<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-2025-478
Date of Submission: 2025-03-09

This report was submitted by a Nurse from Kim Inc Medical Center concerning patient ANON-PX-2899. The subject is an adult male with a significant medical history including anxiety, hypertension, atrial fibrillation, type 2 diabetes. 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 60mg, initiated on 2024-12-23 for Thromboembolism prevention and discontinued on 2025-01-28.

On approximately 2025-01-03, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Stevens-Johnson syndrome. The Vomiting was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed economy and advised west. The current patient status regarding this symptom is 'Fatal'. The Stevens-Johnson syndrome was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed place and advised country. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 7 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. 

</data>
report_id: ADR-2025-478
report_date: '2025-03-09'
patient_details:
  patient_id: ANON-PX-2899
  gender: Male
  relevant_history:
  - anxiety
  - hypertension
  - atrial fibrillation
  - type 2 diabetes
suspected_drugs:
- drug_name: Warfarin
  dosage: 60mg
  route_of_administration: Topical
  start_date: '2024-12-23'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2025-01-28'
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2025-01-03'
  severity: Mild
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed economy and advised west.
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-01-03'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed place and advised country.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 7
reporting_facility: Kim Inc Medical Center
reporter_type: Nurse
