<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-2025-238
Date of Submission: 2025-02-19

This report was submitted by a Nurse from Reynolds, Arnold and Case Medical Center concerning patient ANON-PX-1095. The subject is a 75-year-old female with a significant medical history including hypertension, coronary artery 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): Atorvastatin (Statin) administered via the Intravenous route at a dosage of 454mg, initiated on 2024-12-18 for Hypercholesterolemia and discontinued on 2025-01-22.

On approximately 2025-01-01, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Hepatotoxicity, Stevens-Johnson syndrome, Headache, Somnolence, Diarrhea. The Hepatotoxicity was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Stevens-Johnson syndrome was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Headache was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Somnolence was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed particular and advised present. The current patient status regarding this symptom is 'Recovering'. The Diarrhea was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 4 was calculated, The assessment concluded the relationship was 'Possible'. 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: Institution scene cold wish against billion. Thousand kind well Congress.</data>
report_id: ADR-2025-238
report_date: '2025-02-19'
patient_details:
  patient_id: ANON-PX-1095
  gender: Female
  relevant_history:
  - hypertension
  - coronary artery disease
  age_at_reaction: 75
suspected_drugs:
- drug_name: Atorvastatin
  dosage: 454mg
  route_of_administration: Intravenous
  start_date: '2024-12-18'
  indication_for_use: Hypercholesterolemia
  drug_class: Statin
  end_date: '2025-01-22'
adverse_reactions:
- symptom_name: Hepatotoxicity
  onset_date: '2025-01-01'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-01-01'
  severity: Mild
  outcome: Recovered
  intervention_required: false
- symptom_name: Headache
  onset_date: '2025-01-01'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2025-01-01'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed particular and advised present.
- symptom_name: Diarrhea
  onset_date: '2025-01-01'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 4
reporting_facility: Reynolds, Arnold and Case Medical Center
reporter_type: Nurse
notes: Institution scene cold wish against billion. Thousand kind well Congress.
