<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-2024-124
Date of Submission: 2024-12-01

This report was submitted by a Pharmacist from Cortez Group Medical Center concerning patient ANON-PX-9706. The subject is an adult other with a significant medical history including migraines, hypertension, asthma. 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): Sertraline administered via the Topical route at a dosage of 124mg, initiated on 2024-11-11 for Major depressive disorder and discontinued on 2024-11-30; Warfarin (Anticoagulant) administered via the Topical route at a dosage of 160mg, initiated on 2024-11-11 for Thromboembolism prevention and discontinued on 2024-11-30.

On approximately 2024-11-27, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Somnolence, Nausea, Stevens-Johnson syndrome, Diarrhea, Maculopapular Rash. The Somnolence was classified as Severe in severity. No specific therapeutic intervention was required. 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 'Unknown'. The Stevens-Johnson syndrome was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Diarrhea was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Maculopapular Rash 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. The assessment concluded the relationship was 'Probable'. 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: First than what may research clearly. Piece while writer herself something free store.</data>
report_id: ADR-2024-124
report_date: '2024-12-01'
patient_details:
  patient_id: ANON-PX-9706
  gender: Other
  relevant_history:
  - migraines
  - hypertension
  - asthma
suspected_drugs:
- drug_name: Sertraline
  dosage: 124mg
  route_of_administration: Topical
  start_date: '2024-11-11'
  indication_for_use: Major depressive disorder
  end_date: '2024-11-30'
- drug_name: Warfarin
  dosage: 160mg
  route_of_administration: Topical
  start_date: '2024-11-11'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2024-11-30'
adverse_reactions:
- symptom_name: Somnolence
  onset_date: '2024-11-27'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2024-11-27'
  severity: Mild
  outcome: Unknown
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-11-27'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2024-11-27'
  severity: Severe
  outcome: Recovering
  intervention_required: true
- symptom_name: Maculopapular Rash
  onset_date: '2024-11-27'
  severity: Severe
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
reporting_facility: Cortez Group Medical Center
reporter_type: Pharmacist
notes: First than what may research clearly. Piece while writer herself something
  free store.
