<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-2024-123
Date of Submission: 2024-09-16

This report was submitted by a Other Healthcare Professional from Flynn, Molina and Ortega Medical Center concerning patient ANON-PX-7493. The subject is a 36-year-old male with a significant medical history including asthma, chronic kidney disease, 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): Amoxicillin (Penicillin antibiotic) administered via the Intravenous route at a dosage of 227mg, initiated on 2024-08-04 for Bacterial infection and discontinued on 2024-09-13; Warfarin (Anticoagulant) administered via the Intramuscular route at a dosage of 208mg, initiated on 2024-08-04 for Thromboembolism prevention and discontinued on 2024-09-13.

On approximately 2024-08-12, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Hepatotoxicity, Vomiting, Somnolence, Dizziness. The Hepatotoxicity was classified as Life-threatening 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'. The Somnolence was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed world and advised increase. The current patient status regarding this symptom is 'Recovering'. The Dizziness was classified as Life-threatening 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 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. 

</data>
report_id: ADR-2024-123
report_date: '2024-09-16'
patient_details:
  patient_id: ANON-PX-7493
  gender: Male
  relevant_history:
  - asthma
  - chronic kidney disease
  - hypertension
  - type 2 diabetes
  age_at_reaction: 36
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 227mg
  route_of_administration: Intravenous
  start_date: '2024-08-04'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2024-09-13'
- drug_name: Warfarin
  dosage: 208mg
  route_of_administration: Intramuscular
  start_date: '2024-08-04'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2024-09-13'
adverse_reactions:
- symptom_name: Hepatotoxicity
  onset_date: '2024-08-12'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2024-08-12'
  severity: Severe
  outcome: Recovering
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2024-08-12'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed world and advised increase.
- symptom_name: Dizziness
  onset_date: '2024-08-12'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 6
reporting_facility: Flynn, Molina and Ortega Medical Center
reporter_type: Other Healthcare Professional
