<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-2025-111
Date of Submission: 2025-04-23

This report was submitted by a Nurse from Taylor-Cameron Medical Center concerning patient ANON-PX-5808. The subject is a 90-year-old female with a significant medical history including seasonal allergies, chronic kidney disease, coronary artery disease, 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 Oral route at a dosage of 125mg, initiated on 2025-04-12 for Hypertension with the course ongoing.

On approximately 2025-04-17, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Somnolence. The Stevens-Johnson syndrome was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed simply and advised act. The current patient status regarding this symptom is 'Unknown'. The Somnolence was classified as Mild 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 10 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: North toward hand east finally. Ask book level include. Production five program. Others financial bar management.</data>
report_id: ADR-2025-111
report_date: '2025-04-23'
patient_details:
  patient_id: ANON-PX-5808
  gender: Female
  relevant_history:
  - seasonal allergies
  - chronic kidney disease
  - coronary artery disease
  - atrial fibrillation
  age_at_reaction: 90
suspected_drugs:
- drug_name: Lisinopril
  dosage: 125mg
  route_of_administration: Oral
  start_date: '2025-04-12'
  indication_for_use: Hypertension
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-04-17'
  severity: Severe
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed simply and advised act.
- symptom_name: Somnolence
  onset_date: '2025-04-17'
  severity: Mild
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 10
reporting_facility: Taylor-Cameron Medical Center
reporter_type: Nurse
notes: North toward hand east finally. Ask book level include. Production five program.
  Others financial bar management.
