<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-2025-400
Date of Submission: 2025-05-20

This report was submitted by a Pharmacist from Lane, Adams and Chavez Medical Center concerning patient ANON-PX-1889. The subject is a 70-year-old male with a significant medical history including hypertension, type 2 diabetes, anxiety, asthma. 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 209mg, initiated on 2025-04-15 for Hypertension with the course ongoing.

On approximately 2025-05-13, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Nausea, Anaphylaxis, Somnolence, Hepatotoxicity, Vomiting. The Nausea was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Anaphylaxis was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Somnolence was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed stay and advised according. The current patient status regarding this symptom is 'Fatal'. The Hepatotoxicity was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed cause and advised north. 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 reason and advised general. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: In whole continue effect care. Alone Mr easy area others near project. Identify drop some low value decide gas.</data>
report_id: ADR-2025-400
report_date: '2025-05-20'
patient_details:
  patient_id: ANON-PX-1889
  gender: Male
  relevant_history:
  - hypertension
  - type 2 diabetes
  - anxiety
  - asthma
  age_at_reaction: 70
suspected_drugs:
- drug_name: Lisinopril
  dosage: 209mg
  route_of_administration: Subcutaneous
  start_date: '2025-04-15'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
adverse_reactions:
- symptom_name: Nausea
  onset_date: '2025-05-13'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2025-05-13'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2025-05-13'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed stay and advised according.
- symptom_name: Hepatotoxicity
  onset_date: '2025-05-13'
  severity: Mild
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed cause and advised north.
- symptom_name: Vomiting
  onset_date: '2025-05-13'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed reason and advised general.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
reporting_facility: Lane, Adams and Chavez Medical Center
reporter_type: Pharmacist
notes: In whole continue effect care. Alone Mr easy area others near project. Identify
  drop some low value decide gas.
