<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-2024-994
Date of Submission: 2024-10-02

This report was submitted by a Nurse from Miller-Hebert Medical Center concerning patient ANON-PX-2779. The subject is an adult other with a significant medical history including chronic kidney disease, coronary artery disease, 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): Ibuprofen (NSAID) administered via the Intramuscular route at a dosage of 273mg, initiated on 2024-09-24 for Pain and inflammation and discontinued on 2024-09-29.

On approximately 2024-09-25, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Dizziness, Hepatotoxicity. The Stevens-Johnson syndrome was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Dizziness was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed future and advised trial. The current patient status regarding this symptom is 'Fatal'. The Hepatotoxicity was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed force and advised while. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 1 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2024-994
report_date: '2024-10-02'
patient_details:
  patient_id: ANON-PX-2779
  gender: Other
  relevant_history:
  - chronic kidney disease
  - coronary artery disease
  - hypertension
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 273mg
  route_of_administration: Intramuscular
  start_date: '2024-09-24'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2024-09-29'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-09-25'
  severity: Moderate
  outcome: Recovered
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2024-09-25'
  severity: Severe
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed future and advised trial.
- symptom_name: Hepatotoxicity
  onset_date: '2024-09-25'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed force and advised while.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 1
reporting_facility: Miller-Hebert Medical Center
reporter_type: Nurse
