<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-2024-839
Date of Submission: 2024-11-01

This report was submitted by a Pharmacist from Duncan-Sellers Medical Center concerning patient ANON-PX-5474. The subject is a 84-year-old female with a significant medical history including seasonal allergies, anxiety, 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): Warfarin administered via the Oral route at a dosage of 240mg, initiated on 2024-10-23 for Thromboembolism prevention and discontinued on 2024-10-27.

On approximately 2024-10-26, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Somnolence. The Pruritus was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Somnolence 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 6 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Avoid realize memory water. Prove example learn join whether religious moment.</data>
report_id: ADR-2024-839
report_date: '2024-11-01'
patient_details:
  patient_id: ANON-PX-5474
  gender: Female
  relevant_history:
  - seasonal allergies
  - anxiety
  - atrial fibrillation
  age_at_reaction: 84
suspected_drugs:
- drug_name: Warfarin
  dosage: 240mg
  route_of_administration: Oral
  start_date: '2024-10-23'
  indication_for_use: Thromboembolism prevention
  end_date: '2024-10-27'
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2024-10-26'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2024-10-26'
  severity: Mild
  outcome: Not Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 6
reporting_facility: Duncan-Sellers Medical Center
reporter_type: Pharmacist
notes: Avoid realize memory water. Prove example learn join whether religious moment.
