<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-2024-898
Date of Submission: 2024-12-06

This report was submitted by a Patient from Chan, Murray and Jackson Medical Center concerning patient ANON-PX-4809. The subject is a 82-year-old female with a significant medical history including chronic kidney disease, 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): Ibuprofen administered via the Intramuscular route at a dosage of 299mg, initiated on 2024-11-04 for Pain and inflammation and discontinued on 2024-11-20; Lisinopril administered via the Subcutaneous route at a dosage of 33mg, initiated on 2024-11-04 for Hypertension and discontinued on 2024-11-20.

On approximately 2024-11-17, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Diarrhea, Anaphylaxis, Stevens-Johnson syndrome. The Diarrhea was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed per and advised house. The current patient status regarding this symptom is 'Fatal'. The Anaphylaxis was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. The Stevens-Johnson syndrome was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed individual and advised week. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 9 was calculated, The assessment concluded the relationship was 'Highly Probable'. Dechallenge/Rechallenge status was noted as: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: It provide impact lawyer mouth. Director more everyone wear affect loss type ago. Probably past new customer.</data>
report_id: ADR-2024-898
report_date: '2024-12-06'
patient_details:
  patient_id: ANON-PX-4809
  gender: Female
  relevant_history:
  - chronic kidney disease
  - asthma
  age_at_reaction: 82
suspected_drugs:
- drug_name: Ibuprofen
  dosage: 299mg
  route_of_administration: Intramuscular
  start_date: '2024-11-04'
  indication_for_use: Pain and inflammation
  end_date: '2024-11-20'
- drug_name: Lisinopril
  dosage: 33mg
  route_of_administration: Subcutaneous
  start_date: '2024-11-04'
  indication_for_use: Hypertension
  end_date: '2024-11-20'
adverse_reactions:
- symptom_name: Diarrhea
  onset_date: '2024-11-17'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed per and advised house.
- symptom_name: Anaphylaxis
  onset_date: '2024-11-17'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: true
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-11-17'
  severity: Mild
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed individual and advised week.
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 9
reporting_facility: Chan, Murray and Jackson Medical Center
reporter_type: Patient
notes: It provide impact lawyer mouth. Director more everyone wear affect loss type
  ago. Probably past new customer.
