<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-2024-321
Date of Submission: 2024-12-05

This report was submitted by a Patient from Nguyen PLC Medical Center concerning patient ANON-PX-1197. The subject is a 30-year-old other with a significant medical history including hypertension, anxiety. 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 Intravenous route at a dosage of 466mg, initiated on 2024-10-27 for Thromboembolism prevention and discontinued on 2024-11-20; Amoxicillin (Penicillin antibiotic) administered via the Intravenous route at a dosage of 198mg, initiated on 2024-10-27 for Bacterial infection and discontinued on 2024-11-20.

On approximately 2024-11-07, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Hepatotoxicity, Somnolence, Vomiting. The Hepatotoxicity was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. The Somnolence was classified as Mild in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. The Vomiting was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 9 was calculated, The assessment concluded the relationship was 'Highly Probable'. Dechallenge/Rechallenge status was noted as: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Including spend wonder data lawyer have understand. Another wish through cultural participant real.</data>
report_id: ADR-2024-321
report_date: '2024-12-05'
patient_details:
  patient_id: ANON-PX-1197
  gender: Other
  relevant_history:
  - hypertension
  - anxiety
  age_at_reaction: 30
suspected_drugs:
- drug_name: Warfarin
  dosage: 466mg
  route_of_administration: Intravenous
  start_date: '2024-10-27'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2024-11-20'
- drug_name: Amoxicillin
  dosage: 198mg
  route_of_administration: Intravenous
  start_date: '2024-10-27'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2024-11-20'
adverse_reactions:
- symptom_name: Hepatotoxicity
  onset_date: '2024-11-07'
  severity: Moderate
  outcome: Recovering
  intervention_required: true
- symptom_name: Somnolence
  onset_date: '2024-11-07'
  severity: Mild
  outcome: Recovered
  intervention_required: true
- symptom_name: Vomiting
  onset_date: '2024-11-07'
  severity: Mild
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 9
reporting_facility: Nguyen PLC Medical Center
reporter_type: Patient
notes: Including spend wonder data lawyer have understand. Another wish through cultural
  participant real.
