OperationOutcome "Patient // OperationOutcome.Location is deprecated, please use OperationOutcome.Expression"

[arjun8001]

Describe the bug
I stored my custom FHIR profile, and even though it stores the profile properly, it is unable to create and validate new resource properly.

FHIR Version?
Stu3/R4/R5
Stu3

Data provider?
CosmosDB/SQL Server

To Reproduce
Steps to reproduce the behavior:

1. Create Patient Profile structure as given below. Using POSTMAN
   x-ms-profile-validation is set to TRUE
   POST {{fhirurl}}/StructureDefinition

Body

{
  "resourceType": "StructureDefinition",
  "url": "http://cihi.ca/fhir/nsir/StructureDefinition/TutorialPatient",
  "name": "TutorialPatient",
  "status": "draft",
  "fhirVersion": "3.0.2",
  "kind": "resource",
  "abstract": false,
  "type": "Patient",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Patient",
  "derivation": "constraint",
  "differential": {
    "element": [
      {
        "id": "Patient.identifier",
        "path": "Patient.identifier",
        "min": 1
      },
      {
        "id": "Patient.name",
        "path": "Patient.name",
        "min": 1
      },
      {
        "id": "Patient.gender",
        "path": "Patient.gender",
        "min": 1
      }
    ]
  }
}

2. Create new Patient

{
    "resourceType" : "Patient",
    "meta" : {
        "profile":[
            "http://cihi.ca/fhir/nsir/StructureDefinition/TutorialPatient"
        ]
    },
    "birthDate": "1950-01-02", 
    "gender": "male",
    "identifier": [
        {
            "system": "http://example.com/something",
            "value": "test"
        }
    ],
    "name": [
        {
            "use":"official",
            "given": ["ABC"],
            "family": "DEF"

        }
        
    ]
}

Expected behavior

Once you create, it should give you below

{
    "resourceType": "Patient",
    "id": "25b4123e-4123-48c1-9e84-9605cef78ea3",
    "meta": {
        "versionId": "1",
        "lastUpdated": "2023-02-13T21:48:40.303+00:00",
        "profile": [
            "http://cihi.ca/fhir/nsir/StructureDefinition/TutorialPatient"
        ]
    },
    "identifier": [
        {
            "system": "http://example.com/something",
            "value": "arjun"
        }
    ],
    "name": [
        {
            "use": "official",
            "family": "DEF",
            "given": [
                "ABC"
            ]
        }
    ],
    "gender": "male",
    "birthDate": "1950-01-02"
}

Actual behavior
When I try to create new Patient, I receive this error
POST {{fhirurl}}/Patient

{
    "resourceType": "OperationOutcome",
    "id": "31a5faf4ba6c5f8b5777be0a9eb836be",
    "meta": {
        "lastUpdated": "2023-02-13T22:03:37.6992072+00:00"
    },
    "issue": [
        {
            "severity": "error",
            "code": "incomplete",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/dotnet-api-operation-outcome",
                        "code": "4000"
                    }
                ],
                "text": "Unable to resolve reference to profile 'http://cihi.ca/fhir/nsir/StructureDefinition/TutorialPatient'"
            },
            "location": [
                "Patient // OperationOutcome.Location is deprecated, please use OperationOutcome.Expression"
            ],
            "expression": [
                "Patient"
            ]
        }
    ]
}

After hitting POST second time, the new patient is created.

Same is happening when I try to validate.

AB#101364

[brendankowitz]

@LTA-Thinking could this be related to caching?

[LTA-Thinking]

@brendankowitz yes, I think this is due to caching.
@arjun8001, does this deployment have multiple instances? If it is one of our managed offerings it does. The instances poll the database for new definitions every 10 minutes. It looks like the request that failed hit an instance that hadn't picked up the new definition yet, while the successful request hit the service that created the definition and was updated at that time. Does the new definition work reliably after waiting a few minutes?
@feordin, does this sound correct?

[arjun8001]

@LTA-Thinking
The new definition was picked up.

1. I made the definition.
2. Made a request to create tutorial patient- rejected
3. Made a request to create tutorial patient- accepted
4. Made a request to create tutorial patient- rejected
5. Made a request to create tutorial patient- accepted

below are the two services that I created one is for R4 and one is for STU 3 and I have been using for STU3

[EXPEkesheth]

@arjun8001 - is this issue resolved, can we close the issue?

[arjun8001]

@EXPEkesheth ,
It is not resolved. I have been waiting to hear from you guys.

[LTA-Thinking]

Hi @arjun8001
Sorry for the delay. We are aware of some users having issues with the polling not picking up new Profiles on instances they weren't created on. My question, and I believe Ketki's follow up, was trying to find out if the issue persisted after some time had passed. This will help us determine if you are being affected by the known bug, or if the polling worked correctly for you but just is taking too long.

[visharadsharmaji]

We are also facing the same issue. I am posting messages bundles from the custom created utility and getting the below error when posting. Utility posts around 4 messages at every 30 seconds delay. However when i post using Postman it posts bundle successfully.

Error:

28T13:12:03.4069764+00:00"},"issue":[{"severity":"error","code":"invalid","diagnostics":"Resource type in the URL must match resourceType in the resource.","location":["TypeName // OperationOutcome.Location is deprecated, please use OperationOutcome.Expression"],"expression":["TypeName"]}]}

[EXPEkesheth]

Thanks for providing information. We have added this in backlog for further investigation.
AB#98127

[moloneyd-draeger]

We have also noticed the same issue. Based on our logs, this seems to have started to occur on 2023-02-15, and has been happening sporadically since.

The error reported in issue[0].details.text is always "Unable to resolve reference to profile '{profile_url}'". The profile resources definitely exist on the server, and the validation process works before and after the "issue" is seen in the logs.

Any update on this issue is appreciated as we have disabled profile validation on some services as a workaround for this problem.

FHIR Version?
R4

Data provider?
CosmosDB

{
    "resourceType": "OperationOutcome",
    "id": "a8831a235e1c1633109b0177c2c8ceb5",
    "meta": {
        "lastUpdated": "2023-03-01T13:16:44.9637258+00:00"
    },
    "issue": [
        {
            "severity": "error",
            "code": "incomplete",
            "details": {
                "coding": [
                    {
                        "system": "http://hl7.org/fhir/dotnet-api-operation-outcome",
                        "code": "4000"
                    }
                ],
                "text": "Unable to resolve reference to profile 'http://hl7.org/fhir/uv/pocd/StructureDefinition/MdsDevice'"
            },
            "location": [
                "Device // OperationOutcome.Location is deprecated, please use OperationOutcome.Expression"
            ],
            "expression": [
                "Device"
            ]
        }
    ]
}

[WhiteOlivierus]

I did have this problem too, what fixed it for me was checking if this folder C:\Users\%USER%\AppData\Local\Temp\FhirArtifactCache-4.3.0....\specification was empty. If it's not, then it's not causing this problem. Otherwise, remove the cache folder and restart.

[WardEerland]

We are also experiencing the same issue on the managed service. I tried both with a built-in profile (us-core-patient) and a custom profile, both are present in the service. Both validation outcomes give the "Unable to resolve reference to profile ..." error.

{ "resourceType": "OperationOutcome", "issue": [ { "severity": "error", "code": "incomplete", "details": { "coding": [ { "system": "http://hl7.org/fhir/dotnet-api-operation-outcome", "code": "4000" } ], "text": "Unable to resolve reference to profile 'http://hl7.org/fhir/us/core/StructureDefinition/us-core-patient'" }, "location": [ "Patient // OperationOutcome.Location is deprecated, please use OperationOutcome.Expression" ], "expression": [ "Patient" ] } ] }

[EXPEkesheth]

Thanks for reporting the issue . Backlog feature [#105394]

[edwinnswift]

We are experiencing the same issue with the OSS version running as an App Service. We cannot make use of $validate due to this issue. Is there an expected fix date?