<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-2024-916
Date of Submission: 2024-12-18

This report was submitted by a Nurse from Joseph Inc Medical Center concerning patient ANON-PX-4197. The subject is a 67-year-old female with a significant medical history including osteoarthritis, 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): Warfarin administered via the Subcutaneous route at a dosage of 222mg, initiated on 2024-09-20 for Thromboembolism prevention and discontinued on 2024-12-16.

On approximately 2024-12-10, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Nausea, Hepatotoxicity, Angioedema, Somnolence. The Nausea was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Hepatotoxicity was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Angioedema was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Somnolence was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. 

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

Reporter's Narrative Summary: Music house else cultural experience age child. Shake gun company imagine term candidate.</data>
report_id: ADR-2024-916
report_date: '2024-12-18'
patient_details:
  patient_id: ANON-PX-4197
  gender: Female
  relevant_history:
  - osteoarthritis
  - anxiety
  - type 2 diabetes
  age_at_reaction: 67
suspected_drugs:
- drug_name: Warfarin
  dosage: 222mg
  route_of_administration: Subcutaneous
  start_date: '2024-09-20'
  indication_for_use: Thromboembolism prevention
  end_date: '2024-12-16'
adverse_reactions:
- symptom_name: Nausea
  onset_date: '2024-12-10'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2024-12-10'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2024-12-10'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2024-12-10'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Not applicable
  naranjo_score: 9
reporting_facility: Joseph Inc Medical Center
reporter_type: Nurse
notes: Music house else cultural experience age child. Shake gun company imagine term
  candidate.
