<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-2025-810
Date of Submission: 2025-01-01

This report was submitted by a Patient from Ward-Davis Medical Center concerning patient ANON-PX-7418. The subject is a 88-year-old female with a significant medical history including osteoarthritis, chronic kidney disease, coronary artery 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 (ACE inhibitor) administered via the Intramuscular route at a dosage of 210mg, initiated on 2024-12-20 for Hypertension with the course ongoing.

On approximately 2024-12-25, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Diarrhea, Hepatotoxicity, Headache, Nausea, Stevens-Johnson syndrome. The Diarrhea was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Hepatotoxicity was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Headache was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed care and advised class. The current patient status regarding this symptom is 'Fatal'. 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 documented action was: Prescribed answer and advised want. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. The assessment concluded the relationship was '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: Ten include whatever wall fly peace. Into however set choose last mother tax.</data>
report_id: ADR-2025-810
report_date: '2025-01-01'
patient_details:
  patient_id: ANON-PX-7418
  gender: Female
  relevant_history:
  - osteoarthritis
  - chronic kidney disease
  - coronary artery disease
  age_at_reaction: 88
suspected_drugs:
- drug_name: Lisinopril
  dosage: 210mg
  route_of_administration: Intramuscular
  start_date: '2024-12-20'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
adverse_reactions:
- symptom_name: Diarrhea
  onset_date: '2024-12-25'
  severity: Mild
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2024-12-25'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Headache
  onset_date: '2024-12-25'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed care and advised class.
- symptom_name: Nausea
  onset_date: '2024-12-25'
  severity: Mild
  outcome: Fatal
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-12-25'
  severity: Mild
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed answer and advised want.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
reporting_facility: Ward-Davis Medical Center
reporter_type: Patient
notes: Ten include whatever wall fly peace. Into however set choose last mother tax.
