<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-2025-552
Date of Submission: 2025-03-11

This report was submitted by a Patient from Cole, Moore and Guerra Medical Center concerning patient ANON-PX-4641. The subject is a 31-year-old other with a significant medical history including osteoarthritis, type 2 diabetes, anxiety. 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 (ACE inhibitor) administered via the Topical route at a dosage of 433mg, initiated on 2025-01-28 for Hypertension and discontinued on 2025-02-22; Atorvastatin (Statin) administered via the Subcutaneous route at a dosage of 142mg, initiated on 2025-01-28 for Hypercholesterolemia and discontinued on 2025-02-22.

On approximately 2025-02-22, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Vomiting, Headache. The Pruritus was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Vomiting was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Headache 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 2 was calculated, The assessment concluded the relationship was 'Possible'. 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: Garden effort executive wait crime building animal nice. Fear receive benefit whether win good how.</data>
report_id: ADR-2025-552
report_date: '2025-03-11'
patient_details:
  patient_id: ANON-PX-4641
  gender: Other
  relevant_history:
  - osteoarthritis
  - type 2 diabetes
  - anxiety
  age_at_reaction: 31
suspected_drugs:
- drug_name: Lisinopril
  dosage: 433mg
  route_of_administration: Topical
  start_date: '2025-01-28'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2025-02-22'
- drug_name: Atorvastatin
  dosage: 142mg
  route_of_administration: Subcutaneous
  start_date: '2025-01-28'
  indication_for_use: Hypercholesterolemia
  drug_class: Statin
  end_date: '2025-02-22'
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2025-02-22'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-02-22'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Headache
  onset_date: '2025-02-22'
  severity: Moderate
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 2
reporting_facility: Cole, Moore and Guerra Medical Center
reporter_type: Patient
notes: Garden effort executive wait crime building animal nice. Fear receive benefit
  whether win good how.
