<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-2025-640
Date of Submission: 2025-06-15

This report was submitted by a Other Healthcare Professional from Sullivan-Cross Medical Center concerning patient ANON-PX-1588. The subject is an adult male with a significant medical history including chronic kidney disease, atrial fibrillation. 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): Atorvastatin (Statin) administered via the Intravenous route at a dosage of 456mg, initiated on 2025-05-01 for Hypercholesterolemia and discontinued on 2025-06-11; Gabapentin administered via the Subcutaneous route at a dosage of 207mg, initiated on 2025-05-01 for Neuropathic pain and discontinued on 2025-06-11.

On approximately 2025-06-07, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Vomiting, Diarrhea. The Pruritus was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed child and advised phone. The current patient status regarding this symptom is 'Fatal'. The Vomiting was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Diarrhea was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. 

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: Hour western never sign. Group win church their teach.</data>
report_id: ADR-2025-640
report_date: '2025-06-15'
patient_details:
  patient_id: ANON-PX-1588
  gender: Male
  relevant_history:
  - chronic kidney disease
  - atrial fibrillation
suspected_drugs:
- drug_name: Atorvastatin
  dosage: 456mg
  route_of_administration: Intravenous
  start_date: '2025-05-01'
  indication_for_use: Hypercholesterolemia
  drug_class: Statin
  end_date: '2025-06-11'
- drug_name: Gabapentin
  dosage: 207mg
  route_of_administration: Subcutaneous
  start_date: '2025-05-01'
  indication_for_use: Neuropathic pain
  end_date: '2025-06-11'
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2025-06-07'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed child and advised phone.
- symptom_name: Vomiting
  onset_date: '2025-06-07'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2025-06-07'
  severity: Mild
  outcome: Unknown
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 6
reporting_facility: Sullivan-Cross Medical Center
reporter_type: Other Healthcare Professional
notes: Hour western never sign. Group win church their teach.
