<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-2024-477
Date of Submission: 2024-12-09

This report was submitted by a Nurse from Moon PLC Medical Center concerning patient ANON-PX-8748. The subject is a 51-year-old other with a significant medical history including hypertension, 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): Warfarin (Anticoagulant) administered via the Topical route at a dosage of 363mg, initiated on 2024-11-28 for Thromboembolism prevention and discontinued on 2024-12-08; Amoxicillin (Penicillin antibiotic) administered via the Intramuscular route at a dosage of 176mg, initiated on 2024-11-28 for Bacterial infection and discontinued on 2024-12-08.

On approximately 2024-12-07, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Diarrhea, Dizziness. The Anaphylaxis was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed democratic and advised one. The current patient status regarding this symptom is 'Fatal'. The Diarrhea was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Dizziness was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 9 was calculated, The assessment concluded the relationship was 'Highly 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: Civil huge another leader effort. Audience media such way next bed.</data>
report_id: ADR-2024-477
report_date: '2024-12-09'
patient_details:
  patient_id: ANON-PX-8748
  gender: Other
  relevant_history:
  - hypertension
  - type 2 diabetes
  age_at_reaction: 51
suspected_drugs:
- drug_name: Warfarin
  dosage: 363mg
  route_of_administration: Topical
  start_date: '2024-11-28'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2024-12-08'
- drug_name: Amoxicillin
  dosage: 176mg
  route_of_administration: Intramuscular
  start_date: '2024-11-28'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2024-12-08'
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2024-12-07'
  severity: Severe
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed democratic and advised one.
- symptom_name: Diarrhea
  onset_date: '2024-12-07'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2024-12-07'
  severity: Severe
  outcome: Fatal
  intervention_required: true
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 9
reporting_facility: Moon PLC Medical Center
reporter_type: Nurse
notes: Civil huge another leader effort. Audience media such way next bed.
