<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-2025-923
Date of Submission: 2025-03-06

This report was submitted by a Nurse from Sullivan Group Medical Center concerning patient ANON-PX-2789. The subject is an adult other with a significant medical history including osteoarthritis, migraines. 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 Intramuscular route at a dosage of 339mg, initiated on 2025-02-03 for Hypertension and discontinued on 2025-03-05.

On approximately 2025-03-03, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Stevens-Johnson syndrome, Nausea, Headache. The Vomiting was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed reason and advised carry. The current patient status regarding this symptom is 'Recovering'. The Stevens-Johnson syndrome was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Nausea was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed laugh and advised result. The current patient status regarding this symptom is 'Unknown'. The Headache was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. 

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: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Mouth strong me some available might. Quite street nature grow.</data>
report_id: ADR-2025-923
report_date: '2025-03-06'
patient_details:
  patient_id: ANON-PX-2789
  gender: Other
  relevant_history:
  - osteoarthritis
  - migraines
suspected_drugs:
- drug_name: Lisinopril
  dosage: 339mg
  route_of_administration: Intramuscular
  start_date: '2025-02-03'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2025-03-05'
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2025-03-03'
  severity: Severe
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed reason and advised carry.
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-03-03'
  severity: Mild
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2025-03-03'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed laugh and advised result.
- symptom_name: Headache
  onset_date: '2025-03-03'
  severity: Severe
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 2
reporting_facility: Sullivan Group Medical Center
reporter_type: Nurse
notes: Mouth strong me some available might. Quite street nature grow.
