{
  "scenario": {
    "id": "respiratory-failure-01",
    "name": "Post-Surgical Respiratory Deterioration",
    "description": "55-year-old man on surgical ward after abdominal surgery. Stable for 2 hours, then gradual respiratory deterioration: falling SpO2, rising RR, supplemental oxygen started. NEWS2 reaches HIGH risk by hour 3.",
    "durationMinutes": 240,
    "tags": ["respiratory", "surgical", "deterioration", "supplemental-o2"]
  },
  "patient": {
    "firstName": "Robert",
    "lastName": "Wang",
    "dateOfBirth": "1971-08-22",
    "gender": "Male",
    "mrn": "SIM-002"
  },
  "encounter": {
    "department": "Surgical",
    "room": "SURG-4B",
    "bed": "1",
    "encounterType": "Inpatient",
    "chiefComplaint": "Post-op day 1 — laparoscopic cholecystectomy"
  },
  "events": [
    { "offsetMinutes": 0, "type": "observation", "data": { "code": "HEART_RATE", "value": 76, "unit": "bpm", "source": "monitor" } },
    { "offsetMinutes": 0, "type": "observation", "data": { "code": "RESP_RATE", "value": 14, "unit": "/min", "source": "manual" } },
    { "offsetMinutes": 0, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 132, "unit": "mmHg", "source": "manual" } },
    { "offsetMinutes": 0, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 82, "unit": "mmHg", "source": "manual" } },
    { "offsetMinutes": 0, "type": "observation", "data": { "code": "TEMP_C", "value": 37.0, "unit": "°C", "source": "manual" } },
    { "offsetMinutes": 0, "type": "observation", "data": { "code": "SPO2", "value": 98, "unit": "%", "source": "monitor" } },
    { "offsetMinutes": 0, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "manual" } },

    { "offsetMinutes": 60, "type": "observation", "data": { "code": "HEART_RATE", "value": 78, "unit": "bpm", "source": "monitor" } },
    { "offsetMinutes": 60, "type": "observation", "data": { "code": "RESP_RATE", "value": 15, "unit": "/min", "source": "manual" } },
    { "offsetMinutes": 60, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 130, "unit": "mmHg", "source": "manual" } },
    { "offsetMinutes": 60, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 80, "unit": "mmHg", "source": "manual" } },
    { "offsetMinutes": 60, "type": "observation", "data": { "code": "TEMP_C", "value": 37.1, "unit": "°C", "source": "manual" } },
    { "offsetMinutes": 60, "type": "observation", "data": { "code": "SPO2", "value": 97, "unit": "%", "source": "monitor" } },
    { "offsetMinutes": 60, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "manual" } },

    { "offsetMinutes": 120, "type": "observation", "data": { "code": "HEART_RATE", "value": 82, "unit": "bpm", "source": "monitor" } },
    { "offsetMinutes": 120, "type": "observation", "data": { "code": "RESP_RATE", "value": 18, "unit": "/min", "source": "manual" } },
    { "offsetMinutes": 120, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 126, "unit": "mmHg", "source": "manual" } },
    { "offsetMinutes": 120, "type": "observation", "data": { "code": "DIASTOLIC_BP", "value": 78, "unit": "mmHg", "source": "manual" } },
    { "offsetMinutes": 120, "type": "observation", "data": { "code": "TEMP_C", "value": 37.3, "unit": "°C", "source": "manual" } },
    { "offsetMinutes": 120, "type": "observation", "data": { "code": "SPO2", "value": 95, "unit": "%", "source": "monitor" }, "note": "SpO2 starting to drift down" },
    { "offsetMinutes": 120, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "manual" } },

    { "offsetMinutes": 140, "type": "observation", "data": { "code": "HEART_RATE", "value": 88, "unit": "bpm", "source": "monitor" } },
    { "offsetMinutes": 140, "type": "observation", "data": { "code": "RESP_RATE", "value": 21, "unit": "/min", "source": "manual" } },
    { "offsetMinutes": 140, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 124, "unit": "mmHg", "source": "manual" } },
    { "offsetMinutes": 140, "type": "observation", "data": { "code": "TEMP_C", "value": 37.4, "unit": "°C", "source": "manual" } },
    { "offsetMinutes": 140, "type": "observation", "data": { "code": "SPO2", "value": 93, "unit": "%", "source": "monitor" } },
    { "offsetMinutes": 140, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "manual" } },

    { "offsetMinutes": 150, "type": "observation", "data": { "code": "SUPPLEMENTAL_O2", "value": 1, "unit": "flag", "source": "manual" }, "note": "Nurse starts 2L nasal cannula" },

    { "offsetMinutes": 160, "type": "observation", "data": { "code": "HEART_RATE", "value": 94, "unit": "bpm", "source": "monitor" } },
    { "offsetMinutes": 160, "type": "observation", "data": { "code": "RESP_RATE", "value": 24, "unit": "/min", "source": "manual" } },
    { "offsetMinutes": 160, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 120, "unit": "mmHg", "source": "manual" } },
    { "offsetMinutes": 160, "type": "observation", "data": { "code": "TEMP_C", "value": 37.5, "unit": "°C", "source": "manual" } },
    { "offsetMinutes": 160, "type": "observation", "data": { "code": "SPO2", "value": 92, "unit": "%", "source": "monitor" }, "note": "SpO2 92 despite supplemental O2" },
    { "offsetMinutes": 160, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "manual" } },

    { "offsetMinutes": 180, "type": "observation", "data": { "code": "HEART_RATE", "value": 102, "unit": "bpm", "source": "monitor" } },
    { "offsetMinutes": 180, "type": "observation", "data": { "code": "RESP_RATE", "value": 26, "unit": "/min", "source": "manual" } },
    { "offsetMinutes": 180, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 118, "unit": "mmHg", "source": "manual" } },
    { "offsetMinutes": 180, "type": "observation", "data": { "code": "TEMP_C", "value": 37.6, "unit": "°C", "source": "manual" } },
    { "offsetMinutes": 180, "type": "observation", "data": { "code": "SPO2", "value": 90, "unit": "%", "source": "monitor" }, "note": "SpO2 dropping further" },
    { "offsetMinutes": 180, "type": "observation", "data": { "code": "SUPPLEMENTAL_O2", "value": 1, "unit": "flag", "source": "manual" } },
    { "offsetMinutes": 180, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "manual" } },

    { "offsetMinutes": 210, "type": "observation", "data": { "code": "HEART_RATE", "value": 108, "unit": "bpm", "source": "monitor" } },
    { "offsetMinutes": 210, "type": "observation", "data": { "code": "RESP_RATE", "value": 28, "unit": "/min", "source": "manual" } },
    { "offsetMinutes": 210, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 116, "unit": "mmHg", "source": "manual" } },
    { "offsetMinutes": 210, "type": "observation", "data": { "code": "TEMP_C", "value": 37.7, "unit": "°C", "source": "manual" } },
    { "offsetMinutes": 210, "type": "observation", "data": { "code": "SPO2", "value": 88, "unit": "%", "source": "monitor" } },
    { "offsetMinutes": 210, "type": "observation", "data": { "code": "SUPPLEMENTAL_O2", "value": 1, "unit": "flag", "source": "manual" } },
    { "offsetMinutes": 210, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "manual" } },

    { "offsetMinutes": 240, "type": "observation", "data": { "code": "HEART_RATE", "value": 112, "unit": "bpm", "source": "monitor" } },
    { "offsetMinutes": 240, "type": "observation", "data": { "code": "RESP_RATE", "value": 30, "unit": "/min", "source": "manual" } },
    { "offsetMinutes": 240, "type": "observation", "data": { "code": "SYSTOLIC_BP", "value": 114, "unit": "mmHg", "source": "manual" } },
    { "offsetMinutes": 240, "type": "observation", "data": { "code": "TEMP_C", "value": 37.8, "unit": "°C", "source": "manual" } },
    { "offsetMinutes": 240, "type": "observation", "data": { "code": "SPO2", "value": 86, "unit": "%", "source": "monitor" }, "note": "Critical desaturation — ICU consult called" },
    { "offsetMinutes": 240, "type": "observation", "data": { "code": "SUPPLEMENTAL_O2", "value": 1, "unit": "flag", "source": "manual" } },
    { "offsetMinutes": 240, "type": "observation", "data": { "code": "AVPU", "value": 0, "unit": "score", "source": "manual" } }
  ],
  "expectedOutcomes": [
    { "afterOffsetMinutes": 140, "type": "alert", "alertType": "WARNING_RESP_RATE", "description": "RR 21 enters warning range" },
    { "afterOffsetMinutes": 140, "type": "score", "scoreType": "NEWS2", "expectedMinimum": 4, "description": "NEWS2 rising from SpO2 and RR contributions" },
    { "afterOffsetMinutes": 160, "type": "alert", "alertType": "NEWS2_WARNING", "description": "NEWS2 5-6 with supplemental O2 + low SpO2 + high RR" },
    { "afterOffsetMinutes": 160, "type": "alert", "alertType": "RAPID_DETERIORATION", "description": "SpO2 dropping 98→92 over short window" },
    { "afterOffsetMinutes": 180, "type": "alert", "alertType": "NEWS2_EMERGENCY", "description": "NEWS2 ≥7 with critical SpO2 on supplemental O2" },
    { "afterOffsetMinutes": 210, "type": "alert", "alertType": "WARNING_HEART_RATE", "description": "HR 108 enters warning range" }
  ]
}