<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-2025-218
Date of Submission: 2025-05-18

This report was submitted by a Patient from Mccormick-Myers Medical Center concerning patient ANON-PX-9437. The subject is a 53-year-old other with a significant medical history including coronary artery disease, 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 (Anticoagulant) administered via the Subcutaneous route at a dosage of 158mg, initiated on 2025-04-22 for Thromboembolism prevention with the course ongoing.

On approximately 2025-05-04, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Hepatotoxicity, Pruritus, Headache. The Stevens-Johnson syndrome was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Hepatotoxicity was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. The Pruritus was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Headache was classified as Moderate 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. 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: Serious already order bed. Charge surface late maybe mention. Particular someone use culture.</data>
report_id: ADR-2025-218
report_date: '2025-05-18'
patient_details:
  patient_id: ANON-PX-9437
  gender: Other
  relevant_history:
  - coronary artery disease
  - asthma
  age_at_reaction: 53
suspected_drugs:
- drug_name: Warfarin
  dosage: 158mg
  route_of_administration: Subcutaneous
  start_date: '2025-04-22'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-05-04'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2025-05-04'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
- symptom_name: Pruritus
  onset_date: '2025-05-04'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Headache
  onset_date: '2025-05-04'
  severity: Moderate
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
reporting_facility: Mccormick-Myers Medical Center
reporter_type: Patient
notes: Serious already order bed. Charge surface late maybe mention. Particular someone
  use culture.
