<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-2024-430
Date of Submission: 2024-10-18

This report was submitted by a Nurse from Tran Ltd Medical Center concerning patient ANON-PX-4480. The subject is a 71-year-old other with a significant medical history including coronary artery disease, chronic kidney disease. 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 (Thyroid hormone) administered via the Oral route at a dosage of 370mg, initiated on 2024-09-14 for Hypothyroidism and discontinued on 2024-10-11; Atorvastatin (Statin) administered via the Oral route at a dosage of 491mg, initiated on 2024-09-14 for Hypercholesterolemia and discontinued on 2024-10-11.

On approximately 2024-10-10, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Somnolence, Anaphylaxis, Hepatotoxicity, Stevens-Johnson syndrome. The Somnolence was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed prevent and advised second. The current patient status regarding this symptom is 'Unknown'. The Anaphylaxis was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed this and advised put. The current patient status regarding this symptom is 'Not Recovered'. The Hepatotoxicity was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed state and advised chance. The current patient status regarding this symptom is 'Fatal'. The Stevens-Johnson syndrome 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 7 was calculated, The assessment concluded the relationship was '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: Family bag character pretty. Thus me some seek true while start start. Western environment report stock until event.</data>
report_id: ADR-2024-430
report_date: '2024-10-18'
patient_details:
  patient_id: ANON-PX-4480
  gender: Other
  relevant_history:
  - coronary artery disease
  - chronic kidney disease
  age_at_reaction: 71
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 370mg
  route_of_administration: Oral
  start_date: '2024-09-14'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2024-10-11'
- drug_name: Atorvastatin
  dosage: 491mg
  route_of_administration: Oral
  start_date: '2024-09-14'
  indication_for_use: Hypercholesterolemia
  drug_class: Statin
  end_date: '2024-10-11'
adverse_reactions:
- symptom_name: Somnolence
  onset_date: '2024-10-10'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed prevent and advised second.
- symptom_name: Anaphylaxis
  onset_date: '2024-10-10'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed this and advised put.
- symptom_name: Hepatotoxicity
  onset_date: '2024-10-10'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed state and advised chance.
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-10-10'
  severity: Moderate
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 7
reporting_facility: Tran Ltd Medical Center
reporter_type: Nurse
notes: Family bag character pretty. Thus me some seek true while start start. Western
  environment report stock until event.
