<DetectedIssue xmlns="http://hl7.org/fhir">
  <id value="core-examples-DetectedIssue-example" />
  <meta>
    <versionId value="1" />
    <lastUpdated value="2016-09-08T11:37:48.217+00:00" />
  </meta>
  <text>
    <status value="generated" />
    <div xmlns="http://www.w3.org/1999/xhtml">
      <p>
        <b>Severity: High</b> - Risk of internal bleeding</p>
      <p>Those who take acetaminophen along with the widely used blood-thinning drug warfarin may face the risk of serious internal bleeding. People on warfarin who take acetaminophen for at least seven days in a row should be closely watched for bleeding.</p>
      <ul>
        <li>
          <a href="MedicationStatement/tylenol">500 mg Acetaminophen tablet 1/day, PRN since 2010</a>
        </li>
        <li>
          <a href="MedicationOrder/warfarin">Warfarin 1 MG TAB prescribed Jan. 5, 2014</a>
        </li>
      </ul>
      <p>Mitigation: Jan 5, 2014 by Dr. Adam Careful: </p>
      <p>Asked patient to discontinue regular use of Tylenol and to consult with clinician if they need to resume to allow appropriate INR monitoring</p>
    </div>
  </text>
  <category>
    <coding>
      <system value="http://hl7.org/fhir/v3/ActCode" />
      <code value="DRG" />
      <display value="Drug Interaction Alert" />
    </coding>
  </category>
  <severity value="high" />
  <implicated>
    <reference value="MedicationStatement/tylenol" />
    <display value="500 mg Acetaminophen tablet 1/day, PRN since 2010" />
  </implicated>
  <implicated>
    <reference value="MedicationOrder/warfarin" />
    <display value="Warfarin 1 MG TAB prescribed Jan. 5, 2014" />
  </implicated>
  <detail value="Risk of internal bleeding.  Those who take acetaminophen along with the widely used blood-thinning drug warfarin may face the risk of serious internal bleeding. People on warfarin who take acetaminophen for at least seven days in a row should be closely watched for bleeding." />
  <date value="2014-01-05" />
  <author>
    <reference value="Device/dsp" />
  </author>
  <mitigation>
    <action>
      <coding>
        <system value="http://hl7.org/fhir/v3/ActCode" />
        <code value="13" />
        <display value="Stopped Concurrent Therapy" />
      </coding>
      <text value="Asked patient to discontinue regular use of Tylenol and to consult with clinician if they need to resume to allow appropriate INR monitoring" />
    </action>
    <date value="2014-01-05" />
    <author>
      <reference value="Practitioner/example" />
      <display value="Dr. Adam Careful" />
    </author>
  </mitigation>
</DetectedIssue>