<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-2024-398
Date of Submission: 2024-10-25

This report was submitted by a Nurse from Woods-Stephens Medical Center concerning patient ANON-PX-6460. The subject is a 86-year-old female with a significant medical history including hypertension, migraines, 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): Lisinopril administered via the Intravenous route at a dosage of 279mg, initiated on 2024-09-10 for Hypertension and discontinued on 2024-10-24; Warfarin (Anticoagulant) administered via the Subcutaneous route at a dosage of 401mg, initiated on 2024-09-10 for Thromboembolism prevention and discontinued on 2024-10-24.

On approximately 2024-10-20, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Diarrhea, Vomiting. The Stevens-Johnson syndrome was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed catch and advised list. The current patient status regarding this symptom is 'Recovering'. The Diarrhea was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Vomiting was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed once and advised treatment. The current patient status regarding this symptom is 'Fatal'. 

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

</data>
report_id: ADR-2024-398
report_date: '2024-10-25'
patient_details:
  patient_id: ANON-PX-6460
  gender: Female
  relevant_history:
  - hypertension
  - migraines
  - chronic kidney disease
  age_at_reaction: 86
suspected_drugs:
- drug_name: Lisinopril
  dosage: 279mg
  route_of_administration: Intravenous
  start_date: '2024-09-10'
  indication_for_use: Hypertension
  end_date: '2024-10-24'
- drug_name: Warfarin
  dosage: 401mg
  route_of_administration: Subcutaneous
  start_date: '2024-09-10'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2024-10-24'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-10-20'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed catch and advised list.
- symptom_name: Diarrhea
  onset_date: '2024-10-20'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
- symptom_name: Vomiting
  onset_date: '2024-10-20'
  severity: Severe
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed once and advised treatment.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
reporting_facility: Woods-Stephens Medical Center
reporter_type: Nurse
