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FA-64351 / Clinical triage scoring / Open access

Aggregate early warning score with oxygen scale: supplemental oxygen points · case 01

Scale 2 patients on oxygen do not receive the oxygen points.

Verified by executionVariant 1 · 11 checks per implementationDownload source bundle ↓JSON ↗

ROOT CAUSE

The oxygen points are suppressed on scale 2, conflating the saturation scale with oxygen use.

VERIFIED REPAIR

Add 2 points whenever supplemental oxygen is in use.

Unsuccessful approach: Waiving the points when saturation is 96% or higher hides the oxygen requirement.

Case contract

Input {rr, spo2, on_o2, scale2, temp (1 dp), sbp, hr, avpu}. Toy points: RR <=8:3, 9-11:1, 12-20:0, 21-24:2, >=25:3. SpO2 scale 1: <=91:3, 92-93:2, 94-95:1, >=96:0. Scale 2: <=83:3, 84-85:2, 86-87:1, 88-92:0, and >=93 scores 0 on air but on oxygen 93-94:1, 95-96:2, >=97:3. Oxygen +2. Temp <=35.0:3, 35.1-36.0:1, 36.1-38.0:0, 38.1-39.0:1, >=39.1:2. SBP <=90:3, 91-100:2, 101-110:1, 111-219:0, >=220:3. HR <=40:3, 41-50:1, 51-90:0, 91-110:1, 111-130:2, >=131:3. AVPU "A" 0, any other (C new confusion, V, P, U) 3. Risk: total >=7 HIGH, >=5 MEDIUM, else LOW_MEDIUM if any single parameter scores 3, else LOW. Return {score, risk}.

Why this case matters

Aggregate early warning scores drive escalation; each parameter table, the oxygen scale switch and the single-parameter trigger are separate failure points.

1 / The failure

Exit 1
"""Failure Map reference implementation. Python standard library only."""
import json
import math
from fractions import Fraction
N = 1
observations = []
def solve(x):
    rr = x['rr']
    s_rr = 3 if rr <= 8 else 1 if rr <= 11 else 0 if rr <= 20 else 2 if rr <= 24 else 3
    sp = x['spo2']
    if x['scale2']:
        if sp <= 83:
            s_sp = 3
        elif sp <= 85:
            s_sp = 2
        elif sp <= 87:
            s_sp = 1
        elif sp <= 92 or not x['on_o2']:
            s_sp = 0
        elif sp <= 94:
            s_sp = 1
        elif sp <= 96:
            s_sp = 2
        else:
            s_sp = 3
    else:
        s_sp = 3 if sp <= 91 else 2 if sp <= 93 else 1 if sp <= 95 else 0
    s_o2 = 2 if x['on_o2'] and not x['scale2'] else 0
    t = Fraction(str(x['temp'])) * 10
    s_t = 3 if t <= 350 else 1 if t <= 360 else 0 if t <= 380 else 1 if t <= 390 else 2
    bp = x['sbp']
    s_bp = 3 if bp <= 90 else 2 if bp <= 100 else 1 if bp <= 110 else 0 if bp <= 219 else 3
    hr = x['hr']
    s_hr = 3 if hr <= 40 else 1 if hr <= 50 else 0 if hr <= 90 else 1 if hr <= 110 else 2 if hr <= 130 else 3
    s_c = 0 if x['avpu'] == 'A' else 3
    parts = [s_rr, s_sp, s_o2, s_t, s_bp, s_hr, s_c]
    total = sum(parts)
    if total >= 7:
        risk = 'HIGH'
    elif total >= 5:
        risk = 'MEDIUM'
    elif 3 in parts:
        risk = 'LOW_MEDIUM'
    else:
        risk = 'LOW'
    return {'score': total, 'risk': risk}
def check(label, actual, expected):
    observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('healthy control',
   {'rr': 16, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 71, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('new confusion scores three',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.1', 'sbp': 120, 'hr': 80, 'avpu': 'C'},
   {'score': 5, 'risk': 'MEDIUM'}),
  ('responds to voice only',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': False, 'temp': '37.2', 'sbp': 126, 'hr': 85, 'avpu': 'V'},
   {'score': 3, 'risk': 'LOW_MEDIUM'}),
  ('scale 2 high saturation on air',
   {'rr': 18, 'spo2': 95, 'on_o2': False, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('scale 2 target range on oxygen',
   {'rr': 18, 'spo2': 89, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('scale 2 above target on oxygen',
   {'rr': 18, 'spo2': 95, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 81, 'avpu': 'A'},
   {'score': 4, 'risk': 'LOW'}),
  ('saturating well on oxygen',
   {'rr': 18, 'spo2': 98, 'on_o2': True, 'scale2': False, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('temperature exactly 36.0',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.0', 'sbp': 135, 'hr': 76, 'avpu': 'A'},
   {'score': 1, 'risk': 'LOW'}),
  ('temperature 36.x scores zero',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.3', 'sbp': 135, 'hr': 75, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('aggregate three without red parameter',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 140, 'hr': 96, 'avpu': 'A'},
   {'score': 3, 'risk': 'LOW'}),
  ('pain-only response is red parameter',
   {'rr': 16, 'spo2': 98, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 61, 'avpu': 'P'},
   {'score': 3, 'risk': 'LOW_MEDIUM'})],
 [('healthy control',
   {'rr': 16, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 72, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('new confusion scores three',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.2', 'sbp': 120, 'hr': 80, 'avpu': 'C'},
   {'score': 5, 'risk': 'MEDIUM'}),
  ('responds to voice only',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': False, 'temp': '37.2', 'sbp': 127, 'hr': 85, 'avpu': 'V'},
   {'score': 3, 'risk': 'LOW_MEDIUM'}),
  ('scale 2 high saturation on air',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('scale 2 target range on oxygen',
   {'rr': 18, 'spo2': 90, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('scale 2 above target on oxygen',
   {'rr': 18, 'spo2': 95, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 82, 'avpu': 'A'},
   {'score': 4, 'risk': 'LOW'}),
  ('saturating well on oxygen',
   {'rr': 18, 'spo2': 99, 'on_o2': True, 'scale2': False, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('temperature exactly 36.0',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.0', 'sbp': 135, 'hr': 77, 'avpu': 'A'},
   {'score': 1, 'risk': 'LOW'}),
  ('temperature 36.x scores zero',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.4', 'sbp': 135, 'hr': 75, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('aggregate three without red parameter',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 140, 'hr': 97, 'avpu': 'A'},
   {'score': 3, 'risk': 'LOW'}),
  ('pain-only response is red parameter',
   {'rr': 16, 'spo2': 98, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 62, 'avpu': 'P'},
   {'score': 3, 'risk': 'LOW_MEDIUM'})],
 [('healthy control',
   {'rr': 16, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 73, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('new confusion scores three',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.3', 'sbp': 120, 'hr': 80, 'avpu': 'C'},
   {'score': 5, 'risk': 'MEDIUM'}),
  ('responds to voice only',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': False, 'temp': '37.2', 'sbp': 128, 'hr': 85, 'avpu': 'V'},
   {'score': 3, 'risk': 'LOW_MEDIUM'}),
  ('scale 2 high saturation on air',
   {'rr': 18, 'spo2': 94, 'on_o2': False, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('scale 2 target range on oxygen',
   {'rr': 18, 'spo2': 91, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('scale 2 above target on oxygen',
   {'rr': 18, 'spo2': 95, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 83, 'avpu': 'A'},
   {'score': 4, 'risk': 'LOW'}),
  ('saturating well on oxygen',
   {'rr': 18, 'spo2': 97, 'on_o2': True, 'scale2': False, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('temperature exactly 36.0',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.0', 'sbp': 135, 'hr': 78, 'avpu': 'A'},
   {'score': 1, 'risk': 'LOW'}),
  ('temperature 36.x scores zero',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.5', 'sbp': 135, 'hr': 75, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('aggregate three without red parameter',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 140, 'hr': 98, 'avpu': 'A'},
   {'score': 3, 'risk': 'LOW'}),
  ('pain-only response is red parameter',
   {'rr': 16, 'spo2': 98, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 63, 'avpu': 'P'},
   {'score': 3, 'risk': 'LOW_MEDIUM'})],
 [('healthy control',
   {'rr': 16, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 74, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('new confusion scores three',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.4', 'sbp': 120, 'hr': 80, 'avpu': 'C'},
   {'score': 5, 'risk': 'MEDIUM'}),
  ('responds to voice only',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': False, 'temp': '37.2', 'sbp': 129, 'hr': 85, 'avpu': 'V'},
   {'score': 3, 'risk': 'LOW_MEDIUM'}),
  ('scale 2 high saturation on air',
   {'rr': 18, 'spo2': 95, 'on_o2': False, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('scale 2 target range on oxygen',
   {'rr': 18, 'spo2': 92, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('scale 2 above target on oxygen',
   {'rr': 18, 'spo2': 95, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 84, 'avpu': 'A'},
   {'score': 4, 'risk': 'LOW'}),
  ('saturating well on oxygen',
   {'rr': 18, 'spo2': 98, 'on_o2': True, 'scale2': False, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('temperature exactly 36.0',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.0', 'sbp': 135, 'hr': 79, 'avpu': 'A'},
   {'score': 1, 'risk': 'LOW'}),
  ('temperature 36.x scores zero',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.6', 'sbp': 135, 'hr': 75, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('aggregate three without red parameter',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 140, 'hr': 99, 'avpu': 'A'},
   {'score': 3, 'risk': 'LOW'}),
  ('pain-only response is red parameter',
   {'rr': 16, 'spo2': 98, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 64, 'avpu': 'P'},
   {'score': 3, 'risk': 'LOW_MEDIUM'})],
 [('healthy control',
   {'rr': 16, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 75, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('new confusion scores three',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.5', 'sbp': 120, 'hr': 80, 'avpu': 'C'},
   {'score': 5, 'risk': 'MEDIUM'}),
  ('responds to voice only',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': False, 'temp': '37.2', 'sbp': 130, 'hr': 85, 'avpu': 'V'},
   {'score': 3, 'risk': 'LOW_MEDIUM'}),
  ('scale 2 high saturation on air',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('scale 2 target range on oxygen',
   {'rr': 18, 'spo2': 88, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('scale 2 above target on oxygen',
   {'rr': 18, 'spo2': 95, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 85, 'avpu': 'A'},
   {'score': 4, 'risk': 'LOW'}),
  ('saturating well on oxygen',
   {'rr': 18, 'spo2': 99, 'on_o2': True, 'scale2': False, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('temperature exactly 36.0',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.0', 'sbp': 135, 'hr': 80, 'avpu': 'A'},
   {'score': 1, 'risk': 'LOW'}),
  ('temperature 36.x scores zero',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.7', 'sbp': 135, 'hr': 75, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('aggregate three without red parameter',
   {'rr': 22,
    'spo2': 97,
    'on_o2': False,
    'scale2': False,
    'temp': '37.0',
    'sbp': 140,
    'hr': 100,
    'avpu': 'A'},
   {'score': 3, 'risk': 'LOW'}),
  ('pain-only response is red parameter',
   {'rr': 16, 'spo2': 98, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 65, 'avpu': 'P'},
   {'score': 3, 'risk': 'LOW_MEDIUM'})]]
for label, args, expected in fixtures[N-1]:
    check(label, solve(args), expected)
print(json.dumps({"observations": observations, "passed": all(x["passed"] for x in observations)}, ensure_ascii=False))
raise SystemExit(0 if all(x["passed"] for x in observations) else 1)
Boundary fixtureActualExpectedOutcome
healthy control{'risk': 'LOW', 'score': 0}{'risk': 'LOW', 'score': 0}Passed
new confusion scores three{'risk': 'MEDIUM', 'score': 5}{'risk': 'MEDIUM', 'score': 5}Passed
responds to voice only{'risk': 'LOW_MEDIUM', 'score': 3}{'risk': 'LOW_MEDIUM', 'score': 3}Passed
scale 2 high saturation on air{'risk': 'LOW', 'score': 0}{'risk': 'LOW', 'score': 0}Passed
scale 2 target range on oxygen{'risk': 'LOW', 'score': 0}{'risk': 'LOW', 'score': 2}Failed
scale 2 above target on oxygen{'risk': 'LOW', 'score': 2}{'risk': 'LOW', 'score': 4}Failed
saturating well on oxygen{'risk': 'LOW', 'score': 2}{'risk': 'LOW', 'score': 2}Passed
temperature exactly 36.0{'risk': 'LOW', 'score': 1}{'risk': 'LOW', 'score': 1}Passed
temperature 36.x scores zero{'risk': 'LOW', 'score': 0}{'risk': 'LOW', 'score': 0}Passed
aggregate three without red parameter{'risk': 'LOW', 'score': 3}{'risk': 'LOW', 'score': 3}Passed
pain-only response is red parameter{'risk': 'LOW_MEDIUM', 'score': 3}{'risk': 'LOW_MEDIUM', 'score': 3}Passed

SHA-256 / b8098b1c0f73b0f99af16ff651df95f4c8b243bde4810432dbe1a044ef5299f3

2 / The unsuccessful fix

Exit 1
"""Failure Map reference implementation. Python standard library only."""
import json
import math
from fractions import Fraction
N = 1
observations = []
def solve(x):
    rr = x['rr']
    s_rr = 3 if rr <= 8 else 1 if rr <= 11 else 0 if rr <= 20 else 2 if rr <= 24 else 3
    sp = x['spo2']
    if x['scale2']:
        if sp <= 83:
            s_sp = 3
        elif sp <= 85:
            s_sp = 2
        elif sp <= 87:
            s_sp = 1
        elif sp <= 92 or not x['on_o2']:
            s_sp = 0
        elif sp <= 94:
            s_sp = 1
        elif sp <= 96:
            s_sp = 2
        else:
            s_sp = 3
    else:
        s_sp = 3 if sp <= 91 else 2 if sp <= 93 else 1 if sp <= 95 else 0
    s_o2 = 2 if x['on_o2'] and sp < 96 else 0
    t = Fraction(str(x['temp'])) * 10
    s_t = 3 if t <= 350 else 1 if t <= 360 else 0 if t <= 380 else 1 if t <= 390 else 2
    bp = x['sbp']
    s_bp = 3 if bp <= 90 else 2 if bp <= 100 else 1 if bp <= 110 else 0 if bp <= 219 else 3
    hr = x['hr']
    s_hr = 3 if hr <= 40 else 1 if hr <= 50 else 0 if hr <= 90 else 1 if hr <= 110 else 2 if hr <= 130 else 3
    s_c = 0 if x['avpu'] == 'A' else 3
    parts = [s_rr, s_sp, s_o2, s_t, s_bp, s_hr, s_c]
    total = sum(parts)
    if total >= 7:
        risk = 'HIGH'
    elif total >= 5:
        risk = 'MEDIUM'
    elif 3 in parts:
        risk = 'LOW_MEDIUM'
    else:
        risk = 'LOW'
    return {'score': total, 'risk': risk}
def check(label, actual, expected):
    observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('healthy control',
   {'rr': 16, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 71, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('new confusion scores three',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.1', 'sbp': 120, 'hr': 80, 'avpu': 'C'},
   {'score': 5, 'risk': 'MEDIUM'}),
  ('responds to voice only',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': False, 'temp': '37.2', 'sbp': 126, 'hr': 85, 'avpu': 'V'},
   {'score': 3, 'risk': 'LOW_MEDIUM'}),
  ('scale 2 high saturation on air',
   {'rr': 18, 'spo2': 95, 'on_o2': False, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('scale 2 target range on oxygen',
   {'rr': 18, 'spo2': 89, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('scale 2 above target on oxygen',
   {'rr': 18, 'spo2': 95, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 81, 'avpu': 'A'},
   {'score': 4, 'risk': 'LOW'}),
  ('saturating well on oxygen',
   {'rr': 18, 'spo2': 98, 'on_o2': True, 'scale2': False, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('temperature exactly 36.0',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.0', 'sbp': 135, 'hr': 76, 'avpu': 'A'},
   {'score': 1, 'risk': 'LOW'}),
  ('temperature 36.x scores zero',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.3', 'sbp': 135, 'hr': 75, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('aggregate three without red parameter',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 140, 'hr': 96, 'avpu': 'A'},
   {'score': 3, 'risk': 'LOW'}),
  ('pain-only response is red parameter',
   {'rr': 16, 'spo2': 98, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 61, 'avpu': 'P'},
   {'score': 3, 'risk': 'LOW_MEDIUM'})],
 [('healthy control',
   {'rr': 16, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 72, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('new confusion scores three',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.2', 'sbp': 120, 'hr': 80, 'avpu': 'C'},
   {'score': 5, 'risk': 'MEDIUM'}),
  ('responds to voice only',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': False, 'temp': '37.2', 'sbp': 127, 'hr': 85, 'avpu': 'V'},
   {'score': 3, 'risk': 'LOW_MEDIUM'}),
  ('scale 2 high saturation on air',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('scale 2 target range on oxygen',
   {'rr': 18, 'spo2': 90, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('scale 2 above target on oxygen',
   {'rr': 18, 'spo2': 95, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 82, 'avpu': 'A'},
   {'score': 4, 'risk': 'LOW'}),
  ('saturating well on oxygen',
   {'rr': 18, 'spo2': 99, 'on_o2': True, 'scale2': False, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('temperature exactly 36.0',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.0', 'sbp': 135, 'hr': 77, 'avpu': 'A'},
   {'score': 1, 'risk': 'LOW'}),
  ('temperature 36.x scores zero',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.4', 'sbp': 135, 'hr': 75, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('aggregate three without red parameter',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 140, 'hr': 97, 'avpu': 'A'},
   {'score': 3, 'risk': 'LOW'}),
  ('pain-only response is red parameter',
   {'rr': 16, 'spo2': 98, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 62, 'avpu': 'P'},
   {'score': 3, 'risk': 'LOW_MEDIUM'})],
 [('healthy control',
   {'rr': 16, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 73, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('new confusion scores three',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.3', 'sbp': 120, 'hr': 80, 'avpu': 'C'},
   {'score': 5, 'risk': 'MEDIUM'}),
  ('responds to voice only',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': False, 'temp': '37.2', 'sbp': 128, 'hr': 85, 'avpu': 'V'},
   {'score': 3, 'risk': 'LOW_MEDIUM'}),
  ('scale 2 high saturation on air',
   {'rr': 18, 'spo2': 94, 'on_o2': False, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('scale 2 target range on oxygen',
   {'rr': 18, 'spo2': 91, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('scale 2 above target on oxygen',
   {'rr': 18, 'spo2': 95, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 83, 'avpu': 'A'},
   {'score': 4, 'risk': 'LOW'}),
  ('saturating well on oxygen',
   {'rr': 18, 'spo2': 97, 'on_o2': True, 'scale2': False, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('temperature exactly 36.0',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.0', 'sbp': 135, 'hr': 78, 'avpu': 'A'},
   {'score': 1, 'risk': 'LOW'}),
  ('temperature 36.x scores zero',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.5', 'sbp': 135, 'hr': 75, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('aggregate three without red parameter',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 140, 'hr': 98, 'avpu': 'A'},
   {'score': 3, 'risk': 'LOW'}),
  ('pain-only response is red parameter',
   {'rr': 16, 'spo2': 98, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 63, 'avpu': 'P'},
   {'score': 3, 'risk': 'LOW_MEDIUM'})],
 [('healthy control',
   {'rr': 16, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 74, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('new confusion scores three',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.4', 'sbp': 120, 'hr': 80, 'avpu': 'C'},
   {'score': 5, 'risk': 'MEDIUM'}),
  ('responds to voice only',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': False, 'temp': '37.2', 'sbp': 129, 'hr': 85, 'avpu': 'V'},
   {'score': 3, 'risk': 'LOW_MEDIUM'}),
  ('scale 2 high saturation on air',
   {'rr': 18, 'spo2': 95, 'on_o2': False, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('scale 2 target range on oxygen',
   {'rr': 18, 'spo2': 92, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('scale 2 above target on oxygen',
   {'rr': 18, 'spo2': 95, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 84, 'avpu': 'A'},
   {'score': 4, 'risk': 'LOW'}),
  ('saturating well on oxygen',
   {'rr': 18, 'spo2': 98, 'on_o2': True, 'scale2': False, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('temperature exactly 36.0',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.0', 'sbp': 135, 'hr': 79, 'avpu': 'A'},
   {'score': 1, 'risk': 'LOW'}),
  ('temperature 36.x scores zero',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.6', 'sbp': 135, 'hr': 75, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('aggregate three without red parameter',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 140, 'hr': 99, 'avpu': 'A'},
   {'score': 3, 'risk': 'LOW'}),
  ('pain-only response is red parameter',
   {'rr': 16, 'spo2': 98, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 64, 'avpu': 'P'},
   {'score': 3, 'risk': 'LOW_MEDIUM'})],
 [('healthy control',
   {'rr': 16, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 75, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('new confusion scores three',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.5', 'sbp': 120, 'hr': 80, 'avpu': 'C'},
   {'score': 5, 'risk': 'MEDIUM'}),
  ('responds to voice only',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': False, 'temp': '37.2', 'sbp': 130, 'hr': 85, 'avpu': 'V'},
   {'score': 3, 'risk': 'LOW_MEDIUM'}),
  ('scale 2 high saturation on air',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('scale 2 target range on oxygen',
   {'rr': 18, 'spo2': 88, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('scale 2 above target on oxygen',
   {'rr': 18, 'spo2': 95, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 85, 'avpu': 'A'},
   {'score': 4, 'risk': 'LOW'}),
  ('saturating well on oxygen',
   {'rr': 18, 'spo2': 99, 'on_o2': True, 'scale2': False, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('temperature exactly 36.0',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.0', 'sbp': 135, 'hr': 80, 'avpu': 'A'},
   {'score': 1, 'risk': 'LOW'}),
  ('temperature 36.x scores zero',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.7', 'sbp': 135, 'hr': 75, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('aggregate three without red parameter',
   {'rr': 22,
    'spo2': 97,
    'on_o2': False,
    'scale2': False,
    'temp': '37.0',
    'sbp': 140,
    'hr': 100,
    'avpu': 'A'},
   {'score': 3, 'risk': 'LOW'}),
  ('pain-only response is red parameter',
   {'rr': 16, 'spo2': 98, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 65, 'avpu': 'P'},
   {'score': 3, 'risk': 'LOW_MEDIUM'})]]
for label, args, expected in fixtures[N-1]:
    check(label, solve(args), expected)
print(json.dumps({"observations": observations, "passed": all(x["passed"] for x in observations)}, ensure_ascii=False))
raise SystemExit(0 if all(x["passed"] for x in observations) else 1)
Boundary fixtureActualExpectedOutcome
healthy control{'risk': 'LOW', 'score': 0}{'risk': 'LOW', 'score': 0}Passed
new confusion scores three{'risk': 'MEDIUM', 'score': 5}{'risk': 'MEDIUM', 'score': 5}Passed
responds to voice only{'risk': 'LOW_MEDIUM', 'score': 3}{'risk': 'LOW_MEDIUM', 'score': 3}Passed
scale 2 high saturation on air{'risk': 'LOW', 'score': 0}{'risk': 'LOW', 'score': 0}Passed
scale 2 target range on oxygen{'risk': 'LOW', 'score': 2}{'risk': 'LOW', 'score': 2}Passed
scale 2 above target on oxygen{'risk': 'LOW', 'score': 4}{'risk': 'LOW', 'score': 4}Passed
saturating well on oxygen{'risk': 'LOW', 'score': 0}{'risk': 'LOW', 'score': 2}Failed
temperature exactly 36.0{'risk': 'LOW', 'score': 1}{'risk': 'LOW', 'score': 1}Passed
temperature 36.x scores zero{'risk': 'LOW', 'score': 0}{'risk': 'LOW', 'score': 0}Passed
aggregate three without red parameter{'risk': 'LOW', 'score': 3}{'risk': 'LOW', 'score': 3}Passed
pain-only response is red parameter{'risk': 'LOW_MEDIUM', 'score': 3}{'risk': 'LOW_MEDIUM', 'score': 3}Passed

SHA-256 / 8ea7059b37397ffb8cee1296ea766a5da5d96ea385602a8d54e876d3a02cf6d3

3 / The verified repair

Exit 0
"""Failure Map reference implementation. Python standard library only."""
import json
import math
from fractions import Fraction
N = 1
observations = []
def solve(x):
    rr = x['rr']
    s_rr = 3 if rr <= 8 else 1 if rr <= 11 else 0 if rr <= 20 else 2 if rr <= 24 else 3
    sp = x['spo2']
    if x['scale2']:
        if sp <= 83:
            s_sp = 3
        elif sp <= 85:
            s_sp = 2
        elif sp <= 87:
            s_sp = 1
        elif sp <= 92 or not x['on_o2']:
            s_sp = 0
        elif sp <= 94:
            s_sp = 1
        elif sp <= 96:
            s_sp = 2
        else:
            s_sp = 3
    else:
        s_sp = 3 if sp <= 91 else 2 if sp <= 93 else 1 if sp <= 95 else 0
    s_o2 = 2 if x['on_o2'] else 0
    t = Fraction(str(x['temp'])) * 10
    s_t = 3 if t <= 350 else 1 if t <= 360 else 0 if t <= 380 else 1 if t <= 390 else 2
    bp = x['sbp']
    s_bp = 3 if bp <= 90 else 2 if bp <= 100 else 1 if bp <= 110 else 0 if bp <= 219 else 3
    hr = x['hr']
    s_hr = 3 if hr <= 40 else 1 if hr <= 50 else 0 if hr <= 90 else 1 if hr <= 110 else 2 if hr <= 130 else 3
    s_c = 0 if x['avpu'] == 'A' else 3
    parts = [s_rr, s_sp, s_o2, s_t, s_bp, s_hr, s_c]
    total = sum(parts)
    if total >= 7:
        risk = 'HIGH'
    elif total >= 5:
        risk = 'MEDIUM'
    elif 3 in parts:
        risk = 'LOW_MEDIUM'
    else:
        risk = 'LOW'
    return {'score': total, 'risk': risk}
def check(label, actual, expected):
    observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('healthy control',
   {'rr': 16, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 71, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('new confusion scores three',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.1', 'sbp': 120, 'hr': 80, 'avpu': 'C'},
   {'score': 5, 'risk': 'MEDIUM'}),
  ('responds to voice only',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': False, 'temp': '37.2', 'sbp': 126, 'hr': 85, 'avpu': 'V'},
   {'score': 3, 'risk': 'LOW_MEDIUM'}),
  ('scale 2 high saturation on air',
   {'rr': 18, 'spo2': 95, 'on_o2': False, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('scale 2 target range on oxygen',
   {'rr': 18, 'spo2': 89, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('scale 2 above target on oxygen',
   {'rr': 18, 'spo2': 95, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 81, 'avpu': 'A'},
   {'score': 4, 'risk': 'LOW'}),
  ('saturating well on oxygen',
   {'rr': 18, 'spo2': 98, 'on_o2': True, 'scale2': False, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('temperature exactly 36.0',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.0', 'sbp': 135, 'hr': 76, 'avpu': 'A'},
   {'score': 1, 'risk': 'LOW'}),
  ('temperature 36.x scores zero',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.3', 'sbp': 135, 'hr': 75, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('aggregate three without red parameter',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 140, 'hr': 96, 'avpu': 'A'},
   {'score': 3, 'risk': 'LOW'}),
  ('pain-only response is red parameter',
   {'rr': 16, 'spo2': 98, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 61, 'avpu': 'P'},
   {'score': 3, 'risk': 'LOW_MEDIUM'})],
 [('healthy control',
   {'rr': 16, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 72, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('new confusion scores three',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.2', 'sbp': 120, 'hr': 80, 'avpu': 'C'},
   {'score': 5, 'risk': 'MEDIUM'}),
  ('responds to voice only',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': False, 'temp': '37.2', 'sbp': 127, 'hr': 85, 'avpu': 'V'},
   {'score': 3, 'risk': 'LOW_MEDIUM'}),
  ('scale 2 high saturation on air',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('scale 2 target range on oxygen',
   {'rr': 18, 'spo2': 90, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('scale 2 above target on oxygen',
   {'rr': 18, 'spo2': 95, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 82, 'avpu': 'A'},
   {'score': 4, 'risk': 'LOW'}),
  ('saturating well on oxygen',
   {'rr': 18, 'spo2': 99, 'on_o2': True, 'scale2': False, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('temperature exactly 36.0',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.0', 'sbp': 135, 'hr': 77, 'avpu': 'A'},
   {'score': 1, 'risk': 'LOW'}),
  ('temperature 36.x scores zero',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.4', 'sbp': 135, 'hr': 75, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('aggregate three without red parameter',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 140, 'hr': 97, 'avpu': 'A'},
   {'score': 3, 'risk': 'LOW'}),
  ('pain-only response is red parameter',
   {'rr': 16, 'spo2': 98, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 62, 'avpu': 'P'},
   {'score': 3, 'risk': 'LOW_MEDIUM'})],
 [('healthy control',
   {'rr': 16, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 73, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('new confusion scores three',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.3', 'sbp': 120, 'hr': 80, 'avpu': 'C'},
   {'score': 5, 'risk': 'MEDIUM'}),
  ('responds to voice only',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': False, 'temp': '37.2', 'sbp': 128, 'hr': 85, 'avpu': 'V'},
   {'score': 3, 'risk': 'LOW_MEDIUM'}),
  ('scale 2 high saturation on air',
   {'rr': 18, 'spo2': 94, 'on_o2': False, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('scale 2 target range on oxygen',
   {'rr': 18, 'spo2': 91, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('scale 2 above target on oxygen',
   {'rr': 18, 'spo2': 95, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 83, 'avpu': 'A'},
   {'score': 4, 'risk': 'LOW'}),
  ('saturating well on oxygen',
   {'rr': 18, 'spo2': 97, 'on_o2': True, 'scale2': False, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('temperature exactly 36.0',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.0', 'sbp': 135, 'hr': 78, 'avpu': 'A'},
   {'score': 1, 'risk': 'LOW'}),
  ('temperature 36.x scores zero',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.5', 'sbp': 135, 'hr': 75, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('aggregate three without red parameter',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 140, 'hr': 98, 'avpu': 'A'},
   {'score': 3, 'risk': 'LOW'}),
  ('pain-only response is red parameter',
   {'rr': 16, 'spo2': 98, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 63, 'avpu': 'P'},
   {'score': 3, 'risk': 'LOW_MEDIUM'})],
 [('healthy control',
   {'rr': 16, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 74, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('new confusion scores three',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.4', 'sbp': 120, 'hr': 80, 'avpu': 'C'},
   {'score': 5, 'risk': 'MEDIUM'}),
  ('responds to voice only',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': False, 'temp': '37.2', 'sbp': 129, 'hr': 85, 'avpu': 'V'},
   {'score': 3, 'risk': 'LOW_MEDIUM'}),
  ('scale 2 high saturation on air',
   {'rr': 18, 'spo2': 95, 'on_o2': False, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('scale 2 target range on oxygen',
   {'rr': 18, 'spo2': 92, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('scale 2 above target on oxygen',
   {'rr': 18, 'spo2': 95, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 84, 'avpu': 'A'},
   {'score': 4, 'risk': 'LOW'}),
  ('saturating well on oxygen',
   {'rr': 18, 'spo2': 98, 'on_o2': True, 'scale2': False, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('temperature exactly 36.0',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.0', 'sbp': 135, 'hr': 79, 'avpu': 'A'},
   {'score': 1, 'risk': 'LOW'}),
  ('temperature 36.x scores zero',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.6', 'sbp': 135, 'hr': 75, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('aggregate three without red parameter',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 140, 'hr': 99, 'avpu': 'A'},
   {'score': 3, 'risk': 'LOW'}),
  ('pain-only response is red parameter',
   {'rr': 16, 'spo2': 98, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 64, 'avpu': 'P'},
   {'score': 3, 'risk': 'LOW_MEDIUM'})],
 [('healthy control',
   {'rr': 16, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 75, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('new confusion scores three',
   {'rr': 22, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '37.5', 'sbp': 120, 'hr': 80, 'avpu': 'C'},
   {'score': 5, 'risk': 'MEDIUM'}),
  ('responds to voice only',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': False, 'temp': '37.2', 'sbp': 130, 'hr': 85, 'avpu': 'V'},
   {'score': 3, 'risk': 'LOW_MEDIUM'}),
  ('scale 2 high saturation on air',
   {'rr': 18, 'spo2': 96, 'on_o2': False, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('scale 2 target range on oxygen',
   {'rr': 18, 'spo2': 88, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('scale 2 above target on oxygen',
   {'rr': 18, 'spo2': 95, 'on_o2': True, 'scale2': True, 'temp': '37.0', 'sbp': 130, 'hr': 85, 'avpu': 'A'},
   {'score': 4, 'risk': 'LOW'}),
  ('saturating well on oxygen',
   {'rr': 18, 'spo2': 99, 'on_o2': True, 'scale2': False, 'temp': '37.0', 'sbp': 130, 'hr': 80, 'avpu': 'A'},
   {'score': 2, 'risk': 'LOW'}),
  ('temperature exactly 36.0',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.0', 'sbp': 135, 'hr': 80, 'avpu': 'A'},
   {'score': 1, 'risk': 'LOW'}),
  ('temperature 36.x scores zero',
   {'rr': 18, 'spo2': 97, 'on_o2': False, 'scale2': False, 'temp': '36.7', 'sbp': 135, 'hr': 75, 'avpu': 'A'},
   {'score': 0, 'risk': 'LOW'}),
  ('aggregate three without red parameter',
   {'rr': 22,
    'spo2': 97,
    'on_o2': False,
    'scale2': False,
    'temp': '37.0',
    'sbp': 140,
    'hr': 100,
    'avpu': 'A'},
   {'score': 3, 'risk': 'LOW'}),
  ('pain-only response is red parameter',
   {'rr': 16, 'spo2': 98, 'on_o2': False, 'scale2': False, 'temp': '37.0', 'sbp': 120, 'hr': 65, 'avpu': 'P'},
   {'score': 3, 'risk': 'LOW_MEDIUM'})]]
for label, args, expected in fixtures[N-1]:
    check(label, solve(args), expected)
print(json.dumps({"observations": observations, "passed": all(x["passed"] for x in observations)}, ensure_ascii=False))
raise SystemExit(0 if all(x["passed"] for x in observations) else 1)
Boundary fixtureActualExpectedOutcome
healthy control{'risk': 'LOW', 'score': 0}{'risk': 'LOW', 'score': 0}Passed
new confusion scores three{'risk': 'MEDIUM', 'score': 5}{'risk': 'MEDIUM', 'score': 5}Passed
responds to voice only{'risk': 'LOW_MEDIUM', 'score': 3}{'risk': 'LOW_MEDIUM', 'score': 3}Passed
scale 2 high saturation on air{'risk': 'LOW', 'score': 0}{'risk': 'LOW', 'score': 0}Passed
scale 2 target range on oxygen{'risk': 'LOW', 'score': 2}{'risk': 'LOW', 'score': 2}Passed
scale 2 above target on oxygen{'risk': 'LOW', 'score': 4}{'risk': 'LOW', 'score': 4}Passed
saturating well on oxygen{'risk': 'LOW', 'score': 2}{'risk': 'LOW', 'score': 2}Passed
temperature exactly 36.0{'risk': 'LOW', 'score': 1}{'risk': 'LOW', 'score': 1}Passed
temperature 36.x scores zero{'risk': 'LOW', 'score': 0}{'risk': 'LOW', 'score': 0}Passed
aggregate three without red parameter{'risk': 'LOW', 'score': 3}{'risk': 'LOW', 'score': 3}Passed
pain-only response is red parameter{'risk': 'LOW_MEDIUM', 'score': 3}{'risk': 'LOW_MEDIUM', 'score': 3}Passed

SHA-256 / d78417ebd750465ec07230ebd67e27e958ee566cebc3f1064cdcb11ec42f22c5

Verification & scope

A deterministic toy software model with explicitly stipulated thresholds and formulas; it is not clinical guidance, not a validated medical calculator, and makes no claim of conformance to any published protocol. Numbered variants vary patient and order inputs. This reproducer isolates one failure mechanism. Results cover the supplied fixtures. Variants within a family share a test contract and should remain grouped when constructing evaluation splits. Related mechanisms with a shared evaluation_group must also remain together; these controlled models are not independent production incidents.

Observations recorded using Python 3.12.14 at 2026-09-29T14:47:23.539748+00:00.

Case digest / c6bbb1fd5fd8396759e7ba1dfa6950019fc66182bd7fff975bcbcf8cd6bbb1f0