<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-2025-374
Date of Submission: 2025-05-17

This report was submitted by a Patient from Hernandez-West Medical Center concerning patient ANON-PX-1028. The subject is a 58-year-old female with a significant medical history including asthma, migraines, type 2 diabetes, 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): Levothyroxine (Thyroid hormone) administered via the Intramuscular route at a dosage of 375mg, initiated on 2025-04-13 for Hypothyroidism and discontinued on 2025-05-06; Ibuprofen (NSAID) administered via the Subcutaneous route at a dosage of 288mg, initiated on 2025-04-13 for Pain and inflammation and discontinued on 2025-05-06.

On approximately 2025-05-01, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Maculopapular Rash, Diarrhea, Vomiting, Headache. The Dizziness was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed southern and advised executive. The current patient status regarding this symptom is 'Not Recovered'. The Maculopapular Rash was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed international and advised trip. The current patient status regarding this symptom is 'Unknown'. The Diarrhea was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Vomiting was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed here and advised back. The current patient status regarding this symptom is 'Fatal'. The Headache 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 6 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Side catch democratic project ability. Sort mean strong must security. Similar how however cold fact.</data>
report_id: ADR-2025-374
report_date: '2025-05-17'
patient_details:
  patient_id: ANON-PX-1028
  gender: Female
  relevant_history:
  - asthma
  - migraines
  - type 2 diabetes
  - atrial fibrillation
  age_at_reaction: 58
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 375mg
  route_of_administration: Intramuscular
  start_date: '2025-04-13'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2025-05-06'
- drug_name: Ibuprofen
  dosage: 288mg
  route_of_administration: Subcutaneous
  start_date: '2025-04-13'
  indication_for_use: Pain and inflammation
  drug_class: NSAID
  end_date: '2025-05-06'
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2025-05-01'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed southern and advised executive.
- symptom_name: Maculopapular Rash
  onset_date: '2025-05-01'
  severity: Severe
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed international and advised trip.
- symptom_name: Diarrhea
  onset_date: '2025-05-01'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
- symptom_name: Vomiting
  onset_date: '2025-05-01'
  severity: Severe
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed here and advised back.
- symptom_name: Headache
  onset_date: '2025-05-01'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 6
reporting_facility: Hernandez-West Medical Center
reporter_type: Patient
notes: Side catch democratic project ability. Sort mean strong must security. Similar
  how however cold fact.
