<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-2025-763
Date of Submission: 2025-02-19

This report was submitted by a Pharmacist from Watts LLC Medical Center concerning patient ANON-PX-1937. The subject is an adult female with a significant medical history including chronic kidney disease, 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): Atorvastatin administered via the Subcutaneous route at a dosage of 235mg, initiated on 2024-12-25 for Hypercholesterolemia and discontinued on 2025-01-03.

On approximately 2024-12-28, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Hepatotoxicity. The Maculopapular Rash was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed well and advised wait. The current patient status regarding this symptom is 'Recovering'. The Hepatotoxicity was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 5 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Six but trade yeah though. First per skill. Record speak away share ready answer report. Yes officer especially myself statement evidence.</data>
report_id: ADR-2025-763
report_date: '2025-02-19'
patient_details:
  patient_id: ANON-PX-1937
  gender: Female
  relevant_history:
  - chronic kidney disease
  - coronary artery disease
  - atrial fibrillation
suspected_drugs:
- drug_name: Atorvastatin
  dosage: 235mg
  route_of_administration: Subcutaneous
  start_date: '2024-12-25'
  indication_for_use: Hypercholesterolemia
  end_date: '2025-01-03'
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2024-12-28'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed well and advised wait.
- symptom_name: Hepatotoxicity
  onset_date: '2024-12-28'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 5
reporting_facility: Watts LLC Medical Center
reporter_type: Pharmacist
notes: Six but trade yeah though. First per skill. Record speak away share ready answer
  report. Yes officer especially myself statement evidence.
