Bug #641
closed“Batch sign” stays disabled even though a critical lab report needs the doctor’s action
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Description
Description: On the Inbox & Results page, there’s a lab report (“Lab report ready” — Alminta VJ, LAB-20261015-0001, 3 tests) that appears under the “Needs action” filter with a “Review” status badge. Opening the underlying report shows 12 abnormal results, including a value flagged “Critical” (LYM). Despite this, the page header still reads “0 awaiting your signature,” and the “Batch sign” button stays disabled the whole time — it never becomes clickable. Checking the patient’s full Labs tab for this report also shows no Sign/Acknowledge action anywhere, so there is currently no way for the doctor to sign off on this critical result at all.
Steps:
Go to “Inbox & Results.”
Note the header: “0 urgent · 0 awaiting your signature · 2 total,” and that “Batch sign” is greyed out.
Click the “Needs action” tab — it shows 1 item: “Lab report ready · Alminta VJ · LAB-20261015-0001 · 3 tests” with a “Review” badge.
Click the item → “Open record” → go to the patient’s “Labs” tab.
Observe the LAB-20261015-0001 report: 12 abnormal results, including a “Critical” flag on LYM, with no sign/acknowledge action anywhere on the page.
Return to Inbox & Results — “Batch sign” is still disabled.
Expected Result: A lab report with critical/abnormal results that needs the doctor’s review should count toward “awaiting your signature,” and the doctor should have a way to sign/acknowledge it — either from the Inbox item directly or from the Labs tab on the patient record — which should also enable “Batch sign” when one or more such items exist.
Actual Result: The item shows under

“Needs action” with a “Review” badge and contains a critical result, but it’s not counted in “awaiting your signature” (stays at 0), there’s no sign/acknowledge action available anywhere for it, and “Batch sign” remains permanently disabled.
Files
S- Updated by SK - 14 days ago
- Assignee changed from Fiza M. to Roshni Harish.
Investigated end to end (nuvita-doctor Inbox + nuvita-diagnostics critical-value pipeline). No code defect found in Doctor Desktop: both a bulk 'Mark all read' action and a per-item 'Acknowledge' action already exist and work correctly for critical lab results that have a CriticalValueEvent (apps/portal/src/app/(app)/inbox/page.tsx + InboxDetailDialog.tsx, reading IDiagnosticsClinicalReadContract.GetCriticalResultsAsync). The root cause of this specific repro is that LAB-20261015-0001's critical LYM value never generated a CriticalValueEvent, because nuvita-diagnostics only fires one when a matching CriticalValueDefinition rule exists for that hospital+test+parameter (apps/api/src/Nuvita.Lab/CriticalValues/CriticalValueService.cs, FireFromResultAsync) - and no such rule is configured for LYM at the hospital in this repro. The report's own 'Critical' badge comes from a separate reference-range flag calculation, independent of the rule-based alerting pipeline, which is why the result can display as Critical while never raising an alert. This is a data/configuration gap, not a code bug: nuvita-diagnostics already has a working admin screen and API for this (Laboratory -> Critical Values, LabCriticalValueRulesController / CreateDefinitionAsync). Recommend adding a CriticalValueDefinition for LYM (and auditing other parameters for the same gap) via that screen, for the affected hospital. No code change made. Reassigning to Roshni - please route to whoever administers that hospital's lab critical-value rules, or confirm this is the expected cause before closing.