<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-2025-329
Date of Submission: 2025-07-31

This report was submitted by a Patient from Haley-Brown Medical Center concerning patient ANON-PX-5752. The subject is an adult male with a significant medical history including osteoarthritis, type 2 diabetes, seasonal allergies, atrial fibrillation. 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 356mg, initiated on 2025-05-18 for Thromboembolism prevention and discontinued on 2025-07-26.

On approximately 2025-06-25, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Pruritus, Stevens-Johnson syndrome, Maculopapular Rash, Vomiting, Diarrhea. The Pruritus was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed reflect and advised then. The current patient status regarding this symptom is 'Fatal'. The Stevens-Johnson syndrome was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed play and advised writer. The current patient status regarding this symptom is 'Unknown'. The Maculopapular Rash was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed produce and advised task. The current patient status regarding this symptom is 'Recovered'. The Vomiting was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed field and advised seat. The current patient status regarding this symptom is 'Recovering'. The Diarrhea was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 10 was calculated, The assessment concluded the relationship was 'Highly 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: Certainly low land author Mr. Trade collection modern action good.</data>
report_id: ADR-2025-329
report_date: '2025-07-31'
patient_details:
  patient_id: ANON-PX-5752
  gender: Male
  relevant_history:
  - osteoarthritis
  - type 2 diabetes
  - seasonal allergies
  - atrial fibrillation
suspected_drugs:
- drug_name: Warfarin
  dosage: 356mg
  route_of_administration: Topical
  start_date: '2025-05-18'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2025-07-26'
adverse_reactions:
- symptom_name: Pruritus
  onset_date: '2025-06-25'
  severity: Severe
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed reflect and advised then.
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-06-25'
  severity: Mild
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed play and advised writer.
- symptom_name: Maculopapular Rash
  onset_date: '2025-06-25'
  severity: Severe
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed produce and advised task.
- symptom_name: Vomiting
  onset_date: '2025-06-25'
  severity: Severe
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed field and advised seat.
- symptom_name: Diarrhea
  onset_date: '2025-06-25'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: true
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 10
reporting_facility: Haley-Brown Medical Center
reporter_type: Patient
notes: Certainly low land author Mr. Trade collection modern action good.
