When the Guard Does Not Guard: Mutation-Based Verification of a Gate-Enforced Hospital Governance Platform. A Single-System Case Study

Hospital quality systems predominantly detect deviations after they occur. A system that records a deviation does not prevent it. Preventive enforcement is achievable in software, but it introduces a verification problem that detective systems do not face: a guard that silently permits what it claims to block appears correct in every test that exercises the compliant path.