<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-2025-840
Date of Submission: 2025-06-06

This report was submitted by a Other Healthcare Professional from Cooper and Sons Medical Center concerning patient ANON-PX-4810. The subject is a 41-year-old male with a significant medical history including asthma, hypertension, migraines. 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): Gabapentin (Anticonvulsant) administered via the Oral route at a dosage of 147mg, initiated on 2025-05-02 for Neuropathic pain and discontinued on 2025-05-25; Levothyroxine (Thyroid hormone) administered via the Topical route at a dosage of 324mg, initiated on 2025-05-02 for Hypothyroidism and discontinued on 2025-05-25.

On approximately 2025-05-11, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Hepatotoxicity, Headache. The Vomiting was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. The Hepatotoxicity was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Headache was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 2 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Phone industry night happen me. With find health difficult kid picture game.</data>
report_id: ADR-2025-840
report_date: '2025-06-06'
patient_details:
  patient_id: ANON-PX-4810
  gender: Male
  relevant_history:
  - asthma
  - hypertension
  - migraines
  age_at_reaction: 41
suspected_drugs:
- drug_name: Gabapentin
  dosage: 147mg
  route_of_administration: Oral
  start_date: '2025-05-02'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
  end_date: '2025-05-25'
- drug_name: Levothyroxine
  dosage: 324mg
  route_of_administration: Topical
  start_date: '2025-05-02'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2025-05-25'
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2025-05-11'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Hepatotoxicity
  onset_date: '2025-05-11'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Headache
  onset_date: '2025-05-11'
  severity: Mild
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 2
reporting_facility: Cooper and Sons Medical Center
reporter_type: Other Healthcare Professional
notes: Phone industry night happen me. With find health difficult kid picture game.
