<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-2025-980
Date of Submission: 2025-07-17

This report was submitted by a Nurse from Stout Group Medical Center concerning patient ANON-PX-1299. The subject is a 28-year-old female with a significant medical history including asthma, osteoarthritis, 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): Lisinopril (ACE inhibitor) administered via the Oral route at a dosage of 453mg, initiated on 2025-05-28 for Hypertension and discontinued on 2025-06-23; Gabapentin (Anticonvulsant) administered via the Topical route at a dosage of 302mg, initiated on 2025-05-28 for Neuropathic pain and discontinued on 2025-06-23.

On approximately 2025-06-23, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Headache, Nausea, Angioedema, Hepatotoxicity. The Headache was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Nausea was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed continue and advised director. The current patient status regarding this symptom is 'Not Recovered'. The Angioedema was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed letter and advised guy. The current patient status regarding this symptom is 'Recovering'. The Hepatotoxicity was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. 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: Challenge specific act. Often what than point. Personal always only brother discover.</data>
report_id: ADR-2025-980
report_date: '2025-07-17'
patient_details:
  patient_id: ANON-PX-1299
  gender: Female
  relevant_history:
  - asthma
  - osteoarthritis
  - coronary artery disease
  age_at_reaction: 28
suspected_drugs:
- drug_name: Lisinopril
  dosage: 453mg
  route_of_administration: Oral
  start_date: '2025-05-28'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2025-06-23'
- drug_name: Gabapentin
  dosage: 302mg
  route_of_administration: Topical
  start_date: '2025-05-28'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
  end_date: '2025-06-23'
adverse_reactions:
- symptom_name: Headache
  onset_date: '2025-06-23'
  severity: Severe
  outcome: Recovering
  intervention_required: true
- symptom_name: Nausea
  onset_date: '2025-06-23'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed continue and advised director.
- symptom_name: Angioedema
  onset_date: '2025-06-23'
  severity: Severe
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed letter and advised guy.
- symptom_name: Hepatotoxicity
  onset_date: '2025-06-23'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
reporting_facility: Stout Group Medical Center
reporter_type: Nurse
notes: Challenge specific act. Often what than point. Personal always only brother
  discover.
