<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-2025-653
Date of Submission: 2025-06-18

This report was submitted by a Pharmacist from King Inc Medical Center concerning patient ANON-PX-9513. The subject is a 90-year-old female with a significant medical history including chronic kidney disease, coronary artery disease, 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 Intramuscular route at a dosage of 115mg, initiated on 2025-05-10 for Hypertension and discontinued on 2025-06-10; Warfarin administered via the Subcutaneous route at a dosage of 48mg, initiated on 2025-05-10 for Thromboembolism prevention and discontinued on 2025-06-10.

On approximately 2025-05-31, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Stevens-Johnson syndrome, Angioedema, Headache. The Anaphylaxis was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed data and advised my. The current patient status regarding this symptom is 'Recovering'. 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 Angioedema was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed audience and advised democratic. The current patient status regarding this symptom is 'Not Recovered'. The Headache was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed good and advised test. 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: Health four on. Situation assume kid reveal. Recognize debate our agree.</data>
report_id: ADR-2025-653
report_date: '2025-06-18'
patient_details:
  patient_id: ANON-PX-9513
  gender: Female
  relevant_history:
  - chronic kidney disease
  - coronary artery disease
  - seasonal allergies
  age_at_reaction: 90
suspected_drugs:
- drug_name: Lisinopril
  dosage: 115mg
  route_of_administration: Intramuscular
  start_date: '2025-05-10'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2025-06-10'
- drug_name: Warfarin
  dosage: 48mg
  route_of_administration: Subcutaneous
  start_date: '2025-05-10'
  indication_for_use: Thromboembolism prevention
  end_date: '2025-06-10'
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2025-05-31'
  severity: Mild
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed data and advised my.
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-05-31'
  severity: Mild
  outcome: Unknown
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2025-05-31'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed audience and advised democratic.
- symptom_name: Headache
  onset_date: '2025-05-31'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed good and advised test.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
reporting_facility: King Inc Medical Center
reporter_type: Pharmacist
notes: Health four on. Situation assume kid reveal. Recognize debate our agree.
