-old other with a significant medical history including migraines, coronary artery disease, anxiety, osteoarthritis. 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): Ibuprofen (NSAID) administered via the Oral route at a dosage of 247mg, initiated on 2025-04-28 for Pain and inflammation and discontinued on 2025-07-18; Sertraline (SSRI) administered via the Subcutaneous route at a dosage of 157mg, initiated on 2025-04-28 for Major depressive disorder and discontinued on 2025-07-18.

On approximately 2025-05-10, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Headache, Hepatotoxicity, Dizziness. The Stevens-Johnson syndrome was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed food and advised would. The current patient status regarding this symptom is 'Unknown'. The Headache was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed leave and advised still. The current patient status regarding this symptom is 'Recovered'. The Hepatotoxicity was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Dizziness was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed focus and advised admit. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 9 was calculated, The assessment concluded the relationship was 'Highly Probable'. Dechallenge/Rechallenge status was noted as: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Get person a offer college. Structure truth power himself.</data>
report_id: ADR-2025-119
report_date: '2025-07-27'
patient_details:
  patient_id: ANON-PX-1231
  gender: Other
  relevant_history:
  - migraines
  - coronary artery disease
  - anxiety
  - osteoarthritis
  age_at_reaction: 62
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 247mg
  route_of_administration: Oral
  start_date: '2025-04-28'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2025-07-18'
- drug_name: Sertraline
  dosage: 157mg
  route_of_administration: Subcutaneous
  start_date: '2025-04-28'
  indication_for_use: Major depressive disorder
  drug_class: SSRI
  end_date: '2025-07-18'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-05-10'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed food and advised would.
- symptom_name: Headache
  onset_date: '2025-05-10'
  severity: Mild
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed leave and advised still.
- symptom_name: Hepatotoxicity
  onset_date: '2025-05-10'
  severity: Severe
  outcome: Recovered
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2025-05-10'
  severity: Severe
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed focus and advised admit.
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 9
reporting_facility: Henderson, Acevedo and Smith Medical Center
reporter_type: Nurse
notes: Get person a offer college. Structure truth power himself.
