<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-2024-976
Date of Submission: 2024-12-08

This report was submitted by a Nurse from Ellis Group Medical Center concerning patient ANON-PX-4079. The subject is a 72-year-old other with a significant medical history including osteoarthritis, type 2 diabetes. 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): Amoxicillin (Penicillin antibiotic) administered via the Subcutaneous route at a dosage of 173mg, initiated on 2024-09-18 for Bacterial infection and discontinued on 2024-12-03.

On approximately 2024-11-18, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Nausea, Hepatotoxicity, Anaphylaxis, Somnolence, Diarrhea. The Nausea was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Hepatotoxicity was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed really and advised change. The current patient status regarding this symptom is 'Unknown'. The Anaphylaxis was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed behind and advised choose. The current patient status regarding this symptom is 'Not Recovered'. The Somnolence was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Diarrhea was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed worker and advised movie. 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: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Economy chance southern. Mouth newspaper type up.</data>
report_id: ADR-2024-976
report_date: '2024-12-08'
patient_details:
  patient_id: ANON-PX-4079
  gender: Other
  relevant_history:
  - osteoarthritis
  - type 2 diabetes
  age_at_reaction: 72
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 173mg
  route_of_administration: Subcutaneous
  start_date: '2024-09-18'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2024-12-03'
adverse_reactions:
- symptom_name: Nausea
  onset_date: '2024-11-18'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2024-11-18'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed really and advised change.
- symptom_name: Anaphylaxis
  onset_date: '2024-11-18'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed behind and advised choose.
- symptom_name: Somnolence
  onset_date: '2024-11-18'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2024-11-18'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed worker and advised movie.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 4
reporting_facility: Ellis Group Medical Center
reporter_type: Nurse
notes: Economy chance southern. Mouth newspaper type up.
