<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-2025-118
Date of Submission: 2025-03-15

This report was submitted by a Nurse from Lowe-Le Medical Center concerning patient ANON-PX-5489. The subject is an adult other with a significant medical history including osteoarthritis, migraines, seasonal allergies, 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 administered via the Oral route at a dosage of 293mg, initiated on 2025-01-08 for Thromboembolism prevention and discontinued on 2025-02-22; Amoxicillin (Penicillin antibiotic) administered via the Intramuscular route at a dosage of 86mg, initiated on 2025-01-08 for Bacterial infection and discontinued on 2025-02-22.

On approximately 2025-01-12, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Nausea, Maculopapular Rash, Pruritus, Headache, Somnolence. The Nausea was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Maculopapular Rash was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. The Pruritus was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Headache was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Somnolence was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. 

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: 'Not applicable'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Our book dinner sport ball knowledge keep actually. Current morning exist other crime raise call.</data>
report_id: ADR-2025-118
report_date: '2025-03-15'
patient_details:
  patient_id: ANON-PX-5489
  gender: Other
  relevant_history:
  - osteoarthritis
  - migraines
  - seasonal allergies
  - coronary artery disease
suspected_drugs:
- drug_name: Warfarin
  dosage: 293mg
  route_of_administration: Oral
  start_date: '2025-01-08'
  indication_for_use: Thromboembolism prevention
  end_date: '2025-02-22'
- drug_name: Amoxicillin
  dosage: 86mg
  route_of_administration: Intramuscular
  start_date: '2025-01-08'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2025-02-22'
adverse_reactions:
- symptom_name: Nausea
  onset_date: '2025-01-12'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2025-01-12'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Pruritus
  onset_date: '2025-01-12'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Headache
  onset_date: '2025-01-12'
  severity: Severe
  outcome: Recovering
  intervention_required: true
- symptom_name: Somnolence
  onset_date: '2025-01-12'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 6
reporting_facility: Lowe-Le Medical Center
reporter_type: Nurse
notes: Our book dinner sport ball knowledge keep actually. Current morning exist other
  crime raise call.
