<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-2025-563
Date of Submission: 2025-03-25

This report was submitted by a Patient from Schmidt and Sons Medical Center concerning patient ANON-PX-2908. The subject is a 36-year-old male with a significant medical history including asthma, coronary artery disease, 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 (ACE inhibitor) administered via the Intramuscular route at a dosage of 178mg, initiated on 2025-01-30 for Hypertension with the course ongoing.

On approximately 2025-02-08, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Headache, Hepatotoxicity, Diarrhea, Somnolence, Dizziness. The Headache was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed add and advised politics. The current patient status regarding this symptom is 'Recovering'. The Hepatotoxicity was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Diarrhea was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Somnolence was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Dizziness 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. 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: Goal skin main area. System score eight provide three top deep shake.</data>
report_id: ADR-2025-563
report_date: '2025-03-25'
patient_details:
  patient_id: ANON-PX-2908
  gender: Male
  relevant_history:
  - asthma
  - coronary artery disease
  - type 2 diabetes
  age_at_reaction: 36
suspected_drugs:
- drug_name: Lisinopril
  dosage: 178mg
  route_of_administration: Intramuscular
  start_date: '2025-01-30'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
adverse_reactions:
- symptom_name: Headache
  onset_date: '2025-02-08'
  severity: Severe
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed add and advised politics.
- symptom_name: Hepatotoxicity
  onset_date: '2025-02-08'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2025-02-08'
  severity: Mild
  outcome: Fatal
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2025-02-08'
  severity: Mild
  outcome: Recovering
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2025-02-08'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
reporting_facility: Schmidt and Sons Medical Center
reporter_type: Patient
notes: Goal skin main area. System score eight provide three top deep shake.
