id stringclasses 6
values | case_title stringclasses 6
values | patient_context stringclasses 6
values | initiating_intervention stringclasses 6
values | decision_rationale stringclasses 6
values | baseline_risk_factors stringclasses 6
values | expected_response stringclasses 6
values | actual_early_response stringclasses 6
values | early_warning_signals stringclasses 6
values | early_warning_signals_missed stringclasses 6
values | initial_failure_mode stringclasses 5
values | expected_vs_actual_response stringclasses 6
values | initial_detection_opportunity stringclasses 6
values | first_safe_alternative stringclasses 6
values | notes stringclasses 6
values | constraints stringclasses 1
value | gold_checklist stringclasses 1
value |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
IOFI-001 | Vancomycin nephrotoxicity cascade | 72M CKD stage 3; sepsis concern | start vancomycin + piptazo | broad coverage | CKD; dehydration | infection control without renal injury | creatinine rises 24h; oliguria | rising creatinine; low urine output | creatinine trend ignored | dose/monitoring failure | expected stable renal function; actual rapid decline | 24h lab review + dose adjust | renal dosing + early trough + alternative agent | Origin is dosing+monitoring | Under 320 words. | origin+mode+missed+alt |
IOFI-002 | Contrast-induced AKI after CT angiography | 65F diabetic; borderline renal function | CTPA with contrast | rule out PE | diabetes; eGFR 42 | safe imaging | AKI 48h; nausea | eGFR borderline; dehydration | hydration omitted | risk stratification failure | expected minimal renal effect; actual AKI | pre-scan hydration and risk check | V/Q scan or ultrasound pathway | Seed is imaging choice | Under 320 words. | origin+mode+missed+alt |
IOFI-003 | Opioid respiratory depression | 58M COPD; post-op pain | high-dose opioid PCA | pain control | COPD; sleep apnea | analgesia without hypoventilation | somnolence; CO2 retention | increasing sedation score | sedation monitoring lax | dose selection failure | expected comfort; actual hypoventilation | nursing sedation checks + capnography | lower dose + multimodal analgesia | Origin is dosing and monitoring | Under 320 words. | origin+mode+missed+alt |
IOFI-004 | C. difficile after broad antibiotics | 40F post-surgery | prolonged broad-spectrum antibiotics | prevent infection | prior antibiotics exposure | no infection; smooth recovery | diarrhea day 7; fever | loose stools; abdominal pain | early diarrhea minimized | indication drift | expected prophylaxis benefit; actual microbiome collapse | review need at day 3-5 | stop early; narrow spectrum; stewardship consult | Origin is unnecessary duration | Under 320 words. | origin+mode+missed+alt |
IOFI-005 | Bleed after anticoag without dose check | 80F AF; fall risk | start DOAC standard dose | stroke prevention | age; renal impairment; fall risk | stroke risk reduction | melena; Hb drop | baseline eGFR low; bruising | renal dosing not applied | dose selection failure | expected safe anticoag; actual bleed | baseline renal check + dose adjust | dose-reduced DOAC or alternative plan | Seed is dosing rules ignored | Under 320 words. | origin+mode+missed+alt |
IOFI-006 | Post-op sepsis from line infection | 55M ICU stay | central line left in longer | access convenience | ICU exposure; immunosuppression | stable access; no infection | fever day 5; cultures positive | line tenderness; rising WBC | site signs overlooked | maintenance failure | expected stable course; actual HAI | daily line necessity review | remove line; aseptic audit | Origin is maintenance lapse | Under 320 words. | origin+mode+missed+alt |
What this dataset tests
Whether an intelligence system can identify
where iatrogenic harm is first seeded
and what safe alternative existed at that moment.
Required outputs
- initiating intervention
- initial failure mode
- expected vs actual response
- missed early warning signals
- initial detection opportunity
- first safe alternative
Use case
First layer of the Iatrogenic Harm Cascade Library.
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