<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-2025-193
Date of Submission: 2025-01-17

This report was submitted by a Pharmacist from Hughes, Hubbard and Alvarez Medical Center concerning patient ANON-PX-1718. The subject is a 82-year-old male with a significant medical history including osteoarthritis, anxiety. 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 Subcutaneous route at a dosage of 214mg, initiated on 2024-12-28 for Hypertension and discontinued on 2024-12-30.

On approximately 2024-12-29, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Angioedema, Somnolence. The Angioedema was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Somnolence was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 1 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: Garden data thousand strong smile name in. Cover option natural step begin.</data>
report_id: ADR-2025-193
report_date: '2025-01-17'
patient_details:
  patient_id: ANON-PX-1718
  gender: Male
  relevant_history:
  - osteoarthritis
  - anxiety
  age_at_reaction: 82
suspected_drugs:
- drug_name: Lisinopril
  dosage: 214mg
  route_of_administration: Subcutaneous
  start_date: '2024-12-28'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2024-12-30'
adverse_reactions:
- symptom_name: Angioedema
  onset_date: '2024-12-29'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2024-12-29'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Not applicable
  naranjo_score: 1
reporting_facility: Hughes, Hubbard and Alvarez Medical Center
reporter_type: Pharmacist
notes: Garden data thousand strong smile name in. Cover option natural step begin.
