<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-2025-490
Date of Submission: 2025-07-21

This report was submitted by a Pharmacist from Bowers and Sons Medical Center concerning patient ANON-PX-6408. The subject is a 80-year-old other with a significant medical history including atrial fibrillation, anxiety, 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): Amoxicillin (Penicillin antibiotic) administered via the Subcutaneous route at a dosage of 285mg, initiated on 2025-06-21 for Bacterial infection and discontinued on 2025-07-08; Sertraline administered via the Subcutaneous route at a dosage of 163mg, initiated on 2025-06-21 for Major depressive disorder and discontinued on 2025-07-08.

On approximately 2025-06-23, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Stevens-Johnson syndrome, Diarrhea, Hepatotoxicity, Vomiting. The Pruritus was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Stevens-Johnson syndrome was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed professional and advised friend. The current patient status regarding this symptom is 'Not Recovered'. The Diarrhea was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Hepatotoxicity was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed modern and advised painting. The current patient status regarding this symptom is 'Unknown'. The Vomiting was classified as Moderate 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 3 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Arrive big because. Race page source. Of I themselves require government.</data>
report_id: ADR-2025-490
report_date: '2025-07-21'
patient_details:
  patient_id: ANON-PX-6408
  gender: Other
  relevant_history:
  - atrial fibrillation
  - anxiety
  - type 2 diabetes
  age_at_reaction: 80
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 285mg
  route_of_administration: Subcutaneous
  start_date: '2025-06-21'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2025-07-08'
- drug_name: Sertraline
  dosage: 163mg
  route_of_administration: Subcutaneous
  start_date: '2025-06-21'
  indication_for_use: Major depressive disorder
  end_date: '2025-07-08'
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2025-06-23'
  severity: Mild
  outcome: Fatal
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-06-23'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed professional and advised friend.
- symptom_name: Diarrhea
  onset_date: '2025-06-23'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2025-06-23'
  severity: Severe
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed modern and advised painting.
- symptom_name: Vomiting
  onset_date: '2025-06-23'
  severity: Moderate
  outcome: Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Not applicable
  naranjo_score: 3
reporting_facility: Bowers and Sons Medical Center
reporter_type: Pharmacist
notes: Arrive big because. Race page source. Of I themselves require government.
