<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-2025-554
Date of Submission: 2025-07-03

This report was submitted by a Physician from Allen Inc Medical Center concerning patient ANON-PX-8329. The subject is an adult other with a significant medical history including osteoarthritis, 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 Intramuscular route at a dosage of 241mg, initiated on 2025-04-26 for Neuropathic pain with the course ongoing; Lisinopril (ACE inhibitor) administered via the Subcutaneous route at a dosage of 194mg, initiated on 2025-04-26 for Hypertension with the course ongoing.

On approximately 2025-06-07, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Maculopapular Rash, Vomiting, Hepatotoxicity, Headache. The Anaphylaxis was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed professional and advised home. The current patient status regarding this symptom is 'Recovered'. The Maculopapular Rash was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Vomiting was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed leg and advised along. 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 'Recovering'. The Headache 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. The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2025-554
report_date: '2025-07-03'
patient_details:
  patient_id: ANON-PX-8329
  gender: Other
  relevant_history:
  - osteoarthritis
  - seasonal allergies
suspected_drugs:
- drug_name: Gabapentin
  dosage: 241mg
  route_of_administration: Intramuscular
  start_date: '2025-04-26'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
- drug_name: Lisinopril
  dosage: 194mg
  route_of_administration: Subcutaneous
  start_date: '2025-04-26'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2025-06-07'
  severity: Mild
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed professional and advised home.
- symptom_name: Maculopapular Rash
  onset_date: '2025-06-07'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-06-07'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed leg and advised along.
- symptom_name: Hepatotoxicity
  onset_date: '2025-06-07'
  severity: Severe
  outcome: Recovering
  intervention_required: false
- symptom_name: Headache
  onset_date: '2025-06-07'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
reporting_facility: Allen Inc Medical Center
reporter_type: Physician
