<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-2025-155
Date of Submission: 2025-05-16

This report was submitted by a Physician from Smith-Chavez Medical Center concerning patient ANON-PX-8721. The subject is a 20-year-old other with a significant medical history including atrial fibrillation, coronary artery disease. 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 37mg, initiated on 2025-03-24 for Hypothyroidism and discontinued on 2025-05-15; Warfarin (Anticoagulant) administered via the Subcutaneous route at a dosage of 323mg, initiated on 2025-03-24 for Thromboembolism prevention and discontinued on 2025-05-15.

On approximately 2025-04-29, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Diarrhea, Nausea. The Dizziness was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Diarrhea was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Nausea 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 4 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Itself never prevent owner Mrs there for. Edge treatment line door at. His wall thank officer.</data>
report_id: ADR-2025-155
report_date: '2025-05-16'
patient_details:
  patient_id: ANON-PX-8721
  gender: Other
  relevant_history:
  - atrial fibrillation
  - coronary artery disease
  age_at_reaction: 20
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 37mg
  route_of_administration: Intravenous
  start_date: '2025-03-24'
  indication_for_use: Hypothyroidism
  end_date: '2025-05-15'
- drug_name: Warfarin
  dosage: 323mg
  route_of_administration: Subcutaneous
  start_date: '2025-03-24'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2025-05-15'
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2025-04-29'
  severity: Mild
  outcome: Recovering
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2025-04-29'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2025-04-29'
  severity: Severe
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 4
reporting_facility: Smith-Chavez Medical Center
reporter_type: Physician
notes: Itself never prevent owner Mrs there for. Edge treatment line door at. His
  wall thank officer.
