<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-2025-998
Date of Submission: 2025-05-18

This report was submitted by a Other Healthcare Professional from Smith, Larson and Ferrell Medical Center concerning patient ANON-PX-2833. The subject is a 45-year-old other with a significant medical history including migraines, 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): Gabapentin (Anticonvulsant) administered via the Topical route at a dosage of 236mg, initiated on 2025-03-28 for Neuropathic pain and discontinued on 2025-04-29.

On approximately 2025-04-20, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Somnolence, Vomiting, Anaphylaxis, Nausea, Pruritus. The Somnolence was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Vomiting was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Anaphylaxis was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed question and advised look. The current patient status regarding this symptom is 'Not Recovered'. The Nausea was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed bit and advised account. The current patient status regarding this symptom is 'Unknown'. The Pruritus was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. 

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: Measure too door. Animal current seem by specific matter.</data>
report_id: ADR-2025-998
report_date: '2025-05-18'
patient_details:
  patient_id: ANON-PX-2833
  gender: Other
  relevant_history:
  - migraines
  - seasonal allergies
  age_at_reaction: 45
suspected_drugs:
- drug_name: Gabapentin
  dosage: 236mg
  route_of_administration: Topical
  start_date: '2025-03-28'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
  end_date: '2025-04-29'
adverse_reactions:
- symptom_name: Somnolence
  onset_date: '2025-04-20'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-04-20'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2025-04-20'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed question and advised look.
- symptom_name: Nausea
  onset_date: '2025-04-20'
  severity: Severe
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed bit and advised account.
- symptom_name: Pruritus
  onset_date: '2025-04-20'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
reporting_facility: Smith, Larson and Ferrell Medical Center
reporter_type: Other Healthcare Professional
notes: Measure too door. Animal current seem by specific matter.
