<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-2025-296
Date of Submission: 2025-04-28

This report was submitted by a Nurse from Mayer Inc Medical Center concerning patient ANON-PX-8040. The subject is a 79-year-old male with a significant medical history including chronic kidney disease, coronary artery 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): Atorvastatin administered via the Intramuscular route at a dosage of 388mg, initiated on 2025-03-08 for Hypercholesterolemia with the course ongoing; Levothyroxine administered via the Oral route at a dosage of 383mg, initiated on 2025-03-08 for Hypothyroidism with the course ongoing.

On approximately 2025-04-16, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Angioedema, Somnolence, Hepatotoxicity. The Angioedema was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed prepare and advised environment. The current patient status regarding this symptom is 'Not Recovered'. The Somnolence was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Hepatotoxicity was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed money and advised while. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 7 was calculated, 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: For avoid news describe. Woman do conference people chair. All style wrong trial know couple.</data>
report_id: ADR-2025-296
report_date: '2025-04-28'
patient_details:
  patient_id: ANON-PX-8040
  gender: Male
  relevant_history:
  - chronic kidney disease
  - coronary artery disease
  age_at_reaction: 79
suspected_drugs:
- drug_name: Atorvastatin
  dosage: 388mg
  route_of_administration: Intramuscular
  start_date: '2025-03-08'
  indication_for_use: Hypercholesterolemia
- drug_name: Levothyroxine
  dosage: 383mg
  route_of_administration: Oral
  start_date: '2025-03-08'
  indication_for_use: Hypothyroidism
adverse_reactions:
- symptom_name: Angioedema
  onset_date: '2025-04-16'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed prepare and advised environment.
- symptom_name: Somnolence
  onset_date: '2025-04-16'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
- symptom_name: Hepatotoxicity
  onset_date: '2025-04-16'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed money and advised while.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 7
reporting_facility: Mayer Inc Medical Center
reporter_type: Nurse
notes: For avoid news describe. Woman do conference people chair. All style wrong
  trial know couple.
