<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-2025-537
Date of Submission: 2025-02-16

This report was submitted by a Nurse from Hatfield and Sons Medical Center concerning patient ANON-PX-5930. The subject is an adult female with a significant medical history including seasonal allergies, 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 (ACE inhibitor) administered via the Intramuscular route at a dosage of 485mg, initiated on 2024-12-30 for Hypertension and discontinued on 2025-02-04.

On approximately 2025-01-21, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Hepatotoxicity. The Anaphylaxis was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed court and advised authority. The current patient status regarding this symptom is 'Recovering'. The Hepatotoxicity was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed interest and advised thought. The current patient status regarding this symptom is 'Fatal'. 

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: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2025-537
report_date: '2025-02-16'
patient_details:
  patient_id: ANON-PX-5930
  gender: Female
  relevant_history:
  - seasonal allergies
  - atrial fibrillation
suspected_drugs:
- drug_name: Lisinopril
  dosage: 485mg
  route_of_administration: Intramuscular
  start_date: '2024-12-30'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2025-02-04'
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2025-01-21'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed court and advised authority.
- symptom_name: Hepatotoxicity
  onset_date: '2025-01-21'
  severity: Mild
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed interest and advised thought.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 4
reporting_facility: Hatfield and Sons Medical Center
reporter_type: Nurse
