<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-2025-588
Date of Submission: 2025-03-01

This report was submitted by a Other Healthcare Professional from Carey, Thomas and Mccullough Medical Center concerning patient ANON-PX-4989. The subject is a 52-year-old other with a significant medical history including asthma, hypertension, atrial fibrillation, 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): Ibuprofen (NSAID) administered via the Topical route at a dosage of 242mg, initiated on 2025-01-18 for Pain and inflammation with the course ongoing; Levothyroxine (Thyroid hormone) administered via the Intramuscular route at a dosage of 153mg, initiated on 2025-01-18 for Hypothyroidism with the course ongoing.

On approximately 2025-02-19, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Pruritus, Hepatotoxicity. The Dizziness was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Pruritus was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed memory and advised prevent. The current patient status regarding this symptom is 'Recovering'. The Hepatotoxicity was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Thousand rich war design medical. Democrat coach day its person point size sure.</data>
report_id: ADR-2025-588
report_date: '2025-03-01'
patient_details:
  patient_id: ANON-PX-4989
  gender: Other
  relevant_history:
  - asthma
  - hypertension
  - atrial fibrillation
  - seasonal allergies
  age_at_reaction: 52
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 242mg
  route_of_administration: Topical
  start_date: '2025-01-18'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
- drug_name: Levothyroxine
  dosage: 153mg
  route_of_administration: Intramuscular
  start_date: '2025-01-18'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2025-02-19'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2025-02-19'
  severity: Severe
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed memory and advised prevent.
- symptom_name: Hepatotoxicity
  onset_date: '2025-02-19'
  severity: Mild
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
reporting_facility: Carey, Thomas and Mccullough Medical Center
reporter_type: Other Healthcare Professional
notes: Thousand rich war design medical. Democrat coach day its person point size
  sure.
