<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-2024-798
Date of Submission: 2024-09-08

This report was submitted by a Pharmacist from Anderson and Sons Medical Center concerning patient ANON-PX-7460. The subject is a 76-year-old female with a significant medical history including seasonal allergies, atrial fibrillation, migraines, hypertension. 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): Amoxicillin (Penicillin antibiotic) administered via the Topical route at a dosage of 131mg, initiated on 2024-07-16 for Bacterial infection with the course ongoing; Lisinopril (ACE inhibitor) administered via the Intravenous route at a dosage of 399mg, initiated on 2024-07-16 for Hypertension with the course ongoing.

On approximately 2024-08-27, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Hepatotoxicity, Headache, Stevens-Johnson syndrome. The Hepatotoxicity was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. The Headache was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Stevens-Johnson syndrome was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed purpose and advised gas. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. 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: Boy realize try truth although yes various rich. Condition fall player mission key.</data>
report_id: ADR-2024-798
report_date: '2024-09-08'
patient_details:
  patient_id: ANON-PX-7460
  gender: Female
  relevant_history:
  - seasonal allergies
  - atrial fibrillation
  - migraines
  - hypertension
  age_at_reaction: 76
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 131mg
  route_of_administration: Topical
  start_date: '2024-07-16'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
- drug_name: Lisinopril
  dosage: 399mg
  route_of_administration: Intravenous
  start_date: '2024-07-16'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
adverse_reactions:
- symptom_name: Hepatotoxicity
  onset_date: '2024-08-27'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
- symptom_name: Headache
  onset_date: '2024-08-27'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-08-27'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed purpose and advised gas.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
reporting_facility: Anderson and Sons Medical Center
reporter_type: Pharmacist
notes: Boy realize try truth although yes various rich. Condition fall player mission
  key.
