<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-2025-569
Date of Submission: 2025-08-02

This report was submitted by a Other Healthcare Professional from Brewer LLC Medical Center concerning patient ANON-PX-9626. The subject is a 76-year-old male 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): Omeprazole (Proton-pump inhibitor) administered via the Subcutaneous route at a dosage of 414mg, initiated on 2025-07-12 for Gastroesophageal reflux disease and discontinued on 2025-07-26; Amoxicillin (Penicillin antibiotic) administered via the Topical route at a dosage of 310mg, initiated on 2025-07-12 for Bacterial infection and discontinued on 2025-07-26.

On approximately 2025-07-22, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Maculopapular Rash. The Vomiting was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Maculopapular Rash was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. 

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

Reporter's Narrative Summary: Base suggest center might idea. Admit him back per seem always purpose.</data>
report_id: ADR-2025-569
report_date: '2025-08-02'
patient_details:
  patient_id: ANON-PX-9626
  gender: Male
  relevant_history:
  - coronary artery disease
  - seasonal allergies
  age_at_reaction: 76
suspected_drugs:
- drug_name: Omeprazole
  dosage: 414mg
  route_of_administration: Subcutaneous
  start_date: '2025-07-12'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
  end_date: '2025-07-26'
- drug_name: Amoxicillin
  dosage: 310mg
  route_of_administration: Topical
  start_date: '2025-07-12'
  indication_for_use: Bacterial infection
  drug_class: Penicillin antibiotic
  end_date: '2025-07-26'
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2025-07-22'
  severity: Moderate
  outcome: Unknown
  intervention_required: false
- symptom_name: Maculopapular Rash
  onset_date: '2025-07-22'
  severity: Mild
  outcome: Recovered
  intervention_required: false
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Negative dechallenge
  naranjo_score: 4
reporting_facility: Brewer LLC Medical Center
reporter_type: Other Healthcare Professional
notes: Base suggest center might idea. Admit him back per seem always purpose.
