<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-2024-269
Date of Submission: 2024-10-22

This report was submitted by a Pharmacist from Dickson, Wilson and Sharp Medical Center concerning patient ANON-PX-6359. The subject is a 84-year-old male with a significant medical history including hypertension, coronary artery disease. 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): Gabapentin (Anticonvulsant) administered via the Intramuscular route at a dosage of 220mg, initiated on 2024-10-13 for Neuropathic pain with the course ongoing; Amoxicillin (Penicillin antibiotic) administered via the Subcutaneous route at a dosage of 163mg, initiated on 2024-10-13 for Bacterial infection with the course ongoing.

On approximately 2024-10-16, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Hepatotoxicity, Somnolence, Diarrhea. The Hepatotoxicity was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed key and advised everybody. The current patient status regarding this symptom is 'Recovered'. The Somnolence was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. The Diarrhea was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed color and advised role. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 1 was calculated, The assessment concluded the relationship was 'Possible'. 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: Again test single require and. From often deep color score. Yeah government expect several black evidence police.</data>
report_id: ADR-2024-269
report_date: '2024-10-22'
patient_details:
  patient_id: ANON-PX-6359
  gender: Male
  relevant_history:
  - hypertension
  - coronary artery disease
  age_at_reaction: 84
suspected_drugs:
- drug_name: Gabapentin
  dosage: 220mg
  route_of_administration: Intramuscular
  start_date: '2024-10-13'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
- drug_name: Amoxicillin
  dosage: 163mg
  route_of_administration: Subcutaneous
  start_date: '2024-10-13'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
adverse_reactions:
- symptom_name: Hepatotoxicity
  onset_date: '2024-10-16'
  severity: Severe
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed key and advised everybody.
- symptom_name: Somnolence
  onset_date: '2024-10-16'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: true
- symptom_name: Diarrhea
  onset_date: '2024-10-16'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed color and advised role.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 1
reporting_facility: Dickson, Wilson and Sharp Medical Center
reporter_type: Pharmacist
notes: Again test single require and. From often deep color score. Yeah government
  expect several black evidence police.
