<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-2024-230
Date of Submission: 2024-09-14

This report was submitted by a Patient from Wyatt Group Medical Center concerning patient ANON-PX-2437. The subject is a 89-year-old male with a significant medical history including asthma, osteoarthritis, seasonal allergies, anxiety. 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 administered via the Subcutaneous route at a dosage of 495mg, initiated on 2024-07-27 for Bacterial infection and discontinued on 2024-08-26; Gabapentin (Anticonvulsant) administered via the Topical route at a dosage of 349mg, initiated on 2024-07-27 for Neuropathic pain and discontinued on 2024-08-26.

On approximately 2024-08-23, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Maculopapular Rash, Dizziness, Somnolence, Diarrhea. The Pruritus was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed compare and advised by. The current patient status regarding this symptom is 'Unknown'. The Maculopapular Rash was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Dizziness was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. The Somnolence 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 Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. The assessment concluded the relationship was 'Probable'. 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: Tough only realize. Let church attorney. Store race process structure.</data>
report_id: ADR-2024-230
report_date: '2024-09-14'
patient_details:
  patient_id: ANON-PX-2437
  gender: Male
  relevant_history:
  - asthma
  - osteoarthritis
  - seasonal allergies
  - anxiety
  age_at_reaction: 89
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 495mg
  route_of_administration: Subcutaneous
  start_date: '2024-07-27'
  indication_for_use: Bacterial infection
  end_date: '2024-08-26'
- drug_name: Gabapentin
  dosage: 349mg
  route_of_administration: Topical
  start_date: '2024-07-27'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
  end_date: '2024-08-26'
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2024-08-23'
  severity: Mild
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed compare and advised by.
- symptom_name: Maculopapular Rash
  onset_date: '2024-08-23'
  severity: Moderate
  outcome: Recovered
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2024-08-23'
  severity: Severe
  outcome: Recovered
  intervention_required: true
- symptom_name: Somnolence
  onset_date: '2024-08-23'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2024-08-23'
  severity: Mild
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
reporting_facility: Wyatt Group Medical Center
reporter_type: Patient
notes: Tough only realize. Let church attorney. Store race process structure.
