<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-2025-347
Date of Submission: 2025-01-15

This report was submitted by a Pharmacist from Barker and Sons Medical Center concerning patient ANON-PX-7643. The subject is a 80-year-old female with a significant medical history including osteoarthritis, migraines. 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 29mg, initiated on 2024-11-07 for Neuropathic pain and discontinued on 2024-12-09; Levothyroxine administered via the Subcutaneous route at a dosage of 466mg, initiated on 2024-11-07 for Hypothyroidism and discontinued on 2024-12-09.

On approximately 2024-11-11, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Diarrhea, Angioedema, Hepatotoxicity. The Diarrhea was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Angioedema was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Hepatotoxicity 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. 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: Attention brother size unit. American image wall anyone. Color old modern line leader list.</data>
report_id: ADR-2025-347
report_date: '2025-01-15'
patient_details:
  patient_id: ANON-PX-7643
  gender: Female
  relevant_history:
  - osteoarthritis
  - migraines
  age_at_reaction: 80
suspected_drugs:
- drug_name: Gabapentin
  dosage: 29mg
  route_of_administration: Subcutaneous
  start_date: '2024-11-07'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
  end_date: '2024-12-09'
- drug_name: Levothyroxine
  dosage: 466mg
  route_of_administration: Subcutaneous
  start_date: '2024-11-07'
  indication_for_use: Hypothyroidism
  end_date: '2024-12-09'
adverse_reactions:
- symptom_name: Diarrhea
  onset_date: '2024-11-11'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2024-11-11'
  severity: Mild
  outcome: Fatal
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2024-11-11'
  severity: Severe
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
reporting_facility: Barker and Sons Medical Center
reporter_type: Pharmacist
notes: Attention brother size unit. American image wall anyone. Color old modern line
  leader list.
