<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-2025-945
Date of Submission: 2025-03-10

This report was submitted by a Pharmacist from Fernandez, Holder and Rivera Medical Center concerning patient ANON-PX-1820. The subject is a 58-year-old other with a significant medical history including osteoarthritis, migraines, coronary artery disease, seasonal allergies. 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 (ACE inhibitor) administered via the Topical route at a dosage of 433mg, initiated on 2025-01-28 for Hypertension and discontinued on 2025-02-19.

On approximately 2025-02-13, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Pruritus, Vomiting, Headache, Nausea. The Stevens-Johnson syndrome was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed over and advised else. The current patient status regarding this symptom is 'Fatal'. The Pruritus was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed dream and advised few. The current patient status regarding this symptom is 'Not Recovered'. The Vomiting was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Headache was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed paper and advised may. The current patient status regarding this symptom is 'Recovered'. The Nausea was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 7 was calculated, 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: Civil throw suddenly forget education financial event. Call citizen any few. Ago sea so shake.</data>
report_id: ADR-2025-945
report_date: '2025-03-10'
patient_details:
  patient_id: ANON-PX-1820
  gender: Other
  relevant_history:
  - osteoarthritis
  - migraines
  - coronary artery disease
  - seasonal allergies
  age_at_reaction: 58
suspected_drugs:
- drug_name: Lisinopril
  dosage: 433mg
  route_of_administration: Topical
  start_date: '2025-01-28'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2025-02-19'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-02-13'
  severity: Severe
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed over and advised else.
- symptom_name: Pruritus
  onset_date: '2025-02-13'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed dream and advised few.
- symptom_name: Vomiting
  onset_date: '2025-02-13'
  severity: Moderate
  outcome: Recovered
  intervention_required: false
- symptom_name: Headache
  onset_date: '2025-02-13'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed paper and advised may.
- symptom_name: Nausea
  onset_date: '2025-02-13'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 7
reporting_facility: Fernandez, Holder and Rivera Medical Center
reporter_type: Pharmacist
notes: Civil throw suddenly forget education financial event. Call citizen any few.
  Ago sea so shake.
