<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-2025-741
Date of Submission: 2025-07-11

This report was submitted by a Nurse from Howell, White and Gallegos Medical Center concerning patient ANON-PX-7212. The subject is a 90-year-old female with a significant medical history including osteoarthritis, chronic kidney disease, 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 administered via the Oral route at a dosage of 344mg, initiated on 2025-07-01 for Gastroesophageal reflux disease and discontinued on 2025-07-08; Metformin (Biguanide) administered via the Intramuscular route at a dosage of 271mg, initiated on 2025-07-01 for Type 2 diabetes and discontinued on 2025-07-08.

On approximately 2025-07-07, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Anaphylaxis, Nausea, Angioedema, Dizziness. The Vomiting was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Anaphylaxis was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Nausea was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed catch and advised expert. The current patient status regarding this symptom is 'Recovered'. The Angioedema was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Dizziness was classified as Moderate 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 6 was calculated, The assessment concluded the relationship was 'Probable'. Dechallenge/Rechallenge status was noted as: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Region religious PM free guess election. Oil record suffer price major until have. Middle its almost list tree.</data>
report_id: ADR-2025-741
report_date: '2025-07-11'
patient_details:
  patient_id: ANON-PX-7212
  gender: Female
  relevant_history:
  - osteoarthritis
  - chronic kidney disease
  - seasonal allergies
  age_at_reaction: 90
suspected_drugs:
- drug_name: Omeprazole
  dosage: 344mg
  route_of_administration: Oral
  start_date: '2025-07-01'
  indication_for_use: Gastroesophageal reflux disease
  end_date: '2025-07-08'
- drug_name: Metformin
  dosage: 271mg
  route_of_administration: Intramuscular
  start_date: '2025-07-01'
  indication_for_use: Type 2 diabetes
  drug_class: Biguanide
  end_date: '2025-07-08'
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2025-07-07'
  severity: Mild
  outcome: Unknown
  intervention_required: false
- symptom_name: Anaphylaxis
  onset_date: '2025-07-07'
  severity: Mild
  outcome: Unknown
  intervention_required: false
- symptom_name: Nausea
  onset_date: '2025-07-07'
  severity: Mild
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed catch and advised expert.
- symptom_name: Angioedema
  onset_date: '2025-07-07'
  severity: Moderate
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2025-07-07'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 6
reporting_facility: Howell, White and Gallegos Medical Center
reporter_type: Nurse
notes: Region religious PM free guess election. Oil record suffer price major until
  have. Middle its almost list tree.
