<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-2024-127
Date of Submission: 2024-12-17

This report was submitted by a Nurse from Eaton-Dorsey Medical Center concerning patient ANON-PX-4933. The subject is an adult female with a significant medical history including coronary artery disease, osteoarthritis, atrial fibrillation, 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): Atorvastatin (Statin) administered via the Intravenous route at a dosage of 269mg, initiated on 2024-11-27 for Hypercholesterolemia with the course ongoing; Lisinopril (ACE inhibitor) administered via the Subcutaneous route at a dosage of 221mg, initiated on 2024-11-27 for Hypertension with the course ongoing.

On approximately 2024-12-13, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Maculopapular Rash, Hepatotoxicity, Dizziness. The Pruritus was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed not and advised admit. The current patient status regarding this symptom is 'Not Recovered'. The Maculopapular Rash was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Hepatotoxicity was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Dizziness was classified as Mild 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. A Naranjo score of 6 was calculated, 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: Ability security kitchen up. Necessary or again stay.</data>
report_id: ADR-2024-127
report_date: '2024-12-17'
patient_details:
  patient_id: ANON-PX-4933
  gender: Female
  relevant_history:
  - coronary artery disease
  - osteoarthritis
  - atrial fibrillation
  - seasonal allergies
suspected_drugs:
- drug_name: Atorvastatin
  dosage: 269mg
  route_of_administration: Intravenous
  start_date: '2024-11-27'
  indication_for_use: Hypercholesterolemia
  drug_class: Statin
- drug_name: Lisinopril
  dosage: 221mg
  route_of_administration: Subcutaneous
  start_date: '2024-11-27'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2024-12-13'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed not and advised admit.
- symptom_name: Maculopapular Rash
  onset_date: '2024-12-13'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2024-12-13'
  severity: Mild
  outcome: Recovered
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2024-12-13'
  severity: Mild
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 6
reporting_facility: Eaton-Dorsey Medical Center
reporter_type: Nurse
notes: Ability security kitchen up. Necessary or again stay.
