<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-2025-159
Date of Submission: 2025-04-16

This report was submitted by a Pharmacist from Davis Ltd Medical Center concerning patient ANON-PX-3400. The subject is a 55-year-old female with a significant medical history including migraines, coronary artery disease, osteoarthritis, seasonal allergies. 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 Subcutaneous route at a dosage of 377mg, initiated on 2025-02-16 for Bacterial infection and discontinued on 2025-04-02; Sertraline (SSRI) administered via the Oral route at a dosage of 68mg, initiated on 2025-02-16 for Major depressive disorder and discontinued on 2025-04-02.

On approximately 2025-03-18, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Maculopapular Rash, Pruritus, Dizziness, Anaphylaxis. The Stevens-Johnson syndrome was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Maculopapular Rash was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed she and advised talk. The current patient status regarding this symptom is 'Recovering'. The Pruritus was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed wait and advised matter. The current patient status regarding this symptom is 'Fatal'. The Dizziness was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Anaphylaxis was classified as Life-threatening 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. A Naranjo score of 10 was calculated, The assessment concluded the relationship was 'Highly Probable'. Dechallenge/Rechallenge status was noted as: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Decision dog fish body. Pull development price spring at child. Least democratic significant while. Boy every them fast.</data>
report_id: ADR-2025-159
report_date: '2025-04-16'
patient_details:
  patient_id: ANON-PX-3400
  gender: Female
  relevant_history:
  - migraines
  - coronary artery disease
  - osteoarthritis
  - seasonal allergies
  age_at_reaction: 55
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 377mg
  route_of_administration: Subcutaneous
  start_date: '2025-02-16'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2025-04-02'
- drug_name: Sertraline
  dosage: 68mg
  route_of_administration: Oral
  start_date: '2025-02-16'
  indication_for_use: Major depressive disorder
  drug_class: SSRI
  end_date: '2025-04-02'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-03-18'
  severity: Mild
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2025-03-18'
  severity: Severe
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed she and advised talk.
- symptom_name: Pruritus
  onset_date: '2025-03-18'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed wait and advised matter.
- symptom_name: Dizziness
  onset_date: '2025-03-18'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2025-03-18'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 10
reporting_facility: Davis Ltd Medical Center
reporter_type: Pharmacist
notes: Decision dog fish body. Pull development price spring at child. Least democratic
  significant while. Boy every them fast.
