<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-2024-374
Date of Submission: 2024-12-05

This report was submitted by a Pharmacist from Wilkinson Inc Medical Center concerning patient ANON-PX-7885. The subject is a 18-year-old female with a significant medical history including coronary artery disease, seasonal allergies, 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 Subcutaneous route at a dosage of 34mg, initiated on 2024-09-17 for Hypertension and discontinued on 2024-10-29.

On approximately 2024-10-13, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Hepatotoxicity, Pruritus, Dizziness, Somnolence. The Hepatotoxicity was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. The Pruritus was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Dizziness was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed western and advised series. The current patient status regarding this symptom is 'Fatal'. The Somnolence was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed involve and advised company. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 2 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Score three hard indicate TV service. Participant tell popular commercial both almost. See in reach part help firm.</data>
report_id: ADR-2024-374
report_date: '2024-12-05'
patient_details:
  patient_id: ANON-PX-7885
  gender: Female
  relevant_history:
  - coronary artery disease
  - seasonal allergies
  - type 2 diabetes
  age_at_reaction: 18
suspected_drugs:
- drug_name: Lisinopril
  dosage: 34mg
  route_of_administration: Subcutaneous
  start_date: '2024-09-17'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2024-10-29'
adverse_reactions:
- symptom_name: Hepatotoxicity
  onset_date: '2024-10-13'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
- symptom_name: Pruritus
  onset_date: '2024-10-13'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2024-10-13'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed western and advised series.
- symptom_name: Somnolence
  onset_date: '2024-10-13'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed involve and advised company.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 2
reporting_facility: Wilkinson Inc Medical Center
reporter_type: Pharmacist
notes: Score three hard indicate TV service. Participant tell popular commercial both
  almost. See in reach part help firm.
