<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-2024-554
Date of Submission: 2024-10-31

This report was submitted by a Pharmacist from Brown LLC Medical Center concerning patient ANON-PX-7991. The subject is an adult male with a significant medical history including chronic kidney disease, hypertension. 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 Intramuscular route at a dosage of 46mg, initiated on 2024-10-15 for Gastroesophageal reflux disease and discontinued on 2024-10-29.

On approximately 2024-10-29, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Hepatotoxicity. The Vomiting was classified as Life-threatening in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Hepatotoxicity was classified as Moderate in severity. This necessitated clinical intervention. The current patient status regarding this symptom is 'Recovered'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. 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: Away blue challenge source when. Choice husband ahead fast choose physical.</data>
report_id: ADR-2024-554
report_date: '2024-10-31'
patient_details:
  patient_id: ANON-PX-7991
  gender: Male
  relevant_history:
  - chronic kidney disease
  - hypertension
suspected_drugs:
- drug_name: Omeprazole
  dosage: 46mg
  route_of_administration: Intramuscular
  start_date: '2024-10-15'
  indication_for_use: Gastroesophageal reflux disease
  end_date: '2024-10-29'
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2024-10-29'
  severity: Life-threatening
  outcome: Fatal
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2024-10-29'
  severity: Moderate
  outcome: Recovered
  intervention_required: true
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive rechallenge
reporting_facility: Brown LLC Medical Center
reporter_type: Pharmacist
notes: Away blue challenge source when. Choice husband ahead fast choose physical.
