<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-2025-667
Date of Submission: 2025-07-14

This report was submitted by a Physician from Richards, Butler and Washington Medical Center concerning patient ANON-PX-2588. The subject is a 58-year-old other with a significant medical history including atrial fibrillation, hypertension, 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 Topical route at a dosage of 298mg, initiated on 2025-04-25 for Thromboembolism prevention and discontinued on 2025-07-07.

On approximately 2025-06-09, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Nausea, Stevens-Johnson syndrome. The Nausea was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Stevens-Johnson syndrome was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed way and advised institution. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. 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: Him other necessary company movement operation exactly. Parent with memory maintain phone. Bit picture much race.</data>
report_id: ADR-2025-667
report_date: '2025-07-14'
patient_details:
  patient_id: ANON-PX-2588
  gender: Other
  relevant_history:
  - atrial fibrillation
  - hypertension
  - asthma
  age_at_reaction: 58
suspected_drugs:
- drug_name: Warfarin
  dosage: 298mg
  route_of_administration: Topical
  start_date: '2025-04-25'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2025-07-07'
adverse_reactions:
- symptom_name: Nausea
  onset_date: '2025-06-09'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: false
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-06-09'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed way and advised institution.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
reporting_facility: Richards, Butler and Washington Medical Center
reporter_type: Physician
notes: Him other necessary company movement operation exactly. Parent with memory
  maintain phone. Bit picture much race.
