<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-2025-689
Date of Submission: 2025-01-27

This report was submitted by a Other Healthcare Professional from Brewer and Sons Medical Center concerning patient ANON-PX-2391. The subject is a 65-year-old male with a significant medical history including asthma, chronic kidney disease, atrial fibrillation, type 2 diabetes. 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): Ibuprofen administered via the Intravenous route at a dosage of 168mg, initiated on 2024-12-15 for Pain and inflammation with the course ongoing; Atorvastatin administered via the Intramuscular route at a dosage of 389mg, initiated on 2024-12-15 for Hypercholesterolemia with the course ongoing.

On approximately 2025-01-13, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Headache, Stevens-Johnson syndrome, Hepatotoxicity. The Maculopapular Rash was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. The Headache was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Stevens-Johnson syndrome was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Hepatotoxicity was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 8 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: Financial house question support. Capital full sometimes where seven recognize thousand decide.</data>
report_id: ADR-2025-689
report_date: '2025-01-27'
patient_details:
  patient_id: ANON-PX-2391
  gender: Male
  relevant_history:
  - asthma
  - chronic kidney disease
  - atrial fibrillation
  - type 2 diabetes
  age_at_reaction: 65
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 168mg
  route_of_administration: Intravenous
  start_date: '2024-12-15'
  indication_for_use: Pain and inflammation
- drug_name: Atorvastatin
  dosage: 389mg
  route_of_administration: Intramuscular
  start_date: '2024-12-15'
  indication_for_use: Hypercholesterolemia
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2025-01-13'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Headache
  onset_date: '2025-01-13'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-01-13'
  severity: Mild
  outcome: Unknown
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2025-01-13'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 8
reporting_facility: Brewer and Sons Medical Center
reporter_type: Other Healthcare Professional
notes: Financial house question support. Capital full sometimes where seven recognize
  thousand decide.
