<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-2025-589
Date of Submission: 2025-06-13

This report was submitted by a Nurse from Parks-Porter Medical Center concerning patient ANON-PX-7544. The subject is a 32-year-old female with a significant medical history including asthma, type 2 diabetes, coronary artery disease. 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 418mg, initiated on 2025-05-06 for Hypothyroidism with the course ongoing.

On approximately 2025-06-09, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Nausea. The Vomiting was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed sense and advised box. The current patient status regarding this symptom is 'Unknown'. The Nausea was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed need and advised worker. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 7 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: Pass finish police population front. Writer word small family.</data>
report_id: ADR-2025-589
report_date: '2025-06-13'
patient_details:
  patient_id: ANON-PX-7544
  gender: Female
  relevant_history:
  - asthma
  - type 2 diabetes
  - coronary artery disease
  age_at_reaction: 32
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 418mg
  route_of_administration: Intramuscular
  start_date: '2025-05-06'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2025-06-09'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed sense and advised box.
- symptom_name: Nausea
  onset_date: '2025-06-09'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed need and advised worker.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 7
reporting_facility: Parks-Porter Medical Center
reporter_type: Nurse
notes: Pass finish police population front. Writer word small family.
