<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-2024-934
Date of Submission: 2024-11-29

This report was submitted by a Patient from Johnson-Welch Medical Center concerning patient ANON-PX-1157. The subject is a 80-year-old male with a significant medical history including osteoarthritis, coronary artery disease, 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): Lisinopril (ACE inhibitor) administered via the Topical route at a dosage of 286mg, initiated on 2024-10-31 for Hypertension with the course ongoing.

On approximately 2024-11-19, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Hepatotoxicity, Headache, Dizziness, Vomiting. The Anaphylaxis was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. The Hepatotoxicity was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed born and advised movie. The current patient status regarding this symptom is 'Not Recovered'. The Headache was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Dizziness was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Vomiting was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. The assessment concluded the relationship was '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: Stay report successful. Price ago play leader career exactly. Child consider situation student my like.</data>
report_id: ADR-2024-934
report_date: '2024-11-29'
patient_details:
  patient_id: ANON-PX-1157
  gender: Male
  relevant_history:
  - osteoarthritis
  - coronary artery disease
  - chronic kidney disease
  age_at_reaction: 80
suspected_drugs:
- drug_name: Lisinopril
  dosage: 286mg
  route_of_administration: Topical
  start_date: '2024-10-31'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2024-11-19'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Hepatotoxicity
  onset_date: '2024-11-19'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed born and advised movie.
- symptom_name: Headache
  onset_date: '2024-11-19'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2024-11-19'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2024-11-19'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
reporting_facility: Johnson-Welch Medical Center
reporter_type: Patient
notes: Stay report successful. Price ago play leader career exactly. Child consider
  situation student my like.
