<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-2025-968
Date of Submission: 2025-04-26

This report was submitted by a Physician from Kent-Coleman Medical Center concerning patient ANON-PX-6856. The subject is an adult female with a significant medical history including anxiety, asthma, coronary artery disease, type 2 diabetes. 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): Atorvastatin administered via the Topical route at a dosage of 296mg, initiated on 2025-02-27 for Hypercholesterolemia and discontinued on 2025-04-16.

On approximately 2025-03-12, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Diarrhea, Nausea, Angioedema, Anaphylaxis, Hepatotoxicity. The Diarrhea was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed network and advised north. The current patient status regarding this symptom is 'Fatal'. The Nausea was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Angioedema was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Anaphylaxis was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. The Hepatotoxicity was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. 

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: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Follow now drug seek leave leg such myself.</data>
report_id: ADR-2025-968
report_date: '2025-04-26'
patient_details:
  patient_id: ANON-PX-6856
  gender: Female
  relevant_history:
  - anxiety
  - asthma
  - coronary artery disease
  - type 2 diabetes
suspected_drugs:
- drug_name: Atorvastatin
  dosage: 296mg
  route_of_administration: Topical
  start_date: '2025-02-27'
  indication_for_use: Hypercholesterolemia
  end_date: '2025-04-16'
adverse_reactions:
- symptom_name: Diarrhea
  onset_date: '2025-03-12'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed network and advised north.
- symptom_name: Nausea
  onset_date: '2025-03-12'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2025-03-12'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
- symptom_name: Anaphylaxis
  onset_date: '2025-03-12'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
- symptom_name: Hepatotoxicity
  onset_date: '2025-03-12'
  severity: Mild
  outcome: Fatal
  intervention_required: true
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 9
reporting_facility: Kent-Coleman Medical Center
reporter_type: Physician
notes: Follow now drug seek leave leg such myself.
