FAILURE MAP
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FA-64401 / Clinical triage scoring / Open access

Coma scale total with intubated verbal component: intubated display · case 01

An intubated patient is displayed as 7T when eye+motor is 6.

Verified by executionVariant 1 · 10 checks per implementationDownload source bundle ↓JSON ↗

ROOT CAUSE

The display uses the severity total, which already includes the substituted verbal point.

THE FAILURE

The display uses the severity total, which already includes the substituted verbal point.

Unsuccessful approach: Putting the T first breaks the stipulated display format.

Case contract

Input {eye 1-4, verbal 1-5 or "T" (intubated), motor 1-6}. Out-of-range components return {error INVALID}. Toy rule: an intubated verbal counts as 1 for severity but the display is "<eye+motor>T"; otherwise the display is the total. Severity: 13-15 MILD, 9-12 MODERATE, 3-8 SEVERE. airway_alert is true for totals <= 8 unless already intubated. Return {display, severity, airway_alert}.

Why this case matters

Coma scale tooling mixes numeric totals with an intubation marker; validation, display and severity bands fail independently.

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):
    e, v, m = x['eye'], x['verbal'], x['motor']
    tube = v == 'T'
    if not (1 <= e <= 4 and 1 <= m <= 6 and (tube or 1 <= v <= 5)):
        return {'error': 'INVALID'}
    total = e + m + (1 if tube else v)
    disp = '%dT' % total if tube else str(total)
    sev = 'MILD' if total >= 13 else 'MODERATE' if total >= 9 else 'SEVERE'
    airway = total <= 8 and not tube
    return {'display': disp, 'severity': sev, 'airway_alert': airway}
def check(label, actual, expected):
    observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('fully alert',
   {'eye': 4, 'verbal': 5, 'motor': 6},
   {'display': '15', 'severity': 'MILD', 'airway_alert': False}),
  ('obeys commands motor six',
   {'eye': 3, 'verbal': 4, 'motor': 5},
   {'display': '12', 'severity': 'MODERATE', 'airway_alert': False}),
  ('motor seven invalid', {'eye': 2, 'verbal': 2, 'motor': 7}, {'error': 'INVALID'}),
  ('motor zero invalid', {'eye': 2, 'verbal': 2, 'motor': 0}, {'error': 'INVALID'}),
  ('intubated patient',
   {'eye': 2, 'verbal': 'T', 'motor': 6},
   {'display': '8T', 'severity': 'MODERATE', 'airway_alert': False}),
  ('intubated low score',
   {'eye': 1, 'verbal': 'T', 'motor': 3},
   {'display': '4T', 'severity': 'SEVERE', 'airway_alert': False}),
  ('total exactly 9',
   {'eye': 2, 'verbal': 3, 'motor': 4},
   {'display': '9', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 12',
   {'eye': 3, 'verbal': 4, 'motor': 5},
   {'display': '12', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 8',
   {'eye': 2, 'verbal': 2, 'motor': 4},
   {'display': '8', 'severity': 'SEVERE', 'airway_alert': True}),
  ('severe unintubated',
   {'eye': 1, 'verbal': 1, 'motor': 2},
   {'display': '4', 'severity': 'SEVERE', 'airway_alert': True})],
 [('fully alert',
   {'eye': 4, 'verbal': 5, 'motor': 6},
   {'display': '15', 'severity': 'MILD', 'airway_alert': False}),
  ('obeys commands motor six',
   {'eye': 3, 'verbal': 4, 'motor': 6},
   {'display': '13', 'severity': 'MILD', 'airway_alert': False}),
  ('motor seven invalid', {'eye': 2, 'verbal': 2, 'motor': 7}, {'error': 'INVALID'}),
  ('motor zero invalid', {'eye': 3, 'verbal': 2, 'motor': 0}, {'error': 'INVALID'}),
  ('intubated patient',
   {'eye': 3, 'verbal': 'T', 'motor': 5},
   {'display': '8T', 'severity': 'MODERATE', 'airway_alert': False}),
  ('intubated low score',
   {'eye': 1, 'verbal': 'T', 'motor': 4},
   {'display': '5T', 'severity': 'SEVERE', 'airway_alert': False}),
  ('total exactly 9',
   {'eye': 2, 'verbal': 3, 'motor': 4},
   {'display': '9', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 12',
   {'eye': 3, 'verbal': 4, 'motor': 5},
   {'display': '12', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 8',
   {'eye': 2, 'verbal': 2, 'motor': 4},
   {'display': '8', 'severity': 'SEVERE', 'airway_alert': True}),
  ('severe unintubated',
   {'eye': 1, 'verbal': 1, 'motor': 3},
   {'display': '5', 'severity': 'SEVERE', 'airway_alert': True})],
 [('fully alert',
   {'eye': 4, 'verbal': 5, 'motor': 6},
   {'display': '15', 'severity': 'MILD', 'airway_alert': False}),
  ('obeys commands motor six',
   {'eye': 3, 'verbal': 4, 'motor': 5},
   {'display': '12', 'severity': 'MODERATE', 'airway_alert': False}),
  ('motor seven invalid', {'eye': 2, 'verbal': 2, 'motor': 7}, {'error': 'INVALID'}),
  ('motor zero invalid', {'eye': 4, 'verbal': 2, 'motor': 0}, {'error': 'INVALID'}),
  ('intubated patient',
   {'eye': 4, 'verbal': 'T', 'motor': 4},
   {'display': '8T', 'severity': 'MODERATE', 'airway_alert': False}),
  ('intubated low score',
   {'eye': 1, 'verbal': 'T', 'motor': 2},
   {'display': '3T', 'severity': 'SEVERE', 'airway_alert': False}),
  ('total exactly 9',
   {'eye': 2, 'verbal': 3, 'motor': 4},
   {'display': '9', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 12',
   {'eye': 3, 'verbal': 4, 'motor': 5},
   {'display': '12', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 8',
   {'eye': 2, 'verbal': 2, 'motor': 4},
   {'display': '8', 'severity': 'SEVERE', 'airway_alert': True}),
  ('severe unintubated',
   {'eye': 1, 'verbal': 1, 'motor': 4},
   {'display': '6', 'severity': 'SEVERE', 'airway_alert': True})],
 [('fully alert',
   {'eye': 4, 'verbal': 5, 'motor': 6},
   {'display': '15', 'severity': 'MILD', 'airway_alert': False}),
  ('obeys commands motor six',
   {'eye': 3, 'verbal': 4, 'motor': 6},
   {'display': '13', 'severity': 'MILD', 'airway_alert': False}),
  ('motor seven invalid', {'eye': 2, 'verbal': 2, 'motor': 7}, {'error': 'INVALID'}),
  ('motor zero invalid', {'eye': 1, 'verbal': 2, 'motor': 0}, {'error': 'INVALID'}),
  ('intubated patient',
   {'eye': 3, 'verbal': 'T', 'motor': 5},
   {'display': '8T', 'severity': 'MODERATE', 'airway_alert': False}),
  ('intubated low score',
   {'eye': 1, 'verbal': 'T', 'motor': 3},
   {'display': '4T', 'severity': 'SEVERE', 'airway_alert': False}),
  ('total exactly 9',
   {'eye': 2, 'verbal': 3, 'motor': 4},
   {'display': '9', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 12',
   {'eye': 3, 'verbal': 4, 'motor': 5},
   {'display': '12', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 8',
   {'eye': 2, 'verbal': 2, 'motor': 4},
   {'display': '8', 'severity': 'SEVERE', 'airway_alert': True}),
  ('severe unintubated',
   {'eye': 1, 'verbal': 1, 'motor': 5},
   {'display': '7', 'severity': 'SEVERE', 'airway_alert': True})],
 [('fully alert',
   {'eye': 4, 'verbal': 5, 'motor': 6},
   {'display': '15', 'severity': 'MILD', 'airway_alert': False}),
  ('obeys commands motor six',
   {'eye': 3, 'verbal': 4, 'motor': 5},
   {'display': '12', 'severity': 'MODERATE', 'airway_alert': False}),
  ('motor seven invalid', {'eye': 2, 'verbal': 2, 'motor': 7}, {'error': 'INVALID'}),
  ('motor zero invalid', {'eye': 2, 'verbal': 2, 'motor': 0}, {'error': 'INVALID'}),
  ('intubated patient',
   {'eye': 2, 'verbal': 'T', 'motor': 6},
   {'display': '8T', 'severity': 'MODERATE', 'airway_alert': False}),
  ('intubated low score',
   {'eye': 1, 'verbal': 'T', 'motor': 4},
   {'display': '5T', 'severity': 'SEVERE', 'airway_alert': False}),
  ('total exactly 9',
   {'eye': 2, 'verbal': 3, 'motor': 4},
   {'display': '9', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 12',
   {'eye': 3, 'verbal': 4, 'motor': 5},
   {'display': '12', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 8',
   {'eye': 2, 'verbal': 2, 'motor': 4},
   {'display': '8', 'severity': 'SEVERE', 'airway_alert': True}),
  ('severe unintubated',
   {'eye': 1, 'verbal': 1, 'motor': 6},
   {'display': '8', 'severity': 'SEVERE', 'airway_alert': True})]]
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
fully alert{'airway_alert': False, 'display': '15', 'severity': 'MILD'}{'airway_alert': False, 'display': '15', 'severity': 'MILD'}Passed
obeys commands motor six{'airway_alert': False, 'display': '12', 'severity': 'MODERATE'}{'airway_alert': False, 'display': '12', 'severity': 'MODERATE'}Passed
motor seven invalid{'error': 'INVALID'}{'error': 'INVALID'}Passed
motor zero invalid{'error': 'INVALID'}{'error': 'INVALID'}Passed
intubated patient{'airway_alert': False, 'display': '9T', 'severity': 'MODERATE'}{'airway_alert': False, 'display': '8T', 'severity': 'MODERATE'}Failed
intubated low score{'airway_alert': False, 'display': '5T', 'severity': 'SEVERE'}{'airway_alert': False, 'display': '4T', 'severity': 'SEVERE'}Failed
total exactly 9{'airway_alert': False, 'display': '9', 'severity': 'MODERATE'}{'airway_alert': False, 'display': '9', 'severity': 'MODERATE'}Passed
total exactly 12{'airway_alert': False, 'display': '12', 'severity': 'MODERATE'}{'airway_alert': False, 'display': '12', 'severity': 'MODERATE'}Passed
total exactly 8{'airway_alert': True, 'display': '8', 'severity': 'SEVERE'}{'airway_alert': True, 'display': '8', 'severity': 'SEVERE'}Passed
severe unintubated{'airway_alert': True, 'display': '4', 'severity': 'SEVERE'}{'airway_alert': True, 'display': '4', 'severity': 'SEVERE'}Passed

SHA-256 / b884874b8317320766e18289f4f9cc372d10d9177423a089fd5d953be3d178e4

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):
    e, v, m = x['eye'], x['verbal'], x['motor']
    tube = v == 'T'
    if not (1 <= e <= 4 and 1 <= m <= 6 and (tube or 1 <= v <= 5)):
        return {'error': 'INVALID'}
    total = e + m + (1 if tube else v)
    disp = 'T%d' % (e + m) if tube else str(total)
    sev = 'MILD' if total >= 13 else 'MODERATE' if total >= 9 else 'SEVERE'
    airway = total <= 8 and not tube
    return {'display': disp, 'severity': sev, 'airway_alert': airway}
def check(label, actual, expected):
    observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('fully alert',
   {'eye': 4, 'verbal': 5, 'motor': 6},
   {'display': '15', 'severity': 'MILD', 'airway_alert': False}),
  ('obeys commands motor six',
   {'eye': 3, 'verbal': 4, 'motor': 5},
   {'display': '12', 'severity': 'MODERATE', 'airway_alert': False}),
  ('motor seven invalid', {'eye': 2, 'verbal': 2, 'motor': 7}, {'error': 'INVALID'}),
  ('motor zero invalid', {'eye': 2, 'verbal': 2, 'motor': 0}, {'error': 'INVALID'}),
  ('intubated patient',
   {'eye': 2, 'verbal': 'T', 'motor': 6},
   {'display': '8T', 'severity': 'MODERATE', 'airway_alert': False}),
  ('intubated low score',
   {'eye': 1, 'verbal': 'T', 'motor': 3},
   {'display': '4T', 'severity': 'SEVERE', 'airway_alert': False}),
  ('total exactly 9',
   {'eye': 2, 'verbal': 3, 'motor': 4},
   {'display': '9', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 12',
   {'eye': 3, 'verbal': 4, 'motor': 5},
   {'display': '12', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 8',
   {'eye': 2, 'verbal': 2, 'motor': 4},
   {'display': '8', 'severity': 'SEVERE', 'airway_alert': True}),
  ('severe unintubated',
   {'eye': 1, 'verbal': 1, 'motor': 2},
   {'display': '4', 'severity': 'SEVERE', 'airway_alert': True})],
 [('fully alert',
   {'eye': 4, 'verbal': 5, 'motor': 6},
   {'display': '15', 'severity': 'MILD', 'airway_alert': False}),
  ('obeys commands motor six',
   {'eye': 3, 'verbal': 4, 'motor': 6},
   {'display': '13', 'severity': 'MILD', 'airway_alert': False}),
  ('motor seven invalid', {'eye': 2, 'verbal': 2, 'motor': 7}, {'error': 'INVALID'}),
  ('motor zero invalid', {'eye': 3, 'verbal': 2, 'motor': 0}, {'error': 'INVALID'}),
  ('intubated patient',
   {'eye': 3, 'verbal': 'T', 'motor': 5},
   {'display': '8T', 'severity': 'MODERATE', 'airway_alert': False}),
  ('intubated low score',
   {'eye': 1, 'verbal': 'T', 'motor': 4},
   {'display': '5T', 'severity': 'SEVERE', 'airway_alert': False}),
  ('total exactly 9',
   {'eye': 2, 'verbal': 3, 'motor': 4},
   {'display': '9', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 12',
   {'eye': 3, 'verbal': 4, 'motor': 5},
   {'display': '12', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 8',
   {'eye': 2, 'verbal': 2, 'motor': 4},
   {'display': '8', 'severity': 'SEVERE', 'airway_alert': True}),
  ('severe unintubated',
   {'eye': 1, 'verbal': 1, 'motor': 3},
   {'display': '5', 'severity': 'SEVERE', 'airway_alert': True})],
 [('fully alert',
   {'eye': 4, 'verbal': 5, 'motor': 6},
   {'display': '15', 'severity': 'MILD', 'airway_alert': False}),
  ('obeys commands motor six',
   {'eye': 3, 'verbal': 4, 'motor': 5},
   {'display': '12', 'severity': 'MODERATE', 'airway_alert': False}),
  ('motor seven invalid', {'eye': 2, 'verbal': 2, 'motor': 7}, {'error': 'INVALID'}),
  ('motor zero invalid', {'eye': 4, 'verbal': 2, 'motor': 0}, {'error': 'INVALID'}),
  ('intubated patient',
   {'eye': 4, 'verbal': 'T', 'motor': 4},
   {'display': '8T', 'severity': 'MODERATE', 'airway_alert': False}),
  ('intubated low score',
   {'eye': 1, 'verbal': 'T', 'motor': 2},
   {'display': '3T', 'severity': 'SEVERE', 'airway_alert': False}),
  ('total exactly 9',
   {'eye': 2, 'verbal': 3, 'motor': 4},
   {'display': '9', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 12',
   {'eye': 3, 'verbal': 4, 'motor': 5},
   {'display': '12', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 8',
   {'eye': 2, 'verbal': 2, 'motor': 4},
   {'display': '8', 'severity': 'SEVERE', 'airway_alert': True}),
  ('severe unintubated',
   {'eye': 1, 'verbal': 1, 'motor': 4},
   {'display': '6', 'severity': 'SEVERE', 'airway_alert': True})],
 [('fully alert',
   {'eye': 4, 'verbal': 5, 'motor': 6},
   {'display': '15', 'severity': 'MILD', 'airway_alert': False}),
  ('obeys commands motor six',
   {'eye': 3, 'verbal': 4, 'motor': 6},
   {'display': '13', 'severity': 'MILD', 'airway_alert': False}),
  ('motor seven invalid', {'eye': 2, 'verbal': 2, 'motor': 7}, {'error': 'INVALID'}),
  ('motor zero invalid', {'eye': 1, 'verbal': 2, 'motor': 0}, {'error': 'INVALID'}),
  ('intubated patient',
   {'eye': 3, 'verbal': 'T', 'motor': 5},
   {'display': '8T', 'severity': 'MODERATE', 'airway_alert': False}),
  ('intubated low score',
   {'eye': 1, 'verbal': 'T', 'motor': 3},
   {'display': '4T', 'severity': 'SEVERE', 'airway_alert': False}),
  ('total exactly 9',
   {'eye': 2, 'verbal': 3, 'motor': 4},
   {'display': '9', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 12',
   {'eye': 3, 'verbal': 4, 'motor': 5},
   {'display': '12', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 8',
   {'eye': 2, 'verbal': 2, 'motor': 4},
   {'display': '8', 'severity': 'SEVERE', 'airway_alert': True}),
  ('severe unintubated',
   {'eye': 1, 'verbal': 1, 'motor': 5},
   {'display': '7', 'severity': 'SEVERE', 'airway_alert': True})],
 [('fully alert',
   {'eye': 4, 'verbal': 5, 'motor': 6},
   {'display': '15', 'severity': 'MILD', 'airway_alert': False}),
  ('obeys commands motor six',
   {'eye': 3, 'verbal': 4, 'motor': 5},
   {'display': '12', 'severity': 'MODERATE', 'airway_alert': False}),
  ('motor seven invalid', {'eye': 2, 'verbal': 2, 'motor': 7}, {'error': 'INVALID'}),
  ('motor zero invalid', {'eye': 2, 'verbal': 2, 'motor': 0}, {'error': 'INVALID'}),
  ('intubated patient',
   {'eye': 2, 'verbal': 'T', 'motor': 6},
   {'display': '8T', 'severity': 'MODERATE', 'airway_alert': False}),
  ('intubated low score',
   {'eye': 1, 'verbal': 'T', 'motor': 4},
   {'display': '5T', 'severity': 'SEVERE', 'airway_alert': False}),
  ('total exactly 9',
   {'eye': 2, 'verbal': 3, 'motor': 4},
   {'display': '9', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 12',
   {'eye': 3, 'verbal': 4, 'motor': 5},
   {'display': '12', 'severity': 'MODERATE', 'airway_alert': False}),
  ('total exactly 8',
   {'eye': 2, 'verbal': 2, 'motor': 4},
   {'display': '8', 'severity': 'SEVERE', 'airway_alert': True}),
  ('severe unintubated',
   {'eye': 1, 'verbal': 1, 'motor': 6},
   {'display': '8', 'severity': 'SEVERE', 'airway_alert': True})]]
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
fully alert{'airway_alert': False, 'display': '15', 'severity': 'MILD'}{'airway_alert': False, 'display': '15', 'severity': 'MILD'}Passed
obeys commands motor six{'airway_alert': False, 'display': '12', 'severity': 'MODERATE'}{'airway_alert': False, 'display': '12', 'severity': 'MODERATE'}Passed
motor seven invalid{'error': 'INVALID'}{'error': 'INVALID'}Passed
motor zero invalid{'error': 'INVALID'}{'error': 'INVALID'}Passed
intubated patient{'airway_alert': False, 'display': 'T8', 'severity': 'MODERATE'}{'airway_alert': False, 'display': '8T', 'severity': 'MODERATE'}Failed
intubated low score{'airway_alert': False, 'display': 'T4', 'severity': 'SEVERE'}{'airway_alert': False, 'display': '4T', 'severity': 'SEVERE'}Failed
total exactly 9{'airway_alert': False, 'display': '9', 'severity': 'MODERATE'}{'airway_alert': False, 'display': '9', 'severity': 'MODERATE'}Passed
total exactly 12{'airway_alert': False, 'display': '12', 'severity': 'MODERATE'}{'airway_alert': False, 'display': '12', 'severity': 'MODERATE'}Passed
total exactly 8{'airway_alert': True, 'display': '8', 'severity': 'SEVERE'}{'airway_alert': True, 'display': '8', 'severity': 'SEVERE'}Passed
severe unintubated{'airway_alert': True, 'display': '4', 'severity': 'SEVERE'}{'airway_alert': True, 'display': '4', 'severity': 'SEVERE'}Passed

SHA-256 / c0782f6ef75c6fb63eec8900478c4fafe1aa413f2544ab5f3a5a9ec1478cd011

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This mechanism has 10 recorded checks per implementation. The open-access tier publishes the failure and the unsuccessful fix; the repaired source that passes every check, and the observations that prove it, are available to members.

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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 2026-09-29T14:47:24.032564+00:00.

Case digest / 470c98d96c02e0c36aa0c1ec27a870f685639a68113264d6e9af5190ca241ba5