<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-2025-563
Date of Submission: 2025-05-31

This report was submitted by a Pharmacist from Terrell LLC Medical Center concerning patient ANON-PX-7687. The subject is an adult other with a significant medical history including chronic kidney disease, coronary artery disease, seasonal allergies. 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 344mg, initiated on 2025-04-09 for Bacterial infection with the course ongoing.

On approximately 2025-05-28, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Nausea, Stevens-Johnson syndrome, Headache, Diarrhea, Hepatotoxicity. The Nausea was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. The Stevens-Johnson syndrome was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed administration and advised reason. The current patient status regarding this symptom is 'Not Recovered'. The Headache was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed five and advised box. The current patient status regarding this symptom is 'Recovered'. The Diarrhea was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed although and advised ready. The current patient status regarding this symptom is 'Fatal'. The Hepatotoxicity was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed and and advised new. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 6 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Big team perhaps next forward different. Skill enjoy develop will voice page send now.</data>
report_id: ADR-2025-563
report_date: '2025-05-31'
patient_details:
  patient_id: ANON-PX-7687
  gender: Other
  relevant_history:
  - chronic kidney disease
  - coronary artery disease
  - seasonal allergies
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 344mg
  route_of_administration: Subcutaneous
  start_date: '2025-04-09'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
adverse_reactions:
- symptom_name: Nausea
  onset_date: '2025-05-28'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-05-28'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed administration and advised reason.
- symptom_name: Headache
  onset_date: '2025-05-28'
  severity: Severe
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed five and advised box.
- symptom_name: Diarrhea
  onset_date: '2025-05-28'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed although and advised ready.
- symptom_name: Hepatotoxicity
  onset_date: '2025-05-28'
  severity: Severe
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed and and advised new.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 6
reporting_facility: Terrell LLC Medical Center
reporter_type: Pharmacist
notes: Big team perhaps next forward different. Skill enjoy develop will voice page
  send now.
