<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-2025-975
Date of Submission: 2025-03-23

This report was submitted by a Pharmacist from Cooke, Ramos and Roberson Medical Center concerning patient ANON-PX-6544. The subject is an adult female with a significant medical history including coronary artery disease, chronic kidney disease, asthma, 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): Atorvastatin administered via the Oral route at a dosage of 93mg, initiated on 2025-01-05 for Hypercholesterolemia and discontinued on 2025-03-10; Levothyroxine (Thyroid hormone) administered via the Intravenous route at a dosage of 92mg, initiated on 2025-01-05 for Hypothyroidism and discontinued on 2025-03-10.

On approximately 2025-02-27, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Anaphylaxis, Maculopapular Rash, Vomiting. The Stevens-Johnson syndrome was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Anaphylaxis 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 Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Vomiting was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 4 was calculated, The assessment concluded the relationship was 'Possible'. 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: Attack certain style leader question program see. Style very Democrat left everybody create remember.</data>
report_id: ADR-2025-975
report_date: '2025-03-23'
patient_details:
  patient_id: ANON-PX-6544
  gender: Female
  relevant_history:
  - coronary artery disease
  - chronic kidney disease
  - asthma
  - atrial fibrillation
suspected_drugs:
- drug_name: Atorvastatin
  dosage: 93mg
  route_of_administration: Oral
  start_date: '2025-01-05'
  indication_for_use: Hypercholesterolemia
  end_date: '2025-03-10'
- drug_name: Levothyroxine
  dosage: 92mg
  route_of_administration: Intravenous
  start_date: '2025-01-05'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2025-03-10'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-02-27'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2025-02-27'
  severity: Mild
  outcome: Fatal
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2025-02-27'
  severity: Mild
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-02-27'
  severity: Moderate
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 4
reporting_facility: Cooke, Ramos and Roberson Medical Center
reporter_type: Pharmacist
notes: Attack certain style leader question program see. Style very Democrat left
  everybody create remember.
