<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-2025-889
Date of Submission: 2025-04-16

This report was submitted by a Pharmacist from Flores-Chandler Medical Center concerning patient ANON-PX-7365. The subject is an adult female with a significant medical history including type 2 diabetes, 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): Sertraline (SSRI) administered via the Topical route at a dosage of 139mg, initiated on 2025-01-23 for Major depressive disorder with the course ongoing; Warfarin (Anticoagulant) administered via the Topical route at a dosage of 145mg, initiated on 2025-01-23 for Thromboembolism prevention with the course ongoing.

On approximately 2025-01-25, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Diarrhea, Angioedema. The Diarrhea was classified as Severe 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. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 8 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: Field magazine now role. Edge other this. Specific reveal way capital.</data>
report_id: ADR-2025-889
report_date: '2025-04-16'
patient_details:
  patient_id: ANON-PX-7365
  gender: Female
  relevant_history:
  - type 2 diabetes
  - atrial fibrillation
  - asthma
suspected_drugs:
- drug_name: Sertraline
  dosage: 139mg
  route_of_administration: Topical
  start_date: '2025-01-23'
  indication_for_use: Major depressive disorder
  drug_class: SSRI
- drug_name: Warfarin
  dosage: 145mg
  route_of_administration: Topical
  start_date: '2025-01-23'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
adverse_reactions:
- symptom_name: Diarrhea
  onset_date: '2025-01-25'
  severity: Severe
  outcome: Unknown
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2025-01-25'
  severity: Severe
  outcome: Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 8
reporting_facility: Flores-Chandler Medical Center
reporter_type: Pharmacist
notes: Field magazine now role. Edge other this. Specific reveal way capital.
