{
  "scenario": {
    "id": "stable-baseline-01",
    "name": "Stable Baseline \u2014 Routine Inpatient Monitoring",
    "description": "52-year-old female admitted for elective cholecystectomy. Completely uneventful 8-hour post-op monitoring period with all vitals remaining normal throughout. This is a CONTROL scenario that validates the system does NOT generate false alerts on a stable patient. NEWS2 remains 0 at every observation cluster.",
    "durationMinutes": 480,
    "tags": [
      "stable",
      "baseline",
      "control",
      "surgery",
      "post-op",
      "cholecystectomy",
      "no-alert"
    ]
  },
  "patient": {
    "firstName": "Linda",
    "lastName": "Weston",
    "dateOfBirth": "1974-02-18",
    "gender": "Female"
  },
  "encounter": {
    "department": "Surgery",
    "encounterType": "Inpatient",
    "attendingPhysician": "Dr. James Nakamura",
    "roomBed": "SURG-204B",
    "admissionReason": "Elective laparoscopic cholecystectomy \u2014 routine post-operative monitoring"
  },
  "events": [
    {
      "offsetMinutes": 0,
      "type": "observation",
      "data": {
        "code": "HEART_RATE",
        "value": 72,
        "unit": "bpm",
        "source": "Device"
      },
      "note": "Post-op arrival to surgical floor. All vitals normal, patient alert and comfortable. NEWS2=0"
    },
    {
      "offsetMinutes": 0,
      "type": "observation",
      "data": {
        "code": "RESP_RATE",
        "value": 14,
        "unit": "/min",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 0,
      "type": "observation",
      "data": {
        "code": "SYSTOLIC_BP",
        "value": 124,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 0,
      "type": "observation",
      "data": {
        "code": "DIASTOLIC_BP",
        "value": 74,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 0,
      "type": "observation",
      "data": {
        "code": "TEMP_C",
        "value": 36.8,
        "unit": "\u00b0C",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 0,
      "type": "observation",
      "data": {
        "code": "SPO2",
        "value": 98,
        "unit": "%",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 0,
      "type": "observation",
      "data": {
        "code": "AVPU",
        "value": 0,
        "unit": "score",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 0,
      "type": "observation",
      "data": {
        "code": "GCS_EYE",
        "value": 4,
        "unit": "score",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 0,
      "type": "observation",
      "data": {
        "code": "GCS_VERBAL",
        "value": 5,
        "unit": "score",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 0,
      "type": "observation",
      "data": {
        "code": "GCS_MOTOR",
        "value": 6,
        "unit": "score",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 30,
      "type": "observation",
      "data": {
        "code": "HEART_RATE",
        "value": 74,
        "unit": "bpm",
        "source": "Device"
      },
      "note": "First routine check \u2014 minor physiological noise, all normal. NEWS2=0"
    },
    {
      "offsetMinutes": 30,
      "type": "observation",
      "data": {
        "code": "RESP_RATE",
        "value": 15,
        "unit": "/min",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 30,
      "type": "observation",
      "data": {
        "code": "SYSTOLIC_BP",
        "value": 122,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 30,
      "type": "observation",
      "data": {
        "code": "DIASTOLIC_BP",
        "value": 76,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 30,
      "type": "observation",
      "data": {
        "code": "TEMP_C",
        "value": 36.7,
        "unit": "\u00b0C",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 30,
      "type": "observation",
      "data": {
        "code": "SPO2",
        "value": 98,
        "unit": "%",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 30,
      "type": "observation",
      "data": {
        "code": "AVPU",
        "value": 0,
        "unit": "score",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 60,
      "type": "observation",
      "data": {
        "code": "HEART_RATE",
        "value": 70,
        "unit": "bpm",
        "source": "Device"
      },
      "note": "Second routine check \u2014 all normal. NEWS2=0"
    },
    {
      "offsetMinutes": 60,
      "type": "observation",
      "data": {
        "code": "RESP_RATE",
        "value": 14,
        "unit": "/min",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 60,
      "type": "observation",
      "data": {
        "code": "SYSTOLIC_BP",
        "value": 126,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 60,
      "type": "observation",
      "data": {
        "code": "DIASTOLIC_BP",
        "value": 73,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 60,
      "type": "observation",
      "data": {
        "code": "TEMP_C",
        "value": 36.8,
        "unit": "\u00b0C",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 60,
      "type": "observation",
      "data": {
        "code": "SPO2",
        "value": 99,
        "unit": "%",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 60,
      "type": "observation",
      "data": {
        "code": "AVPU",
        "value": 0,
        "unit": "score",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 60,
      "type": "observation",
      "data": {
        "code": "GLUCOSE_MG_DL",
        "value": 118,
        "unit": "mg/dL",
        "source": "Lab"
      },
      "note": "Routine post-op labs \u2014 all within normal limits"
    },
    {
      "offsetMinutes": 60,
      "type": "observation",
      "data": {
        "code": "POTASSIUM_MEQ_L",
        "value": 4.0,
        "unit": "mEq/L",
        "source": "Lab"
      }
    },
    {
      "offsetMinutes": 61,
      "type": "observation",
      "data": {
        "code": "WBC_K_UL",
        "value": 8.2,
        "unit": "\u00d710\u00b3/\u00b5L",
        "source": "Lab"
      }
    },
    {
      "offsetMinutes": 90,
      "type": "observation",
      "data": {
        "code": "HEART_RATE",
        "value": 73,
        "unit": "bpm",
        "source": "Device"
      },
      "note": "Third routine check \u2014 all normal. NEWS2=0"
    },
    {
      "offsetMinutes": 90,
      "type": "observation",
      "data": {
        "code": "RESP_RATE",
        "value": 15,
        "unit": "/min",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 90,
      "type": "observation",
      "data": {
        "code": "SYSTOLIC_BP",
        "value": 120,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 90,
      "type": "observation",
      "data": {
        "code": "DIASTOLIC_BP",
        "value": 74,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 90,
      "type": "observation",
      "data": {
        "code": "TEMP_C",
        "value": 36.9,
        "unit": "\u00b0C",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 90,
      "type": "observation",
      "data": {
        "code": "SPO2",
        "value": 98,
        "unit": "%",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 90,
      "type": "observation",
      "data": {
        "code": "AVPU",
        "value": 0,
        "unit": "score",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 120,
      "type": "observation",
      "data": {
        "code": "HEART_RATE",
        "value": 71,
        "unit": "bpm",
        "source": "Device"
      },
      "note": "Fourth routine check \u2014 patient reports mild incisional discomfort. All vitals normal. NEWS2=0"
    },
    {
      "offsetMinutes": 120,
      "type": "observation",
      "data": {
        "code": "RESP_RATE",
        "value": 14,
        "unit": "/min",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 120,
      "type": "observation",
      "data": {
        "code": "SYSTOLIC_BP",
        "value": 125,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 120,
      "type": "observation",
      "data": {
        "code": "DIASTOLIC_BP",
        "value": 75,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 120,
      "type": "observation",
      "data": {
        "code": "TEMP_C",
        "value": 36.8,
        "unit": "\u00b0C",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 120,
      "type": "observation",
      "data": {
        "code": "SPO2",
        "value": 98,
        "unit": "%",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 120,
      "type": "observation",
      "data": {
        "code": "AVPU",
        "value": 0,
        "unit": "score",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 120,
      "type": "medication",
      "data": {
        "drugName": "Acetaminophen",
        "dose": 1000,
        "doseUnit": "mg",
        "route": "PO",
        "administeredBy": "RN Garcia"
      },
      "note": "Acetaminophen 1000mg PO for mild post-op incisional discomfort"
    },
    {
      "offsetMinutes": 150,
      "type": "observation",
      "data": {
        "code": "HEART_RATE",
        "value": 66,
        "unit": "bpm",
        "source": "Device"
      },
      "note": "Patient sleeping \u2014 mild sleep bradycardia, HR dips to 66. Entirely normal. NEWS2=0"
    },
    {
      "offsetMinutes": 150,
      "type": "observation",
      "data": {
        "code": "RESP_RATE",
        "value": 12,
        "unit": "/min",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 150,
      "type": "observation",
      "data": {
        "code": "SYSTOLIC_BP",
        "value": 118,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 150,
      "type": "observation",
      "data": {
        "code": "DIASTOLIC_BP",
        "value": 70,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 150,
      "type": "observation",
      "data": {
        "code": "TEMP_C",
        "value": 36.7,
        "unit": "\u00b0C",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 150,
      "type": "observation",
      "data": {
        "code": "SPO2",
        "value": 98,
        "unit": "%",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 150,
      "type": "observation",
      "data": {
        "code": "AVPU",
        "value": 0,
        "unit": "score",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 180,
      "type": "observation",
      "data": {
        "code": "HEART_RATE",
        "value": 73,
        "unit": "bpm",
        "source": "Device"
      },
      "note": "Sixth check \u2014 patient awake, back to baseline. NEWS2=0"
    },
    {
      "offsetMinutes": 180,
      "type": "observation",
      "data": {
        "code": "RESP_RATE",
        "value": 15,
        "unit": "/min",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 180,
      "type": "observation",
      "data": {
        "code": "SYSTOLIC_BP",
        "value": 126,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 180,
      "type": "observation",
      "data": {
        "code": "DIASTOLIC_BP",
        "value": 76,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 180,
      "type": "observation",
      "data": {
        "code": "TEMP_C",
        "value": 36.9,
        "unit": "\u00b0C",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 180,
      "type": "observation",
      "data": {
        "code": "SPO2",
        "value": 97,
        "unit": "%",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 180,
      "type": "observation",
      "data": {
        "code": "AVPU",
        "value": 0,
        "unit": "score",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 210,
      "type": "observation",
      "data": {
        "code": "HEART_RATE",
        "value": 75,
        "unit": "bpm",
        "source": "Device"
      },
      "note": "Seventh check \u2014 all normal. NEWS2=0"
    },
    {
      "offsetMinutes": 210,
      "type": "observation",
      "data": {
        "code": "RESP_RATE",
        "value": 16,
        "unit": "/min",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 210,
      "type": "observation",
      "data": {
        "code": "SYSTOLIC_BP",
        "value": 128,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 210,
      "type": "observation",
      "data": {
        "code": "DIASTOLIC_BP",
        "value": 78,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 210,
      "type": "observation",
      "data": {
        "code": "TEMP_C",
        "value": 36.8,
        "unit": "\u00b0C",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 210,
      "type": "observation",
      "data": {
        "code": "SPO2",
        "value": 98,
        "unit": "%",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 210,
      "type": "observation",
      "data": {
        "code": "AVPU",
        "value": 0,
        "unit": "score",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 210,
      "type": "observation",
      "data": {
        "code": "GLUCOSE_MG_DL",
        "value": 105,
        "unit": "mg/dL",
        "source": "Lab"
      },
      "note": "Second routine lab draw \u2014 all within normal limits"
    },
    {
      "offsetMinutes": 210,
      "type": "observation",
      "data": {
        "code": "POTASSIUM_MEQ_L",
        "value": 4.1,
        "unit": "mEq/L",
        "source": "Lab"
      }
    },
    {
      "offsetMinutes": 240,
      "type": "observation",
      "data": {
        "code": "HEART_RATE",
        "value": 72,
        "unit": "bpm",
        "source": "Device"
      },
      "note": "Eighth check \u2014 all normal, temp 37.0. Surgical wound check performed. NEWS2=0"
    },
    {
      "offsetMinutes": 240,
      "type": "observation",
      "data": {
        "code": "RESP_RATE",
        "value": 14,
        "unit": "/min",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 240,
      "type": "observation",
      "data": {
        "code": "SYSTOLIC_BP",
        "value": 124,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 240,
      "type": "observation",
      "data": {
        "code": "DIASTOLIC_BP",
        "value": 74,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 240,
      "type": "observation",
      "data": {
        "code": "TEMP_C",
        "value": 37.0,
        "unit": "\u00b0C",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 240,
      "type": "observation",
      "data": {
        "code": "SPO2",
        "value": 98,
        "unit": "%",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 240,
      "type": "observation",
      "data": {
        "code": "AVPU",
        "value": 0,
        "unit": "score",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 235,
      "type": "order",
      "data": {
        "orderType": "Procedure",
        "description": "Surgical wound assessment \u2014 laparoscopic cholecystectomy port sites",
        "orderedBy": "Dr. James Nakamura"
      }
    },
    {
      "offsetMinutes": 240,
      "type": "order_result",
      "data": {
        "orderDescription": "Surgical wound assessment \u2014 laparoscopic cholecystectomy port sites",
        "resultSummary": "All four port sites intact, clean and dry. No erythema, swelling, drainage, or dehiscence. Steri-strips in place. No signs of infection."
      },
      "note": "Routine post-op wound check \u2014 normal findings"
    },
    {
      "offsetMinutes": 300,
      "type": "observation",
      "data": {
        "code": "HEART_RATE",
        "value": 70,
        "unit": "bpm",
        "source": "Device"
      },
      "note": "Check at 5 hours \u2014 all normal. NEWS2=0"
    },
    {
      "offsetMinutes": 300,
      "type": "observation",
      "data": {
        "code": "RESP_RATE",
        "value": 15,
        "unit": "/min",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 300,
      "type": "observation",
      "data": {
        "code": "SYSTOLIC_BP",
        "value": 122,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 300,
      "type": "observation",
      "data": {
        "code": "DIASTOLIC_BP",
        "value": 73,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 300,
      "type": "observation",
      "data": {
        "code": "TEMP_C",
        "value": 36.9,
        "unit": "\u00b0C",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 300,
      "type": "observation",
      "data": {
        "code": "SPO2",
        "value": 99,
        "unit": "%",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 300,
      "type": "observation",
      "data": {
        "code": "AVPU",
        "value": 0,
        "unit": "score",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 360,
      "type": "observation",
      "data": {
        "code": "HEART_RATE",
        "value": 74,
        "unit": "bpm",
        "source": "Device"
      },
      "note": "Check at 6 hours \u2014 all normal. NEWS2=0"
    },
    {
      "offsetMinutes": 360,
      "type": "observation",
      "data": {
        "code": "RESP_RATE",
        "value": 14,
        "unit": "/min",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 360,
      "type": "observation",
      "data": {
        "code": "SYSTOLIC_BP",
        "value": 130,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 360,
      "type": "observation",
      "data": {
        "code": "DIASTOLIC_BP",
        "value": 78,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 360,
      "type": "observation",
      "data": {
        "code": "TEMP_C",
        "value": 37.0,
        "unit": "\u00b0C",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 360,
      "type": "observation",
      "data": {
        "code": "SPO2",
        "value": 98,
        "unit": "%",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 360,
      "type": "observation",
      "data": {
        "code": "AVPU",
        "value": 0,
        "unit": "score",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 420,
      "type": "observation",
      "data": {
        "code": "HEART_RATE",
        "value": 71,
        "unit": "bpm",
        "source": "Device"
      },
      "note": "Check at 7 hours \u2014 all normal. NEWS2=0"
    },
    {
      "offsetMinutes": 420,
      "type": "observation",
      "data": {
        "code": "RESP_RATE",
        "value": 16,
        "unit": "/min",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 420,
      "type": "observation",
      "data": {
        "code": "SYSTOLIC_BP",
        "value": 126,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 420,
      "type": "observation",
      "data": {
        "code": "DIASTOLIC_BP",
        "value": 75,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 420,
      "type": "observation",
      "data": {
        "code": "TEMP_C",
        "value": 36.8,
        "unit": "\u00b0C",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 420,
      "type": "observation",
      "data": {
        "code": "SPO2",
        "value": 98,
        "unit": "%",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 420,
      "type": "observation",
      "data": {
        "code": "AVPU",
        "value": 0,
        "unit": "score",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 480,
      "type": "observation",
      "data": {
        "code": "HEART_RATE",
        "value": 73,
        "unit": "bpm",
        "source": "Device"
      },
      "note": "Final check at 8 hours \u2014 all vitals normal. Patient stable, tolerating diet, ambulating. NEWS2=0. Ready for discharge planning."
    },
    {
      "offsetMinutes": 480,
      "type": "observation",
      "data": {
        "code": "RESP_RATE",
        "value": 14,
        "unit": "/min",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 480,
      "type": "observation",
      "data": {
        "code": "SYSTOLIC_BP",
        "value": 124,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 480,
      "type": "observation",
      "data": {
        "code": "DIASTOLIC_BP",
        "value": 74,
        "unit": "mmHg",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 480,
      "type": "observation",
      "data": {
        "code": "TEMP_C",
        "value": 36.9,
        "unit": "\u00b0C",
        "source": "Manual"
      }
    },
    {
      "offsetMinutes": 480,
      "type": "observation",
      "data": {
        "code": "SPO2",
        "value": 98,
        "unit": "%",
        "source": "Device"
      }
    },
    {
      "offsetMinutes": 480,
      "type": "observation",
      "data": {
        "code": "AVPU",
        "value": 0,
        "unit": "score",
        "source": "Manual"
      }
    }
  ],
  "expectedOutcomes": [
    {
      "afterOffsetMinutes": 0,
      "type": "score",
      "scoreType": "NEWS2",
      "expectedMinimum": 0,
      "description": "NEWS2 score is 0 at baseline (T+0). All parameters in normal range: HR 72 (score 0), RR 14 (score 0), SBP 124 (score 0), SpO2 98 (score 0), Temp 36.8 (score 0), AVPU 0 (score 0), no supplemental O2 (score 0)."
    },
    {
      "afterOffsetMinutes": 150,
      "type": "score",
      "scoreType": "NEWS2",
      "expectedMinimum": 0,
      "description": "NEWS2 score remains 0 during sleep period (T+150). Sleep bradycardia HR 66 still within NEWS2 score-0 range (51-90), RR 12 still within score-0 range (12-20). No alert should fire."
    },
    {
      "afterOffsetMinutes": 240,
      "type": "score",
      "scoreType": "NEWS2",
      "expectedMinimum": 0,
      "description": "NEWS2 score remains 0 at mid-monitoring (T+240). All vitals stable and well within normal ranges. Surgical wound check normal."
    },
    {
      "afterOffsetMinutes": 480,
      "type": "score",
      "scoreType": "NEWS2",
      "expectedMinimum": 0,
      "description": "NEWS2 score remains 0 at end of 8-hour monitoring period (T+480). No alerts fired throughout entire scenario. Patient stable for discharge planning. This confirms the system correctly avoids false positives on a stable patient."
    }
  ]
}
