<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-2025-799
Date of Submission: 2025-07-02

This report was submitted by a Pharmacist from Harrison, Cohen and Garza Medical Center concerning patient ANON-PX-4542. The subject is a 81-year-old other with a significant medical history including migraines, coronary artery 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): Warfarin administered via the Intramuscular route at a dosage of 305mg, initiated on 2025-06-20 for Thromboembolism prevention with the course ongoing.

On approximately 2025-06-30, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Somnolence, Nausea. The Somnolence was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Nausea was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 7 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: Our red miss focus our these nation. Home behind item might. Work model control western moment.</data>
report_id: ADR-2025-799
report_date: '2025-07-02'
patient_details:
  patient_id: ANON-PX-4542
  gender: Other
  relevant_history:
  - migraines
  - coronary artery disease
  age_at_reaction: 81
suspected_drugs:
- drug_name: Warfarin
  dosage: 305mg
  route_of_administration: Intramuscular
  start_date: '2025-06-20'
  indication_for_use: Thromboembolism prevention
adverse_reactions:
- symptom_name: Somnolence
  onset_date: '2025-06-30'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2025-06-30'
  severity: Severe
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 7
reporting_facility: Harrison, Cohen and Garza Medical Center
reporter_type: Pharmacist
notes: Our red miss focus our these nation. Home behind item might. Work model control
  western moment.
