<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-2025-439
Date of Submission: 2025-01-10

This report was submitted by a Patient from Shah, Davis and Robinson Medical Center concerning patient ANON-PX-9877. The subject is a 40-year-old other with a significant medical history including hypertension, 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 administered via the Subcutaneous route at a dosage of 186mg, initiated on 2024-12-14 for Gastroesophageal reflux disease and discontinued on 2025-01-08; Levothyroxine (Thyroid hormone) administered via the Oral route at a dosage of 493mg, initiated on 2024-12-14 for Hypothyroidism and discontinued on 2025-01-08.

On approximately 2025-01-06, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Dizziness, Angioedema, Vomiting, Headache, Stevens-Johnson syndrome. The Dizziness was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Recovered'. The Angioedema was classified as Severe in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. The Vomiting was classified as Mild in severity. This necessitated clinical intervention. The documented action was: Prescribed cut and advised Mrs. The current patient status regarding this symptom is 'Not Recovered'. The Headache was classified as Moderate in severity. This necessitated clinical intervention. The documented action was: Prescribed federal and advised whom. The current patient status regarding this symptom is 'Unknown'. The Stevens-Johnson syndrome was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed set and advised suffer. The current patient status regarding this symptom is 'Not Recovered'. 

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

Reporter's Narrative Summary: Bring again box bar. Practice ago expect financial wear. Expect lot success.</data>
report_id: ADR-2025-439
report_date: '2025-01-10'
patient_details:
  patient_id: ANON-PX-9877
  gender: Other
  relevant_history:
  - hypertension
  - seasonal allergies
  age_at_reaction: 40
suspected_drugs:
- drug_name: Omeprazole
  dosage: 186mg
  route_of_administration: Subcutaneous
  start_date: '2024-12-14'
  indication_for_use: Gastroesophageal reflux disease
  end_date: '2025-01-08'
- drug_name: Levothyroxine
  dosage: 493mg
  route_of_administration: Oral
  start_date: '2024-12-14'
  indication_for_use: Hypothyroidism
  drug_class: Thyroid hormone
  end_date: '2025-01-08'
adverse_reactions:
- symptom_name: Dizziness
  onset_date: '2025-01-06'
  severity: Life-threatening
  outcome: Recovered
  intervention_required: false
- symptom_name: Angioedema
  onset_date: '2025-01-06'
  severity: Severe
  outcome: Recovered
  intervention_required: true
- symptom_name: Vomiting
  onset_date: '2025-01-06'
  severity: Mild
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed cut and advised Mrs.
- symptom_name: Headache
  onset_date: '2025-01-06'
  severity: Moderate
  outcome: Unknown
  intervention_required: true
  intervention_details: Prescribed federal and advised whom.
- symptom_name: Stevens-Johnson syndrome
  onset_date: '2025-01-06'
  severity: Severe
  outcome: Not Recovered
  intervention_required: true
  intervention_details: Prescribed set and advised suffer.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
  naranjo_score: 5
reporting_facility: Shah, Davis and Robinson Medical Center
reporter_type: Patient
notes: Bring again box bar. Practice ago expect financial wear. Expect lot success.
