FHIR-53259 - Extension BiologicallyDerivedProduct Manipulation should have 0..* cardinality

[ssi-db]

Extensions Pack Pull Request

NOTE: In the check-lists below, work groups are asked to attest that they've checked for overlapping functionality. This means that they've checked that the extension either does not overlap functionality of other existing core elements or extensions (including HL7 IG-published extensions) or clearly defines how to manage such overlap such that it's clear when implementers should use this extension in preference to other approaches.

(If there's more than one extension, repeat the following one for each that has different answers)

Extension Name: ________________ (not needed if only one extension or all answers are the same for all extensions)
[ ] - New extension (complete 'new extension' section below)
[X] - Updated extension (complete 'updated extension' section below)

Updated extension

Please attest to one of the following:
[ ] - This PR contains no breaking changes from the previous version of the extension
[ ] - This extension is marked as 'draft' and is not referenced in any known published specifications or used in any implementations.
[ ] - This PR does not meet ether of the above, but has received FMG approval as documented in their minutes here: _____

This is a breaking change due to extension cardinality. Extension is Trial Use but is not referenced in any known published specifications or used in any known implementations.

Summary:

• This change aligns the 0..1 Manipulation extension with the 0..* Processing extension which makes sense as they are related
• It is very much possible for there to be multiple processing and manipulation activities related to a BDP
• These elements were originally part of the core spec in R4 when BDP was less mature. In R5 these were pulled into an extension to clean up the resource but the R4 content itself was not really revisited. This all occurred before cross version extensions existed.
• The extension as it exists today has limited utility without being able to describe multiple levels of manipulation and there are no known users of the extension

https://jira.hl7.org/browse/FHIR-53259

[ssi-db]

This has been escalated to FMG co-chairs for review/approval. OO is comfortable with the change. See comments on the ticket for context.