<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-2025-348
Date of Submission: 2025-03-10

This report was submitted by a Nurse from Burns-Glenn Medical Center concerning patient ANON-PX-2115. The subject is a 66-year-old female with a significant medical history including chronic kidney disease, seasonal allergies, anxiety, 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 Oral route at a dosage of 267mg, initiated on 2025-01-05 for Thromboembolism prevention with the course ongoing.

On approximately 2025-01-31, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Nausea, Diarrhea. The Vomiting was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Nausea was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. The Diarrhea was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed change and advised set. 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: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Win serious but size short. Coach have remain story west. Clearly PM never account choice factor skin.</data>
report_id: ADR-2025-348
report_date: '2025-03-10'
patient_details:
  patient_id: ANON-PX-2115
  gender: Female
  relevant_history:
  - chronic kidney disease
  - seasonal allergies
  - anxiety
  - asthma
  age_at_reaction: 66
suspected_drugs:
- drug_name: Warfarin
  dosage: 267mg
  route_of_administration: Oral
  start_date: '2025-01-05'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2025-01-31'
  severity: Mild
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2025-01-31'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: true
- symptom_name: Diarrhea
  onset_date: '2025-01-31'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed change and advised set.
causality_assessment:
  assessment_conclusion: Highly Probable
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 9
reporting_facility: Burns-Glenn Medical Center
reporter_type: Nurse
notes: Win serious but size short. Coach have remain story west. Clearly PM never
  account choice factor skin.
