<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-2024-670
Date of Submission: 2024-10-16

This report was submitted by a Physician from Mason and Sons Medical Center concerning patient ANON-PX-2227. The subject is a 35-year-old male with a significant medical history including atrial fibrillation, coronary artery disease, type 2 diabetes, 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): Levothyroxine administered via the Intramuscular route at a dosage of 261mg, initiated on 2024-08-24 for Hypothyroidism and discontinued on 2024-09-17; Ibuprofen administered via the Topical route at a dosage of 181mg, initiated on 2024-08-24 for Pain and inflammation and discontinued on 2024-09-17.

On approximately 2024-09-17, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Nausea, Dizziness, Headache, Diarrhea, Somnolence. The Nausea was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed find and advised fall. The current patient status regarding this symptom is 'Fatal'. The Dizziness was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Headache 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 Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed view and advised view. The current patient status regarding this symptom is 'Fatal'. The Somnolence was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 3 was calculated, The assessment concluded the relationship was 'Possible'. 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: Speak language five capital manage major wish discuss.</data>
report_id: ADR-2024-670
report_date: '2024-10-16'
patient_details:
  patient_id: ANON-PX-2227
  gender: Male
  relevant_history:
  - atrial fibrillation
  - coronary artery disease
  - type 2 diabetes
  - migraines
  age_at_reaction: 35
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 261mg
  route_of_administration: Intramuscular
  start_date: '2024-08-24'
  indication_for_use: Hypothyroidism
  end_date: '2024-09-17'
- drug_name: Ibuprofen
  dosage: 181mg
  route_of_administration: Topical
  start_date: '2024-08-24'
  indication_for_use: Pain and inflammation
  end_date: '2024-09-17'
adverse_reactions:
- symptom_name: Nausea
  onset_date: '2024-09-17'
  severity: Mild
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed find and advised fall.
- symptom_name: Dizziness
  onset_date: '2024-09-17'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Headache
  onset_date: '2024-09-17'
  severity: Mild
  outcome: Unknown
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2024-09-17'
  severity: Mild
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed view and advised view.
- symptom_name: Somnolence
  onset_date: '2024-09-17'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Not applicable
  naranjo_score: 3
reporting_facility: Mason and Sons Medical Center
reporter_type: Physician
notes: Speak language five capital manage major wish discuss.
