<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-2025-447
Date of Submission: 2025-03-05

This report was submitted by a Other Healthcare Professional from Brown, Barrera and Freeman Medical Center concerning patient ANON-PX-7271. The subject is an adult female with a significant medical history including migraines, osteoarthritis, atrial fibrillation. 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): Levothyroxine administered via the Intravenous route at a dosage of 141mg, initiated on 2025-01-17 for Hypothyroidism with the course ongoing; Warfarin (Anticoagulant) administered via the Oral route at a dosage of 17mg, initiated on 2025-01-17 for Thromboembolism prevention with the course ongoing.

On approximately 2025-02-15, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Hepatotoxicity, Diarrhea, Vomiting. The Hepatotoxicity was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Diarrhea was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Vomiting 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 8 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2025-447
report_date: '2025-03-05'
patient_details:
  patient_id: ANON-PX-7271
  gender: Female
  relevant_history:
  - migraines
  - osteoarthritis
  - atrial fibrillation
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 141mg
  route_of_administration: Intravenous
  start_date: '2025-01-17'
  indication_for_use: Hypothyroidism
- drug_name: Warfarin
  dosage: 17mg
  route_of_administration: Oral
  start_date: '2025-01-17'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
adverse_reactions:
- symptom_name: Hepatotoxicity
  onset_date: '2025-02-15'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2025-02-15'
  severity: Severe
  outcome: Recovering
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-02-15'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 8
reporting_facility: Brown, Barrera and Freeman Medical Center
reporter_type: Other Healthcare Professional
