<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-2025-695
Date of Submission: 2025-03-10

This report was submitted by a Nurse from Lewis-Mendoza Medical Center concerning patient ANON-PX-4607. The subject is an adult male with a significant medical history including coronary artery disease, asthma, 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): Amoxicillin (Penicillin antibiotic) administered via the Subcutaneous route at a dosage of 118mg, initiated on 2025-02-08 for Bacterial infection with the course ongoing; Atorvastatin (Statin) administered via the Topical route at a dosage of 80mg, initiated on 2025-02-08 for Hypercholesterolemia with the course ongoing.

On approximately 2025-03-02, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Anaphylaxis, Nausea, Vomiting. The Stevens-Johnson syndrome was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. The Anaphylaxis was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. The Nausea was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Vomiting was classified as Severe 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 7 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Loss right nature leader relate themselves. From blood as stand.</data>
report_id: ADR-2025-695
report_date: '2025-03-10'
patient_details:
  patient_id: ANON-PX-4607
  gender: Male
  relevant_history:
  - coronary artery disease
  - asthma
  - anxiety
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 118mg
  route_of_administration: Subcutaneous
  start_date: '2025-02-08'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
- drug_name: Atorvastatin
  dosage: 80mg
  route_of_administration: Topical
  start_date: '2025-02-08'
  indication_for_use: Hypercholesterolemia
  drug_class: Statin
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-03-02'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: true
- symptom_name: Anaphylaxis
  onset_date: '2025-03-02'
  severity: Severe
  outcome: Fatal
  intervention_required: true
- symptom_name: Nausea
  onset_date: '2025-03-02'
  severity: Mild
  outcome: Fatal
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-03-02'
  severity: Severe
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 7
reporting_facility: Lewis-Mendoza Medical Center
reporter_type: Nurse
notes: Loss right nature leader relate themselves. From blood as stand.
