<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-2025-247
Date of Submission: 2025-06-18

This report was submitted by a Nurse from Murray, Salazar and Graham Medical Center concerning patient ANON-PX-5637. The subject is an adult other with a significant medical history including migraines, seasonal allergies, 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): Gabapentin (Anticonvulsant) administered via the Subcutaneous route at a dosage of 84mg, initiated on 2025-05-24 for Neuropathic pain with the course ongoing.

On approximately 2025-06-10, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Maculopapular Rash, Somnolence. The Dizziness was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Maculopapular Rash was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed partner and advised trouble. The current patient status regarding this symptom is 'Recovering'. The Somnolence was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed serious and advised skill. 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: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Music begin finally article which. Bring economic any speak develop rise religious evening.</data>
report_id: ADR-2025-247
report_date: '2025-06-18'
patient_details:
  patient_id: ANON-PX-5637
  gender: Other
  relevant_history:
  - migraines
  - seasonal allergies
  - chronic kidney disease
suspected_drugs:
- drug_name: Gabapentin
  dosage: 84mg
  route_of_administration: Subcutaneous
  start_date: '2025-05-24'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2025-06-10'
  severity: Mild
  outcome: Fatal
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2025-06-10'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed partner and advised trouble.
- symptom_name: Somnolence
  onset_date: '2025-06-10'
  severity: Mild
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed serious and advised skill.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
reporting_facility: Murray, Salazar and Graham Medical Center
reporter_type: Nurse
notes: Music begin finally article which. Bring economic any speak develop rise religious
  evening.
