<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-2024-365
Date of Submission: 2024-09-10

This report was submitted by a Pharmacist from Chavez LLC Medical Center concerning patient ANON-PX-5066. The subject is an adult other with a significant medical history including chronic kidney disease, atrial fibrillation. 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): Levothyroxine (Thyroid hormone) administered via the Oral route at a dosage of 483mg, initiated on 2024-07-03 for Hypothyroidism and discontinued on 2024-07-31.

On approximately 2024-07-08, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Dizziness, Nausea, Somnolence, Hepatotoxicity. The Maculopapular Rash was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed take and advised thank. The current patient status regarding this symptom is 'Fatal'. The Dizziness was classified as Mild in severity. This necessitated clinical intervention. 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 'Recovering'. The Somnolence was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Hepatotoxicity was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 3 was calculated, The assessment concluded the relationship was 'Possible'. 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: Later turn house talk. May consider wall offer. Spend describe miss.</data>
report_id: ADR-2024-365
report_date: '2024-09-10'
patient_details:
  patient_id: ANON-PX-5066
  gender: Other
  relevant_history:
  - chronic kidney disease
  - atrial fibrillation
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 483mg
  route_of_administration: Oral
  start_date: '2024-07-03'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2024-07-31'
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2024-07-08'
  severity: Severe
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed take and advised thank.
- symptom_name: Dizziness
  onset_date: '2024-07-08'
  severity: Mild
  outcome: Fatal
  intervention_required: true
- symptom_name: Nausea
  onset_date: '2024-07-08'
  severity: Severe
  outcome: Recovering
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2024-07-08'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2024-07-08'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 3
reporting_facility: Chavez LLC Medical Center
reporter_type: Pharmacist
notes: Later turn house talk. May consider wall offer. Spend describe miss.
