<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-2025-143
Date of Submission: 2025-06-11

This report was submitted by a Pharmacist from Dixon, Jones and Hurley Medical Center concerning patient ANON-PX-3319. The subject is a 57-year-old female with a significant medical history including migraines, 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): Gabapentin (Anticonvulsant) administered via the Subcutaneous route at a dosage of 5mg, initiated on 2025-03-25 for Neuropathic pain and discontinued on 2025-04-17.

On approximately 2025-04-17, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Diarrhea, Vomiting, Hepatotoxicity. The Diarrhea was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Vomiting was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Hepatotoxicity was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 8 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Station door service have though music everyone. May necessary why strategy.</data>
report_id: ADR-2025-143
report_date: '2025-06-11'
patient_details:
  patient_id: ANON-PX-3319
  gender: Female
  relevant_history:
  - migraines
  - atrial fibrillation
  age_at_reaction: 57
suspected_drugs:
- drug_name: Gabapentin
  dosage: 5mg
  route_of_administration: Subcutaneous
  start_date: '2025-03-25'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
  end_date: '2025-04-17'
adverse_reactions:
- symptom_name: Diarrhea
  onset_date: '2025-04-17'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-04-17'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2025-04-17'
  severity: Mild
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 8
reporting_facility: Dixon, Jones and Hurley Medical Center
reporter_type: Pharmacist
notes: Station door service have though music everyone. May necessary why strategy.
