<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-2025-709
Date of Submission: 2025-01-08

This report was submitted by a Patient from Davis-Medina Medical Center concerning patient ANON-PX-2339. The subject is a 37-year-old male with a significant medical history including asthma, hypertension, coronary artery disease. 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 Intramuscular route at a dosage of 426mg, initiated on 2024-11-17 for Thromboembolism prevention and discontinued on 2025-01-01; Amoxicillin (Penicillin antibiotic) administered via the Subcutaneous route at a dosage of 492mg, initiated on 2024-11-17 for Bacterial infection and discontinued on 2025-01-01.

On approximately 2024-12-13, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Headache, Anaphylaxis, Pruritus, Angioedema. The Maculopapular Rash was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Headache was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Anaphylaxis was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed tell and advised week. The current patient status regarding this symptom is 'Fatal'. The Pruritus was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Angioedema was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 7 was calculated, The assessment concluded the relationship was '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: Investment their area price. Break manage best occur. Impact research write.</data>
report_id: ADR-2025-709
report_date: '2025-01-08'
patient_details:
  patient_id: ANON-PX-2339
  gender: Male
  relevant_history:
  - asthma
  - hypertension
  - coronary artery disease
  age_at_reaction: 37
suspected_drugs:
- drug_name: Warfarin
  dosage: 426mg
  route_of_administration: Intramuscular
  start_date: '2024-11-17'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2025-01-01'
- drug_name: Amoxicillin
  dosage: 492mg
  route_of_administration: Subcutaneous
  start_date: '2024-11-17'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2025-01-01'
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2024-12-13'
  severity: Severe
  outcome: Recovering
  intervention_required: false
- symptom_name: Headache
  onset_date: '2024-12-13'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2024-12-13'
  severity: Mild
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed tell and advised week.
- symptom_name: Pruritus
  onset_date: '2024-12-13'
  severity: Mild
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2024-12-13'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 7
reporting_facility: Davis-Medina Medical Center
reporter_type: Patient
notes: Investment their area price. Break manage best occur. Impact research write.
