<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-2024-982
Date of Submission: 2024-11-24

This report was submitted by a Nurse from Hernandez Group Medical Center concerning patient ANON-PX-8756. The subject is a 79-year-old female with a significant medical history including anxiety, migraines, seasonal allergies. 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 220mg, initiated on 2024-11-08 for Hypothyroidism and discontinued on 2024-11-14; Atorvastatin (Statin) administered via the Intramuscular route at a dosage of 459mg, initiated on 2024-11-08 for Hypercholesterolemia and discontinued on 2024-11-14.

On approximately 2024-11-12, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Nausea, Angioedema. The Pruritus was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Nausea was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed check and advised six. The current patient status regarding this symptom is 'Fatal'. The Angioedema was classified as Mild 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: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Fire if professional decision after son player. Evidence sea contain level. Garden them down finish dinner.</data>
report_id: ADR-2024-982
report_date: '2024-11-24'
patient_details:
  patient_id: ANON-PX-8756
  gender: Female
  relevant_history:
  - anxiety
  - migraines
  - seasonal allergies
  age_at_reaction: 79
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 220mg
  route_of_administration: Oral
  start_date: '2024-11-08'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2024-11-14'
- drug_name: Atorvastatin
  dosage: 459mg
  route_of_administration: Intramuscular
  start_date: '2024-11-08'
  indication_for_use: Hypercholesterolemia
  drug_class: Statin
  end_date: '2024-11-14'
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2024-11-12'
  severity: Severe
  outcome: Recovered
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2024-11-12'
  severity: Severe
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed check and advised six.
- symptom_name: Angioedema
  onset_date: '2024-11-12'
  severity: Mild
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 2
reporting_facility: Hernandez Group Medical Center
reporter_type: Nurse
notes: Fire if professional decision after son player. Evidence sea contain level.
  Garden them down finish dinner.
