<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-2024-448
Date of Submission: 2024-11-30

This report was submitted by a Pharmacist from Aguilar-Phillips Medical Center concerning patient ANON-PX-1158. The subject is a 58-year-old other with a significant medical history including migraines, type 2 diabetes. 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 231mg, initiated on 2024-09-21 for Thromboembolism prevention with the course ongoing; Atorvastatin administered via the Subcutaneous route at a dosage of 195mg, initiated on 2024-09-21 for Hypercholesterolemia with the course ongoing.

On approximately 2024-11-15, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Stevens-Johnson syndrome, Vomiting, Somnolence, Nausea, Maculopapular Rash. The Stevens-Johnson syndrome was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Vomiting was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Somnolence was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed movie and advised off. The current patient status regarding this symptom is 'Recovering'. The Nausea was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. The Maculopapular Rash was classified as Moderate 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 8 was calculated, 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: Society born a everyone. Might attack quickly certainly. Over address lead worker vote meet risk.</data>
report_id: ADR-2024-448
report_date: '2024-11-30'
patient_details:
  patient_id: ANON-PX-1158
  gender: Other
  relevant_history:
  - migraines
  - type 2 diabetes
  age_at_reaction: 58
suspected_drugs:
- drug_name: Warfarin
  dosage: 231mg
  route_of_administration: Intramuscular
  start_date: '2024-09-21'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
- drug_name: Atorvastatin
  dosage: 195mg
  route_of_administration: Subcutaneous
  start_date: '2024-09-21'
  indication_for_use: Hypercholesterolemia
adverse_reactions:
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2024-11-15'
  severity: Mild
  outcome: Unknown
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2024-11-15'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2024-11-15'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed movie and advised off.
- symptom_name: Nausea
  onset_date: '2024-11-15'
  severity: Severe
  outcome: Recovering
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2024-11-15'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 8
reporting_facility: Aguilar-Phillips Medical Center
reporter_type: Pharmacist
notes: Society born a everyone. Might attack quickly certainly. Over address lead
  worker vote meet risk.
