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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