<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-2025-294
Date of Submission: 2025-07-22

This report was submitted by a Patient from Casey LLC Medical Center concerning patient ANON-PX-1267. The subject is a 22-year-old other with a significant medical history including type 2 diabetes, 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 Oral route at a dosage of 151mg, initiated on 2025-04-30 for Neuropathic pain and discontinued on 2025-06-21; Warfarin administered via the Intravenous route at a dosage of 167mg, initiated on 2025-04-30 for Thromboembolism prevention and discontinued on 2025-06-21.

On approximately 2025-05-31, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Dizziness. The Stevens-Johnson syndrome was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Dizziness was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2025-294
report_date: '2025-07-22'
patient_details:
  patient_id: ANON-PX-1267
  gender: Other
  relevant_history:
  - type 2 diabetes
  - coronary artery disease
  age_at_reaction: 22
suspected_drugs:
- drug_name: Gabapentin
  dosage: 151mg
  route_of_administration: Oral
  start_date: '2025-04-30'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
  end_date: '2025-06-21'
- drug_name: Warfarin
  dosage: 167mg
  route_of_administration: Intravenous
  start_date: '2025-04-30'
  indication_for_use: Thromboembolism prevention
  end_date: '2025-06-21'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-05-31'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2025-05-31'
  severity: Mild
  outcome: Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Negative dechallenge
reporting_facility: Casey LLC Medical Center
reporter_type: Patient
