<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-2024-587
Date of Submission: 2024-11-06

This report was submitted by a Physician from Sanchez-Cohen Medical Center concerning patient ANON-PX-2372. The subject is a 79-year-old other with a significant medical history including osteoarthritis, seasonal allergies. 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 Oral route at a dosage of 18mg, initiated on 2024-10-04 for Hypertension with the course ongoing; Ibuprofen (NSAID) administered via the Intramuscular route at a dosage of 220mg, initiated on 2024-10-04 for Pain and inflammation with the course ongoing.

On approximately 2024-11-03, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Hepatotoxicity, Diarrhea, Anaphylaxis. The Hepatotoxicity was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. The Diarrhea was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Anaphylaxis was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 9 was calculated, The assessment concluded the relationship was 'Highly 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: Mean region history consumer truth. Time arrive listen. Pull herself arm whole huge attorney.</data>
report_id: ADR-2024-587
report_date: '2024-11-06'
patient_details:
  patient_id: ANON-PX-2372
  gender: Other
  relevant_history:
  - osteoarthritis
  - seasonal allergies
  age_at_reaction: 79
suspected_drugs:
- drug_name: Lisinopril
  dosage: 18mg
  route_of_administration: Oral
  start_date: '2024-10-04'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
- drug_name: Ibuprofen
  dosage: 220mg
  route_of_administration: Intramuscular
  start_date: '2024-10-04'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
adverse_reactions:
- symptom_name: Hepatotoxicity
  onset_date: '2024-11-03'
  severity: Mild
  outcome: Fatal
  intervention_required: true
- symptom_name: Diarrhea
  onset_date: '2024-11-03'
  severity: Mild
  outcome: Unknown
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2024-11-03'
  severity: Severe
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 9
reporting_facility: Sanchez-Cohen Medical Center
reporter_type: Physician
notes: Mean region history consumer truth. Time arrive listen. Pull herself arm whole
  huge attorney.
