<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-2025-451
Date of Submission: 2025-05-17

This report was submitted by a Nurse from Harris, Kent and Wilcox Medical Center concerning patient ANON-PX-4500. The subject is a 18-year-old female with a significant medical history including type 2 diabetes, seasonal allergies. 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 196mg, initiated on 2025-04-09 for Hypothyroidism and discontinued on 2025-05-10.

On approximately 2025-05-09, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Somnolence, Headache, Diarrhea, Dizziness. The Somnolence was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Headache was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed force and advised believe. The current patient status regarding this symptom is 'Not Recovered'. The Diarrhea was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. 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 10 was calculated, The assessment concluded the relationship was 'Highly Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Act time upon car. Hair after full room much Mrs perform.</data>
report_id: ADR-2025-451
report_date: '2025-05-17'
patient_details:
  patient_id: ANON-PX-4500
  gender: Female
  relevant_history:
  - type 2 diabetes
  - seasonal allergies
  age_at_reaction: 18
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 196mg
  route_of_administration: Intravenous
  start_date: '2025-04-09'
  indication_for_use: Hypothyroidism
  end_date: '2025-05-10'
adverse_reactions:
- symptom_name: Somnolence
  onset_date: '2025-05-09'
  severity: Mild
  outcome: Unknown
  intervention_required: false
- symptom_name: Headache
  onset_date: '2025-05-09'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed force and advised believe.
- symptom_name: Diarrhea
  onset_date: '2025-05-09'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2025-05-09'
  severity: Moderate
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 10
reporting_facility: Harris, Kent and Wilcox Medical Center
reporter_type: Nurse
notes: Act time upon car. Hair after full room much Mrs perform.
