diff --git a/packages/core/src/external/carequality/ihe-gateway-v2/ihe-gateway-v2-async.ts b/packages/core/src/external/carequality/ihe-gateway-v2/ihe-gateway-v2-async.ts
index 95250a969b..9509cdafa4 100644
--- a/packages/core/src/external/carequality/ihe-gateway-v2/ihe-gateway-v2-async.ts
+++ b/packages/core/src/external/carequality/ihe-gateway-v2/ihe-gateway-v2-async.ts
@@ -4,11 +4,17 @@ import {
   OutboundDocumentQueryReq,
   OutboundDocumentRetrievalReq,
 } from "@metriport/ihe-gateway-sdk";
+import { sleep } from "@metriport/shared";
 import { makeLambdaClient } from "../../aws/lambda";
 import { Config } from "../../../util/config";
 import { processAsyncError } from "../../../util/error/shared";
 import { IHEGatewayV2 } from "./ihe-gateway-v2";
+import dayjs from "dayjs";
+import duration from "dayjs/plugin/duration";
 
+dayjs.extend(duration);
+
+const SLEEP_IN_BETWEEN_DOCUMENT_RETRIEVAL_REQUESTS = dayjs.duration({ seconds: 1 });
 const MAX_GATEWAYS_BEFORE_CHUNK = 1000;
 const MAX_DOCUMENT_QUERY_REQUESTS_PER_INVOCATION = 20;
 const MAX_DOCUMENT_RETRIEVAL_REQUESTS_PER_INVOCATION = 20;
@@ -108,9 +114,13 @@ export class IHEGatewayV2Async extends IHEGatewayV2 {
       MAX_DOCUMENT_RETRIEVAL_REQUESTS_PER_INVOCATION
     );
 
-    for (const chunk of requestChunks) {
+    for (const [i, chunk] of requestChunks.entries()) {
       const params = { patientId, cxId, requestId, drRequestsGatewayV2: chunk };
 
+      if (i > 0) {
+        await sleep(SLEEP_IN_BETWEEN_DOCUMENT_RETRIEVAL_REQUESTS.asMilliseconds());
+      }
+
       // intentionally not waiting
       lambdaClient
         .invoke({
diff --git a/packages/core/src/external/carequality/ihe-gateway-v2/outbound/xcpd/process/error.ts b/packages/core/src/external/carequality/ihe-gateway-v2/outbound/xcpd/process/error.ts
index ce9697e6f7..b9a80f8953 100644
--- a/packages/core/src/external/carequality/ihe-gateway-v2/outbound/xcpd/process/error.ts
+++ b/packages/core/src/external/carequality/ihe-gateway-v2/outbound/xcpd/process/error.ts
@@ -37,6 +37,7 @@ export function handleHttpErrorResponse({
     gateway,
     patientId: outboundRequest?.patientId,
     patientMatch: null,
+    iheGatewayV2: true,
     operationOutcome,
   };
 }
@@ -74,6 +75,7 @@ export function handlePatientErrorResponse({
     gateway,
     patientId: outboundRequest.patientId,
     patientMatch: null,
+    iheGatewayV2: true,
     operationOutcome,
   };
   return response;
@@ -108,6 +110,7 @@ export function handleSchemaErrorResponse({
     gateway,
     patientId: outboundRequest.patientId,
     patientMatch: null,
+    iheGatewayV2: true,
     operationOutcome,
   };
   return response;
diff --git a/packages/core/src/external/carequality/ihe-gateway-v2/saml/saml-client.ts b/packages/core/src/external/carequality/ihe-gateway-v2/saml/saml-client.ts
index 28dcde7980..051facf79a 100644
--- a/packages/core/src/external/carequality/ihe-gateway-v2/saml/saml-client.ts
+++ b/packages/core/src/external/carequality/ihe-gateway-v2/saml/saml-client.ts
@@ -2,13 +2,14 @@ import https from "https";
 import { constants } from "crypto";
 import axios from "axios";
 import * as AWS from "aws-sdk";
+import dayjs from "dayjs";
+import duration from "dayjs/plugin/duration";
 import { SamlCertsAndKeys } from "./security/types";
 import { Config } from "../../../../util/config";
 import { out } from "../../../../util/log";
 import { MetriportError } from "../../../../util/error/metriport-error";
 import { createMtomContentTypeAndPayload } from "../outbound/xca/mtom/builder";
 import { executeWithNetworkRetries } from "@metriport/shared";
-
 import {
   parseMtomResponse,
   getBoundaryFromMtomResponse,
@@ -16,8 +17,12 @@ import {
   convertSoapResponseToMtomResponse,
 } from "../outbound/xca/mtom/parser";
 
+dayjs.extend(duration);
+
 const { log } = out("Saml Client");
-const timeout = 120000;
+const httpTimeout = dayjs.duration({ seconds: 120 });
+const initialDelay = dayjs.duration({ seconds: 3 });
+const maxPayloadSize = Infinity;
 let rejectUnauthorized = true;
 let trustedStore: string | undefined = undefined;
 async function getTrustedKeyStore(): Promise<string> {
@@ -84,7 +89,7 @@ export async function sendSignedXml({
   const response = await executeWithNetworkRetries(
     async () => {
       return axios.post(url, signedXml, {
-        timeout: 120000,
+        timeout: httpTimeout.asMilliseconds(),
         headers: {
           "Content-Type": "application/soap+xml;charset=UTF-8",
           Accept: "application/soap+xml",
@@ -94,7 +99,7 @@ export async function sendSignedXml({
       });
     },
     {
-      initialDelay: 3000,
+      initialDelay: initialDelay.asMilliseconds(),
       maxAttempts: 3,
       //TODO: This introduces retry on timeout without needing to specify the http Code: https://github.com/metriport/metriport/pull/2285. Remove once PR is merged
       httpCodesToRetry: ["ECONNREFUSED", "ECONNRESET", "ETIMEDOUT"],
@@ -129,7 +134,7 @@ export async function sendSignedXmlMtom({
   const response = await executeWithNetworkRetries(
     async () => {
       return axios.post(url, payload, {
-        timeout: timeout,
+        timeout: httpTimeout.asMilliseconds(),
         headers: {
           "Accept-Encoding": "gzip, deflate",
           "Content-Type": contentType,
@@ -137,13 +142,21 @@ export async function sendSignedXmlMtom({
         },
         httpsAgent: agent,
         responseType: "arraybuffer",
+        maxBodyLength: maxPayloadSize,
+        maxContentLength: maxPayloadSize,
       });
     },
     {
-      initialDelay: 3000,
-      maxAttempts: 3,
+      initialDelay: initialDelay.asMilliseconds(),
+      maxAttempts: 4,
       //TODO: This introduces retry on timeout without needing to specify the http Code: https://github.com/metriport/metriport/pull/2285. Remove once PR is merged
-      httpCodesToRetry: ["ECONNREFUSED", "ECONNRESET", "ETIMEDOUT"],
+      httpCodesToRetry: [
+        "ECONNREFUSED",
+        "ECONNRESET",
+        "ETIMEDOUT",
+        "ECONNABORTED",
+        "ERR_BAD_RESPONSE",
+      ],
     }
   );
 
diff --git a/packages/shared/src/net/error.ts b/packages/shared/src/net/error.ts
index 0b9793b215..194bcc342d 100644
--- a/packages/shared/src/net/error.ts
+++ b/packages/shared/src/net/error.ts
@@ -3,6 +3,9 @@ import { AxiosError } from "axios";
 // https://nodejs.org/docs/latest-v18.x/api/errors.html#common-system-errors
 export type NodeNetworkError = "ECONNREFUSED" | "ECONNRESET";
 
-export type AxiosNetworkError = typeof AxiosError.ETIMEDOUT | typeof AxiosError.ECONNABORTED;
+export type AxiosNetworkError =
+  | typeof AxiosError.ETIMEDOUT
+  | typeof AxiosError.ECONNABORTED
+  | typeof AxiosError.ERR_BAD_RESPONSE;
 
 export type NetworkError = NodeNetworkError | AxiosNetworkError;