<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-2025-153
Date of Submission: 2025-06-12

This report was submitted by a Nurse from Andersen, Walker and West Medical Center concerning patient ANON-PX-6334. The subject is a 88-year-old female with a significant medical history including migraines, anxiety. 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 Subcutaneous route at a dosage of 22mg, initiated on 2025-05-17 for Thromboembolism prevention with the course ongoing.

On approximately 2025-05-25, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Somnolence, Angioedema, Vomiting. The Anaphylaxis was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Somnolence was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Angioedema was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Vomiting was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 9 was calculated, The assessment concluded the relationship was 'Highly 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: Wish thus production quality. Since social blood pressure difference.</data>
report_id: ADR-2025-153
report_date: '2025-06-12'
patient_details:
  patient_id: ANON-PX-6334
  gender: Female
  relevant_history:
  - migraines
  - anxiety
  age_at_reaction: 88
suspected_drugs:
- drug_name: Warfarin
  dosage: 22mg
  route_of_administration: Subcutaneous
  start_date: '2025-05-17'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2025-05-25'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2025-05-25'
  severity: Mild
  outcome: Recovering
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2025-05-25'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-05-25'
  severity: Mild
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 9
reporting_facility: Andersen, Walker and West Medical Center
reporter_type: Nurse
notes: Wish thus production quality. Since social blood pressure difference.
