<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-2025-181
Date of Submission: 2025-07-04

This report was submitted by a Pharmacist from Williams, Davidson and Martin Medical Center concerning patient ANON-PX-9439. The subject is a 72-year-old other with a significant medical history including migraines, type 2 diabetes. 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 Intramuscular route at a dosage of 103mg, initiated on 2025-04-11 for Neuropathic pain and discontinued on 2025-06-30; Warfarin (Anticoagulant) administered via the Intravenous route at a dosage of 24mg, initiated on 2025-04-11 for Thromboembolism prevention and discontinued on 2025-06-30.

On approximately 2025-06-24, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Diarrhea, Vomiting, Pruritus, Maculopapular Rash, Stevens-Johnson syndrome. The Diarrhea was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed again and advised back. The current patient status regarding this symptom is 'Fatal'. The Vomiting was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. The Pruritus was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Maculopapular Rash was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. The Stevens-Johnson syndrome was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed player and advised care. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 6 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2025-181
report_date: '2025-07-04'
patient_details:
  patient_id: ANON-PX-9439
  gender: Other
  relevant_history:
  - migraines
  - type 2 diabetes
  age_at_reaction: 72
suspected_drugs:
- drug_name: Gabapentin
  dosage: 103mg
  route_of_administration: Intramuscular
  start_date: '2025-04-11'
  indication_for_use: Neuropathic pain
  drug_class: Anticonvulsant
  end_date: '2025-06-30'
- drug_name: Warfarin
  dosage: 24mg
  route_of_administration: Intravenous
  start_date: '2025-04-11'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2025-06-30'
adverse_reactions:
- symptom_name: Diarrhea
  onset_date: '2025-06-24'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed again and advised back.
- symptom_name: Vomiting
  onset_date: '2025-06-24'
  severity: Severe
  outcome: Recovered
  intervention_required: true
- symptom_name: Pruritus
  onset_date: '2025-06-24'
  severity: Moderate
  outcome: Recovering
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2025-06-24'
  severity: Severe
  outcome: Fatal
  intervention_required: true
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-06-24'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed player and advised care.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 6
reporting_facility: Williams, Davidson and Martin Medical Center
reporter_type: Pharmacist
