<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-2025-439
Date of Submission: 2025-08-06

This report was submitted by a Physician from Cummings, Buck and Small Medical Center concerning patient ANON-PX-6778. The subject is an adult male with a significant medical history including type 2 diabetes, seasonal allergies, chronic kidney disease, osteoarthritis. 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 204mg, initiated on 2025-05-13 for Bacterial infection and discontinued on 2025-08-03.

On approximately 2025-07-21, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Nausea, Diarrhea, Vomiting. The Nausea was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Diarrhea was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. The Vomiting was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 10 was calculated, The assessment concluded the relationship was 'Highly 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: Style surface image television perform. Piece painting class. Million south fall end response hard.</data>
report_id: ADR-2025-439
report_date: '2025-08-06'
patient_details:
  patient_id: ANON-PX-6778
  gender: Male
  relevant_history:
  - type 2 diabetes
  - seasonal allergies
  - chronic kidney disease
  - osteoarthritis
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 204mg
  route_of_administration: Intravenous
  start_date: '2025-05-13'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2025-08-03'
adverse_reactions:
- symptom_name: Nausea
  onset_date: '2025-07-21'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2025-07-21'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Vomiting
  onset_date: '2025-07-21'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 10
reporting_facility: Cummings, Buck and Small Medical Center
reporter_type: Physician
notes: Style surface image television perform. Piece painting class. Million south
  fall end response hard.
