<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-2025-705
Date of Submission: 2025-05-26

This report was submitted by a Nurse from Hampton, Bell and Wagner Medical Center concerning patient ANON-PX-4796. The subject is an adult female with a significant medical history including osteoarthritis, type 2 diabetes, seasonal allergies, migraines. 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): Gabapentin (Anticonvulsant) administered via the Oral route at a dosage of 357mg, initiated on 2025-04-28 for Neuropathic pain and discontinued on 2025-05-20; Sertraline (SSRI) administered via the Oral route at a dosage of 61mg, initiated on 2025-04-28 for Major depressive disorder and discontinued on 2025-05-20.

On approximately 2025-05-18, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Hepatotoxicity, Dizziness. The Hepatotoxicity was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Dizziness 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 2 was calculated, The assessment concluded the relationship was 'Possible'. 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: Feeling poor great little treat. Support speech by move son than race rock. Ten health article then professional democratic.</data>
report_id: ADR-2025-705
report_date: '2025-05-26'
patient_details:
  patient_id: ANON-PX-4796
  gender: Female
  relevant_history:
  - osteoarthritis
  - type 2 diabetes
  - seasonal allergies
  - migraines
suspected_drugs:
- drug_name: Gabapentin
  dosage: 357mg
  route_of_administration: Oral
  start_date: '2025-04-28'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
  end_date: '2025-05-20'
- drug_name: Sertraline
  dosage: 61mg
  route_of_administration: Oral
  start_date: '2025-04-28'
  indication_for_use: Major depressive disorder
  drug_class: SSRI
  end_date: '2025-05-20'
adverse_reactions:
- symptom_name: Hepatotoxicity
  onset_date: '2025-05-18'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2025-05-18'
  severity: Moderate
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 2
reporting_facility: Hampton, Bell and Wagner Medical Center
reporter_type: Nurse
notes: Feeling poor great little treat. Support speech by move son than race rock.
  Ten health article then professional democratic.
