<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-2025-629
Date of Submission: 2025-05-29

This report was submitted by a Physician from Morris Inc Medical Center concerning patient ANON-PX-7688. The subject is a 69-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): Levothyroxine (Thyroid hormone) administered via the Intramuscular route at a dosage of 122mg, initiated on 2025-05-03 for Hypothyroidism with the course ongoing; Atorvastatin administered via the Oral route at a dosage of 132mg, initiated on 2025-05-03 for Hypercholesterolemia with the course ongoing.

On approximately 2025-05-21, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Diarrhea, Maculopapular Rash, Stevens-Johnson syndrome, Vomiting. The Diarrhea was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Maculopapular Rash was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Stevens-Johnson syndrome was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed worker and advised box. The current patient status regarding this symptom is 'Not Recovered'. The Vomiting was classified as Life-threatening 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: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Student although religious mention wall father matter. Down support assume hear would letter trial perform. Run determine table main animal.</data>
report_id: ADR-2025-629
report_date: '2025-05-29'
patient_details:
  patient_id: ANON-PX-7688
  gender: Male
  relevant_history:
  - osteoarthritis
  - anxiety
  age_at_reaction: 69
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 122mg
  route_of_administration: Intramuscular
  start_date: '2025-05-03'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
- drug_name: Atorvastatin
  dosage: 132mg
  route_of_administration: Oral
  start_date: '2025-05-03'
  indication_for_use: Hypercholesterolemia
adverse_reactions:
- symptom_name: Diarrhea
  onset_date: '2025-05-21'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2025-05-21'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-05-21'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed worker and advised box.
- symptom_name: Vomiting
  onset_date: '2025-05-21'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
reporting_facility: Morris Inc Medical Center
reporter_type: Physician
notes: Student although religious mention wall father matter. Down support assume
  hear would letter trial perform. Run determine table main animal.
