---
type: "example"
title: "DetectedIssue Example: detectedissue-example"
resource: "DetectedIssue"
example: "detectedissue-example"
---
# DetectedIssue Example: detectedissue-example

## Narrative

**Severity: High** - 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.

-   [500 mg Acetaminophen tablet 1/day, PRN since 2010](MedicationStatement/tylenol)
-   [Warfarin 1 MG TAB prescribed Jan. 5, 2014](MedicationRequest/warfarin)

Mitigation: Jan 5, 2014 by Dr. Adam Careful:

Asked patient to discontinue regular use of Tylenol and to consult with clinician if they need to resume to allow appropriate INR monitoring

## Example XML



```xml
<?xml version="1.0" encoding="UTF-8"?>
<DetectedIssue xmlns="http://hl7.org/fhir" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://hl7.org/fhir ../../schema/detectedissue.xsd">
  <id value="ddi"/>
  <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="MedicationRequest/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>
  <status value="final"/>
  <category>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      <code value="DRG"/>
      <display value="Drug Interaction Alert"/>
    </coding>
  </category>
  <code>
    <coding>
      <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
      <code value="DRG"/>
      <display value="Drug Interaction Alert"/>
    </coding>
  </code>
  <severity>
    <coding>
      <system value="http://hl7.org/fhir/detectedissue-severity"/>
      <code value="high"/>
      <display value="High"/>
    </coding>
  </severity>
  <subject>
    <reference value="Device/example"/>
  </subject>
  <identifiedDateTime value="2014-01-05"/>
  <implicated>
    <reference value="MedicationStatement/example001"/>
    <display value="500 mg Acetaminophen tablet 1/day, PRN since 2010"/>
  </implicated>
  <implicated>
    <reference value="MedicationRequest/medrx0331"/>
    <display value="Warfarin 1 MG TAB prescribed Jan. 15, 2015"/>
  </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."/>
  <mitigation>
    <action>
      <coding>
        <system value="http://terminology.hl7.org/CodeSystem/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>
```