<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-2025-811
Date of Submission: 2025-06-23

This report was submitted by a Nurse from Johnson LLC Medical Center concerning patient ANON-PX-9816. The subject is an adult other with a significant medical history including hypertension, anxiety, type 2 diabetes. 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): Levothyroxine administered via the Intravenous route at a dosage of 43mg, initiated on 2025-03-27 for Hypothyroidism and discontinued on 2025-05-21; Sertraline (SSRI) administered via the Topical route at a dosage of 414mg, initiated on 2025-03-27 for Major depressive disorder and discontinued on 2025-05-21.

On approximately 2025-04-15, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Vomiting. The Dizziness was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Vomiting 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. The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Particular social down believe order evening road. Media avoid region dream beautiful time main.</data>
report_id: ADR-2025-811
report_date: '2025-06-23'
patient_details:
  patient_id: ANON-PX-9816
  gender: Other
  relevant_history:
  - hypertension
  - anxiety
  - type 2 diabetes
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 43mg
  route_of_administration: Intravenous
  start_date: '2025-03-27'
  indication_for_use: Hypothyroidism
  end_date: '2025-05-21'
- drug_name: Sertraline
  dosage: 414mg
  route_of_administration: Topical
  start_date: '2025-03-27'
  indication_for_use: Major depressive disorder
  drug_class: SSRI
  end_date: '2025-05-21'
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2025-04-15'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-04-15'
  severity: Mild
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Negative dechallenge
reporting_facility: Johnson LLC Medical Center
reporter_type: Nurse
notes: Particular social down believe order evening road. Media avoid region dream
  beautiful time main.
