<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-2025-295
Date of Submission: 2025-05-28

This report was submitted by a Nurse from Lee-Clements Medical Center concerning patient ANON-PX-9107. The subject is a 34-year-old female with a significant medical history including atrial fibrillation, hypertension, coronary artery disease, seasonal allergies. 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 379mg, initiated on 2025-03-18 for Thromboembolism prevention and discontinued on 2025-05-20.

On approximately 2025-05-13, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Vomiting. The Maculopapular Rash was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed half and advised structure. The current patient status regarding this symptom is 'Not Recovered'. The Vomiting was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. 

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. 

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report_id: ADR-2025-295
report_date: '2025-05-28'
patient_details:
  patient_id: ANON-PX-9107
  gender: Female
  relevant_history:
  - atrial fibrillation
  - hypertension
  - coronary artery disease
  - seasonal allergies
  age_at_reaction: 34
suspected_drugs:
- drug_name: Warfarin
  dosage: 379mg
  route_of_administration: Oral
  start_date: '2025-03-18'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2025-05-20'
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2025-05-13'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed half and advised structure.
- symptom_name: Vomiting
  onset_date: '2025-05-13'
  severity: Severe
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
reporting_facility: Lee-Clements Medical Center
reporter_type: Nurse
notes: Group kid discuss yet article more stuff church. Own property concern according
  stage cell. Scientist wait personal week situation. Between from source subject
  however remain.
