Datasets:
id stringclasses 6 values | case_title stringclasses 6 values | cascade_summary stringclasses 6 values | safety_checkpoints_expected stringclasses 6 values | interruption_points_observed stringclasses 6 values | failed_interruption_points stringclasses 6 values | recovery_opportunities_lost stringclasses 6 values | normalization_of_deviance_flags stringclasses 6 values | authority_gradient_effects stringclasses 6 values | resilience_gap_index float64 0.7 0.82 | preventability_score float64 0.68 0.85 | minimal_system_fix_set stringclasses 6 values | notes stringclasses 6 values | constraints stringclasses 1 value | gold_checklist stringclasses 1 value |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
SCBA-001 | Vancomycin nephrotoxicity cascade | Cr rise -> oliguria -> overload -> ICU | renal dose check; 24h labs; pharmacist review | 24h labs done; no action | 24h lab review; dose adjustment; stop nephrotoxin | early de-escalation; fluid management before overload | routine acceptance of rising Cr | junior nurse concern dismissed | 0.78 | 0.8 | hard stop on Cr rise; pharmacist signoff; escalation rule | System had multiple chances | Under 320 words. | failed+gap+fix |
SCBA-002 | Contrast AKI escalation | contrast -> AKI -> hypotension -> ICU | hydration protocol; post-contrast labs | labs delayed; dehydration ignored | pre-scan hydration; post-scan monitoring | alternate imaging; early fluids | contrast ordered as default | radiology risk note not acted on | 0.72 | 0.7 | contrast risk gate; hydration bundle; eGFR hard rule | Default pathway failed | Under 320 words. | failed+gap+fix |
SCBA-003 | Opioid respiratory collapse | sedation -> CO2 retention -> hypoxia | sedation scoring; capnography high-risk | sedation scored; no escalation | sedation escalation trigger; dose reduction | early naloxone; switch analgesia | sleeping patient assumed stable | nurse escalation blocked by hierarchy | 0.82 | 0.85 | capnography for COPD; mandatory sedation trigger; rapid review | Classic monitoring failure | Under 320 words. | failed+gap+fix |
SCBA-004 | C. diff systemic decline | antibiotics -> diarrhea -> AKI -> sepsis | antibiotic review day3; stool trigger policy | diarrhea noted; minimized | antibiotic stop review; early stool testing | early isolation; fluids; stewardship consult | diarrhea treated as nuisance | stewardship advice deferred | 0.74 | 0.75 | day3 antibiotic stop rule; diarrhea escalation protocol | Slow drift not interrupted | Under 320 words. | failed+gap+fix |
SCBA-005 | Anticoagulation bleed cascade | bleed -> anemia -> hypotension -> fall | renal dosing check; Hb monitoring | Hb low; no action | dose verification; early bleed workup | hold DOAC; gastro eval | bruising normalized | family concerns discounted | 0.7 | 0.68 | dose gate by eGFR; Hb trigger; fall-risk plan | Multiple weak signals ignored | Under 320 words. | failed+gap+fix |
SCBA-006 | Line infection escalation | line kept -> bacteremia -> shock | daily line necessity review; site inspection | site checked; tenderness missed | daily removal decision; asepsis audit | early removal; culture earlier | lines left for convenience | junior staff not empowered to remove | 0.76 | 0.78 | mandatory daily line check; empower removal; checklist audit | Maintenance system failed | Under 320 words. | failed+gap+fix |
What this dataset tests
Whether an intelligence system can explain
why a clinical system failed to self-correct
during an iatrogenic harm cascade.
Required outputs
- failed interruption points
- recovery opportunities lost
- resilience gap index
- normalization of deviance flags
- authority gradient effects
- preventability score
- minimal system fix set
Use case
Third layer of the Iatrogenic Harm Cascade Library.
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