<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-2024-848
Date of Submission: 2024-11-07

This report was submitted by a Pharmacist from Martin, Pratt and Mccormick Medical Center concerning patient ANON-PX-5626. The subject is an adult male with a significant medical history including coronary artery disease, type 2 diabetes, chronic kidney disease. 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): Gabapentin (Anticonvulsant) administered via the Subcutaneous route at a dosage of 25mg, initiated on 2024-10-13 for Neuropathic pain and discontinued on 2024-11-05; Levothyroxine (Thyroid hormone) administered via the Topical route at a dosage of 406mg, initiated on 2024-10-13 for Hypothyroidism and discontinued on 2024-11-05.

On approximately 2024-11-02, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Vomiting. The Stevens-Johnson syndrome was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Vomiting was classified as Severe in severity. No specific therapeutic intervention was required. 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: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Job color push either likely fund exactly anyone. Name must brother local.</data>
report_id: ADR-2024-848
report_date: '2024-11-07'
patient_details:
  patient_id: ANON-PX-5626
  gender: Male
  relevant_history:
  - coronary artery disease
  - type 2 diabetes
  - chronic kidney disease
suspected_drugs:
- drug_name: Gabapentin
  dosage: 25mg
  route_of_administration: Subcutaneous
  start_date: '2024-10-13'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
  end_date: '2024-11-05'
- drug_name: Levothyroxine
  dosage: 406mg
  route_of_administration: Topical
  start_date: '2024-10-13'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2024-11-05'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-11-02'
  severity: Mild
  outcome: Recovering
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2024-11-02'
  severity: Severe
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Negative dechallenge
reporting_facility: Martin, Pratt and Mccormick Medical Center
reporter_type: Pharmacist
notes: Job color push either likely fund exactly anyone. Name must brother local.
