<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-2024-979
Date of Submission: 2024-10-12

This report was submitted by a Physician from Dixon and Sons Medical Center concerning patient ANON-PX-7539. The subject is a 78-year-old female with a significant medical history including coronary artery disease, 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 192mg, initiated on 2024-09-25 for Thromboembolism prevention and discontinued on 2024-10-11.

On approximately 2024-10-09, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Hepatotoxicity, Vomiting. The Hepatotoxicity was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. The Vomiting was classified as Life-threatening 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. 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. 

</data>
report_id: ADR-2024-979
report_date: '2024-10-12'
patient_details:
  patient_id: ANON-PX-7539
  gender: Female
  relevant_history:
  - coronary artery disease
  - type 2 diabetes
  age_at_reaction: 78
suspected_drugs:
- drug_name: Warfarin
  dosage: 192mg
  route_of_administration: Intramuscular
  start_date: '2024-09-25'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2024-10-11'
adverse_reactions:
- symptom_name: Hepatotoxicity
  onset_date: '2024-10-09'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
- symptom_name: Vomiting
  onset_date: '2024-10-09'
  severity: Life-threatening
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Negative dechallenge
reporting_facility: Dixon and Sons Medical Center
reporter_type: Physician
