Clinical Case Studies

This directory holds Cairn's clinical case-mining record — the highest-signal generative mode for stress-testing the architecture before and during product build. Case-mining takes a real clinical failure mode (from the field, from the literature, or from a practising clinician's lived experience) and asks a single question: do the existing primitives absorb it, or does it force new architecture?

So far the event-overlay + key-custody + actor primitives have absorbed every case without needing new architecture. That track record is only meaningful if the cases are real and adversarial — a case study that confirms what we already believe teaches nothing. Each record here therefore states plainly where a case did surface new design work, an unverified assumption, or a slice worth checking against code, not just where the primitives held.

Why a separate area

Same discipline as the spikes: the spec stays a clean statement of what Cairn is, the ADR log stays a clean statement of why. A case study is a third thing — a real-world failure mode held up against the design, and what that comparison taught. Keeping it out of the spec preserves the §3.13 discipline that the architecture documents describe a settled design, not a lab notebook. A case study can still feed the spec: a case that surfaces genuinely new surface sends a question back to the design (an open question, then a spike, then an ADR).

Index

Case	Source	Verdict	Surfaced work
0001	A 16-part Australian GP-magazine column on clinical-software shortcomings (Dr Oliver Frank, 2015–2017)	Absorbed — 0 new architecture	3 items worth acting on: re-affirmation currency in the demographics slice being built now; a possible open-loop / obligation projection; the impossible-vs-uncertain constraint boundary