Units "L/min" is not a valid unit of measure for valueQuantity.

[floofydoug]

Describe the bug using US CORE 3.1.1. Attempting to store the standard us-core-pulse-oximetry example file.

POST request {{API_URL}}/tenant/sitetenant/Observation with body: 
{
    "resourceType": "Observation",
    "id": "satO2-fiO2",
    "meta": {
        "profile": ["http://hl7.org/fhir/us/core/StructureDefinition/us-core-pulse-oximetry"]
    },
    "text": {
        "status": "generated",
        "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><p><b>Generated Narrative</b></p><p><b>id</b>: satO2-fiO2</p><p><b>meta</b>: </p><p><b>identifier</b>: id: o1223435-10</p><p></p><p><b>category</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/observation-category vital-signs}\">Vital Signs</span></p><p><b>code</b>: <span title=\"Codes: {http://loinc.org 2708-6}, {http://loinc.org 59408-5}, {urn:iso:std:iso:11073:10101 150456}\">Oxygen saturation in Arterial blood</span></p><p><b>subject</b>: <a href=\"Patient-example.html\">Generated Summary: id: example; Medical Record Number: 1032702 (USUAL); active; Amy V. Shaw , Amy V. Baxter ; ph: 555-555-5555(HOME), amy.shaw@example.com; gender: female; birthDate: 1987-02-20</a></p><p><b>effective</b>: 05/12/2014 7:30:10 PM</p><p><b>value</b>: 95 %</p><p><b>interpretation</b>: <span title=\"Codes: {http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation N}\">Normal (applies to non-numeric results)</span></p><p><b>device</b>: <span>Acme Pulse Oximeter 2000</span></p><h3>ReferenceRanges</h3><table class=\"grid\"><tr><td>-</td><td><b>Low</b></td><td><b>High</b></td></tr><tr><td>*</td><td>90 %</td><td>99 %</td></tr></table><h3>Components</h3><table class=\"grid\"><tr><td>-</td><td><b>Code</b></td><td><b>Value[x]</b></td></tr><tr><td>*</td><td><span title=\"Codes: {http://loinc.org 3151-8}\">Inhaled oxygen flow rate</span></td><td>6 liters/min</td></tr></table></div>"
    },
    "identifier": [{
        "system": "http://goodcare.org/observation/id",
        "value": "o1223435-10"
    }],
    "status": "final",
    "category": [{
        "coding": [{
            "system": "http://terminology.hl7.org/CodeSystem/observation-category",
            "code": "vital-signs",
            "display": "Vital Signs"
        }],
        "text": "Vital Signs"
    }],
    "code": {
        "coding": [{
            "system": "http://loinc.org",
            "code": "2708-6",
            "display": "Oxygen saturation in Arterial blood"
        }, {
            "system": "http://loinc.org",
            "code": "59408-5",
            "display": "Oxygen saturation in Arterial blood by Pulse oximetry"
        }, {
            "system": "urn:iso:std:iso:11073:10101",
            "code": "150456",
            "display": "MDC_PULS_OXIM_SAT_O2"
        }]
    },
    "subject": {
        "reference": "Patient/example"
    },
    "effectiveDateTime": "2014-12-05T09:30:10+01:00",
    "valueQuantity": {
        "value": 95,
        "unit": "%",
        "system": "http://unitsofmeasure.org",
        "code": "%"
    },
    "interpretation": [{
        "coding": [{
            "system": "http://terminology.hl7.org/CodeSystem/v3-ObservationInterpretation",
            "code": "N",
            "display": "Normal"
        }],
        "text": "Normal (applies to non-numeric results)"
    }],
    "device": {
        "display": "Acme Pulse Oximeter 2000"
    },
    "referenceRange": [{
        "low": {
            "value": 90,
            "unit": "%",
            "system": "http://unitsofmeasure.org",
            "code": "%"
        },
        "high": {
            "value": 99,
            "unit": "%",
            "system": "http://unitsofmeasure.org",
            "code": "%"
        }
    }],
    "component": [{
        "code": {
            "coding": [{
                "system": "http://loinc.org",
                "code": "3151-8",
                "display": "Inhaled oxygen flow rate"
            }],
            "text": "Inhaled oxygen flow rate"
        },
        "valueQuantity": {
            "value": 6,
            "unit": "liters/min",
            "system": "http://unitsofmeasure.org",
            "code": "L/min"
        }
    }]
}

Error from validator:

{
    "resourceType": "OperationOutcome",
    "text": {
        "status": "generated",
        "div": "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h1>Operation Outcome</h1><table border=\"0\"><tr><td style=\"font-weight: bold;\">error</td><td>[]</td><td><pre>Observation.component[0].value.ofType(Quantity) - The code provided (http://unitsofmeasure.org#L/min) is not in the value set http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1(which actually refers to http://hl7.org/fhir/ValueSet/ucum-vitals-common), and a code from this value set is required: Unknown code 'http://unitsofmeasure.org#L/min'</pre></td></tr></table></div>"
    },
    "issue": [
        {
            "severity": "error",
            "code": "invalid",
            "diagnostics": "Observation.component[0].value.ofType(Quantity) - The code provided (http://unitsofmeasure.org#L/min) is not in the value set http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1(which actually refers to http://hl7.org/fhir/ValueSet/ucum-vitals-common), and a code from this value set is required: Unknown code 'http://unitsofmeasure.org#L/min'"
        }
    ]

To Reproduce Steps to reproduce the behavior:

1. Attempt to store the standard us-core-pulse-oximetry observation

Expected behavior L/min should be a valid unit of measure. It is the only expected unit for pulse oximetry. See US Core spec: http://hl7.org/fhir/us/core/STU3.1.1/StructureDefinition-us-core-pulse-oximetry.html

[aws-tyler]

Thanks for reporting @floofydoug! We've been able to reproduce; adding it to our backlog.

[sevu1]

@floofydoug , based on detailed investigation: this issue is discussed and requires correction; as a workaround we suggest updating StructureDefinition-us-core-pulse-oximetry.json replacing http://hl7.org/fhir/ValueSet/ucum-vitals-common|4.0.1 (there are 3 places in the file to be updated) with http://hl7.org/fhir/ValueSet/ucum-common|4.0.1, recompile IG and redeploy FHIR.

Hope this will help and let us know if you need more details

[github-actions[bot]]

This issue has been automatically closed because there has been no response to our request for more information from the original author. With only the information that is currently in the issue, we don't have enough information to take action. Please reach out if you have or find the answers we need so that we can investigate further.