<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-2025-962
Date of Submission: 2025-07-18

This report was submitted by a Physician from Schwartz-Mason Medical Center concerning patient ANON-PX-4985. The subject is a 88-year-old other with a significant medical history including anxiety, asthma, hypertension, osteoarthritis. 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 Oral route at a dosage of 320mg, initiated on 2025-06-08 for Hypertension with the course ongoing.

On approximately 2025-06-16, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Nausea, Maculopapular Rash, Hepatotoxicity, Anaphylaxis, Angioedema. The Nausea was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Maculopapular Rash was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed low and advised end. The current patient status regarding this symptom is 'Not Recovered'. The Hepatotoxicity was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. The Anaphylaxis was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Angioedema was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 9 was calculated, The assessment concluded the relationship was 'Highly Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: As of effect chair bag not. Analysis while very idea away coach.</data>
report_id: ADR-2025-962
report_date: '2025-07-18'
patient_details:
  patient_id: ANON-PX-4985
  gender: Other
  relevant_history:
  - anxiety
  - asthma
  - hypertension
  - osteoarthritis
  age_at_reaction: 88
suspected_drugs:
- drug_name: Lisinopril
  dosage: 320mg
  route_of_administration: Oral
  start_date: '2025-06-08'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
adverse_reactions:
- symptom_name: Nausea
  onset_date: '2025-06-16'
  severity: Moderate
  outcome: Recovered
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2025-06-16'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed low and advised end.
- symptom_name: Hepatotoxicity
  onset_date: '2025-06-16'
  severity: Mild
  outcome: Recovered
  intervention_required: true
- symptom_name: Anaphylaxis
  onset_date: '2025-06-16'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2025-06-16'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: true
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 9
reporting_facility: Schwartz-Mason Medical Center
reporter_type: Physician
notes: As of effect chair bag not. Analysis while very idea away coach.
