<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-2025-667
Date of Submission: 2025-02-19

This report was submitted by a Nurse from Ramirez, Hubbard and Preston Medical Center concerning patient ANON-PX-4283. The subject is a 48-year-old other with a significant medical history including coronary artery 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): Levothyroxine administered via the Topical route at a dosage of 500mg, initiated on 2024-12-16 for Hypothyroidism with the course ongoing; Omeprazole (Proton-pump inhibitor) administered via the Oral route at a dosage of 261mg, initiated on 2024-12-16 for Gastroesophageal reflux disease with the course ongoing.

On approximately 2025-02-04, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Diarrhea, Vomiting, Pruritus. The Diarrhea was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Vomiting was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Unknown'. The Pruritus was classified as Life-threatening in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 5 was calculated, The assessment concluded the relationship was 'Probable'. 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: Other remember set arm security. Need deep yourself color.</data>
report_id: ADR-2025-667
report_date: '2025-02-19'
patient_details:
  patient_id: ANON-PX-4283
  gender: Other
  relevant_history:
  - coronary artery disease
  - seasonal allergies
  age_at_reaction: 48
suspected_drugs:
- drug_name: Levothyroxine
  dosage: 500mg
  route_of_administration: Topical
  start_date: '2024-12-16'
  indication_for_use: Hypothyroidism
- drug_name: Omeprazole
  dosage: 261mg
  route_of_administration: Oral
  start_date: '2024-12-16'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
adverse_reactions:
- symptom_name: Diarrhea
  onset_date: '2025-02-04'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Vomiting
  onset_date: '2025-02-04'
  severity: Severe
  outcome: Unknown
  intervention_required: true
- symptom_name: Pruritus
  onset_date: '2025-02-04'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Rechallenge not performed
  naranjo_score: 5
reporting_facility: Ramirez, Hubbard and Preston Medical Center
reporter_type: Nurse
notes: Other remember set arm security. Need deep yourself color.
