<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-2024-479
Date of Submission: 2024-09-03

This report was submitted by a Pharmacist from Obrien PLC Medical Center concerning patient ANON-PX-6693. The subject is a 81-year-old male with a significant medical history including coronary artery disease, anxiety, chronic kidney 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): Levothyroxine (Thyroid hormone) administered via the Topical route at a dosage of 206mg, initiated on 2024-08-24 for Hypothyroidism and discontinued on 2024-09-01.

On approximately 2024-08-28, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Somnolence, Hepatotoxicity. The Maculopapular Rash was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed alone and advised reveal. The current patient status regarding this symptom is 'Recovered'. The Somnolence was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. The Hepatotoxicity 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. The assessment concluded the relationship was 'Probable'. 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: Until need at go attack development. Present say old throw work. Group its protect strong born like.</data>
report_id: ADR-2024-479
report_date: '2024-09-03'
patient_details:
  patient_id: ANON-PX-6693
  gender: Male
  relevant_history:
  - coronary artery disease
  - anxiety
  - chronic kidney disease
  - seasonal allergies
  age_at_reaction: 81
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 206mg
  route_of_administration: Topical
  start_date: '2024-08-24'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2024-09-01'
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2024-08-28'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed alone and advised reveal.
- symptom_name: Somnolence
  onset_date: '2024-08-28'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
- symptom_name: Hepatotoxicity
  onset_date: '2024-08-28'
  severity: Severe
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
reporting_facility: Obrien PLC Medical Center
reporter_type: Pharmacist
notes: Until need at go attack development. Present say old throw work. Group its
  protect strong born like.
