<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-2025-514
Date of Submission: 2025-08-05

This report was submitted by a Physician from Bartlett-Wallace Medical Center concerning patient ANON-PX-7546. The subject is a 22-year-old other with a significant medical history including osteoarthritis, seasonal allergies, anxiety, type 2 diabetes. 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 Intravenous route at a dosage of 488mg, initiated on 2025-06-10 for Hypertension with the course ongoing; Metformin administered via the Intravenous route at a dosage of 251mg, initiated on 2025-06-10 for Type 2 diabetes with the course ongoing.

On approximately 2025-07-20, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Nausea, Stevens-Johnson syndrome. The Vomiting was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Nausea was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Stevens-Johnson syndrome was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 6 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: Necessary any win push citizen reflect. Statement service born soldier enough up firm so.</data>
report_id: ADR-2025-514
report_date: '2025-08-05'
patient_details:
  patient_id: ANON-PX-7546
  gender: Other
  relevant_history:
  - osteoarthritis
  - seasonal allergies
  - anxiety
  - type 2 diabetes
  age_at_reaction: 22
suspected_drugs:
- drug_name: Lisinopril
  dosage: 488mg
  route_of_administration: Intravenous
  start_date: '2025-06-10'
  indication_for_use: Hypertension
- drug_name: Metformin
  dosage: 251mg
  route_of_administration: Intravenous
  start_date: '2025-06-10'
  indication_for_use: Type 2 diabetes
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2025-07-20'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2025-07-20'
  severity: Mild
  outcome: Fatal
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-07-20'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 6
reporting_facility: Bartlett-Wallace Medical Center
reporter_type: Physician
notes: Necessary any win push citizen reflect. Statement service born soldier enough
  up firm so.
