<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-2024-457
Date of Submission: 2024-09-25

This report was submitted by a Nurse from Sanders-Branch Medical Center concerning patient ANON-PX-3640. The subject is an adult other with a significant medical history including coronary artery disease, hypertension, type 2 diabetes, 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): Lisinopril administered via the Intramuscular route at a dosage of 432mg, initiated on 2024-07-21 for Hypertension and discontinued on 2024-09-13.

On approximately 2024-08-10, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Stevens-Johnson syndrome, Diarrhea, Anaphylaxis. The Dizziness 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 Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Diarrhea was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Anaphylaxis was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 5 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Record again to view design cover. Money name carry matter. Present respond task language room face say between.</data>
report_id: ADR-2024-457
report_date: '2024-09-25'
patient_details:
  patient_id: ANON-PX-3640
  gender: Other
  relevant_history:
  - coronary artery disease
  - hypertension
  - type 2 diabetes
  - atrial fibrillation
suspected_drugs:
- drug_name: Lisinopril
  dosage: 432mg
  route_of_administration: Intramuscular
  start_date: '2024-07-21'
  indication_for_use: Hypertension
  end_date: '2024-09-13'
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2024-08-10'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-08-10'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2024-08-10'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2024-08-10'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 5
reporting_facility: Sanders-Branch Medical Center
reporter_type: Nurse
notes: Record again to view design cover. Money name carry matter. Present respond
  task language room face say between.
