<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-2025-768
Date of Submission: 2025-07-30

This report was submitted by a Pharmacist from Ballard-Houston Medical Center concerning patient ANON-PX-2233. The subject is a 20-year-old other with a significant medical history including osteoarthritis, chronic kidney disease, 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): Sertraline (SSRI) administered via the Intravenous route at a dosage of 370mg, initiated on 2025-07-02 for Major depressive disorder and discontinued on 2025-07-18; Warfarin (Anticoagulant) administered via the Topical route at a dosage of 28mg, initiated on 2025-07-02 for Thromboembolism prevention and discontinued on 2025-07-18.

On approximately 2025-07-04, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Angioedema, Anaphylaxis, Pruritus. The Vomiting was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed from and advised fly. The current patient status regarding this symptom is 'Not Recovered'. The Angioedema was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Anaphylaxis was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Pruritus was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed really and advised one. The current patient status regarding this symptom is 'Not Recovered'. 

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: Eye buy skin option different same. Civil involve positive firm difficult travel arm nor. Give less grow. Light for free new buy.</data>
report_id: ADR-2025-768
report_date: '2025-07-30'
patient_details:
  patient_id: ANON-PX-2233
  gender: Other
  relevant_history:
  - osteoarthritis
  - chronic kidney disease
  - anxiety
  age_at_reaction: 20
suspected_drugs:
- drug_name: Sertraline
  dosage: 370mg
  route_of_administration: Intravenous
  start_date: '2025-07-02'
  indication_for_use: Major depressive disorder
  drug_class: SSRI
  end_date: '2025-07-18'
- drug_name: Warfarin
  dosage: 28mg
  route_of_administration: Topical
  start_date: '2025-07-02'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2025-07-18'
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2025-07-04'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed from and advised fly.
- symptom_name: Angioedema
  onset_date: '2025-07-04'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2025-07-04'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2025-07-04'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed really and advised one.
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 10
reporting_facility: Ballard-Houston Medical Center
reporter_type: Pharmacist
notes: Eye buy skin option different same. Civil involve positive firm difficult travel
  arm nor. Give less grow. Light for free new buy.
