FA-64451 / Clinical triage scoring / Open access

Newborn five-sign score and repeat schedule: mandatory five-minute score · case 01

A vigorous newborn scored at 1 minute is never scheduled for the 5-minute score.

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

ROOT CAUSE

The 1-minute special case is missing, so the repeat rule depends on the total from the first score.

VERIFIED REPAIR

Always schedule the 5-minute score after a 1-minute score, then apply the below-7 rule for later scores.

Unsuccessful approach: Making the 1-minute repeat conditional on a low total skips the mandatory 5-minute score for reassuring newborns.

Case contract

Input {hr, resp (absent|weak|good), tone (limp|some|active), reflex (none|grimace|cry), color (blue|acro|pink), minute}. Heart rate: 0 scores 0, 1-99 scores 1, >= 100 scores 2; the other signs score 0/1/2 in the listed order. Category: 7-10 REASSURING, 4-6 MODERATE, 0-3 LOW. repeat_at is 5 after any 1-minute score; after later scores it is minute + 5 when the total is below 7 and minute < 20, else null. Return {score, category, repeat_at}.

Why this case matters

Newborn scoring sums ordinal signs and schedules reassessment; the absent-heart-rate rule, bands and repeat stop condition are distinct.

1 / The failure

Exit 1

"""Failure Map reference implementation. Python standard library only."""
import json

N = 1
observations = []
def solve(x):
    hr = x['hr']
    pts = 0 if hr == 0 else 1 if hr < 100 else 2
    pts += ['absent', 'weak', 'good'].index(x['resp'])
    pts += ['limp', 'some', 'active'].index(x['tone'])
    pts += ['none', 'grimace', 'cry'].index(x['reflex'])
    pts += ['blue', 'acro', 'pink'].index(x['color'])
    cat = 'REASSURING' if pts >= 7 else 'MODERATE' if pts >= 4 else 'LOW'
    rep = x['minute'] + 5 if pts < 7 and x['minute'] < 20 else None
    return {'score': pts, 'category': cat, 'repeat_at': rep}
def check(label, actual, expected):
    observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('vigorous newborn',
   {'hr': 140, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'pink', 'minute': 1},
   {'score': 10, 'category': 'REASSURING', 'repeat_at': 5}),
  ('absent heart rate',
   {'hr': 0, 'resp': 'absent', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 5},
   {'score': 0, 'category': 'LOW', 'repeat_at': 10}),
  ('slow heart rate 50',
   {'hr': 51, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 5}),
  ('total exactly 7',
   {'hr': 120, 'resp': 'good', 'tone': 'some', 'reflex': 'grimace', 'color': 'acro', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 4',
   {'hr': 90, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 10},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 15}),
  ('total 7 with slow heart rate',
   {'hr': 65, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'blue', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 3',
   {'hr': 41, 'resp': 'weak', 'tone': 'some', 'reflex': 'none', 'color': 'blue', 'minute': 1},
   {'score': 3, 'category': 'LOW', 'repeat_at': 5}),
  ('low score at 15 minutes',
   {'hr': 80, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 15},
   {'score': 2, 'category': 'LOW', 'repeat_at': 20}),
  ('low score at 20 minutes stops',
   {'hr': 81, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 20},
   {'score': 2, 'category': 'LOW', 'repeat_at': None}),
  ('moderate at one minute',
   {'hr': 110, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 5, 'category': 'MODERATE', 'repeat_at': 5})],
 [('vigorous newborn',
   {'hr': 140, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'acro', 'minute': 1},
   {'score': 9, 'category': 'REASSURING', 'repeat_at': 5}),
  ('absent heart rate',
   {'hr': 0, 'resp': 'absent', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 10},
   {'score': 0, 'category': 'LOW', 'repeat_at': 15}),
  ('slow heart rate 50',
   {'hr': 52, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 5}),
  ('total exactly 7',
   {'hr': 120, 'resp': 'good', 'tone': 'some', 'reflex': 'grimace', 'color': 'acro', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 4',
   {'hr': 90, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 5},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 10}),
  ('total 7 with slow heart rate',
   {'hr': 70, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'blue', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 3',
   {'hr': 42, 'resp': 'weak', 'tone': 'some', 'reflex': 'none', 'color': 'blue', 'minute': 1},
   {'score': 3, 'category': 'LOW', 'repeat_at': 5}),
  ('low score at 15 minutes',
   {'hr': 80, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 15},
   {'score': 2, 'category': 'LOW', 'repeat_at': 20}),
  ('low score at 20 minutes stops',
   {'hr': 82, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 20},
   {'score': 2, 'category': 'LOW', 'repeat_at': None}),
  ('moderate at one minute',
   {'hr': 110, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 5, 'category': 'MODERATE', 'repeat_at': 5})],
 [('vigorous newborn',
   {'hr': 140, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'pink', 'minute': 1},
   {'score': 10, 'category': 'REASSURING', 'repeat_at': 5}),
  ('absent heart rate',
   {'hr': 0, 'resp': 'absent', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 15},
   {'score': 0, 'category': 'LOW', 'repeat_at': 20}),
  ('slow heart rate 50',
   {'hr': 53, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 5}),
  ('total exactly 7',
   {'hr': 120, 'resp': 'good', 'tone': 'some', 'reflex': 'grimace', 'color': 'acro', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 4',
   {'hr': 90, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 10},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 15}),
  ('total 7 with slow heart rate',
   {'hr': 75, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'blue', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 3',
   {'hr': 43, 'resp': 'weak', 'tone': 'some', 'reflex': 'none', 'color': 'blue', 'minute': 1},
   {'score': 3, 'category': 'LOW', 'repeat_at': 5}),
  ('low score at 15 minutes',
   {'hr': 80, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 15},
   {'score': 2, 'category': 'LOW', 'repeat_at': 20}),
  ('low score at 20 minutes stops',
   {'hr': 83, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 20},
   {'score': 2, 'category': 'LOW', 'repeat_at': None}),
  ('moderate at one minute',
   {'hr': 110, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 5, 'category': 'MODERATE', 'repeat_at': 5})],
 [('vigorous newborn',
   {'hr': 140, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'acro', 'minute': 1},
   {'score': 9, 'category': 'REASSURING', 'repeat_at': 5}),
  ('absent heart rate',
   {'hr': 0, 'resp': 'absent', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 20},
   {'score': 0, 'category': 'LOW', 'repeat_at': None}),
  ('slow heart rate 50',
   {'hr': 54, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 5}),
  ('total exactly 7',
   {'hr': 120, 'resp': 'good', 'tone': 'some', 'reflex': 'grimace', 'color': 'acro', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 4',
   {'hr': 90, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 5},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 10}),
  ('total 7 with slow heart rate',
   {'hr': 80, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'blue', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 3',
   {'hr': 44, 'resp': 'weak', 'tone': 'some', 'reflex': 'none', 'color': 'blue', 'minute': 1},
   {'score': 3, 'category': 'LOW', 'repeat_at': 5}),
  ('low score at 15 minutes',
   {'hr': 80, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 15},
   {'score': 2, 'category': 'LOW', 'repeat_at': 20}),
  ('low score at 20 minutes stops',
   {'hr': 84, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 20},
   {'score': 2, 'category': 'LOW', 'repeat_at': None}),
  ('moderate at one minute',
   {'hr': 110, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 5, 'category': 'MODERATE', 'repeat_at': 5})],
 [('vigorous newborn',
   {'hr': 140, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'pink', 'minute': 1},
   {'score': 10, 'category': 'REASSURING', 'repeat_at': 5}),
  ('absent heart rate',
   {'hr': 0, 'resp': 'absent', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 25},
   {'score': 0, 'category': 'LOW', 'repeat_at': None}),
  ('slow heart rate 50',
   {'hr': 55, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 5}),
  ('total exactly 7',
   {'hr': 120, 'resp': 'good', 'tone': 'some', 'reflex': 'grimace', 'color': 'acro', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 4',
   {'hr': 90, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 10},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 15}),
  ('total 7 with slow heart rate',
   {'hr': 85, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'blue', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 3',
   {'hr': 45, 'resp': 'weak', 'tone': 'some', 'reflex': 'none', 'color': 'blue', 'minute': 1},
   {'score': 3, 'category': 'LOW', 'repeat_at': 5}),
  ('low score at 15 minutes',
   {'hr': 80, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 15},
   {'score': 2, 'category': 'LOW', 'repeat_at': 20}),
  ('low score at 20 minutes stops',
   {'hr': 85, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 20},
   {'score': 2, 'category': 'LOW', 'repeat_at': None}),
  ('moderate at one minute',
   {'hr': 110, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 5, 'category': 'MODERATE', 'repeat_at': 5})]]
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 fixture	Actual	Expected	Outcome
vigorous newborn	`{'category': 'REASSURING', 'repeat_at': None, 'score': 10}`	`{'category': 'REASSURING', 'repeat_at': 5, 'score': 10}`	Failed
absent heart rate	`{'category': 'LOW', 'repeat_at': 10, 'score': 0}`	`{'category': 'LOW', 'repeat_at': 10, 'score': 0}`	Passed
slow heart rate 50	`{'category': 'MODERATE', 'repeat_at': 6, 'score': 4}`	`{'category': 'MODERATE', 'repeat_at': 5, 'score': 4}`	Failed
total exactly 7	`{'category': 'REASSURING', 'repeat_at': None, 'score': 7}`	`{'category': 'REASSURING', 'repeat_at': None, 'score': 7}`	Passed
total exactly 4	`{'category': 'MODERATE', 'repeat_at': 15, 'score': 4}`	`{'category': 'MODERATE', 'repeat_at': 15, 'score': 4}`	Passed
total 7 with slow heart rate	`{'category': 'REASSURING', 'repeat_at': None, 'score': 7}`	`{'category': 'REASSURING', 'repeat_at': None, 'score': 7}`	Passed
total exactly 3	`{'category': 'LOW', 'repeat_at': 6, 'score': 3}`	`{'category': 'LOW', 'repeat_at': 5, 'score': 3}`	Failed
low score at 15 minutes	`{'category': 'LOW', 'repeat_at': 20, 'score': 2}`	`{'category': 'LOW', 'repeat_at': 20, 'score': 2}`	Passed
low score at 20 minutes stops	`{'category': 'LOW', 'repeat_at': None, 'score': 2}`	`{'category': 'LOW', 'repeat_at': None, 'score': 2}`	Passed
moderate at one minute	`{'category': 'MODERATE', 'repeat_at': 6, 'score': 5}`	`{'category': 'MODERATE', 'repeat_at': 5, 'score': 5}`	Failed

SHA-256 / 9a0b2514120073e35d79bdebe988a835e6ce9b95e7c25dfa509a9a66e9982a46

2 / The unsuccessful fix

Exit 1

"""Failure Map reference implementation. Python standard library only."""
import json

N = 1
observations = []
def solve(x):
    hr = x['hr']
    pts = 0 if hr == 0 else 1 if hr < 100 else 2
    pts += ['absent', 'weak', 'good'].index(x['resp'])
    pts += ['limp', 'some', 'active'].index(x['tone'])
    pts += ['none', 'grimace', 'cry'].index(x['reflex'])
    pts += ['blue', 'acro', 'pink'].index(x['color'])
    cat = 'REASSURING' if pts >= 7 else 'MODERATE' if pts >= 4 else 'LOW'
    rep = 5 if x['minute'] == 1 and pts < 7 else x['minute'] + 5 if pts < 7 and x['minute'] < 20 else None
    return {'score': pts, 'category': cat, 'repeat_at': rep}
def check(label, actual, expected):
    observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('vigorous newborn',
   {'hr': 140, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'pink', 'minute': 1},
   {'score': 10, 'category': 'REASSURING', 'repeat_at': 5}),
  ('absent heart rate',
   {'hr': 0, 'resp': 'absent', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 5},
   {'score': 0, 'category': 'LOW', 'repeat_at': 10}),
  ('slow heart rate 50',
   {'hr': 51, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 5}),
  ('total exactly 7',
   {'hr': 120, 'resp': 'good', 'tone': 'some', 'reflex': 'grimace', 'color': 'acro', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 4',
   {'hr': 90, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 10},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 15}),
  ('total 7 with slow heart rate',
   {'hr': 65, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'blue', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 3',
   {'hr': 41, 'resp': 'weak', 'tone': 'some', 'reflex': 'none', 'color': 'blue', 'minute': 1},
   {'score': 3, 'category': 'LOW', 'repeat_at': 5}),
  ('low score at 15 minutes',
   {'hr': 80, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 15},
   {'score': 2, 'category': 'LOW', 'repeat_at': 20}),
  ('low score at 20 minutes stops',
   {'hr': 81, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 20},
   {'score': 2, 'category': 'LOW', 'repeat_at': None}),
  ('moderate at one minute',
   {'hr': 110, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 5, 'category': 'MODERATE', 'repeat_at': 5})],
 [('vigorous newborn',
   {'hr': 140, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'acro', 'minute': 1},
   {'score': 9, 'category': 'REASSURING', 'repeat_at': 5}),
  ('absent heart rate',
   {'hr': 0, 'resp': 'absent', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 10},
   {'score': 0, 'category': 'LOW', 'repeat_at': 15}),
  ('slow heart rate 50',
   {'hr': 52, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 5}),
  ('total exactly 7',
   {'hr': 120, 'resp': 'good', 'tone': 'some', 'reflex': 'grimace', 'color': 'acro', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 4',
   {'hr': 90, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 5},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 10}),
  ('total 7 with slow heart rate',
   {'hr': 70, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'blue', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 3',
   {'hr': 42, 'resp': 'weak', 'tone': 'some', 'reflex': 'none', 'color': 'blue', 'minute': 1},
   {'score': 3, 'category': 'LOW', 'repeat_at': 5}),
  ('low score at 15 minutes',
   {'hr': 80, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 15},
   {'score': 2, 'category': 'LOW', 'repeat_at': 20}),
  ('low score at 20 minutes stops',
   {'hr': 82, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 20},
   {'score': 2, 'category': 'LOW', 'repeat_at': None}),
  ('moderate at one minute',
   {'hr': 110, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 5, 'category': 'MODERATE', 'repeat_at': 5})],
 [('vigorous newborn',
   {'hr': 140, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'pink', 'minute': 1},
   {'score': 10, 'category': 'REASSURING', 'repeat_at': 5}),
  ('absent heart rate',
   {'hr': 0, 'resp': 'absent', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 15},
   {'score': 0, 'category': 'LOW', 'repeat_at': 20}),
  ('slow heart rate 50',
   {'hr': 53, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 5}),
  ('total exactly 7',
   {'hr': 120, 'resp': 'good', 'tone': 'some', 'reflex': 'grimace', 'color': 'acro', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 4',
   {'hr': 90, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 10},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 15}),
  ('total 7 with slow heart rate',
   {'hr': 75, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'blue', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 3',
   {'hr': 43, 'resp': 'weak', 'tone': 'some', 'reflex': 'none', 'color': 'blue', 'minute': 1},
   {'score': 3, 'category': 'LOW', 'repeat_at': 5}),
  ('low score at 15 minutes',
   {'hr': 80, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 15},
   {'score': 2, 'category': 'LOW', 'repeat_at': 20}),
  ('low score at 20 minutes stops',
   {'hr': 83, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 20},
   {'score': 2, 'category': 'LOW', 'repeat_at': None}),
  ('moderate at one minute',
   {'hr': 110, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 5, 'category': 'MODERATE', 'repeat_at': 5})],
 [('vigorous newborn',
   {'hr': 140, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'acro', 'minute': 1},
   {'score': 9, 'category': 'REASSURING', 'repeat_at': 5}),
  ('absent heart rate',
   {'hr': 0, 'resp': 'absent', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 20},
   {'score': 0, 'category': 'LOW', 'repeat_at': None}),
  ('slow heart rate 50',
   {'hr': 54, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 5}),
  ('total exactly 7',
   {'hr': 120, 'resp': 'good', 'tone': 'some', 'reflex': 'grimace', 'color': 'acro', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 4',
   {'hr': 90, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 5},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 10}),
  ('total 7 with slow heart rate',
   {'hr': 80, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'blue', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 3',
   {'hr': 44, 'resp': 'weak', 'tone': 'some', 'reflex': 'none', 'color': 'blue', 'minute': 1},
   {'score': 3, 'category': 'LOW', 'repeat_at': 5}),
  ('low score at 15 minutes',
   {'hr': 80, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 15},
   {'score': 2, 'category': 'LOW', 'repeat_at': 20}),
  ('low score at 20 minutes stops',
   {'hr': 84, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 20},
   {'score': 2, 'category': 'LOW', 'repeat_at': None}),
  ('moderate at one minute',
   {'hr': 110, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 5, 'category': 'MODERATE', 'repeat_at': 5})],
 [('vigorous newborn',
   {'hr': 140, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'pink', 'minute': 1},
   {'score': 10, 'category': 'REASSURING', 'repeat_at': 5}),
  ('absent heart rate',
   {'hr': 0, 'resp': 'absent', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 25},
   {'score': 0, 'category': 'LOW', 'repeat_at': None}),
  ('slow heart rate 50',
   {'hr': 55, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 5}),
  ('total exactly 7',
   {'hr': 120, 'resp': 'good', 'tone': 'some', 'reflex': 'grimace', 'color': 'acro', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 4',
   {'hr': 90, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 10},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 15}),
  ('total 7 with slow heart rate',
   {'hr': 85, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'blue', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 3',
   {'hr': 45, 'resp': 'weak', 'tone': 'some', 'reflex': 'none', 'color': 'blue', 'minute': 1},
   {'score': 3, 'category': 'LOW', 'repeat_at': 5}),
  ('low score at 15 minutes',
   {'hr': 80, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 15},
   {'score': 2, 'category': 'LOW', 'repeat_at': 20}),
  ('low score at 20 minutes stops',
   {'hr': 85, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 20},
   {'score': 2, 'category': 'LOW', 'repeat_at': None}),
  ('moderate at one minute',
   {'hr': 110, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 5, 'category': 'MODERATE', 'repeat_at': 5})]]
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 fixture	Actual	Expected	Outcome
vigorous newborn	`{'category': 'REASSURING', 'repeat_at': None, 'score': 10}`	`{'category': 'REASSURING', 'repeat_at': 5, 'score': 10}`	Failed
absent heart rate	`{'category': 'LOW', 'repeat_at': 10, 'score': 0}`	`{'category': 'LOW', 'repeat_at': 10, 'score': 0}`	Passed
slow heart rate 50	`{'category': 'MODERATE', 'repeat_at': 5, 'score': 4}`	`{'category': 'MODERATE', 'repeat_at': 5, 'score': 4}`	Passed
total exactly 7	`{'category': 'REASSURING', 'repeat_at': None, 'score': 7}`	`{'category': 'REASSURING', 'repeat_at': None, 'score': 7}`	Passed
total exactly 4	`{'category': 'MODERATE', 'repeat_at': 15, 'score': 4}`	`{'category': 'MODERATE', 'repeat_at': 15, 'score': 4}`	Passed
total 7 with slow heart rate	`{'category': 'REASSURING', 'repeat_at': None, 'score': 7}`	`{'category': 'REASSURING', 'repeat_at': None, 'score': 7}`	Passed
total exactly 3	`{'category': 'LOW', 'repeat_at': 5, 'score': 3}`	`{'category': 'LOW', 'repeat_at': 5, 'score': 3}`	Passed
low score at 15 minutes	`{'category': 'LOW', 'repeat_at': 20, 'score': 2}`	`{'category': 'LOW', 'repeat_at': 20, 'score': 2}`	Passed
low score at 20 minutes stops	`{'category': 'LOW', 'repeat_at': None, 'score': 2}`	`{'category': 'LOW', 'repeat_at': None, 'score': 2}`	Passed
moderate at one minute	`{'category': 'MODERATE', 'repeat_at': 5, 'score': 5}`	`{'category': 'MODERATE', 'repeat_at': 5, 'score': 5}`	Passed

SHA-256 / fcd71002b9562c2cff195adeacfbd70601e262c7af7fe1f1c61a7df88010c0a9

3 / The verified repair

Exit 0

"""Failure Map reference implementation. Python standard library only."""
import json

N = 1
observations = []
def solve(x):
    hr = x['hr']
    pts = 0 if hr == 0 else 1 if hr < 100 else 2
    pts += ['absent', 'weak', 'good'].index(x['resp'])
    pts += ['limp', 'some', 'active'].index(x['tone'])
    pts += ['none', 'grimace', 'cry'].index(x['reflex'])
    pts += ['blue', 'acro', 'pink'].index(x['color'])
    cat = 'REASSURING' if pts >= 7 else 'MODERATE' if pts >= 4 else 'LOW'
    rep = 5 if x['minute'] == 1 else x['minute'] + 5 if pts < 7 and x['minute'] < 20 else None
    return {'score': pts, 'category': cat, 'repeat_at': rep}
def check(label, actual, expected):
    observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('vigorous newborn',
   {'hr': 140, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'pink', 'minute': 1},
   {'score': 10, 'category': 'REASSURING', 'repeat_at': 5}),
  ('absent heart rate',
   {'hr': 0, 'resp': 'absent', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 5},
   {'score': 0, 'category': 'LOW', 'repeat_at': 10}),
  ('slow heart rate 50',
   {'hr': 51, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 5}),
  ('total exactly 7',
   {'hr': 120, 'resp': 'good', 'tone': 'some', 'reflex': 'grimace', 'color': 'acro', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 4',
   {'hr': 90, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 10},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 15}),
  ('total 7 with slow heart rate',
   {'hr': 65, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'blue', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 3',
   {'hr': 41, 'resp': 'weak', 'tone': 'some', 'reflex': 'none', 'color': 'blue', 'minute': 1},
   {'score': 3, 'category': 'LOW', 'repeat_at': 5}),
  ('low score at 15 minutes',
   {'hr': 80, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 15},
   {'score': 2, 'category': 'LOW', 'repeat_at': 20}),
  ('low score at 20 minutes stops',
   {'hr': 81, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 20},
   {'score': 2, 'category': 'LOW', 'repeat_at': None}),
  ('moderate at one minute',
   {'hr': 110, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 5, 'category': 'MODERATE', 'repeat_at': 5})],
 [('vigorous newborn',
   {'hr': 140, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'acro', 'minute': 1},
   {'score': 9, 'category': 'REASSURING', 'repeat_at': 5}),
  ('absent heart rate',
   {'hr': 0, 'resp': 'absent', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 10},
   {'score': 0, 'category': 'LOW', 'repeat_at': 15}),
  ('slow heart rate 50',
   {'hr': 52, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 5}),
  ('total exactly 7',
   {'hr': 120, 'resp': 'good', 'tone': 'some', 'reflex': 'grimace', 'color': 'acro', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 4',
   {'hr': 90, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 5},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 10}),
  ('total 7 with slow heart rate',
   {'hr': 70, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'blue', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 3',
   {'hr': 42, 'resp': 'weak', 'tone': 'some', 'reflex': 'none', 'color': 'blue', 'minute': 1},
   {'score': 3, 'category': 'LOW', 'repeat_at': 5}),
  ('low score at 15 minutes',
   {'hr': 80, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 15},
   {'score': 2, 'category': 'LOW', 'repeat_at': 20}),
  ('low score at 20 minutes stops',
   {'hr': 82, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 20},
   {'score': 2, 'category': 'LOW', 'repeat_at': None}),
  ('moderate at one minute',
   {'hr': 110, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 5, 'category': 'MODERATE', 'repeat_at': 5})],
 [('vigorous newborn',
   {'hr': 140, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'pink', 'minute': 1},
   {'score': 10, 'category': 'REASSURING', 'repeat_at': 5}),
  ('absent heart rate',
   {'hr': 0, 'resp': 'absent', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 15},
   {'score': 0, 'category': 'LOW', 'repeat_at': 20}),
  ('slow heart rate 50',
   {'hr': 53, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 5}),
  ('total exactly 7',
   {'hr': 120, 'resp': 'good', 'tone': 'some', 'reflex': 'grimace', 'color': 'acro', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 4',
   {'hr': 90, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 10},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 15}),
  ('total 7 with slow heart rate',
   {'hr': 75, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'blue', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 3',
   {'hr': 43, 'resp': 'weak', 'tone': 'some', 'reflex': 'none', 'color': 'blue', 'minute': 1},
   {'score': 3, 'category': 'LOW', 'repeat_at': 5}),
  ('low score at 15 minutes',
   {'hr': 80, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 15},
   {'score': 2, 'category': 'LOW', 'repeat_at': 20}),
  ('low score at 20 minutes stops',
   {'hr': 83, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 20},
   {'score': 2, 'category': 'LOW', 'repeat_at': None}),
  ('moderate at one minute',
   {'hr': 110, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 5, 'category': 'MODERATE', 'repeat_at': 5})],
 [('vigorous newborn',
   {'hr': 140, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'acro', 'minute': 1},
   {'score': 9, 'category': 'REASSURING', 'repeat_at': 5}),
  ('absent heart rate',
   {'hr': 0, 'resp': 'absent', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 20},
   {'score': 0, 'category': 'LOW', 'repeat_at': None}),
  ('slow heart rate 50',
   {'hr': 54, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 5}),
  ('total exactly 7',
   {'hr': 120, 'resp': 'good', 'tone': 'some', 'reflex': 'grimace', 'color': 'acro', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 4',
   {'hr': 90, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 5},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 10}),
  ('total 7 with slow heart rate',
   {'hr': 80, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'blue', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 3',
   {'hr': 44, 'resp': 'weak', 'tone': 'some', 'reflex': 'none', 'color': 'blue', 'minute': 1},
   {'score': 3, 'category': 'LOW', 'repeat_at': 5}),
  ('low score at 15 minutes',
   {'hr': 80, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 15},
   {'score': 2, 'category': 'LOW', 'repeat_at': 20}),
  ('low score at 20 minutes stops',
   {'hr': 84, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 20},
   {'score': 2, 'category': 'LOW', 'repeat_at': None}),
  ('moderate at one minute',
   {'hr': 110, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 5, 'category': 'MODERATE', 'repeat_at': 5})],
 [('vigorous newborn',
   {'hr': 140, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'pink', 'minute': 1},
   {'score': 10, 'category': 'REASSURING', 'repeat_at': 5}),
  ('absent heart rate',
   {'hr': 0, 'resp': 'absent', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 25},
   {'score': 0, 'category': 'LOW', 'repeat_at': None}),
  ('slow heart rate 50',
   {'hr': 55, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 5}),
  ('total exactly 7',
   {'hr': 120, 'resp': 'good', 'tone': 'some', 'reflex': 'grimace', 'color': 'acro', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 4',
   {'hr': 90, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 10},
   {'score': 4, 'category': 'MODERATE', 'repeat_at': 15}),
  ('total 7 with slow heart rate',
   {'hr': 85, 'resp': 'good', 'tone': 'active', 'reflex': 'cry', 'color': 'blue', 'minute': 5},
   {'score': 7, 'category': 'REASSURING', 'repeat_at': None}),
  ('total exactly 3',
   {'hr': 45, 'resp': 'weak', 'tone': 'some', 'reflex': 'none', 'color': 'blue', 'minute': 1},
   {'score': 3, 'category': 'LOW', 'repeat_at': 5}),
  ('low score at 15 minutes',
   {'hr': 80, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 15},
   {'score': 2, 'category': 'LOW', 'repeat_at': 20}),
  ('low score at 20 minutes stops',
   {'hr': 85, 'resp': 'weak', 'tone': 'limp', 'reflex': 'none', 'color': 'blue', 'minute': 20},
   {'score': 2, 'category': 'LOW', 'repeat_at': None}),
  ('moderate at one minute',
   {'hr': 110, 'resp': 'weak', 'tone': 'some', 'reflex': 'grimace', 'color': 'blue', 'minute': 1},
   {'score': 5, 'category': 'MODERATE', 'repeat_at': 5})]]
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 fixture	Actual	Expected	Outcome
vigorous newborn	`{'category': 'REASSURING', 'repeat_at': 5, 'score': 10}`	`{'category': 'REASSURING', 'repeat_at': 5, 'score': 10}`	Passed
absent heart rate	`{'category': 'LOW', 'repeat_at': 10, 'score': 0}`	`{'category': 'LOW', 'repeat_at': 10, 'score': 0}`	Passed
slow heart rate 50	`{'category': 'MODERATE', 'repeat_at': 5, 'score': 4}`	`{'category': 'MODERATE', 'repeat_at': 5, 'score': 4}`	Passed
total exactly 7	`{'category': 'REASSURING', 'repeat_at': None, 'score': 7}`	`{'category': 'REASSURING', 'repeat_at': None, 'score': 7}`	Passed
total exactly 4	`{'category': 'MODERATE', 'repeat_at': 15, 'score': 4}`	`{'category': 'MODERATE', 'repeat_at': 15, 'score': 4}`	Passed
total 7 with slow heart rate	`{'category': 'REASSURING', 'repeat_at': None, 'score': 7}`	`{'category': 'REASSURING', 'repeat_at': None, 'score': 7}`	Passed
total exactly 3	`{'category': 'LOW', 'repeat_at': 5, 'score': 3}`	`{'category': 'LOW', 'repeat_at': 5, 'score': 3}`	Passed
low score at 15 minutes	`{'category': 'LOW', 'repeat_at': 20, 'score': 2}`	`{'category': 'LOW', 'repeat_at': 20, 'score': 2}`	Passed
low score at 20 minutes stops	`{'category': 'LOW', 'repeat_at': None, 'score': 2}`	`{'category': 'LOW', 'repeat_at': None, 'score': 2}`	Passed
moderate at one minute	`{'category': 'MODERATE', 'repeat_at': 5, 'score': 5}`	`{'category': 'MODERATE', 'repeat_at': 5, 'score': 5}`	Passed

SHA-256 / 945211d5dbdd98967aadec1e58cfae3a876c734a7ebe06ea221e86c6425ed1cf

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 2026-09-29T14:47:24.685335+00:00.

Case digest / 62f62ebfd2af6869490f26d2abe86f4264417e091787c5b86bb3785f93d877b4