<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-2025-309
Date of Submission: 2025-06-17

This report was submitted by a Nurse from Garrison, Mccarthy and Nash Medical Center concerning patient ANON-PX-4059. The subject is an adult male with a significant medical history including migraines, coronary artery disease, asthma, atrial fibrillation. 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 456mg, initiated on 2025-04-18 for Bacterial infection and discontinued on 2025-05-14.

On approximately 2025-04-27, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Hepatotoxicity, Stevens-Johnson syndrome, Pruritus, Diarrhea. The Dizziness was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed leader and advised truth. The current patient status regarding this symptom is 'Fatal'. The Hepatotoxicity was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Stevens-Johnson syndrome was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Pruritus was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Diarrhea was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed tax and advised behavior. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 4 was calculated, The assessment concluded the relationship was 'Possible'. 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: Student whether like pull among. Play suddenly once question. Someone herself job respond single officer door center.</data>
report_id: ADR-2025-309
report_date: '2025-06-17'
patient_details:
  patient_id: ANON-PX-4059
  gender: Male
  relevant_history:
  - migraines
  - coronary artery disease
  - asthma
  - atrial fibrillation
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 456mg
  route_of_administration: Subcutaneous
  start_date: '2025-04-18'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2025-05-14'
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2025-04-27'
  severity: Mild
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed leader and advised truth.
- symptom_name: Hepatotoxicity
  onset_date: '2025-04-27'
  severity: Severe
  outcome: Recovering
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-04-27'
  severity: Moderate
  outcome: Recovered
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2025-04-27'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
- symptom_name: Diarrhea
  onset_date: '2025-04-27'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed tax and advised behavior.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 4
reporting_facility: Garrison, Mccarthy and Nash Medical Center
reporter_type: Nurse
notes: Student whether like pull among. Play suddenly once question. Someone herself
  job respond single officer door center.
