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Die Assertion "count(hl7:entryRelationship[hl7:sequenceNumber='1'])<=1" ist offenbar nicht wirksam.
Bedingung korrigieren.
Möglicherweise ist der Pfad falsch oder es wirkt aus anderen Gründen nicht über die entryRelationships. Jedenfalls können mehrere Abschlussdiagnosen mit sequenceNumber='1' eingesetzt werden, ohne dass die Assertion greift.