Update api/routes/patients.py

api/routes/patients.py

@@ -1,23 +1,15 @@
-from fastapi import APIRouter, HTTPException, Depends, Query, status
+from fastapi import APIRouter, HTTPException, Depends, Response
 from ...db.mongo import patients_collection
 from ...core.security import get_current_user
-from ...utils.db import create_indexes
-from ...utils.helpers import calculate_age, standardize_language
-from ...models.entities import Note
+from ...utils.helpers import calculate_age, escape_latex_special_chars, hyphenate_long_strings, format_timestamp
 from datetime import datetime
 from bson import ObjectId
 from bson.errors import InvalidId
-from typing import Optional, List, Dict
-from pymongo import UpdateOne
-from pymongo.errors import BulkWriteError
-import json
-from pathlib import Path
-import glob
-import uuid
-import re
-import logging
-import time
 import os
+import subprocess
+from tempfile import TemporaryDirectory
+from string import Template
+import logging
 
 # Configure logging
 logging.basicConfig(
@@ -28,441 +20,231 @@ logger = logging.getLogger(__name__)
 
 router = APIRouter()
 
-# Configuration
-BASE_DIR = Path(__file__).resolve().parent.parent.parent
-SYNTHEA_DATA_DIR = BASE_DIR / "output" / "fhir"
-os.makedirs(SYNTHEA_DATA_DIR, exist_ok=True)
+@router.get("/{patient_id}/pdf", response_class=Response)
+async def generate_patient_pdf(patient_id: str, current_user: dict = Depends(get_current_user)):
+    # Suppress logging for this route
+    logger.setLevel(logging.CRITICAL)
+
+    try:
+        if current_user.get('role') not in ['doctor', 'admin']:
+            raise HTTPException(status_code=403, detail="Only clinicians can generate patient PDFs")
 
-async def process_synthea_patient(bundle: dict, file_path: str) -> Optional[dict]:
-    logger.debug(f"Processing patient from file: {file_path}")
-    patient_data = {}
-    notes = []
-    conditions = []
-    medications = []
-    encounters = []
-    
-    # Validate bundle structure
-    if not isinstance(bundle, dict) or 'entry' not in bundle:
-        logger.error(f"Invalid FHIR bundle structure in {file_path}")
-        return None
-    
-    for entry in bundle.get('entry', []):
-        resource = entry.get('resource', {})
-        resource_type = resource.get('resourceType')
-        
-        if not resource_type:
-            logger.warning(f"Skipping entry with missing resourceType in {file_path}")
-            continue
-            
+        # Determine if patient_id is ObjectId or fhir_id
         try:
-            if resource_type == 'Patient':
-                name = resource.get('name', [{}])[0]
-                address = resource.get('address', [{}])[0]
-                
-                patient_data = {
-                    'fhir_id': resource.get('id'),
-                    'full_name': f"{' '.join(name.get('given', ['']))} {name.get('family', '')}".strip(),
-                    'gender': resource.get('gender', 'unknown'),
-                    'date_of_birth': resource.get('birthDate', ''),
-                    'address': ' '.join(address.get('line', [''])),
-                    'city': address.get('city', ''),
-                    'state': address.get('state', ''),
-                    'postal_code': address.get('postalCode', ''),
-                    'country': address.get('country', ''),
-                    'marital_status': resource.get('maritalStatus', {}).get('text', ''),
-                    'language': standardize_language(resource.get('communication', [{}])[0].get('language', {}).get('text', '')),
-                    'source': 'synthea',
-                    'last_updated': datetime.utcnow().isoformat()
-                }
-                
-            elif resource_type == 'Encounter':
-                encounter = {
-                    'id': resource.get('id'),
-                    'type': resource.get('type', [{}])[0].get('text', ''),
-                    'status': resource.get('status'),
-                    'period': resource.get('period', {}),
-                    'service_provider': resource.get('serviceProvider', {}).get('display', '')
-                }
-                encounters.append(encounter)
-                
-                for note in resource.get('note', []):
-                    if note.get('text'):
-                        notes.append({
-                            'date': resource.get('period', {}).get('start', datetime.utcnow().isoformat()),
-                            'type': resource.get('type', [{}])[0].get('text', 'Encounter Note'),
-                            'text': note.get('text'),
-                            'context': f"Encounter: {encounter.get('type')}",
-                            'author': 'System Generated'
-                        })
-                
-            elif resource_type == 'Condition':
-                conditions.append({
-                    'id': resource.get('id'),
-                    'code': resource.get('code', {}).get('text', ''),
-                    'status': resource.get('clinicalStatus', {}).get('text', ''),
-                    'onset_date': resource.get('onsetDateTime'),
-                    'recorded_date': resource.get('recordedDate'),
-                    'verification_status': resource.get('verificationStatus', {}).get('text', '')
-                })
-                
-            elif resource_type == 'MedicationRequest':
-                medications.append({
-                    'id': resource.get('id'),
-                    'name': resource.get('medicationCodeableConcept', {}).get('text', ''),
-                    'status': resource.get('status'),
-                    'prescribed_date': resource.get('authoredOn'),
-                    'requester': resource.get('requester', {}).get('display', ''),
-                    'dosage': resource.get('dosageInstruction', [{}])[0].get('text', '')
-                })
-                
-        except Exception as e:
-            logger.error(f"Error processing {resource_type} in {file_path}: {str(e)}")
-            continue
-    
-    if patient_data:
-        patient_data.update({
-            'notes': notes,
-            'conditions': conditions,
-            'medications': medications,
-            'encounters': encounters,
-            'import_date': datetime.utcnow().isoformat()
-        })
-        logger.info(f"Successfully processed patient {patient_data.get('fhir_id')} from {file_path}")
-        return patient_data
-    logger.warning(f"No valid patient data found in {file_path}")
-    return None
+            obj_id = ObjectId(patient_id)
+            query = {"$or": [{"_id": obj_id}, {"fhir_id": patient_id}]}
+        except InvalidId:
+            query = {"fhir_id": patient_id}
 
-@router.post("/import", status_code=status.HTTP_201_CREATED)
-async def import_patients(
-    limit: int = Query(100, ge=1, le=1000),
-    current_user: dict = Depends(get_current_user)
-):
-    request_id = str(uuid.uuid4())
-    logger.info(f"Starting import request {request_id} by user {current_user.get('email')}")
-    start_time = time.time()
-    
-    if current_user.get('role') not in ['admin', 'doctor']:
-        logger.warning(f"Unauthorized import attempt by {current_user.get('email')}")
-        raise HTTPException(
-            status_code=status.HTTP_403_FORBIDDEN,
-            detail="Only administrators and doctors can import data"
+        patient = await patients_collection.find_one(query)
+        if not patient:
+            raise HTTPException(status_code=404, detail="Patient not found")
+
+        # Prepare table content
+        notes = patient.get("notes", [])
+        notes_content = ""
+        if notes:
+            notes_content = "\\toprule\n" + " \\\\\n".join(
+                "{} & {} & {}".format(
+                    escape_latex_special_chars(hyphenate_long_strings(format_timestamp(n.get("date", "") or ""))),
+                    escape_latex_special_chars(hyphenate_long_strings(n.get("type", "") or "")),
+                    escape_latex_special_chars(hyphenate_long_strings(n.get("text", "") or ""))
+                )
+                for n in notes
+            ) + "\n\\bottomrule"
+        else:
+            notes_content = "\\multicolumn{3}{l}{No notes available}"
+
+        conditions = patient.get("conditions", [])
+        conditions_content = ""
+        if conditions:
+            conditions_content = "\\toprule\n" + " \\\\\n".join(
+                "{} & {} & {} & {} & {}".format(
+                    escape_latex_special_chars(hyphenate_long_strings(c.get("id", "") or "")),
+                    escape_latex_special_chars(hyphenate_long_strings(c.get("code", "") or "")),
+                    escape_latex_special_chars(hyphenate_long_strings(c.get("status", "") or "")),
+                    escape_latex_special_chars(hyphenate_long_strings(format_timestamp(c.get("onset_date", "") or ""))),
+                    escape_latex_special_chars(hyphenate_long_strings(c.get("verification_status", "") or ""))
+                )
+                for c in conditions
+            ) + "\n\\bottomrule"
+        else:
+            conditions_content = "\\multicolumn{5}{l}{No conditions available}"
+
+        medications = patient.get("medications", [])
+        medications_content = ""
+        if medications:
+            medications_content = "\\toprule\n" + " \\\\\n".join(
+                "{} & {} & {} & {} & {}".format(
+                    escape_latex_special_chars(hyphenate_long_strings(m.get("id", "") or "")),
+                    escape_latex_special_chars(hyphenate_long_strings(m.get("name", "") or "")),
+                    escape_latex_special_chars(hyphenate_long_strings(m.get("status", "") or "")),
+                    escape_latex_special_chars(hyphenate_long_strings(format_timestamp(m.get("prescribed_date", "") or ""))),
+                    escape_latex_special_chars(hyphenate_long_strings(m.get("dosage", "") or ""))
+                )
+                for m in medications
+            ) + "\n\\bottomrule"
+        else:
+            medications_content = "\\multicolumn{5}{l}{No medications available}"
+
+        encounters = patient.get("encounters", [])
+        encounters_content = ""
+        if encounters:
+            encounters_content = "\\toprule\n" + " \\\\\n".join(
+                "{} & {} & {} & {} & {}".format(
+                    escape_latex_special_chars(hyphenate_long_strings(e.get("id", "") or "")),
+                    escape_latex_special_chars(hyphenate_long_strings(e.get("type", "") or "")),
+                    escape_latex_special_chars(hyphenate_long_strings(e.get("status", "") or "")),
+                    escape_latex_special_chars(hyphenate_long_strings(format_timestamp(e.get("period", {}).get("start", "") or ""))),
+                    escape_latex_special_chars(hyphenate_long_strings(e.get("service_provider", "") or ""))
+                )
+                for e in encounters
+            ) + "\n\\bottomrule"
+        else:
+            encounters_content = "\\multicolumn{5}{l}{No encounters available}"
+
+        # Use Template for safe insertion
+        latex_template = Template(r"""
+\documentclass[a4paper,12pt]{article}
+\usepackage[utf8]{inputenc}
+\usepackage[T1]{fontenc}
+\usepackage{geometry}
+\geometry{margin=1in}
+\usepackage{booktabs,longtable,fancyhdr}
+\usepackage{array}
+\usepackage{microtype}
+\microtypesetup{expansion=false}  % Disable font expansion to avoid errors
+\setlength{\headheight}{14.5pt}  % Fix fancyhdr warning
+\pagestyle{fancy}
+\fancyhf{}
+\fancyhead[L]{Patient Report}
+\fancyhead[R]{Generated: \today}
+\fancyfoot[C]{\thepage}
+
+\begin{document}
+
+\begin{center}
+    \Large\textbf{Patient Medical Report} \\
+    \vspace{0.2cm}
+    \textit{Generated on $generated_on}
+\end{center}
+
+\section*{Demographics}
+\begin{itemize}
+    \item \textbf{FHIR ID:} $fhir_id
+    \item \textbf{Full Name:} $full_name
+    \item \textbf{Gender:} $gender
+    \item \textbf{Date of Birth:} $dob
+    \item \textbf{Age:} $age
+    \item \textbf{Address:} $address
+    \item \textbf{Marital Status:} $marital_status
+    \item \textbf{Language:} $language
+\end{itemize}
+
+\section*{Clinical Notes}
+\begin{longtable}{>{\raggedright\arraybackslash}p{3.5cm}>{\raggedright\arraybackslash}p{3cm}>{\raggedright\arraybackslash}p{6.5cm}}
+\textbf{Date} & \textbf{Type} & \textbf{Text} \\
+\endhead
+$notes
+\end{longtable}
+
+\section*{Conditions}
+\begin{longtable}{>{\raggedright\arraybackslash}p{2cm}>{\raggedright\arraybackslash}p{3cm}>{\raggedright\arraybackslash}p{2cm}>{\raggedright\arraybackslash}p{3.5cm}>{\raggedright\arraybackslash}p{3cm}}
+\textbf{ID} & \textbf{Code} & \textbf{Status} & \textbf{Onset} & \textbf{Verification} \\
+\endhead
+$conditions
+\end{longtable}
+
+\section*{Medications}
+\begin{longtable}{>{\raggedright\arraybackslash}p{2cm}>{\raggedright\arraybackslash}p{4cm}>{\raggedright\arraybackslash}p{2cm}>{\raggedright\arraybackslash}p{3.5cm}>{\raggedright\arraybackslash}p{3cm}}
+\textbf{ID} & \textbf{Name} & \textbf{Status} & \textbf{Date} & \textbf{Dosage} \\
+\endhead
+$medications
+\end{longtable}
+
+\section*{Encounters}
+\begin{longtable}{>{\raggedright\arraybackslash}p{2.5cm}>{\raggedright\arraybackslash}p{4.5cm}>{\raggedright\arraybackslash}p{2.5cm}>{\raggedright\arraybackslash}p{4.5cm}>{\raggedright\arraybackslash}p{3.5cm}}
+\textbf{ID} & \textbf{Type} & \textbf{Status} & \textbf{Start} & \textbf{Provider} \\
+\endhead
+$encounters
+\end{longtable}
+
+\end{document}
+""")
+
+        # Set the generated_on date to 06:07 PM CET, May 16, 2025 (based on system note)
+        generated_on = datetime.strptime("2025-05-16 18:07:00+02:00", "%Y-%m-%d %H:%M:%S%z").strftime("%A, %B %d, %Y at %I:%M %p %Z")
+
+        latex_filled = latex_template.substitute(
+            generated_on=generated_on,
+            fhir_id=escape_latex_special_chars(hyphenate_long_strings(patient.get("fhir_id", "") or "")),
+            full_name=escape_latex_special_chars(patient.get("full_name", "") or ""),
+            gender=escape_latex_special_chars(patient.get("gender", "") or ""),
+            dob=escape_latex_special_chars(patient.get("date_of_birth", "") or ""),
+            age=escape_latex_special_chars(str(calculate_age(patient.get("date_of_birth", "")) or "N/A")),
+            address=escape_latex_special_chars(", ".join(filter(None, [
+                patient.get("address", ""),
+                patient.get("city", ""),
+                patient.get("state", ""),
+                patient.get("postal_code", ""),
+                patient.get("country", "")
+            ]))),
+            marital_status=escape_latex_special_chars(patient.get("marital_status", "") or ""),
+            language=escape_latex_special_chars(patient.get("language", "") or ""),
+            notes=notes_content,
+            conditions=conditions_content,
+            medications=medications_content,
+            encounters=encounters_content
         )
-    
-    try:
-        await create_indexes()
-        
-        if not SYNTHEA_DATA_DIR.exists():
-            logger.error(f"Synthea data directory not found: {SYNTHEA_DATA_DIR}")
-            raise HTTPException(
-                status_code=status.HTTP_500_INTERNAL_SERVER_ERROR,
-                detail="Data directory not found"
-            )
-            
-        # Filter out non-patient files
-        files = [
-            f for f in glob.glob(str(SYNTHEA_DATA_DIR / "*.json"))
-            if not re.search(r'(hospitalInformation|practitionerInformation)\d+\.json$', f)
-        ]
-        if not files:
-            logger.warning("No valid patient JSON files found in synthea data directory")
-            return {
-                "status": "success",
-                "message": "No patient data files found",
-                "imported": 0,
-                "request_id": request_id
-            }
-            
-        operations = []
-        imported = 0
-        errors = []
-        
-        for file_path in files[:limit]:
-            try:
-                logger.debug(f"Processing file: {file_path}")
-                
-                # Check file accessibility
-                if not os.path.exists(file_path):
-                    logger.error(f"File not found: {file_path}")
-                    errors.append(f"File not found: {file_path}")
-                    continue
-                    
-                # Check file size
-                file_size = os.path.getsize(file_path)
-                if file_size == 0:
-                    logger.warning(f"Empty file: {file_path}")
-                    errors.append(f"Empty file: {file_path}")
-                    continue
-                    
-                with open(file_path, 'r', encoding='utf-8') as f:
-                    try:
-                        bundle = json.load(f)
-                    except json.JSONDecodeError as je:
-                        logger.error(f"Invalid JSON in {file_path}: {str(je)}")
-                        errors.append(f"Invalid JSON in {file_path}: {str(je)}")
-                        continue
-                        
-                patient = await process_synthea_patient(bundle, file_path)
-                if patient:
-                    if not patient.get('fhir_id'):
-                        logger.warning(f"Missing FHIR ID in patient data from {file_path}")
-                        errors.append(f"Missing FHIR ID in {file_path}")
-                        continue
-                        
-                    operations.append(UpdateOne(
-                        {"fhir_id": patient['fhir_id']},
-                        {"$setOnInsert": patient},
-                        upsert=True
-                    ))
-                    imported += 1
-                else:
-                    logger.warning(f"No valid patient data in {file_path}")
-                    errors.append(f"No valid patient data in {file_path}")
-                    
-            except Exception as e:
-                logger.error(f"Error processing {file_path}: {str(e)}")
-                errors.append(f"Error in {file_path}: {str(e)}")
-                continue
-        
-        response = {
-            "status": "success",
-            "imported": imported,
-            "errors": errors,
-            "request_id": request_id,
-            "duration_seconds": time.time() - start_time
-        }
-        
-        if operations:
+
+        # Compile LaTeX in a temporary directory
+        with TemporaryDirectory() as tmpdir:
+            tex_path = os.path.join(tmpdir, "report.tex")
+            pdf_path = os.path.join(tmpdir, "report.pdf")
+
+            with open(tex_path, "w", encoding="utf-8") as f:
+                f.write(latex_filled)
+
             try:
-                result = await patients_collection.bulk_write(operations, ordered=False)
-                response.update({
-                    "upserted": result.upserted_count,
-                    "existing": len(operations) - result.upserted_count
-                })
-                logger.info(f"Import request {request_id} completed: {imported} patients processed, "
-                           f"{result.upserted_count} upserted, {len(errors)} errors")
-            except BulkWriteError as bwe:
-                logger.error(f"Partial bulk write failure for request {request_id}: {str(bwe.details)}")
-                response.update({
-                    "upserted": bwe.details.get('nUpserted', 0),
-                    "existing": len(operations) - bwe.details.get('nUpserted', 0),
-                    "write_errors": [
-                        f"Index {err['index']}: {err['errmsg']}" for err in bwe.details.get('writeErrors', [])
-                    ]
-                })
-                logger.info(f"Import request {request_id} partially completed: {imported} patients processed, "
-                           f"{response['upserted']} upserted, {len(errors)} errors")
-            except Exception as e:
-                logger.error(f"Bulk write failed for request {request_id}: {str(e)}")
+                subprocess.run(
+                    ["latexmk", "-pdf", "-interaction=nonstopmode", tex_path],
+                    cwd=tmpdir,
+                    check=True,
+                    capture_output=True,
+                    text=True
+                )
+            except subprocess.CalledProcessError as e:
                 raise HTTPException(
-                    status_code=status.HTTP_500_INTERNAL_SERVER_ERROR,
-                    detail=f"Database operation failed: {str(e)}"
+                    status_code=500,
+                    detail=f"LaTeX compilation failed: stdout={e.stdout}, stderr={e.stderr}"
                 )
-        else:
-            logger.info(f"Import request {request_id} completed: No new patients to import, {len(errors)} errors")
-            response["message"] = "No new patients found to import"
-            
-        return response
-        
-    except HTTPException:
-        raise
-    except Exception as e:
-        logger.error(f"Import request {request_id} failed: {str(e)}", exc_info=True)
-        raise HTTPException(
-            status_code=status.HTTP_500_INTERNAL_SERVER_ERROR,
-            detail=f"Import failed: {str(e)}"
-        )
 
-@router.get("/patients", response_model=List[dict])
-async def list_patients(
-    search: Optional[str] = Query(None),
-    min_notes: int = Query(0, ge=0),
-    min_conditions: int = Query(0, ge=0),
-    limit: int = Query(100, ge=1, le=500),
-    skip: int = Query(0, ge=0)
-):
-    logger.info(f"Listing patients with search: {search}, limit: {limit}, skip: {skip}")
-    query = {"source": "synthea"}
-    
-    if search:
-        query["$or"] = [
-            {"full_name": {"$regex": search, "$options": "i"}},
-            {"fhir_id": search}
-        ]
-    
-    if min_notes > 0:
-        query[f"notes.{min_notes-1}"] = {"$exists": True}
-    
-    if min_conditions > 0:
-        query[f"conditions.{min_conditions-1}"] = {"$exists": True}
-    
-    # Removed $slice to return full arrays for the frontend
-    projection = {
-        "fhir_id": 1,
-        "full_name": 1,
-        "gender": 1,
-        "date_of_birth": 1,
-        "city": 1,
-        "state": 1,
-        "conditions": 1,
-        "medications": 1,
-        "encounters": 1,
-        "notes": 1
-    }
-    
-    try:
-        cursor = patients_collection.find(query, projection).skip(skip).limit(limit)
-        patients = []
-        
-        async for patient in cursor:
-            patients.append({
-                "id": str(patient["_id"]),
-                "fhir_id": patient.get("fhir_id"),
-                "full_name": patient.get("full_name"),
-                "gender": patient.get("gender"),
-                "date_of_birth": patient.get("date_of_birth"),
-                "city": patient.get("city"),
-                "state": patient.get("state"),
-                "conditions": patient.get("conditions", []),
-                "medications": patient.get("medications", []),
-                "encounters": patient.get("encounters", []),
-                "notes": patient.get("notes", []),
-                "age": calculate_age(patient.get("date_of_birth")),
-                "stats": {
-                    "notes": len(patient.get("notes", [])),
-                    "conditions": len(patient.get("conditions", [])),
-                    "medications": len(patient.get("medications", []))
-                }
-            })
-        
-        logger.info(f"Retrieved {len(patients)} patients")
-        return patients
-        
-    except Exception as e:
-        logger.error(f"Failed to list patients: {str(e)}")
-        raise HTTPException(
-            status_code=status.HTTP_500_INTERNAL_SERVER_ERROR,
-            detail=f"Failed to retrieve patients: {str(e)}"
-        )
+            if not os.path.exists(pdf_path):
+                raise HTTPException(
+                    status_code=500,
+                    detail="PDF file was not generated"
+                )
 
-@router.get("/patients/{patient_id}", response_model=dict)
-async def get_patient(patient_id: str):
-    logger.info(f"Retrieving patient: {patient_id}")
-    try:
-        patient = await patients_collection.find_one({
-            "$or": [
-                {"_id": ObjectId(patient_id)},
-                {"fhir_id": patient_id}
-            ]
-        })
-        
-        if not patient:
-            logger.warning(f"Patient not found: {patient_id}")
-            raise HTTPException(
-                status_code=status.HTTP_404_NOT_FOUND,
-                detail="Patient not found"
-            )
-        
-        response = {
-            "demographics": {
-                "id": str(patient["_id"]),
-                "fhir_id": patient.get("fhir_id"),
-                "full_name": patient.get("full_name"),
-                "gender": patient.get("gender"),
-                "date_of_birth": patient.get("date_of_birth"),
-                "age": calculate_age(patient.get("date_of_birth")),
-                "address": {
-                    "line": patient.get("address"),
-                    "city": patient.get("city"),
-                    "state": patient.get("state"),
-                    "postal_code": patient.get("postal_code"),
-                    "country": patient.get("country")
-                },
-                "marital_status": patient.get("marital_status"),
-                "language": patient.get("language")
-            },
-            "clinical_data": {
-                "notes": patient.get("notes", []),
-                "conditions": patient.get("conditions", []),
-                "medications": patient.get("medications", []),
-                "encounters": patient.get("encounters", [])
-            },
-            "metadata": {
-                "source": patient.get("source"),
-                "import_date": patient.get("import_date"),
-                "last_updated": patient.get("last_updated")
-            }
-        }
-        
-        logger.info(f"Successfully retrieved patient: {patient_id}")
-        return response
-        
-    except ValueError as ve:
-        logger.error(f"Invalid patient ID format: {patient_id}, error: {str(ve)}")
-        raise HTTPException(
-            status_code=status.HTTP_400_BAD_REQUEST,
-            detail="Invalid patient ID format"
-        )
-    except Exception as e:
-        logger.error(f"Failed to retrieve patient {patient_id}: {str(e)}")
-        raise HTTPException(
-            status_code=status.HTTP_500_INTERNAL_SERVER_ERROR,
-            detail=f"Failed to retrieve patient: {str(e)}"
-        )
+            with open(pdf_path, "rb") as f:
+                pdf_bytes = f.read()
 
-@router.post("/patients/{patient_id}/notes", status_code=status.HTTP_201_CREATED)
-async def add_note(
-    patient_id: str,
-    note: Note,
-    current_user: dict = Depends(get_current_user)
-):
-    logger.info(f"Adding note for patient {patient_id} by user {current_user.get('email')}")
-    if current_user.get('role') not in ['doctor', 'admin']:
-        logger.warning(f"Unauthorized note addition attempt by {current_user.get('email')}")
-        raise HTTPException(
-            status_code=status.HTTP_403_FORBIDDEN,
-            detail="Only clinicians can add notes"
-        )
-    
-    try:
-        note_data = note.dict()
-        note_data.update({
-            "author": current_user.get('full_name', 'System'),
-            "timestamp": datetime.utcnow().isoformat()
-        })
-        
-        result = await patients_collection.update_one(
-            {"$or": [
-                {"_id": ObjectId(patient_id)},
-                {"fhir_id": patient_id}
-            ]},
-            {
-                "$push": {"notes": note_data},
-                "$set": {"last_updated": datetime.utcnow().isoformat()}
-            }
-        )
-        
-        if result.modified_count == 0:
-            logger.warning(f"Patient not found for note addition: {patient_id}")
-            raise HTTPException(
-                status_code=status.HTTP_404_NOT_FOUND,
-                detail="Patient not found"
+            response = Response(
+                content=pdf_bytes,
+                media_type="application/pdf",
+                headers={"Content-Disposition": f"attachment; filename=patient_{patient.get('fhir_id', 'unknown')}_report.pdf"}
             )
-        
-        logger.info(f"Note added successfully for patient {patient_id}")
-        return {"status": "success", "message": "Note added"}
-        
-    except ValueError as ve:
-        logger.error(f"Invalid patient ID format: {patient_id}, error: {str(ve)}")
-        raise HTTPException(
-            status_code=status.HTTP_400_BAD_REQUEST,
-            detail="Invalid patient ID format"
-        )
+            return response
+
+    except HTTPException as http_error:
+        raise http_error
     except Exception as e:
-        logger.error(f"Failed to add note for patient {patient_id}: {str(e)}")
         raise HTTPException(
-            status_code=status.HTTP_500_INTERNAL_SERVER_ERROR,
-            detail=f"Failed to add note: {str(e)}"
+            status_code=500,
+            detail=f"Unexpected error generating PDF: {str(e)}"
         )
+    finally:
+        # Restore the logger level for other routes
+        logger.setLevel(logging.INFO)
 
-# Export the router as 'patients' for api.__init__.py
-patients = router
+# Export the router as 'pdf' for api.__init__.py
+pdf = router