<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-2025-393
Date of Submission: 2025-06-05

This report was submitted by a Other Healthcare Professional from Mcclure, Carr and Smith Medical Center concerning patient ANON-PX-1477. The subject is an adult female with a significant medical history including seasonal allergies, osteoarthritis, atrial fibrillation, asthma. 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 386mg, initiated on 2025-04-07 for Thromboembolism prevention with the course ongoing.

On approximately 2025-05-21, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Hepatotoxicity, Nausea. The Hepatotoxicity was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed purpose and advised suddenly. The current patient status regarding this symptom is 'Recovered'. The Nausea was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed professor and advised too. The current patient status regarding this symptom is 'Fatal'. 

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: Friend authority raise mother quite. Minute whether may east process.</data>
report_id: ADR-2025-393
report_date: '2025-06-05'
patient_details:
  patient_id: ANON-PX-1477
  gender: Female
  relevant_history:
  - seasonal allergies
  - osteoarthritis
  - atrial fibrillation
  - asthma
suspected_drugs:
- drug_name: Warfarin
  dosage: 386mg
  route_of_administration: Oral
  start_date: '2025-04-07'
  indication_for_use: Thromboembolism prevention
adverse_reactions:
- symptom_name: Hepatotoxicity
  onset_date: '2025-05-21'
  severity: Mild
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed purpose and advised suddenly.
- symptom_name: Nausea
  onset_date: '2025-05-21'
  severity: Mild
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed professor and advised too.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 6
reporting_facility: Mcclure, Carr and Smith Medical Center
reporter_type: Other Healthcare Professional
notes: Friend authority raise mother quite. Minute whether may east process.
