<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-2024-147
Date of Submission: 2024-08-13

This report was submitted by a Pharmacist from Lewis and Sons Medical Center concerning patient ANON-PX-9062. The subject is an adult other with a significant medical history including type 2 diabetes, asthma. 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 administered via the Intramuscular route at a dosage of 474mg, initiated on 2024-05-23 for Neuropathic pain and discontinued on 2024-07-21; Atorvastatin (Statin) administered via the Topical route at a dosage of 389mg, initiated on 2024-05-23 for Hypercholesterolemia and discontinued on 2024-07-21.

On approximately 2024-07-19, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Hepatotoxicity, Nausea, Pruritus. The Hepatotoxicity was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. The Nausea was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Pruritus was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed identify and advised party. 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: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Story ten town decision lawyer light. Couple since hit through. Rest television power prepare.</data>
report_id: ADR-2024-147
report_date: '2024-08-13'
patient_details:
  patient_id: ANON-PX-9062
  gender: Other
  relevant_history:
  - type 2 diabetes
  - asthma
suspected_drugs:
- drug_name: Gabapentin
  dosage: 474mg
  route_of_administration: Intramuscular
  start_date: '2024-05-23'
  indication_for_use: Neuropathic pain
  end_date: '2024-07-21'
- drug_name: Atorvastatin
  dosage: 389mg
  route_of_administration: Topical
  start_date: '2024-05-23'
  indication_for_use: Hypercholesterolemia
  drug_class: Statin
  end_date: '2024-07-21'
adverse_reactions:
- symptom_name: Hepatotoxicity
  onset_date: '2024-07-19'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: true
- symptom_name: Nausea
  onset_date: '2024-07-19'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2024-07-19'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed identify and advised party.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 4
reporting_facility: Lewis and Sons Medical Center
reporter_type: Pharmacist
notes: Story ten town decision lawyer light. Couple since hit through. Rest television
  power prepare.
