<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-2025-644
Date of Submission: 2025-07-27

This report was submitted by a Patient from Williams and Sons Medical Center concerning patient ANON-PX-6339. The subject is a 76-year-old female with a significant medical history including coronary artery disease, atrial fibrillation, osteoarthritis. 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 Intravenous route at a dosage of 483mg, initiated on 2025-05-15 for Bacterial infection and discontinued on 2025-07-15; Warfarin (Anticoagulant) administered via the Topical route at a dosage of 13mg, initiated on 2025-05-15 for Thromboembolism prevention and discontinued on 2025-07-15.

On approximately 2025-07-05, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Hepatotoxicity, Vomiting, Angioedema, Dizziness. The Maculopapular Rash was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed already and advised forget. 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 'Fatal'. The Vomiting was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Angioedema was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Dizziness was classified as Severe 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 3 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Of with network make once attack base. Woman home law have. Big place whole may. Single man tree.</data>
report_id: ADR-2025-644
report_date: '2025-07-27'
patient_details:
  patient_id: ANON-PX-6339
  gender: Female
  relevant_history:
  - coronary artery disease
  - atrial fibrillation
  - osteoarthritis
  age_at_reaction: 76
suspected_drugs:
- drug_name: Amoxicillin
  dosage: 483mg
  route_of_administration: Intravenous
  start_date: '2025-05-15'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2025-07-15'
- drug_name: Warfarin
  dosage: 13mg
  route_of_administration: Topical
  start_date: '2025-05-15'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2025-07-15'
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2025-07-05'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed already and advised forget.
- symptom_name: Hepatotoxicity
  onset_date: '2025-07-05'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-07-05'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2025-07-05'
  severity: Severe
  outcome: Recovering
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2025-07-05'
  severity: Severe
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 3
reporting_facility: Williams and Sons Medical Center
reporter_type: Patient
notes: Of with network make once attack base. Woman home law have. Big place whole
  may. Single man tree.
