diff --git a/package.json b/package.json
index e08d6e6..e6a6ecf 100644
--- a/package.json
+++ b/package.json
@@ -37,7 +37,7 @@
     "cors": "^2.8.5",
     "errorhandler": "^1.5.1",
     "express": "^4.17.1",
-    "fhir-works-on-aws-interface": "^9.0.0",
+    "fhir-works-on-aws-interface": "^9.1.0",
     "flat": "^5.0.0",
     "http-errors": "^1.8.0",
     "lodash": "^4.17.15",
diff --git a/src/router/routes/errorHandling.ts b/src/router/routes/errorHandling.ts
index e805fff..d351bd7 100644
--- a/src/router/routes/errorHandling.ts
+++ b/src/router/routes/errorHandling.ts
@@ -9,6 +9,7 @@ import {
     IssueSeverity,
     IssueCode,
     isInvalidSearchParameterError,
+    isResourceConflictError,
 } from 'fhir-works-on-aws-interface';
 import OperationsGenerator from '../operationsGenerator';
 
@@ -43,6 +44,10 @@ export const applicationErrorMapper = (
         next(new createError.BadRequest(err.message));
         return;
     }
+    if (isResourceConflictError(err)) {
+        next(new createError.Conflict(err.message));
+        return;
+    }
     next(err);
 };
 
@@ -50,6 +55,7 @@ const statusToOutcome: Record<number, { severity: IssueSeverity; code: IssueCode
     400: { severity: 'error', code: 'invalid' },
     403: { severity: 'error', code: 'security' },
     404: { severity: 'error', code: 'not-found' },
+    409: { severity: 'error', code: 'conflict' },
     500: { severity: 'error', code: 'exception' },
 };