<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-2024-579
Date of Submission: 2024-11-30

This report was submitted by a Physician from Lang PLC Medical Center concerning patient ANON-PX-8644. The subject is a 71-year-old male with a significant medical history including migraines, chronic kidney disease, asthma, 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): Atorvastatin (Statin) administered via the Subcutaneous route at a dosage of 424mg, initiated on 2024-09-13 for Hypercholesterolemia with the course ongoing; Lisinopril (ACE inhibitor) administered via the Subcutaneous route at a dosage of 37mg, initiated on 2024-09-13 for Hypertension with the course ongoing.

On approximately 2024-11-11, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Diarrhea, Angioedema, Nausea, Vomiting. The Diarrhea was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Angioedema was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed herself and advised watch. The current patient status regarding this symptom is 'Fatal'. The Nausea was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Vomiting was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed current and advised end. 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: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Treatment debate note million. Response sea down on. Or mention onto concern.</data>
report_id: ADR-2024-579
report_date: '2024-11-30'
patient_details:
  patient_id: ANON-PX-8644
  gender: Male
  relevant_history:
  - migraines
  - chronic kidney disease
  - asthma
  - type 2 diabetes
  age_at_reaction: 71
suspected_drugs:
- drug_name: Atorvastatin
  dosage: 424mg
  route_of_administration: Subcutaneous
  start_date: '2024-09-13'
  indication_for_use: Hypercholesterolemia
  drug_class: Statin
- drug_name: Lisinopril
  dosage: 37mg
  route_of_administration: Subcutaneous
  start_date: '2024-09-13'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
adverse_reactions:
- symptom_name: Diarrhea
  onset_date: '2024-11-11'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
- symptom_name: Angioedema
  onset_date: '2024-11-11'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed herself and advised watch.
- symptom_name: Nausea
  onset_date: '2024-11-11'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2024-11-11'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed current and advised end.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Negative dechallenge
reporting_facility: Lang PLC Medical Center
reporter_type: Physician
notes: Treatment debate note million. Response sea down on. Or mention onto concern.
