<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-2025-248
Date of Submission: 2025-06-22

This report was submitted by a Physician from Arroyo-Malone Medical Center concerning patient ANON-PX-7695. The subject is a 67-year-old male with a significant medical history including seasonal allergies, hypertension. 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): Warfarin (Anticoagulant) administered via the Subcutaneous route at a dosage of 185mg, initiated on 2025-05-31 for Thromboembolism prevention and discontinued on 2025-06-05; Amoxicillin (Penicillin antibiotic) administered via the Subcutaneous route at a dosage of 317mg, initiated on 2025-05-31 for Bacterial infection and discontinued on 2025-06-05.

On approximately 2025-06-03, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Maculopapular Rash, Vomiting, Somnolence. The Stevens-Johnson syndrome was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. The Maculopapular Rash was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Vomiting was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. The Somnolence was classified as Life-threatening 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 rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: With some Mr bar evening safe garden meet. Including book stock glass cover more.</data>
report_id: ADR-2025-248
report_date: '2025-06-22'
patient_details:
  patient_id: ANON-PX-7695
  gender: Male
  relevant_history:
  - seasonal allergies
  - hypertension
  age_at_reaction: 67
suspected_drugs:
- drug_name: Warfarin
  dosage: 185mg
  route_of_administration: Subcutaneous
  start_date: '2025-05-31'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2025-06-05'
- drug_name: Amoxicillin
  dosage: 317mg
  route_of_administration: Subcutaneous
  start_date: '2025-05-31'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2025-06-05'
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-06-03'
  severity: Mild
  outcome: Unknown
  intervention_required: true
- symptom_name: Maculopapular Rash
  onset_date: '2025-06-03'
  severity: Mild
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-06-03'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: true
- symptom_name: Somnolence
  onset_date: '2025-06-03'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
reporting_facility: Arroyo-Malone Medical Center
reporter_type: Physician
notes: With some Mr bar evening safe garden meet. Including book stock glass cover
  more.
