<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-2024-574
Date of Submission: 2024-08-28

This report was submitted by a Nurse from Reese Group Medical Center concerning patient ANON-PX-9242. The subject is a 89-year-old male with a significant medical history including anxiety, osteoarthritis. 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 271mg, initiated on 2024-07-14 for Gastroesophageal reflux disease and discontinued on 2024-08-20.

On approximately 2024-08-07, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Hepatotoxicity, Vomiting, Pruritus. The Hepatotoxicity was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed value and advised those. The current patient status regarding this symptom is 'Fatal'. The Vomiting was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Fatal'. The Pruritus was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. A Naranjo score of 4 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: Step sure city hotel scientist hot team. Reduce fine finally mouth truth plant computer. Model really matter school in culture.</data>
report_id: ADR-2024-574
report_date: '2024-08-28'
patient_details:
  patient_id: ANON-PX-9242
  gender: Male
  relevant_history:
  - anxiety
  - osteoarthritis
  age_at_reaction: 89
suspected_drugs:
- drug_name: Omeprazole
  dosage: 271mg
  route_of_administration: Subcutaneous
  start_date: '2024-07-14'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
  end_date: '2024-08-20'
adverse_reactions:
- symptom_name: Hepatotoxicity
  onset_date: '2024-08-07'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed value and advised those.
- symptom_name: Vomiting
  onset_date: '2024-08-07'
  severity: Moderate
  outcome: Fatal
  intervention_required: true
- symptom_name: Pruritus
  onset_date: '2024-08-07'
  severity: Moderate
  outcome: Recovering
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 4
reporting_facility: Reese Group Medical Center
reporter_type: Nurse
notes: Step sure city hotel scientist hot team. Reduce fine finally mouth truth plant
  computer. Model really matter school in culture.
