<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-2025-807
Date of Submission: 2025-07-01

This report was submitted by a Physician from Young PLC Medical Center concerning patient ANON-PX-1826. The subject is an adult other with a significant medical history including coronary artery disease, seasonal allergies, type 2 diabetes, hypertension. 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 249mg, initiated on 2025-04-11 for Hypothyroidism and discontinued on 2025-06-30.

On approximately 2025-06-23, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Headache, Vomiting. The Headache was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Vomiting was classified as Life-threatening 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 4 was calculated, The assessment concluded the relationship was 'Possible'. 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: Owner home spring necessary hand page perform. Brother director itself throughout tree dog.</data>
report_id: ADR-2025-807
report_date: '2025-07-01'
patient_details:
  patient_id: ANON-PX-1826
  gender: Other
  relevant_history:
  - coronary artery disease
  - seasonal allergies
  - type 2 diabetes
  - hypertension
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 249mg
  route_of_administration: Topical
  start_date: '2025-04-11'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2025-06-30'
adverse_reactions:
- symptom_name: Headache
  onset_date: '2025-06-23'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-06-23'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: true
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Not applicable
  naranjo_score: 4
reporting_facility: Young PLC Medical Center
reporter_type: Physician
notes: Owner home spring necessary hand page perform. Brother director itself throughout
  tree dog.
