<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-2024-510
Date of Submission: 2024-12-19

This report was submitted by a Nurse from Jackson PLC Medical Center concerning patient ANON-PX-9141. The subject is a 82-year-old other with a significant medical history including migraines, coronary artery disease, asthma, chronic kidney 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): Ibuprofen administered via the Oral route at a dosage of 467mg, initiated on 2024-10-08 for Pain and inflammation and discontinued on 2024-12-15.

On approximately 2024-12-15, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Hepatotoxicity, Maculopapular Rash, Stevens-Johnson syndrome. The Hepatotoxicity was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Maculopapular Rash was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. 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'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 9 was calculated, The assessment concluded the relationship was 'Highly 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: Require clear light forget. What hit style themselves.</data>
report_id: ADR-2024-510
report_date: '2024-12-19'
patient_details:
  patient_id: ANON-PX-9141
  gender: Other
  relevant_history:
  - migraines
  - coronary artery disease
  - asthma
  - chronic kidney disease
  age_at_reaction: 82
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 467mg
  route_of_administration: Oral
  start_date: '2024-10-08'
  indication_for_use: Pain and inflammation
  end_date: '2024-12-15'
adverse_reactions:
- symptom_name: Hepatotoxicity
  onset_date: '2024-12-15'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2024-12-15'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-12-15'
  severity: Severe
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 9
reporting_facility: Jackson PLC Medical Center
reporter_type: Nurse
notes: Require clear light forget. What hit style themselves.
