Medplum::Eprescribe::UpstreamError

What happened

• sync_patient! sends organizationId only if the prescriber has 2 or more practices in Medplum and one matches the patient's state (organization_params).
• If the patient's state is blank or unmatched, the code logs a warning and sends no organizationId. The same happens if the cached practice list has under 2 entries.
• ScriptSure sees 3 organizations for this prescriber and rejects the call as ambiguous. The controller rescues the UpstreamError, calls Bugsnag.notify on purpose, and returns 422.
• Only 3 events for 2 users over 5 days points to a few specific prescriber/patient combinations, not a systemic bug or a deploy problem.

What to do next

1. Check Search the logs for '[Eprescribe] No ScriptSure practice for the patient's state' at the event times (2026-11-05 17:39 and 2026-11-10 13:06). This shows whether the patient's state was blank or unmatched, or whether the prescriber has fewer than 2 practices in Medplum.
2. Check Compare the prescriber's state credentials in Medplum with their ScriptSure organizations (3). Add the missing state practices, or fix the affected patients' resident state and address.
3. Check Decide what to do when no practice matches the patient's state: keep the current behaviour (send no organizationId and rely on ScriptSure's default), or block with a clear 'choose a practice' message. This needs a product decision before any code change.

Queries are shown, never run. Check them before using them on production.