<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-2025-178
Date of Submission: 2025-05-31

This report was submitted by a Other Healthcare Professional from Murphy, Lee and Ramirez Medical Center concerning patient ANON-PX-7043. The subject is an adult male 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): Warfarin (Anticoagulant) administered via the Intravenous route at a dosage of 45mg, initiated on 2025-03-16 for Thromboembolism prevention with the course ongoing.

On approximately 2025-04-30, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Headache, Angioedema, Somnolence. The Headache was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed left and advised anything. The current patient status regarding this symptom is 'Unknown'. The Angioedema was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Somnolence was classified as Life-threatening in severity. This necessitated clinical intervention. 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. 

Reporter's Narrative Summary: Focus ago tonight direction. Land turn allow artist.</data>
report_id: ADR-2025-178
report_date: '2025-05-31'
patient_details:
  patient_id: ANON-PX-7043
  gender: Male
  relevant_history:
  - migraines
  - osteoarthritis
  - atrial fibrillation
suspected_drugs:
- drug_name: Warfarin
  dosage: 45mg
  route_of_administration: Intravenous
  start_date: '2025-03-16'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
adverse_reactions:
- symptom_name: Headache
  onset_date: '2025-04-30'
  severity: Severe
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed left and advised anything.
- symptom_name: Angioedema
  onset_date: '2025-04-30'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2025-04-30'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 8
reporting_facility: Murphy, Lee and Ramirez Medical Center
reporter_type: Other Healthcare Professional
notes: Focus ago tonight direction. Land turn allow artist.
