<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-2024-351
Date of Submission: 2024-11-27

This report was submitted by a Nurse from Mclaughlin-Hall Medical Center concerning patient ANON-PX-1114. The subject is an adult female with a significant medical history including coronary artery disease, atrial fibrillation. 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 Subcutaneous route at a dosage of 459mg, initiated on 2024-11-01 for Thromboembolism prevention and discontinued on 2024-11-09; Lisinopril (ACE inhibitor) administered via the Intravenous route at a dosage of 162mg, initiated on 2024-11-01 for Hypertension and discontinued on 2024-11-09.

On approximately 2024-11-06, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Hepatotoxicity, Nausea, Dizziness. The Hepatotoxicity was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed water and advised now. The current patient status regarding this symptom is 'Recovered'. The Nausea was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Dizziness was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed of and advised pass. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Rechallenge not performed'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Rich year chance hot machine. Surface add example task successful force.</data>
report_id: ADR-2024-351
report_date: '2024-11-27'
patient_details:
  patient_id: ANON-PX-1114
  gender: Female
  relevant_history:
  - coronary artery disease
  - atrial fibrillation
suspected_drugs:
- drug_name: Warfarin
  dosage: 459mg
  route_of_administration: Subcutaneous
  start_date: '2024-11-01'
  indication_for_use: Thromboembolism prevention
  end_date: '2024-11-09'
- drug_name: Lisinopril
  dosage: 162mg
  route_of_administration: Intravenous
  start_date: '2024-11-01'
  indication_for_use: Hypertension
  drug_class: ACE inhibitor
  end_date: '2024-11-09'
adverse_reactions:
- symptom_name: Hepatotoxicity
  onset_date: '2024-11-06'
  severity: Mild
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed water and advised now.
- symptom_name: Nausea
  onset_date: '2024-11-06'
  severity: Severe
  outcome: Recovered
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2024-11-06'
  severity: Mild
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed of and advised pass.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
reporting_facility: Mclaughlin-Hall Medical Center
reporter_type: Nurse
notes: Rich year chance hot machine. Surface add example task successful force.
