<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-2025-780
Date of Submission: 2025-08-08

This report was submitted by a Patient from Martinez-Brewer Medical Center concerning patient ANON-PX-1846. The subject is a 22-year-old male with a significant medical history including migraines, atrial fibrillation. 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 93mg, initiated on 2025-06-22 for Gastroesophageal reflux disease and discontinued on 2025-08-04; Warfarin (Anticoagulant) administered via the Intravenous route at a dosage of 452mg, initiated on 2025-06-22 for Thromboembolism prevention and discontinued on 2025-08-04.

On approximately 2025-08-03, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Angioedema, Dizziness, Hepatotoxicity, Maculopapular Rash. The Angioedema was classified as Moderate in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Dizziness was classified as Life-threatening in severity. This necessitated clinical intervention. The documented action was: Prescribed realize and advised spring. The current patient status regarding this symptom is 'Recovered'. The Hepatotoxicity was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed method and advised way. The current patient status regarding this symptom is 'Recovered'. The Maculopapular Rash was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed peace and advised still. The current patient status regarding this symptom is 'Fatal'. 

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. 

</data>
report_id: ADR-2025-780
report_date: '2025-08-08'
patient_details:
  patient_id: ANON-PX-1846
  gender: Male
  relevant_history:
  - migraines
  - atrial fibrillation
  age_at_reaction: 22
suspected_drugs:
- drug_name: Omeprazole
  dosage: 93mg
  route_of_administration: Subcutaneous
  start_date: '2025-06-22'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
  end_date: '2025-08-04'
- drug_name: Warfarin
  dosage: 452mg
  route_of_administration: Intravenous
  start_date: '2025-06-22'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2025-08-04'
adverse_reactions:
- symptom_name: Angioedema
  onset_date: '2025-08-03'
  severity: Moderate
  outcome: Fatal
  intervention_required: false
- symptom_name: Dizziness
  onset_date: '2025-08-03'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed realize and advised spring.
- symptom_name: Hepatotoxicity
  onset_date: '2025-08-03'
  severity: Mild
  outcome: Recovered
  intervention_required: true
  intervention_details: Prescribed method and advised way.
- symptom_name: Maculopapular Rash
  onset_date: '2025-08-03'
  severity: Severe
  outcome: Fatal
  intervention_required: true
  intervention_details: Prescribed peace and advised still.
causality_assessment:
  assessment_conclusion: Possible
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 3
reporting_facility: Martinez-Brewer Medical Center
reporter_type: Patient
