<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-2025-100
Date of Submission: 2025-07-22

This report was submitted by a Nurse from Shields Inc Medical Center concerning patient ANON-PX-6504. The subject is a 39-year-old other with a significant medical history including migraines, 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): Gabapentin (Anticonvulsant) administered via the Intravenous route at a dosage of 394mg, initiated on 2025-05-31 for Neuropathic pain and discontinued on 2025-07-02; Ibuprofen (NSAID) administered via the Topical route at a dosage of 257mg, initiated on 2025-05-31 for Pain and inflammation and discontinued on 2025-07-02.

On approximately 2025-06-24, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Headache, Diarrhea, Pruritus, Hepatotoxicity. The Headache was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed send and advised far. The current patient status regarding this symptom is 'Not Recovered'. The Diarrhea was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Pruritus was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Hepatotoxicity was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 4 was calculated, The assessment concluded the relationship was 'Possible'. 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: Concern seven design keep early voice town. Skill dream our guess. Ready last room upon against federal back. Help current you.</data>
report_id: ADR-2025-100
report_date: '2025-07-22'
patient_details:
  patient_id: ANON-PX-6504
  gender: Other
  relevant_history:
  - migraines
  - hypertension
  age_at_reaction: 39
suspected_drugs:
- drug_name: Gabapentin
  dosage: 394mg
  route_of_administration: Intravenous
  start_date: '2025-05-31'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
  end_date: '2025-07-02'
- drug_name: Ibuprofen
  dosage: 257mg
  route_of_administration: Topical
  start_date: '2025-05-31'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2025-07-02'
adverse_reactions:
- symptom_name: Headache
  onset_date: '2025-06-24'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed send and advised far.
- symptom_name: Diarrhea
  onset_date: '2025-06-24'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2025-06-24'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2025-06-24'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 4
reporting_facility: Shields Inc Medical Center
reporter_type: Nurse
notes: Concern seven design keep early voice town. Skill dream our guess. Ready last
  room upon against federal back. Help current you.
