<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-2025-963
Date of Submission: 2025-08-06

This report was submitted by a Other Healthcare Professional from Mendoza Inc Medical Center concerning patient ANON-PX-6909. The subject is an adult other with a significant medical history including osteoarthritis, asthma, type 2 diabetes, hypertension. 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): Ibuprofen (NSAID) administered via the Topical route at a dosage of 22mg, initiated on 2025-05-30 for Pain and inflammation and discontinued on 2025-08-05; Gabapentin administered via the Intravenous route at a dosage of 245mg, initiated on 2025-05-30 for Neuropathic pain and discontinued on 2025-08-05.

On approximately 2025-07-11, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Somnolence, Hepatotoxicity, Nausea. The Vomiting was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Somnolence was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Hepatotoxicity was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed many and advised forget. The current patient status regarding this symptom is 'Unknown'. The Nausea was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. 

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: Once approach dog care. Floor audience light.</data>
report_id: ADR-2025-963
report_date: '2025-08-06'
patient_details:
  patient_id: ANON-PX-6909
  gender: Other
  relevant_history:
  - osteoarthritis
  - asthma
  - type 2 diabetes
  - hypertension
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 22mg
  route_of_administration: Topical
  start_date: '2025-05-30'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2025-08-05'
- drug_name: Gabapentin
  dosage: 245mg
  route_of_administration: Intravenous
  start_date: '2025-05-30'
  indication_for_use: Neuropathic pain
  end_date: '2025-08-05'
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2025-07-11'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2025-07-11'
  severity: Severe
  outcome: Recovering
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2025-07-11'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed many and advised forget.
- symptom_name: Nausea
  onset_date: '2025-07-11'
  severity: Severe
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
reporting_facility: Mendoza Inc Medical Center
reporter_type: Other Healthcare Professional
notes: Once approach dog care. Floor audience light.
