<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-2025-953
Date of Submission: 2025-05-29

This report was submitted by a Physician from Lee, Jordan and Hill Medical Center concerning patient ANON-PX-5149. The subject is a 69-year-old male with a significant medical history including type 2 diabetes, anxiety, coronary artery disease, osteoarthritis. 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 299mg, initiated on 2025-04-04 for Pain and inflammation and discontinued on 2025-05-26; Atorvastatin administered via the Topical route at a dosage of 411mg, initiated on 2025-04-04 for Hypercholesterolemia and discontinued on 2025-05-26.

On approximately 2025-05-22, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Pruritus, Nausea. The Vomiting was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Pruritus was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Nausea was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. 

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: Identify future act partner continue. Environmental game war reach good blue. Choose grow participant value whole him oil.</data>
report_id: ADR-2025-953
report_date: '2025-05-29'
patient_details:
  patient_id: ANON-PX-5149
  gender: Male
  relevant_history:
  - type 2 diabetes
  - anxiety
  - coronary artery disease
  - osteoarthritis
  age_at_reaction: 69
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 299mg
  route_of_administration: Intramuscular
  start_date: '2025-04-04'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2025-05-26'
- drug_name: Atorvastatin
  dosage: 411mg
  route_of_administration: Topical
  start_date: '2025-04-04'
  indication_for_use: Hypercholesterolemia
  end_date: '2025-05-26'
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2025-05-22'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2025-05-22'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2025-05-22'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 9
reporting_facility: Lee, Jordan and Hill Medical Center
reporter_type: Physician
notes: Identify future act partner continue. Environmental game war reach good blue.
  Choose grow participant value whole him oil.
