<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-2025-964
Date of Submission: 2025-06-25

This report was submitted by a Pharmacist from Patterson, Sanchez and Lopez Medical Center concerning patient ANON-PX-3265. The subject is a 48-year-old female with a significant medical history including anxiety, type 2 diabetes, 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 Topical route at a dosage of 103mg, initiated on 2025-05-04 for Gastroesophageal reflux disease and discontinued on 2025-06-15; Warfarin (Anticoagulant) administered via the Intravenous route at a dosage of 184mg, initiated on 2025-05-04 for Thromboembolism prevention and discontinued on 2025-06-15.

On approximately 2025-05-31, the patient began to manifest an adverse event. The primary symptoms noted in the clinical log were Vomiting, Somnolence, Hepatotoxicity, Pruritus. The Vomiting was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Not Recovered'. The Somnolence was classified as Severe in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Fatal'. The Hepatotoxicity was classified as Mild in severity. No specific therapeutic intervention was required. The current patient status regarding this symptom is 'Unknown'. The Pruritus was classified as Severe in severity. This necessitated clinical intervention. The documented action was: Prescribed good and advised wonder. The current patient status regarding this symptom is 'Recovering'. 

CAUSALITY ASSESSMENT:
An evaluation of causality was performed. The assessment concluded the relationship was 'Probable'. 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: And leader cell father program throughout. Wonder run per practice before might. Through involve draw.</data>
report_id: ADR-2025-964
report_date: '2025-06-25'
patient_details:
  patient_id: ANON-PX-3265
  gender: Female
  relevant_history:
  - anxiety
  - type 2 diabetes
  - seasonal allergies
  age_at_reaction: 48
suspected_drugs:
- drug_name: Omeprazole
  dosage: 103mg
  route_of_administration: Topical
  start_date: '2025-05-04'
  indication_for_use: Gastroesophageal reflux disease
  drug_class: Proton-pump inhibitor
  end_date: '2025-06-15'
- drug_name: Warfarin
  dosage: 184mg
  route_of_administration: Intravenous
  start_date: '2025-05-04'
  indication_for_use: Thromboembolism prevention
  drug_class: Anticoagulant
  end_date: '2025-06-15'
adverse_reactions:
- symptom_name: Vomiting
  onset_date: '2025-05-31'
  severity: Severe
  outcome: Not Recovered
  intervention_required: false
- symptom_name: Somnolence
  onset_date: '2025-05-31'
  severity: Severe
  outcome: Fatal
  intervention_required: false
- symptom_name: Hepatotoxicity
  onset_date: '2025-05-31'
  severity: Mild
  outcome: Unknown
  intervention_required: false
- symptom_name: Pruritus
  onset_date: '2025-05-31'
  severity: Severe
  outcome: Recovering
  intervention_required: true
  intervention_details: Prescribed good and advised wonder.
causality_assessment:
  assessment_conclusion: Probable
  dechallenge_rechallenge: Positive dechallenge
reporting_facility: Patterson, Sanchez and Lopez Medical Center
reporter_type: Pharmacist
notes: And leader cell father program throughout. Wonder run per practice before might.
  Through involve draw.
