diff --git a/org.hl7.fhir.convertors/src/main/java/org/hl7/fhir/convertors/misc/OMOPImporter.java b/org.hl7.fhir.convertors/src/main/java/org/hl7/fhir/convertors/misc/OMOPImporter.java
new file mode 100644
index 000000000..381b66b0d
--- /dev/null
+++ b/org.hl7.fhir.convertors/src/main/java/org/hl7/fhir/convertors/misc/OMOPImporter.java
@@ -0,0 +1,392 @@
+package org.hl7.fhir.convertors.misc;
+
+import java.sql.DriverManager;
+import java.sql.SQLException;
+import java.sql.Statement;
+import java.util.Map;
+import java.util.HashMap;
+
+import org.hl7.fhir.exceptions.FHIRException;
+import org.hl7.fhir.utilities.CSVReader;
+import org.hl7.fhir.utilities.Utilities;
+
+import java.io.FileInputStream;
+import java.io.FileNotFoundException;
+import java.io.IOException;
+import java.sql.Connection;
+
+public class OMOPImporter {
+
+
+  private Connection con;
+  private Map<String, String> relationships = new HashMap<>();
+
+  public static void main(String[] args) throws Exception {
+    new OMOPImporter().process("/Users/grahamegrieve/Downloads/vocabulary_download_v5_{97cc5432-0dc9-4f14-9da2-d0624129d2f7}_1688068174909");
+  }
+
+  private void process(String folder) throws ClassNotFoundException, SQLException, FHIRException, FileNotFoundException, IOException {
+    connect();
+
+    loadRelationships(folder, true);
+    processVocabularies(folder, false);
+    processDomains(folder, false);
+    processConceptClasses(folder, false);
+    processDrugStrength(folder, false);
+    processConcepts(folder, false);
+    processConceptRelationships(folder, false);
+    processConceptSynonyms(folder, false);
+    processConceptAncestors(folder, false);
+  }
+
+  private void loadRelationships(String folder, boolean process) throws FHIRException, FileNotFoundException, IOException, SQLException {
+
+    CSVReader csv = new CSVReader(new FileInputStream(Utilities.path(folder, "RELATIONSHIP.csv")));
+    csv.setDelimiter('\t');
+    csv.readHeaders();
+    csv.setDoingQuotes(false);
+    int i = 0;
+    Statement stmt = con.createStatement();
+    stmt.executeUpdate("delete from Relationships");
+    while (csv.line()) {
+      relationships.put(csv.cell("relationship_id"), csv.cell("relationship_concept_id"));
+      if (process) {
+        String sql = "INSERT INTO `omop`.`Relationships` (`relationship_concept_id`, `relationship_id`, `relationship_name`, `is_hierarchical`, `defines_ancestry`, `reverse_relationship_id`) VALUES ("+
+            sw(csv.cell("relationship_concept_id"))+", "+
+            sw(csv.cell("relationship_id"))+", "+
+            sw(csv.cell("relationship_name"))+", "+
+            sw(csv.cell("is_hierarchical"))+", "+
+            sw(csv.cell("defines_ancestry"))+", "+
+            sw(csv.cell("reverse_relationship_id"))+")";
+        try {
+          stmt.executeUpdate(sql);
+        } catch (Exception e) {
+          System.out.println("error: "+e.getMessage());
+          System.out.println("i: "+i);        
+          //        System.out.println("sql: "+sql);        
+        }
+      }
+      i++;
+      if (i % 1000 == 0) {
+        System.out.println(i);
+      }
+    }
+    csv.close();    
+    
+  }
+
+  private void processVocabularies(String folder, boolean process) throws FHIRException, FileNotFoundException, IOException, SQLException {
+    if (!process) {
+      return;
+    }
+
+    CSVReader csv = new CSVReader(new FileInputStream(Utilities.path(folder, "VOCABULARY.csv")));
+    csv.setDelimiter('\t');
+    csv.readHeaders();
+    csv.setDoingQuotes(false);
+    int i = 0;
+    Statement stmt = con.createStatement();
+    stmt.executeUpdate("delete from Vocabularies");
+    while (csv.line()) {
+      String sql = "INSERT INTO `omop`.`Vocabularies` (`vocabulary_concept_id`, `vocabulary_id`, `vocabulary_name`, `vocabulary_reference`, `vocabulary_version`) VALUES ("+
+          sw(csv.cell("vocabulary_concept_id"))+", "+
+          sw(csv.cell("vocabulary_id"))+", "+
+          sw(csv.cell("vocabulary_name"))+", "+
+          sw(csv.cell("vocabulary_reference"))+", "+
+          sw(csv.cell("vocabulary_version"))+")";
+      try {
+        stmt.executeUpdate(sql);
+      } catch (Exception e) {
+        System.out.println("error: "+e.getMessage());
+        System.out.println("i: "+i);        
+        //        System.out.println("sql: "+sql);      
+      }
+      i++;
+      if (i % 1000 == 0) {
+        System.out.println(i);
+      }
+    }
+    csv.close();    
+  }
+
+
+  private void processDrugStrength(String folder, boolean process) throws FHIRException, FileNotFoundException, IOException, SQLException {
+    if (!process) {
+      return;
+    }
+
+    CSVReader csv = new CSVReader(new FileInputStream(Utilities.path(folder, "DRUG_STRENGTH.csv")));
+    csv.setDelimiter('\t');
+    csv.readHeaders();
+    csv.setDoingQuotes(false);
+    int i = 0;
+    Statement stmt = con.createStatement();
+    stmt.executeUpdate("delete from DrugStrengths");
+    while (csv.line()) {
+      String sql = "INSERT INTO `omop`.`DrugStrengths` (`drug_concept_id`, `ingredient_concept_id`, `amount_value`, `amount_unit_concept_id`, `numerator_value`, `numerator_unit_concept_id`, `denominator_value`, "
+          + "`denominator_unit_concept_id`, `box_size`, `valid_start_date`, `valid_end_date`, `invalid_reason`) VALUES ("+
+          sw(csv.cell("drug_concept_id"))+", "+
+          sw(csv.cell("ingredient_concept_id"))+", "+
+          sw(csv.cell("amount_value"))+", "+
+          sw(csv.cell("amount_unit_concept_id"))+", "+
+          sw(csv.cell("numerator_value"))+", "+
+          sw(csv.cell("numerator_unit_concept_id"))+", "+
+          sw(csv.cell("denominator_value"))+", "+
+          sw(csv.cell("denominator_unit_concept_id"))+", "+
+          sw(csv.cell("box_size"))+", "+
+          sw(csv.cell("valid_start_date"))+", "+
+          sw(csv.cell("valid_end_date"))+", "+
+          sw(csv.cell("invalid_reason"))+")";
+      try {
+        stmt.executeUpdate(sql);
+      } catch (Exception e) {
+        System.out.println("error: "+e.getMessage());
+        System.out.println("i: "+i);        
+        System.out.println("sql: "+sql);      
+      }
+      i++;
+      if (i % 100 == 0) {
+        System.out.println(i);
+      }
+    }
+    csv.close();    
+  }
+  
+
+  private void processDomains(String folder, boolean process) throws FHIRException, FileNotFoundException, IOException, SQLException {
+    if (!process) {
+      return;
+    }
+
+    CSVReader csv = new CSVReader(new FileInputStream(Utilities.path(folder, "DOMAIN.csv")));
+    csv.setDelimiter('\t');
+    csv.readHeaders();
+    csv.setDoingQuotes(false);
+    int i = 0;
+    Statement stmt = con.createStatement();
+    stmt.executeUpdate("delete from Domains");
+    while (csv.line()) {
+      String sql = "INSERT INTO `omop`.`Domains` (`domain_concept_id`, `domain_id`, `domain_name`) VALUES ("+
+          sw(csv.cell("domain_concept_id"))+", "+
+          sw(csv.cell("domain_id"))+", "+
+          sw(csv.cell("domain_name"))+")";
+      try {
+        stmt.executeUpdate(sql);
+      } catch (Exception e) {
+        System.out.println("error: "+e.getMessage());
+        System.out.println("i: "+i);        
+        //        System.out.println("sql: "+sql);      
+      }
+      i++;
+      if (i % 1000 == 0) {
+        System.out.println(i);
+      }
+    }
+    csv.close();    
+  }
+  
+
+  private void processConceptClasses(String folder, boolean process) throws FHIRException, FileNotFoundException, IOException, SQLException {
+    if (!process) {
+      return;
+    }
+
+    CSVReader csv = new CSVReader(new FileInputStream(Utilities.path(folder, "CONCEPT_CLASS.csv")));
+    csv.setDelimiter('\t');
+    csv.readHeaders();
+    csv.setDoingQuotes(false);
+    int i = 0;
+    Statement stmt = con.createStatement();
+    stmt.executeUpdate("delete from ConceptClasses");
+    while (csv.line()) {
+      String sql = "INSERT INTO `omop`.`ConceptClasses` (`concept_class_concept_id`, `concept_class_id`, `concept_class_name`) VALUES ("+
+          sw(csv.cell("concept_class_concept_id"))+", "+
+          sw(csv.cell("concept_class_id"))+", "+
+          sw(csv.cell("concept_class_name"))+")";
+      try {
+        stmt.executeUpdate(sql);
+      } catch (Exception e) {
+        System.out.println("error: "+e.getMessage());
+        System.out.println("i: "+i);        
+        //        System.out.println("sql: "+sql);      
+      }
+      i++;
+      if (i % 1000 == 0) {
+        System.out.println(i);
+      }
+    }
+    csv.close();    
+  }
+  
+  
+
+  private void processConcepts(String folder, boolean process) throws FHIRException, FileNotFoundException, IOException, SQLException {
+    if (!process) {
+      return;
+    }
+    CSVReader csv = new CSVReader(new FileInputStream(Utilities.path(folder, "CONCEPT.csv")));
+    csv.setDelimiter('\t');
+    csv.readHeaders();
+    csv.setDoingQuotes(false);
+    int i = 0;
+    Statement stmt = con.createStatement();
+    while (csv.line()) {
+      String sql = "INSERT INTO `omop`.`Concepts` (`concept_id`, `concept_name`, `domain_id`, `vocabulary_id`, `concept_class_id`, `standard_concept`, `concept_code`, `valid_start_date`, `valid_end_date`, `invalid_reason`) VALUES ("+
+          sw(csv.cell("concept_id"))+", "+
+          sw(csv.cell("concept_name"))+", "+
+          sw(csv.cell("domain_id"))+", "+
+          sw(csv.cell("vocabulary_id"))+", "+
+          sw(csv.cell("concept_class_id"))+", "+
+          sw(csv.cell("standard_concept"))+", "+
+          sw(csv.cell("concept_code"))+", "+
+          sw(csv.cell("valid_start_date"))+", "+
+          sw(csv.cell("valid_end_date"))+", "+
+          sw(csv.cell("invalid_reason"))+")";
+      try {
+        stmt.executeUpdate(sql);
+      } catch (Exception e) {
+        System.out.println("error: "+e.getMessage());
+        System.out.println("i: "+i);        
+//        System.out.println("sql: "+sql);        
+      }
+      i++;
+      if (i % 1000 == 0) {
+        System.out.println(i);
+      }
+    }
+    csv.close();    
+    
+  }
+
+  private void processConceptSynonyms(String folder, boolean process) throws FHIRException, FileNotFoundException, IOException, SQLException {
+    if (!process) {
+      return;
+    }
+    CSVReader csv = new CSVReader(new FileInputStream(Utilities.path(folder, "CONCEPT_SYNONYM.csv")));
+    csv.setDelimiter('\t');
+    csv.readHeaders();
+    csv.setDoingQuotes(false);
+    int i = 0;
+    int ec = 0;
+    Statement stmt = con.createStatement();
+
+    stmt.executeUpdate("delete from ConceptSynonyms");
+    while (csv.line()) {
+      String sql = "INSERT INTO `omop`.`ConceptSynonyms` (`concept_id`, `concept_synonym_name`, `language_concept_id`) VALUES ("+
+          sw(csv.cell("concept_id"))+", "+
+          sw(csv.cell("concept_synonym_name"))+", "+
+          sw(csv.cell("language_concept_id"))+")";
+      try {
+        stmt.executeUpdate(sql);
+      } catch (Exception e) {
+        System.out.println("error: "+e.getMessage());
+        System.out.println("i: "+i);        
+        System.out.println("sql: "+sql);    
+        ec++;
+      }
+      i++;
+      if (i % 1000 == 0) {
+        System.out.println(i);
+      }
+    }
+    csv.close();    
+    System.out.println("Finished. "+i+" rows, "+ec+" errors");
+  }
+  
+
+  private void processConceptAncestors(String folder, boolean process) throws FHIRException, FileNotFoundException, IOException, SQLException {
+    if (!process) {
+      return;
+    }
+    CSVReader csv = new CSVReader(new FileInputStream(Utilities.path(folder, "CONCEPT_ANCESTOR"
+        + ".csv")));
+    csv.setDelimiter('\t');
+    csv.readHeaders();
+    csv.setDoingQuotes(false);
+    int i = 0;
+    int ec = 0;
+    Statement stmt = con.createStatement();
+
+    stmt.executeUpdate("delete from ConceptAncestors");
+    while (csv.line()) {
+      String sql = "INSERT INTO `omop`.`ConceptAncestors` (`ancestor_concept_id`, `descendant_concept_id`, `min_levels_of_separation`, `max_levels_of_separation`) VALUES ("+
+          sw(csv.cell("ancestor_concept_id"))+", "+
+          sw(csv.cell("descendant_concept_id"))+", "+
+          sw(csv.cell("min_levels_of_separation"))+", "+
+          sw(csv.cell("max_levels_of_separation"))+")";
+      try {
+        stmt.executeUpdate(sql);
+      } catch (Exception e) {
+        System.out.println("error: "+e.getMessage());
+        System.out.println("i: "+i);        
+        System.out.println("sql: "+sql);    
+        ec++;
+      }
+      i++;
+      if (i % 1000 == 0) {
+        System.out.println(i);
+      }
+    }
+    csv.close();    
+    System.out.println("Finished. "+i+" rows, "+ec+" errors");
+  }
+  
+  
+  private void processConceptRelationships(String folder, boolean process) throws FHIRException, FileNotFoundException, IOException, SQLException {
+    if (!process) {
+      return;
+    }
+    CSVReader csv = new CSVReader(new FileInputStream(Utilities.path(folder, "CONCEPT_RELATIONSHIP.csv")));
+    csv.setDelimiter('\t');
+    csv.readHeaders();
+    csv.setDoingQuotes(false);
+    int i = 0;
+    Statement stmt = con.createStatement();
+    while (csv.line()) {
+      String sql = "INSERT INTO `omop`.`ConceptRelationships` (`concept_id_1`, `concept_id_2`, `relationship_id`, `valid_start_date`, `valid_end_date`, `invalid_reason`) VALUES ("+
+          sw(csv.cell("concept_id_1"))+", "+
+          sw(csv.cell("concept_id_2"))+", "+
+          sw(relationships.get(csv.cell("relationship_id")))+", "+
+          sw(csv.cell("valid_start_date"))+", "+
+          sw(csv.cell("valid_end_date"))+", "+
+          sw(csv.cell("invalid_reason"))+")";
+      try {
+        stmt.executeUpdate(sql);
+      } catch (Exception e) {
+        System.out.println("error: "+e.getMessage());
+        System.out.println("i: "+i);        
+//        System.out.println("sql: "+sql);        
+      }
+      i++;
+      if (i % 100 == 0) {
+        System.out.println(i);
+      }
+    }
+    csv.close();    
+    
+  }
+  
+
+  private String sw(String value) {
+    if (value == null) {
+      return  "null";
+    }
+    StringBuilder b = new StringBuilder();
+    b.append('"');
+    for (char ch : value.toCharArray()) {
+      if (ch == '"') {
+        b.append('"');        
+      }
+      b.append(ch);
+    }
+    b.append('"');
+    return b.toString();
+  }
+
+  private void connect() throws SQLException, ClassNotFoundException {
+//    Class.forName("com.mysql.jdbc.Driver");  
+    con = DriverManager.getConnection("jdbc:mysql://localhost:3306/omop?useSSL=false","root","@AZEq|OzHLl1/[50v[CI"); 
+    
+  }
+  
+}
diff --git a/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/CSVReader.java b/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/CSVReader.java
index 60009a350..2b781a1e7 100644
--- a/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/CSVReader.java
+++ b/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/CSVReader.java
@@ -62,6 +62,7 @@ public class CSVReader extends InputStreamReader {
   private String[] cells;
   private char delimiter = ',';
   private boolean multiline;
+  private boolean doingQuotes = true;
   
 	public void readHeaders() throws IOException, FHIRException {
     cols = parseLine();  
@@ -86,11 +87,13 @@ public class CSVReader extends InputStreamReader {
   public String cell(String name) {
     int index = -1;
     for (int i = 0; i < cols.length; i++) {
-      if (name.equals(cols[i].trim()))
+      if (name.equals(cols[i].trim())) {
         index = i;
+        break;
+      }
     }
     if (index == -1)
-      throw new FHIRException("no cell "+name);
+      throw new FHIRException("no cell "+name+" in "+cols);
     String s = cells.length > index ? cells[index] : null;
     if (Utilities.noString(s))
       return null;
@@ -143,7 +146,7 @@ public class CSVReader extends InputStreamReader {
 		while (more() && !finished(inQuote, res.size())) {
 			char c = peek();
 			next();
-			if (c == '"') {
+			if (c == '"' && doingQuotes) {
 				if (ready() && peek() == '"') {
 	        b.append(c);
           next();
@@ -238,5 +241,13 @@ public class CSVReader extends InputStreamReader {
     this.multiline = multiline;
   }
 
+  public boolean isDoingQuotes() {
+    return doingQuotes;
+  }
+
+  public void setDoingQuotes(boolean doingQuotes) {
+    this.doingQuotes = doingQuotes;
+  }
+
 
 }
\ No newline at end of file
diff --git a/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/i18n/I18nConstants.java b/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/i18n/I18nConstants.java
index b9e03ddf8..0365ab0e3 100644
--- a/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/i18n/I18nConstants.java
+++ b/org.hl7.fhir.utilities/src/main/java/org/hl7/fhir/utilities/i18n/I18nConstants.java
@@ -917,6 +917,10 @@ public class I18nConstants {
   public static final String ED_INVARIANT_EXPRESSION_CONFLICT = "ED_INVARIANT_EXPRESSION_CONFLICT";
   public static final String ED_INVARIANT_EXPRESSION_ERROR = "ED_INVARIANT_EXPRESSION_ERROR";
   public static final String SNAPSHOT_IS_EMPTY = "SNAPSHOT_IS_EMPTY";
+  public static final String EXTENSION_CONTEXT_UNABLE_TO_CHECK_PROFILE = "EXTENSION_CONTEXT_UNABLE_TO_CHECK_PROFILE";
+  public static final String EXTENSION_CONTEXT_UNABLE_TO_FIND_PROFILE = "EXTENSION_CONTEXT_UNABLE_TO_FIND_PROFILE";
+  public static final String TERMINOLOGY_TX_HINT = "TERMINOLOGY_TX_HINT";
+  public static final String TERMINOLOGY_TX_WARNING = "TERMINOLOGY_TX_WARNING";
 
 }