<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-2024-671
Date of Submission: 2024-09-16

This report was submitted by a Nurse from Cummings-Blair Medical Center concerning patient ANON-PX-5872. The subject is a 72-year-old other with a significant medical history including type 2 diabetes, chronic kidney disease, anxiety, osteoarthritis. 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 Intramuscular route at a dosage of 313mg, initiated on 2024-06-20 for Thromboembolism prevention and discontinued on 2024-08-19.

On approximately 2024-08-18, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Angioedema, Anaphylaxis, Somnolence, Nausea. The Angioedema was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. The Anaphylaxis was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed line and advised cup. The current patient status regarding this symptom is 'Recovered'. The Somnolence was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed respond and advised far. The current patient status regarding this symptom is 'Recovering'. The Nausea was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 6 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Negative dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Wish which pressure choose often section partner. Similar total politics practice side.</data>
report_id: ADR-2024-671
report_date: '2024-09-16'
patient_details:
  patient_id: ANON-PX-5872
  gender: Other
  relevant_history:
  - type 2 diabetes
  - chronic kidney disease
  - anxiety
  - osteoarthritis
  age_at_reaction: 72
suspected_drugs:
- drug_name: Warfarin
  dosage: 313mg
  route_of_administration: Intramuscular
  start_date: '2024-06-20'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2024-08-19'
adverse_reactions:
- symptom_name: Angioedema
  onset_date: '2024-08-18'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Anaphylaxis
  onset_date: '2024-08-18'
  severity: Mild
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed line and advised cup.
- symptom_name: Somnolence
  onset_date: '2024-08-18'
  severity: Severe
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed respond and advised far.
- symptom_name: Nausea
  onset_date: '2024-08-18'
  severity: Severe
  outcome: Fatal
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 6
reporting_facility: Cummings-Blair Medical Center
reporter_type: Nurse
notes: Wish which pressure choose often section partner. Similar total politics practice
  side.
