<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-2025-267
Date of Submission: 2025-06-01

This report was submitted by a Patient from Rojas, Berry and Powell Medical Center concerning patient ANON-PX-1720. The subject is a 54-year-old female with a significant medical history including seasonal allergies, anxiety. 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 Subcutaneous route at a dosage of 399mg, initiated on 2025-04-13 for Thromboembolism prevention with the course ongoing; Omeprazole administered via the Oral route at a dosage of 27mg, initiated on 2025-04-13 for Gastroesophageal reflux disease with the course ongoing.

On approximately 2025-04-26, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Headache, Diarrhea, Pruritus. The Headache was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Diarrhea was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed white and advised know. The current patient status regarding this symptom is 'Unknown'. The Pruritus was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Not Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 3 was calculated, The assessment concluded the relationship was 'Possible'. Dechallenge/Rechallenge status was noted as: 'Positive rechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Score which ago economic. Peace continue find American. Process suddenly develop early. Suddenly card learn money event next local.</data>
report_id: ADR-2025-267
report_date: '2025-06-01'
patient_details:
  patient_id: ANON-PX-1720
  gender: Female
  relevant_history:
  - seasonal allergies
  - anxiety
  age_at_reaction: 54
suspected_drugs:
- drug_name: Warfarin
  dosage: 399mg
  route_of_administration: Subcutaneous
  start_date: '2025-04-13'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
- drug_name: Omeprazole
  dosage: 27mg
  route_of_administration: Oral
  start_date: '2025-04-13'
  indication_for_use: Gastroesophageal reflux disease
adverse_reactions:
- symptom_name: Headache
  onset_date: '2025-04-26'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Diarrhea
  onset_date: '2025-04-26'
  severity: Severe
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed white and advised know.
- symptom_name: Pruritus
  onset_date: '2025-04-26'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 3
reporting_facility: Rojas, Berry and Powell Medical Center
reporter_type: Patient
notes: Score which ago economic. Peace continue find American. Process suddenly develop
  early. Suddenly card learn money event next local.
