<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-2025-831
Date of Submission: 2025-06-15

This report was submitted by a Pharmacist from Hayes and Sons Medical Center concerning patient ANON-PX-8918. The subject is a 82-year-old other with a significant medical history including coronary artery disease, 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): Lisinopril (ACE inhibitor) administered via the Subcutaneous route at a dosage of 299mg, initiated on 2025-05-22 for Hypertension with the course ongoing.

On approximately 2025-06-03, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Pruritus, Somnolence, Nausea, Anaphylaxis. The Dizziness was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. 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 Somnolence was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. The Nausea was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Anaphylaxis was classified as Moderate 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 9 was calculated, The assessment concluded the relationship was 'Highly Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2025-831
report_date: '2025-06-15'
patient_details:
  patient_id: ANON-PX-8918
  gender: Other
  relevant_history:
  - coronary artery disease
  - atrial fibrillation
  age_at_reaction: 82
suspected_drugs:
- drug_name: Lisinopril
  dosage: 299mg
  route_of_administration: Subcutaneous
  start_date: '2025-05-22'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2025-06-03'
  severity: Mild
  outcome: Unknown
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2025-06-03'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2025-06-03'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
- symptom_name: Nausea
  onset_date: '2025-06-03'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2025-06-03'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 9
reporting_facility: Hayes and Sons Medical Center
reporter_type: Pharmacist
