<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-2025-633
Date of Submission: 2025-02-27

This report was submitted by a Physician from Brown, Lynch and Walker Medical Center concerning patient ANON-PX-6216. The subject is a 56-year-old male with a significant medical history including seasonal allergies, coronary artery disease, anxiety. 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 Intramuscular route at a dosage of 490mg, initiated on 2025-02-10 for Hypertension and discontinued on 2025-02-26.

On approximately 2025-02-18, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Somnolence, Headache, Pruritus, Diarrhea. The Somnolence was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Headache was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Pruritus was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Diarrhea was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. 

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: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Everyone by important sing there region you. We argue admit foot today loss. Eight card board together seek.</data>
report_id: ADR-2025-633
report_date: '2025-02-27'
patient_details:
  patient_id: ANON-PX-6216
  gender: Male
  relevant_history:
  - seasonal allergies
  - coronary artery disease
  - anxiety
  age_at_reaction: 56
suspected_drugs:
- drug_name: Lisinopril
  dosage: 490mg
  route_of_administration: Intramuscular
  start_date: '2025-02-10'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2025-02-26'
adverse_reactions:
- symptom_name: Somnolence
  onset_date: '2025-02-18'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: false
- symptom_name: Headache
  onset_date: '2025-02-18'
  severity: Mild
  outcome: Fatal
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2025-02-18'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2025-02-18'
  severity: Severe
  outcome: Recovered
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 6
reporting_facility: Brown, Lynch and Walker Medical Center
reporter_type: Physician
notes: Everyone by important sing there region you. We argue admit foot today loss.
  Eight card board together seek.
