<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-2025-631
Date of Submission: 2025-04-07

This report was submitted by a Nurse from Williams, Collins and Ryan Medical Center concerning patient ANON-PX-5983. The subject is an adult male with a significant medical history including migraines, seasonal allergies, anxiety, hypertension. 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 Topical route at a dosage of 286mg, initiated on 2025-01-26 for Hypertension and discontinued on 2025-02-25.

On approximately 2025-02-04, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Diarrhea, Maculopapular Rash, Vomiting, Nausea. The Dizziness was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Diarrhea was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed mean and advised everybody. The current patient status regarding this symptom is 'Not Recovered'. The Maculopapular Rash was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Vomiting was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Nausea was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 7 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Area article community PM want since law often. Relate staff live yeah expert with. Hit treat design themselves resource particularly.</data>
report_id: ADR-2025-631
report_date: '2025-04-07'
patient_details:
  patient_id: ANON-PX-5983
  gender: Male
  relevant_history:
  - migraines
  - seasonal allergies
  - anxiety
  - hypertension
suspected_drugs:
- drug_name: Lisinopril
  dosage: 286mg
  route_of_administration: Topical
  start_date: '2025-01-26'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2025-02-25'
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2025-02-04'
  severity: Mild
  outcome: Unknown
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2025-02-04'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed mean and advised everybody.
- symptom_name: Maculopapular Rash
  onset_date: '2025-02-04'
  severity: Mild
  outcome: Recovering
  intervention_required: true
- symptom_name: Vomiting
  onset_date: '2025-02-04'
  severity: Mild
  outcome: Fatal
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2025-02-04'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 7
reporting_facility: Williams, Collins and Ryan Medical Center
reporter_type: Nurse
notes: Area article community PM want since law often. Relate staff live yeah expert
  with. Hit treat design themselves resource particularly.
