FAILURE MAP
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FA-64611 / Clinical triage scoring / Open access

Prehospital stroke severity and time-window routing: large vessel threshold · case 01

A score of 4 is not treated as a suspected large-vessel occlusion.

Verified by executionVariant 1 · 8 checks per implementationDownload source bundle ↓JSON ↗

ROOT CAUSE

The suspicion threshold excludes 4.

VERIFIED REPAIR

Suspect large-vessel occlusion at scores >= 4.

Unsuccessful approach: Requiring facial droop misses arm-and-grip-only presentations scoring 4.

Case contract

Input {face 0-1, arm 0-2, grip 0-2, lkw "HH:MM", now "HH:MM", lkw_yesterday}. Score = face+arm+grip; large-vessel suspicion when score >= 4. elapsed = now - lkw in minutes (+1440 if last known well was yesterday). Pathway: elapsed <= 270 THROMBOLYSIS_WINDOW; else elapsed <= 1440 with suspicion THROMBECTOMY_EVAL; else OUTSIDE_WINDOW. Destination COMPREHENSIVE for any large-vessel suspicion, else NEAREST. Return {score, lvo, elapsed_min, pathway, destination}.

Why this case matters

Stroke routing couples a severity threshold with clock arithmetic over last-known-well; each is a distinct failure mode.

1 / The failure

Exit 1
"""Failure Map reference implementation. Python standard library only."""
import json

N = 1
observations = []
def solve(x):
    s = x['face'] + x['arm'] + x['grip']
    lvo = s > 4
    def mins(t):
        h, m = map(int, t.split(':'))
        return h * 60 + m
    elapsed = mins(x['now']) - mins(x['lkw']) + (1440 if x['lkw_yesterday'] else 0)
    if elapsed <= 270:
        path = 'THROMBOLYSIS_WINDOW'
    elif elapsed <= 1440 and lvo:
        path = 'THROMBECTOMY_EVAL'
    else:
        path = 'OUTSIDE_WINDOW'
    dest = 'COMPREHENSIVE' if lvo else 'NEAREST'
    return {'score': s, 'lvo': lvo, 'elapsed_min': elapsed, 'pathway': path, 'destination': dest}
def check(label, actual, expected):
    observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('mild deficit early',
   {'face': 1, 'arm': 1, 'grip': 0, 'lkw': '10:00', 'now': '10:10', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 10, 'pathway': 'THROMBOLYSIS_WINDOW', 'destination': 'NEAREST'}),
  ('score exactly 4 without facial droop',
   {'face': 0, 'arm': 2, 'grip': 2, 'lkw': '10:00', 'now': '12:00', 'lkw_yesterday': False},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 120,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('last known well yesterday evening',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '22:00', 'now': '01:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 180,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('exactly 4.5 hours',
   {'face': 1, 'arm': 1, 'grip': 1, 'lkw': '01:00', 'now': '05:30', 'lkw_yesterday': False},
   {'score': 3,
    'lvo': False,
    'elapsed_min': 270,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'NEAREST'}),
  ('4 hours 50 minutes',
   {'face': 0, 'arm': 1, 'grip': 1, 'lkw': '08:00', 'now': '12:46', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 286, 'pathway': 'OUTSIDE_WINDOW', 'destination': 'NEAREST'}),
  ('large vessel at 20 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '14:00', 'now': '10:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1200,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel beyond 24 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '08:00', 'now': '08:10', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1450,
    'pathway': 'OUTSIDE_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel exactly 24 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '01:00', 'now': '01:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1440,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'})],
 [('mild deficit early',
   {'face': 1, 'arm': 1, 'grip': 0, 'lkw': '10:00', 'now': '10:20', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 20, 'pathway': 'THROMBOLYSIS_WINDOW', 'destination': 'NEAREST'}),
  ('score exactly 4 without facial droop',
   {'face': 0, 'arm': 2, 'grip': 2, 'lkw': '10:00', 'now': '12:00', 'lkw_yesterday': False},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 120,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('last known well yesterday evening',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '22:00', 'now': '02:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 240,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('exactly 4.5 hours',
   {'face': 1, 'arm': 1, 'grip': 1, 'lkw': '02:00', 'now': '06:30', 'lkw_yesterday': False},
   {'score': 3,
    'lvo': False,
    'elapsed_min': 270,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'NEAREST'}),
  ('4 hours 50 minutes',
   {'face': 0, 'arm': 1, 'grip': 1, 'lkw': '08:00', 'now': '12:47', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 287, 'pathway': 'OUTSIDE_WINDOW', 'destination': 'NEAREST'}),
  ('large vessel at 20 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '14:00', 'now': '10:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1200,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel beyond 24 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '08:00', 'now': '08:20', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1460,
    'pathway': 'OUTSIDE_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel exactly 24 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '02:00', 'now': '02:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1440,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'})],
 [('mild deficit early',
   {'face': 1, 'arm': 1, 'grip': 0, 'lkw': '10:00', 'now': '10:30', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 30, 'pathway': 'THROMBOLYSIS_WINDOW', 'destination': 'NEAREST'}),
  ('score exactly 4 without facial droop',
   {'face': 0, 'arm': 2, 'grip': 2, 'lkw': '10:00', 'now': '12:00', 'lkw_yesterday': False},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 120,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('last known well yesterday evening',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '22:00', 'now': '03:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 300,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('exactly 4.5 hours',
   {'face': 1, 'arm': 1, 'grip': 1, 'lkw': '03:00', 'now': '07:30', 'lkw_yesterday': False},
   {'score': 3,
    'lvo': False,
    'elapsed_min': 270,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'NEAREST'}),
  ('4 hours 50 minutes',
   {'face': 0, 'arm': 1, 'grip': 1, 'lkw': '08:00', 'now': '12:48', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 288, 'pathway': 'OUTSIDE_WINDOW', 'destination': 'NEAREST'}),
  ('large vessel at 20 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '14:00', 'now': '10:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1200,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel beyond 24 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '08:00', 'now': '08:30', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1470,
    'pathway': 'OUTSIDE_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel exactly 24 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '03:00', 'now': '03:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1440,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'})],
 [('mild deficit early',
   {'face': 1, 'arm': 1, 'grip': 0, 'lkw': '10:00', 'now': '10:40', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 40, 'pathway': 'THROMBOLYSIS_WINDOW', 'destination': 'NEAREST'}),
  ('score exactly 4 without facial droop',
   {'face': 0, 'arm': 2, 'grip': 2, 'lkw': '10:00', 'now': '12:00', 'lkw_yesterday': False},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 120,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('last known well yesterday evening',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '22:00', 'now': '04:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 360,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('exactly 4.5 hours',
   {'face': 1, 'arm': 1, 'grip': 1, 'lkw': '04:00', 'now': '08:30', 'lkw_yesterday': False},
   {'score': 3,
    'lvo': False,
    'elapsed_min': 270,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'NEAREST'}),
  ('4 hours 50 minutes',
   {'face': 0, 'arm': 1, 'grip': 1, 'lkw': '08:00', 'now': '12:49', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 289, 'pathway': 'OUTSIDE_WINDOW', 'destination': 'NEAREST'}),
  ('large vessel at 20 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '14:00', 'now': '10:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1200,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel beyond 24 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '08:00', 'now': '08:40', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1480,
    'pathway': 'OUTSIDE_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel exactly 24 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '04:00', 'now': '04:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1440,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'})],
 [('mild deficit early',
   {'face': 1, 'arm': 1, 'grip': 0, 'lkw': '10:00', 'now': '10:50', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 50, 'pathway': 'THROMBOLYSIS_WINDOW', 'destination': 'NEAREST'}),
  ('score exactly 4 without facial droop',
   {'face': 0, 'arm': 2, 'grip': 2, 'lkw': '10:00', 'now': '12:00', 'lkw_yesterday': False},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 120,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('last known well yesterday evening',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '22:00', 'now': '05:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 420,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('exactly 4.5 hours',
   {'face': 1, 'arm': 1, 'grip': 1, 'lkw': '05:00', 'now': '09:30', 'lkw_yesterday': False},
   {'score': 3,
    'lvo': False,
    'elapsed_min': 270,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'NEAREST'}),
  ('4 hours 50 minutes',
   {'face': 0, 'arm': 1, 'grip': 1, 'lkw': '08:00', 'now': '12:50', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 290, 'pathway': 'OUTSIDE_WINDOW', 'destination': 'NEAREST'}),
  ('large vessel at 20 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '14:00', 'now': '10:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1200,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel beyond 24 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '08:00', 'now': '08:50', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1490,
    'pathway': 'OUTSIDE_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel exactly 24 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '05:00', 'now': '05:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1440,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'})]]
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
mild deficit early{'destination': 'NEAREST', 'elapsed_min': 10, 'lvo': False, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 2}{'destination': 'NEAREST', 'elapsed_min': 10, 'lvo': False, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 2}Passed
score exactly 4 without facial droop{'destination': 'NEAREST', 'elapsed_min': 120, 'lvo': False, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 4}{'destination': 'COMPREHENSIVE', 'elapsed_min': 120, 'lvo': True, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 4}Failed
last known well yesterday evening{'destination': 'COMPREHENSIVE', 'elapsed_min': 180, 'lvo': True, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 5}{'destination': 'COMPREHENSIVE', 'elapsed_min': 180, 'lvo': True, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 5}Passed
exactly 4.5 hours{'destination': 'NEAREST', 'elapsed_min': 270, 'lvo': False, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 3}{'destination': 'NEAREST', 'elapsed_min': 270, 'lvo': False, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 3}Passed
4 hours 50 minutes{'destination': 'NEAREST', 'elapsed_min': 286, 'lvo': False, 'pathway': 'OUTSIDE_WINDOW', 'score': 2}{'destination': 'NEAREST', 'elapsed_min': 286, 'lvo': False, 'pathway': 'OUTSIDE_WINDOW', 'score': 2}Passed
large vessel at 20 hours{'destination': 'COMPREHENSIVE', 'elapsed_min': 1200, 'lvo': True, 'pathway': 'THROMBECTOMY_EVAL', 'score': 5}{'destination': 'COMPREHENSIVE', 'elapsed_min': 1200, 'lvo': True, 'pathway': 'THROMBECTOMY_EVAL', 'score': 5}Passed
large vessel beyond 24 hours{'destination': 'COMPREHENSIVE', 'elapsed_min': 1450, 'lvo': True, 'pathway': 'OUTSIDE_WINDOW', 'score': 5}{'destination': 'COMPREHENSIVE', 'elapsed_min': 1450, 'lvo': True, 'pathway': 'OUTSIDE_WINDOW', 'score': 5}Passed
large vessel exactly 24 hours{'destination': 'NEAREST', 'elapsed_min': 1440, 'lvo': False, 'pathway': 'OUTSIDE_WINDOW', 'score': 4}{'destination': 'COMPREHENSIVE', 'elapsed_min': 1440, 'lvo': True, 'pathway': 'THROMBECTOMY_EVAL', 'score': 4}Failed

SHA-256 / 845ab638eec8a7fcc89c14a24abb9275b8810486f96de50681283a7d804c31ae

2 / The unsuccessful fix

Exit 1
"""Failure Map reference implementation. Python standard library only."""
import json

N = 1
observations = []
def solve(x):
    s = x['face'] + x['arm'] + x['grip']
    lvo = s >= 4 and x['face'] == 1
    def mins(t):
        h, m = map(int, t.split(':'))
        return h * 60 + m
    elapsed = mins(x['now']) - mins(x['lkw']) + (1440 if x['lkw_yesterday'] else 0)
    if elapsed <= 270:
        path = 'THROMBOLYSIS_WINDOW'
    elif elapsed <= 1440 and lvo:
        path = 'THROMBECTOMY_EVAL'
    else:
        path = 'OUTSIDE_WINDOW'
    dest = 'COMPREHENSIVE' if lvo else 'NEAREST'
    return {'score': s, 'lvo': lvo, 'elapsed_min': elapsed, 'pathway': path, 'destination': dest}
def check(label, actual, expected):
    observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('mild deficit early',
   {'face': 1, 'arm': 1, 'grip': 0, 'lkw': '10:00', 'now': '10:10', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 10, 'pathway': 'THROMBOLYSIS_WINDOW', 'destination': 'NEAREST'}),
  ('score exactly 4 without facial droop',
   {'face': 0, 'arm': 2, 'grip': 2, 'lkw': '10:00', 'now': '12:00', 'lkw_yesterday': False},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 120,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('last known well yesterday evening',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '22:00', 'now': '01:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 180,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('exactly 4.5 hours',
   {'face': 1, 'arm': 1, 'grip': 1, 'lkw': '01:00', 'now': '05:30', 'lkw_yesterday': False},
   {'score': 3,
    'lvo': False,
    'elapsed_min': 270,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'NEAREST'}),
  ('4 hours 50 minutes',
   {'face': 0, 'arm': 1, 'grip': 1, 'lkw': '08:00', 'now': '12:46', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 286, 'pathway': 'OUTSIDE_WINDOW', 'destination': 'NEAREST'}),
  ('large vessel at 20 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '14:00', 'now': '10:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1200,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel beyond 24 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '08:00', 'now': '08:10', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1450,
    'pathway': 'OUTSIDE_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel exactly 24 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '01:00', 'now': '01:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1440,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'})],
 [('mild deficit early',
   {'face': 1, 'arm': 1, 'grip': 0, 'lkw': '10:00', 'now': '10:20', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 20, 'pathway': 'THROMBOLYSIS_WINDOW', 'destination': 'NEAREST'}),
  ('score exactly 4 without facial droop',
   {'face': 0, 'arm': 2, 'grip': 2, 'lkw': '10:00', 'now': '12:00', 'lkw_yesterday': False},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 120,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('last known well yesterday evening',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '22:00', 'now': '02:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 240,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('exactly 4.5 hours',
   {'face': 1, 'arm': 1, 'grip': 1, 'lkw': '02:00', 'now': '06:30', 'lkw_yesterday': False},
   {'score': 3,
    'lvo': False,
    'elapsed_min': 270,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'NEAREST'}),
  ('4 hours 50 minutes',
   {'face': 0, 'arm': 1, 'grip': 1, 'lkw': '08:00', 'now': '12:47', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 287, 'pathway': 'OUTSIDE_WINDOW', 'destination': 'NEAREST'}),
  ('large vessel at 20 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '14:00', 'now': '10:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1200,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel beyond 24 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '08:00', 'now': '08:20', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1460,
    'pathway': 'OUTSIDE_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel exactly 24 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '02:00', 'now': '02:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1440,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'})],
 [('mild deficit early',
   {'face': 1, 'arm': 1, 'grip': 0, 'lkw': '10:00', 'now': '10:30', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 30, 'pathway': 'THROMBOLYSIS_WINDOW', 'destination': 'NEAREST'}),
  ('score exactly 4 without facial droop',
   {'face': 0, 'arm': 2, 'grip': 2, 'lkw': '10:00', 'now': '12:00', 'lkw_yesterday': False},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 120,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('last known well yesterday evening',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '22:00', 'now': '03:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 300,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('exactly 4.5 hours',
   {'face': 1, 'arm': 1, 'grip': 1, 'lkw': '03:00', 'now': '07:30', 'lkw_yesterday': False},
   {'score': 3,
    'lvo': False,
    'elapsed_min': 270,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'NEAREST'}),
  ('4 hours 50 minutes',
   {'face': 0, 'arm': 1, 'grip': 1, 'lkw': '08:00', 'now': '12:48', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 288, 'pathway': 'OUTSIDE_WINDOW', 'destination': 'NEAREST'}),
  ('large vessel at 20 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '14:00', 'now': '10:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1200,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel beyond 24 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '08:00', 'now': '08:30', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1470,
    'pathway': 'OUTSIDE_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel exactly 24 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '03:00', 'now': '03:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1440,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'})],
 [('mild deficit early',
   {'face': 1, 'arm': 1, 'grip': 0, 'lkw': '10:00', 'now': '10:40', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 40, 'pathway': 'THROMBOLYSIS_WINDOW', 'destination': 'NEAREST'}),
  ('score exactly 4 without facial droop',
   {'face': 0, 'arm': 2, 'grip': 2, 'lkw': '10:00', 'now': '12:00', 'lkw_yesterday': False},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 120,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('last known well yesterday evening',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '22:00', 'now': '04:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 360,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('exactly 4.5 hours',
   {'face': 1, 'arm': 1, 'grip': 1, 'lkw': '04:00', 'now': '08:30', 'lkw_yesterday': False},
   {'score': 3,
    'lvo': False,
    'elapsed_min': 270,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'NEAREST'}),
  ('4 hours 50 minutes',
   {'face': 0, 'arm': 1, 'grip': 1, 'lkw': '08:00', 'now': '12:49', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 289, 'pathway': 'OUTSIDE_WINDOW', 'destination': 'NEAREST'}),
  ('large vessel at 20 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '14:00', 'now': '10:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1200,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel beyond 24 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '08:00', 'now': '08:40', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1480,
    'pathway': 'OUTSIDE_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel exactly 24 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '04:00', 'now': '04:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1440,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'})],
 [('mild deficit early',
   {'face': 1, 'arm': 1, 'grip': 0, 'lkw': '10:00', 'now': '10:50', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 50, 'pathway': 'THROMBOLYSIS_WINDOW', 'destination': 'NEAREST'}),
  ('score exactly 4 without facial droop',
   {'face': 0, 'arm': 2, 'grip': 2, 'lkw': '10:00', 'now': '12:00', 'lkw_yesterday': False},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 120,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('last known well yesterday evening',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '22:00', 'now': '05:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 420,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('exactly 4.5 hours',
   {'face': 1, 'arm': 1, 'grip': 1, 'lkw': '05:00', 'now': '09:30', 'lkw_yesterday': False},
   {'score': 3,
    'lvo': False,
    'elapsed_min': 270,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'NEAREST'}),
  ('4 hours 50 minutes',
   {'face': 0, 'arm': 1, 'grip': 1, 'lkw': '08:00', 'now': '12:50', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 290, 'pathway': 'OUTSIDE_WINDOW', 'destination': 'NEAREST'}),
  ('large vessel at 20 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '14:00', 'now': '10:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1200,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel beyond 24 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '08:00', 'now': '08:50', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1490,
    'pathway': 'OUTSIDE_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel exactly 24 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '05:00', 'now': '05:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1440,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'})]]
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
mild deficit early{'destination': 'NEAREST', 'elapsed_min': 10, 'lvo': False, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 2}{'destination': 'NEAREST', 'elapsed_min': 10, 'lvo': False, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 2}Passed
score exactly 4 without facial droop{'destination': 'NEAREST', 'elapsed_min': 120, 'lvo': False, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 4}{'destination': 'COMPREHENSIVE', 'elapsed_min': 120, 'lvo': True, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 4}Failed
last known well yesterday evening{'destination': 'COMPREHENSIVE', 'elapsed_min': 180, 'lvo': True, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 5}{'destination': 'COMPREHENSIVE', 'elapsed_min': 180, 'lvo': True, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 5}Passed
exactly 4.5 hours{'destination': 'NEAREST', 'elapsed_min': 270, 'lvo': False, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 3}{'destination': 'NEAREST', 'elapsed_min': 270, 'lvo': False, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 3}Passed
4 hours 50 minutes{'destination': 'NEAREST', 'elapsed_min': 286, 'lvo': False, 'pathway': 'OUTSIDE_WINDOW', 'score': 2}{'destination': 'NEAREST', 'elapsed_min': 286, 'lvo': False, 'pathway': 'OUTSIDE_WINDOW', 'score': 2}Passed
large vessel at 20 hours{'destination': 'COMPREHENSIVE', 'elapsed_min': 1200, 'lvo': True, 'pathway': 'THROMBECTOMY_EVAL', 'score': 5}{'destination': 'COMPREHENSIVE', 'elapsed_min': 1200, 'lvo': True, 'pathway': 'THROMBECTOMY_EVAL', 'score': 5}Passed
large vessel beyond 24 hours{'destination': 'COMPREHENSIVE', 'elapsed_min': 1450, 'lvo': True, 'pathway': 'OUTSIDE_WINDOW', 'score': 5}{'destination': 'COMPREHENSIVE', 'elapsed_min': 1450, 'lvo': True, 'pathway': 'OUTSIDE_WINDOW', 'score': 5}Passed
large vessel exactly 24 hours{'destination': 'COMPREHENSIVE', 'elapsed_min': 1440, 'lvo': True, 'pathway': 'THROMBECTOMY_EVAL', 'score': 4}{'destination': 'COMPREHENSIVE', 'elapsed_min': 1440, 'lvo': True, 'pathway': 'THROMBECTOMY_EVAL', 'score': 4}Passed

SHA-256 / bd2cf1bef3132b598a621df10cb73869936d7a0adb678532fbab396589a52b97

3 / The verified repair

Exit 0
"""Failure Map reference implementation. Python standard library only."""
import json

N = 1
observations = []
def solve(x):
    s = x['face'] + x['arm'] + x['grip']
    lvo = s >= 4
    def mins(t):
        h, m = map(int, t.split(':'))
        return h * 60 + m
    elapsed = mins(x['now']) - mins(x['lkw']) + (1440 if x['lkw_yesterday'] else 0)
    if elapsed <= 270:
        path = 'THROMBOLYSIS_WINDOW'
    elif elapsed <= 1440 and lvo:
        path = 'THROMBECTOMY_EVAL'
    else:
        path = 'OUTSIDE_WINDOW'
    dest = 'COMPREHENSIVE' if lvo else 'NEAREST'
    return {'score': s, 'lvo': lvo, 'elapsed_min': elapsed, 'pathway': path, 'destination': dest}
def check(label, actual, expected):
    observations.append({"check": label, "actual": actual, "expected": expected, "passed": actual == expected})
fixtures = [[('mild deficit early',
   {'face': 1, 'arm': 1, 'grip': 0, 'lkw': '10:00', 'now': '10:10', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 10, 'pathway': 'THROMBOLYSIS_WINDOW', 'destination': 'NEAREST'}),
  ('score exactly 4 without facial droop',
   {'face': 0, 'arm': 2, 'grip': 2, 'lkw': '10:00', 'now': '12:00', 'lkw_yesterday': False},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 120,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('last known well yesterday evening',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '22:00', 'now': '01:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 180,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('exactly 4.5 hours',
   {'face': 1, 'arm': 1, 'grip': 1, 'lkw': '01:00', 'now': '05:30', 'lkw_yesterday': False},
   {'score': 3,
    'lvo': False,
    'elapsed_min': 270,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'NEAREST'}),
  ('4 hours 50 minutes',
   {'face': 0, 'arm': 1, 'grip': 1, 'lkw': '08:00', 'now': '12:46', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 286, 'pathway': 'OUTSIDE_WINDOW', 'destination': 'NEAREST'}),
  ('large vessel at 20 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '14:00', 'now': '10:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1200,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel beyond 24 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '08:00', 'now': '08:10', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1450,
    'pathway': 'OUTSIDE_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel exactly 24 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '01:00', 'now': '01:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1440,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'})],
 [('mild deficit early',
   {'face': 1, 'arm': 1, 'grip': 0, 'lkw': '10:00', 'now': '10:20', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 20, 'pathway': 'THROMBOLYSIS_WINDOW', 'destination': 'NEAREST'}),
  ('score exactly 4 without facial droop',
   {'face': 0, 'arm': 2, 'grip': 2, 'lkw': '10:00', 'now': '12:00', 'lkw_yesterday': False},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 120,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('last known well yesterday evening',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '22:00', 'now': '02:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 240,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('exactly 4.5 hours',
   {'face': 1, 'arm': 1, 'grip': 1, 'lkw': '02:00', 'now': '06:30', 'lkw_yesterday': False},
   {'score': 3,
    'lvo': False,
    'elapsed_min': 270,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'NEAREST'}),
  ('4 hours 50 minutes',
   {'face': 0, 'arm': 1, 'grip': 1, 'lkw': '08:00', 'now': '12:47', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 287, 'pathway': 'OUTSIDE_WINDOW', 'destination': 'NEAREST'}),
  ('large vessel at 20 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '14:00', 'now': '10:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1200,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel beyond 24 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '08:00', 'now': '08:20', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1460,
    'pathway': 'OUTSIDE_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel exactly 24 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '02:00', 'now': '02:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1440,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'})],
 [('mild deficit early',
   {'face': 1, 'arm': 1, 'grip': 0, 'lkw': '10:00', 'now': '10:30', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 30, 'pathway': 'THROMBOLYSIS_WINDOW', 'destination': 'NEAREST'}),
  ('score exactly 4 without facial droop',
   {'face': 0, 'arm': 2, 'grip': 2, 'lkw': '10:00', 'now': '12:00', 'lkw_yesterday': False},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 120,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('last known well yesterday evening',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '22:00', 'now': '03:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 300,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('exactly 4.5 hours',
   {'face': 1, 'arm': 1, 'grip': 1, 'lkw': '03:00', 'now': '07:30', 'lkw_yesterday': False},
   {'score': 3,
    'lvo': False,
    'elapsed_min': 270,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'NEAREST'}),
  ('4 hours 50 minutes',
   {'face': 0, 'arm': 1, 'grip': 1, 'lkw': '08:00', 'now': '12:48', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 288, 'pathway': 'OUTSIDE_WINDOW', 'destination': 'NEAREST'}),
  ('large vessel at 20 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '14:00', 'now': '10:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1200,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel beyond 24 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '08:00', 'now': '08:30', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1470,
    'pathway': 'OUTSIDE_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel exactly 24 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '03:00', 'now': '03:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1440,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'})],
 [('mild deficit early',
   {'face': 1, 'arm': 1, 'grip': 0, 'lkw': '10:00', 'now': '10:40', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 40, 'pathway': 'THROMBOLYSIS_WINDOW', 'destination': 'NEAREST'}),
  ('score exactly 4 without facial droop',
   {'face': 0, 'arm': 2, 'grip': 2, 'lkw': '10:00', 'now': '12:00', 'lkw_yesterday': False},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 120,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('last known well yesterday evening',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '22:00', 'now': '04:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 360,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('exactly 4.5 hours',
   {'face': 1, 'arm': 1, 'grip': 1, 'lkw': '04:00', 'now': '08:30', 'lkw_yesterday': False},
   {'score': 3,
    'lvo': False,
    'elapsed_min': 270,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'NEAREST'}),
  ('4 hours 50 minutes',
   {'face': 0, 'arm': 1, 'grip': 1, 'lkw': '08:00', 'now': '12:49', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 289, 'pathway': 'OUTSIDE_WINDOW', 'destination': 'NEAREST'}),
  ('large vessel at 20 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '14:00', 'now': '10:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1200,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel beyond 24 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '08:00', 'now': '08:40', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1480,
    'pathway': 'OUTSIDE_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel exactly 24 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '04:00', 'now': '04:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1440,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'})],
 [('mild deficit early',
   {'face': 1, 'arm': 1, 'grip': 0, 'lkw': '10:00', 'now': '10:50', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 50, 'pathway': 'THROMBOLYSIS_WINDOW', 'destination': 'NEAREST'}),
  ('score exactly 4 without facial droop',
   {'face': 0, 'arm': 2, 'grip': 2, 'lkw': '10:00', 'now': '12:00', 'lkw_yesterday': False},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 120,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('last known well yesterday evening',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '22:00', 'now': '05:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 420,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('exactly 4.5 hours',
   {'face': 1, 'arm': 1, 'grip': 1, 'lkw': '05:00', 'now': '09:30', 'lkw_yesterday': False},
   {'score': 3,
    'lvo': False,
    'elapsed_min': 270,
    'pathway': 'THROMBOLYSIS_WINDOW',
    'destination': 'NEAREST'}),
  ('4 hours 50 minutes',
   {'face': 0, 'arm': 1, 'grip': 1, 'lkw': '08:00', 'now': '12:50', 'lkw_yesterday': False},
   {'score': 2, 'lvo': False, 'elapsed_min': 290, 'pathway': 'OUTSIDE_WINDOW', 'destination': 'NEAREST'}),
  ('large vessel at 20 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '14:00', 'now': '10:00', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1200,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel beyond 24 hours',
   {'face': 1, 'arm': 2, 'grip': 2, 'lkw': '08:00', 'now': '08:50', 'lkw_yesterday': True},
   {'score': 5,
    'lvo': True,
    'elapsed_min': 1490,
    'pathway': 'OUTSIDE_WINDOW',
    'destination': 'COMPREHENSIVE'}),
  ('large vessel exactly 24 hours',
   {'face': 1, 'arm': 2, 'grip': 1, 'lkw': '05:00', 'now': '05:00', 'lkw_yesterday': True},
   {'score': 4,
    'lvo': True,
    'elapsed_min': 1440,
    'pathway': 'THROMBECTOMY_EVAL',
    'destination': 'COMPREHENSIVE'})]]
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
mild deficit early{'destination': 'NEAREST', 'elapsed_min': 10, 'lvo': False, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 2}{'destination': 'NEAREST', 'elapsed_min': 10, 'lvo': False, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 2}Passed
score exactly 4 without facial droop{'destination': 'COMPREHENSIVE', 'elapsed_min': 120, 'lvo': True, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 4}{'destination': 'COMPREHENSIVE', 'elapsed_min': 120, 'lvo': True, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 4}Passed
last known well yesterday evening{'destination': 'COMPREHENSIVE', 'elapsed_min': 180, 'lvo': True, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 5}{'destination': 'COMPREHENSIVE', 'elapsed_min': 180, 'lvo': True, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 5}Passed
exactly 4.5 hours{'destination': 'NEAREST', 'elapsed_min': 270, 'lvo': False, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 3}{'destination': 'NEAREST', 'elapsed_min': 270, 'lvo': False, 'pathway': 'THROMBOLYSIS_WINDOW', 'score': 3}Passed
4 hours 50 minutes{'destination': 'NEAREST', 'elapsed_min': 286, 'lvo': False, 'pathway': 'OUTSIDE_WINDOW', 'score': 2}{'destination': 'NEAREST', 'elapsed_min': 286, 'lvo': False, 'pathway': 'OUTSIDE_WINDOW', 'score': 2}Passed
large vessel at 20 hours{'destination': 'COMPREHENSIVE', 'elapsed_min': 1200, 'lvo': True, 'pathway': 'THROMBECTOMY_EVAL', 'score': 5}{'destination': 'COMPREHENSIVE', 'elapsed_min': 1200, 'lvo': True, 'pathway': 'THROMBECTOMY_EVAL', 'score': 5}Passed
large vessel beyond 24 hours{'destination': 'COMPREHENSIVE', 'elapsed_min': 1450, 'lvo': True, 'pathway': 'OUTSIDE_WINDOW', 'score': 5}{'destination': 'COMPREHENSIVE', 'elapsed_min': 1450, 'lvo': True, 'pathway': 'OUTSIDE_WINDOW', 'score': 5}Passed
large vessel exactly 24 hours{'destination': 'COMPREHENSIVE', 'elapsed_min': 1440, 'lvo': True, 'pathway': 'THROMBECTOMY_EVAL', 'score': 4}{'destination': 'COMPREHENSIVE', 'elapsed_min': 1440, 'lvo': True, 'pathway': 'THROMBECTOMY_EVAL', 'score': 4}Passed

SHA-256 / 107bbcb1a6872ffc383c23d4dd4ee537f7ec7bb3d9b633e0911b26a88ad8f97f

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 2026-09-29T14:47:26.073217+00:00.

Case digest / 61c23bb1db6d2ad25bf5206fcd0e059eb382d5c44b3ad0b83fcdd740afecd6ec