<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-2025-760
Date of Submission: 2025-07-23

This report was submitted by a Pharmacist from Jones-Wagner Medical Center concerning patient ANON-PX-4231. The subject is a 32-year-old other with a significant medical history including chronic kidney disease, anxiety, migraines, asthma. 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 Intravenous route at a dosage of 65mg, initiated on 2025-06-29 for Gastroesophageal reflux disease and discontinued on 2025-07-21; Metformin administered via the Subcutaneous route at a dosage of 293mg, initiated on 2025-06-29 for Type 2 diabetes and discontinued on 2025-07-21.

On approximately 2025-07-16, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Anaphylaxis, Headache. The Anaphylaxis was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed relationship and advised product. The current patient status regarding this symptom is 'Recovering'. The Headache was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed Mrs and advised whatever. The current patient status regarding this symptom is 'Not Recovered'. 

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: 'Positive dechallenge'. The on-site pharmacist concurred with the assessment during a routine case review. 

Reporter's Narrative Summary: Seem million director new a. Unit their contain situation skill. Above design few computer.</data>
report_id: ADR-2025-760
report_date: '2025-07-23'
patient_details:
  patient_id: ANON-PX-4231
  gender: Other
  relevant_history:
  - chronic kidney disease
  - anxiety
  - migraines
  - asthma
  age_at_reaction: 32
suspected_drugs:
- drug_name: Omeprazole
  dosage: 65mg
  route_of_administration: Intravenous
  start_date: '2025-06-29'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
  end_date: '2025-07-21'
- drug_name: Metformin
  dosage: 293mg
  route_of_administration: Subcutaneous
  start_date: '2025-06-29'
  indication_for_use: Type 2 diabetes
  end_date: '2025-07-21'
adverse_reactions:
- symptom_name: Anaphylaxis
  onset_date: '2025-07-16'
  severity: Life-threatening
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed relationship and advised product.
- symptom_name: Headache
  onset_date: '2025-07-16'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed Mrs and advised whatever.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive dechallenge
  naranjo_score: 1
reporting_facility: Jones-Wagner Medical Center
reporter_type: Pharmacist
notes: Seem million director new a. Unit their contain situation skill. Above design
  few computer.
