<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-2025-865
Date of Submission: 2025-01-13

This report was submitted by a Physician from Mitchell-Valdez Medical Center concerning patient ANON-PX-1117. The subject is an adult other with a significant medical history including osteoarthritis, type 2 diabetes, 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): Omeprazole (Proton-pump inhibitor) administered via the Subcutaneous route at a dosage of 410mg, initiated on 2024-12-30 for Gastroesophageal reflux disease and discontinued on 2025-01-07; Amoxicillin (Penicillin antibiotic) administered via the Subcutaneous route at a dosage of 103mg, initiated on 2024-12-30 for Bacterial infection and discontinued on 2025-01-07.

On approximately 2025-01-03, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Maculopapular Rash, Headache. The Maculopapular Rash was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Headache was classified as Severe 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. A Naranjo score of 1 was calculated, The assessment concluded the relationship was 'Possible'. 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: Office friend hit interesting talk.</data>
report_id: ADR-2025-865
report_date: '2025-01-13'
patient_details:
  patient_id: ANON-PX-1117
  gender: Other
  relevant_history:
  - osteoarthritis
  - type 2 diabetes
  - seasonal allergies
suspected_drugs:
- drug_name: Omeprazole
  dosage: 410mg
  route_of_administration: Subcutaneous
  start_date: '2024-12-30'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
  end_date: '2025-01-07'
- drug_name: Amoxicillin
  dosage: 103mg
  route_of_administration: Subcutaneous
  start_date: '2024-12-30'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2025-01-07'
adverse_reactions:
- symptom_name: Maculopapular Rash
  onset_date: '2025-01-03'
  severity: Mild
  outcome: Unknown
  intervention_required: false
- symptom_name: Headache
  onset_date: '2025-01-03'
  severity: Severe
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 1
reporting_facility: Mitchell-Valdez Medical Center
reporter_type: Physician
notes: Office friend hit interesting talk.
