<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-2024-520
Date of Submission: 2024-11-20

This report was submitted by a Physician from Ramirez and Sons Medical Center concerning patient ANON-PX-9650. The subject is an adult other with a significant medical history including type 2 diabetes, osteoarthritis, hypertension, 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): Lisinopril (ACE inhibitor) administered via the Intramuscular route at a dosage of 163mg, initiated on 2024-10-12 for Hypertension with the course ongoing.

On approximately 2024-11-05, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Diarrhea, Nausea. The Diarrhea was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Nausea was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed huge and advised our. 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: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: West six represent. Particularly later drug model difficult executive. Operation show week catch.</data>
report_id: ADR-2024-520
report_date: '2024-11-20'
patient_details:
  patient_id: ANON-PX-9650
  gender: Other
  relevant_history:
  - type 2 diabetes
  - osteoarthritis
  - hypertension
  - atrial fibrillation
suspected_drugs:
- drug_name: Lisinopril
  dosage: 163mg
  route_of_administration: Intramuscular
  start_date: '2024-10-12'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
adverse_reactions:
- symptom_name: Diarrhea
  onset_date: '2024-11-05'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2024-11-05'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed huge and advised our.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 3
reporting_facility: Ramirez and Sons Medical Center
reporter_type: Physician
notes: West six represent. Particularly later drug model difficult executive. Operation
  show week catch.
