<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-2025-567
Date of Submission: 2025-01-19

This report was submitted by a Patient from Michael-Davis Medical Center concerning patient ANON-PX-1090. The subject is a 85-year-old other with a significant medical history including type 2 diabetes, osteoarthritis, asthma. 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): Omeprazole (Proton-pump inhibitor) administered via the Intramuscular route at a dosage of 268mg, initiated on 2024-12-04 for Gastroesophageal reflux disease and discontinued on 2025-01-17; Lisinopril (ACE inhibitor) administered via the Oral route at a dosage of 495mg, initiated on 2024-12-04 for Hypertension and discontinued on 2025-01-17.

On approximately 2025-01-01, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Maculopapular Rash. The Stevens-Johnson syndrome was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. The Maculopapular Rash was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed high and advised type. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 10 was calculated, The assessment concluded the relationship was 'Highly Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: He politics life however huge message. Since seven ahead.</data>
report_id: ADR-2025-567
report_date: '2025-01-19'
patient_details:
  patient_id: ANON-PX-1090
  gender: Other
  relevant_history:
  - type 2 diabetes
  - osteoarthritis
  - asthma
  age_at_reaction: 85
suspected_drugs:
- drug_name: Omeprazole
  dosage: 268mg
  route_of_administration: Intramuscular
  start_date: '2024-12-04'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
  end_date: '2025-01-17'
- drug_name: Lisinopril
  dosage: 495mg
  route_of_administration: Oral
  start_date: '2024-12-04'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2025-01-17'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-01-01'
  severity: Mild
  outcome: Recovered
  intervention_required: true
- symptom_name: Maculopapular Rash
  onset_date: '2025-01-01'
  severity: Severe
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed high and advised type.
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 10
reporting_facility: Michael-Davis Medical Center
reporter_type: Patient
notes: He politics life however huge message. Since seven ahead.
