<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-2025-529
Date of Submission: 2025-04-17

This report was submitted by a Patient from Jackson Inc Medical Center concerning patient ANON-PX-5979. The subject is an adult male with a significant medical history including anxiety, hypertension, chronic kidney 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): Warfarin administered via the Intramuscular route at a dosage of 96mg, initiated on 2025-03-19 for Thromboembolism prevention and discontinued on 2025-04-05.

On approximately 2025-03-25, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Hepatotoxicity, Anaphylaxis, Angioedema. The Vomiting was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed recognize and advised writer. The current patient status regarding this symptom is 'Not Recovered'. The Hepatotoxicity was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed space and advised yet. The current patient status regarding this symptom is 'Fatal'. The Anaphylaxis was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Angioedema was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. 

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: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Boy include out room. Mother century life view sell which. International step son security.</data>
report_id: ADR-2025-529
report_date: '2025-04-17'
patient_details:
  patient_id: ANON-PX-5979
  gender: Male
  relevant_history:
  - anxiety
  - hypertension
  - chronic kidney disease
suspected_drugs:
- drug_name: Warfarin
  dosage: 96mg
  route_of_administration: Intramuscular
  start_date: '2025-03-19'
  indication_for_use: Thromboembolism prevention
  end_date: '2025-04-05'
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2025-03-25'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed recognize and advised writer.
- symptom_name: Hepatotoxicity
  onset_date: '2025-03-25'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed space and advised yet.
- symptom_name: Anaphylaxis
  onset_date: '2025-03-25'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2025-03-25'
  severity: Severe
  outcome: Unknown
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 6
reporting_facility: Jackson Inc Medical Center
reporter_type: Patient
notes: Boy include out room. Mother century life view sell which. International step
  son security.
