<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-2025-389
Date of Submission: 2025-04-24

This report was submitted by a Physician from Huff LLC Medical Center concerning patient ANON-PX-3453. The subject is a 29-year-old male with a significant medical history including coronary artery disease, hypertension, atrial fibrillation, 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 160mg, initiated on 2025-01-30 for Thromboembolism prevention and discontinued on 2025-04-16; Metformin (Biguanide) administered via the Intramuscular route at a dosage of 296mg, initiated on 2025-01-30 for Type 2 diabetes and discontinued on 2025-04-16.

On approximately 2025-04-16, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Angioedema, Pruritus, Hepatotoxicity. The Angioedema was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed benefit and advised minute. The current patient status regarding this symptom is 'Unknown'. The Pruritus was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed phone and advised economic. The current patient status regarding this symptom is 'Not Recovered'. The Hepatotoxicity 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 5 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: Effect street receive suddenly give worry her. Land can avoid attorney become story.</data>
report_id: ADR-2025-389
report_date: '2025-04-24'
patient_details:
  patient_id: ANON-PX-3453
  gender: Male
  relevant_history:
  - coronary artery disease
  - hypertension
  - atrial fibrillation
  - asthma
  age_at_reaction: 29
suspected_drugs:
- drug_name: Warfarin
  dosage: 160mg
  route_of_administration: Oral
  start_date: '2025-01-30'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2025-04-16'
- drug_name: Metformin
  dosage: 296mg
  route_of_administration: Intramuscular
  start_date: '2025-01-30'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
  end_date: '2025-04-16'
adverse_reactions:
- symptom_name: Angioedema
  onset_date: '2025-04-16'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed benefit and advised minute.
- symptom_name: Pruritus
  onset_date: '2025-04-16'
  severity: Life-threatening
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed phone and advised economic.
- symptom_name: Hepatotoxicity
  onset_date: '2025-04-16'
  severity: Mild
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 5
reporting_facility: Huff LLC Medical Center
reporter_type: Physician
notes: Effect street receive suddenly give worry her. Land can avoid attorney become
  story.
