<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-2025-890
Date of Submission: 2025-03-19

This report was submitted by a Pharmacist from Martinez, Spencer and Davis Medical Center concerning patient ANON-PX-1314. The subject is an adult female with a significant medical history including type 2 diabetes, atrial fibrillation. 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 administered via the Intramuscular route at a dosage of 160mg, initiated on 2025-02-15 for Hypothyroidism with the course ongoing.

On approximately 2025-03-13, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Angioedema. The Dizziness was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Angioedema was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed that and advised authority. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 10 was calculated, The assessment concluded the relationship was 'Highly 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: Fish more since arm training owner spend. Rock maintain writer side. Inside degree bring image opportunity others.</data>
report_id: ADR-2025-890
report_date: '2025-03-19'
patient_details:
  patient_id: ANON-PX-1314
  gender: Female
  relevant_history:
  - type 2 diabetes
  - atrial fibrillation
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 160mg
  route_of_administration: Intramuscular
  start_date: '2025-02-15'
  indication_for_use: Hypothyroidism
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2025-03-13'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2025-03-13'
  severity: Mild
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed that and advised authority.
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 10
reporting_facility: Martinez, Spencer and Davis Medical Center
reporter_type: Pharmacist
notes: Fish more since arm training owner spend. Rock maintain writer side. Inside
  degree bring image opportunity others.
