<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-2024-131
Date of Submission: 2024-12-14

This report was submitted by a Pharmacist from Brooks PLC Medical Center concerning patient ANON-PX-9888. The subject is a 58-year-old other with a significant medical history including coronary artery disease, 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 Oral route at a dosage of 400mg, initiated on 2024-09-17 for Hypertension and discontinued on 2024-10-31; Metformin administered via the Subcutaneous route at a dosage of 422mg, initiated on 2024-09-17 for Type 2 diabetes and discontinued on 2024-10-31.

On approximately 2024-10-05, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Angioedema, Maculopapular Rash. The Angioedema was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Maculopapular Rash was classified as Severe 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 6 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Thousand color look several.</data>
report_id: ADR-2024-131
report_date: '2024-12-14'
patient_details:
  patient_id: ANON-PX-9888
  gender: Other
  relevant_history:
  - coronary artery disease
  - migraines
  age_at_reaction: 58
suspected_drugs:
- drug_name: Lisinopril
  dosage: 400mg
  route_of_administration: Oral
  start_date: '2024-09-17'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2024-10-31'
- drug_name: Metformin
  dosage: 422mg
  route_of_administration: Subcutaneous
  start_date: '2024-09-17'
  indication_for_use: Type 2 diabetes
  end_date: '2024-10-31'
adverse_reactions:
- symptom_name: Angioedema
  onset_date: '2024-10-05'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2024-10-05'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 6
reporting_facility: Brooks PLC Medical Center
reporter_type: Pharmacist
notes: Thousand color look several.
