<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-2025-498
Date of Submission: 2025-03-13

This report was submitted by a Nurse from Allen, Johnson and Sweeney Medical Center concerning patient ANON-PX-1851. The subject is a 56-year-old female with a significant medical history including osteoarthritis, chronic kidney disease. 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): Atorvastatin administered via the Intramuscular route at a dosage of 24mg, initiated on 2024-12-31 for Hypercholesterolemia with the course ongoing; Warfarin (Anticoagulant) administered via the Topical route at a dosage of 472mg, initiated on 2024-12-31 for Thromboembolism prevention with the course ongoing.

On approximately 2025-03-01, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Nausea, Vomiting, Diarrhea. The Nausea was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Vomiting was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed and and advised age. The current patient status regarding this symptom is 'Not Recovered'. The Diarrhea was classified as Mild 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 3 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

</data>
report_id: ADR-2025-498
report_date: '2025-03-13'
patient_details:
  patient_id: ANON-PX-1851
  gender: Female
  relevant_history:
  - osteoarthritis
  - chronic kidney disease
  age_at_reaction: 56
suspected_drugs:
- drug_name: Atorvastatin
  dosage: 24mg
  route_of_administration: Intramuscular
  start_date: '2024-12-31'
  indication_for_use: Hypercholesterolemia
- drug_name: Warfarin
  dosage: 472mg
  route_of_administration: Topical
  start_date: '2024-12-31'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
adverse_reactions:
- symptom_name: Nausea
  onset_date: '2025-03-01'
  severity: Moderate
  outcome: Recovering
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-03-01'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed and and advised age.
- symptom_name: Diarrhea
  onset_date: '2025-03-01'
  severity: Mild
  outcome: Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 3
reporting_facility: Allen, Johnson and Sweeney Medical Center
reporter_type: Nurse
