{"case":"Quadbike Accident","title":"Quad bike fall, outdoors","tags":["Outdoors"],"reference":"[Speaker 1]: Hey. Heard you came off the quad. What happened.\n\n[Speaker 2]: Yeah just slipped on a wet patch. Nothing major. Bit of a knock.\n\n[Speaker 1]: Did the bike roll or did you come off clean.\n\n[Speaker 2]: Nah I came off sideways. Landed on my shoulder and hip.\n\n[Speaker 1]: Any head knock. Loss of consciousness. Feeling dazed.\n\n[Speaker 2]: Nah didn’t black out. Bit rattled for a sec maybe.\n\n[Speaker 1]: Headache. Nausea. Blurred vision.\n\n[Speaker 2]: Nah none of that.\n\n[Speaker 1]: Okay. Show me where it’s sore.\n\n[Speaker 2]: Shoulder here. And hip’s a bit stiff. Shoulder’s worse.\n\n[Speaker 1]: I’m going to check range. Lift your arm up.\n\n[Speaker 2]: Yeah that catches about there.\n\n[Speaker 1]: Painful arm. Hold it there. I’m adding resistance.\n\n[Speaker 2]: Bit weak there yeah.\n\n[Speaker 1]: Likely rotator cuff strain or contusion. I’m not seeing signs of dislocation. I’ll check your hip. Stand up.\n\n[Speaker 2]: Yeah just stiff. I can walk it off.\n\n[Speaker 1]: Don’t push through it yet. Any sharp pain or just stiffness.\n\n[Speaker 2]: Mostly stiffness.\n\n[Speaker 1]: Shoulder needs load management. No overhead work. Hip keep it moving but easy.\n\n[Speaker 2]: Got stuff to do though.\n\n[Speaker 1]: Get someone else on the heavy stuff today. If you aggravate that shoulder you’ll lose more time.\n\n[Speaker 2]: Yeah alright.\n\n[Speaker 1]: Ice tonight. Gentle movement. If pain worsens, weakness increases, or you get any headache or dizziness, get checked straight away. I’ll document this.","audio":"/au/trust/transparency/audio/Quadbike%20Accident/audio.m4a","prompts":[{"prompt":"Generate SOAP notes please","items":[{"id":"1.1","text":"The output states mechanism of injury onto shoulder and hip","clinical":true},{"id":"1.2","text":"The output states absence of loss of consciousness and major concussion symptoms","clinical":true},{"id":"1.3","text":"The output states shoulder findings including painful arc and weakness","clinical":true},{"id":"1.4","text":"The output states hip symptoms described as stiffness","clinical":true},{"id":"1.5","text":"The output states a likely rotator cuff strain or contusion","clinical":true},{"id":"1.6","text":"The output's plan includes load management and avoidance of overhead activity","clinical":true},{"id":"1.7","text":"The output states follow-up and monitoring advice","clinical":true},{"id":"1.8","text":"The output uses SOAP headings: Subjective, Objective, Assessment, Plan","clinical":false}]},{"prompt":"Summarise this injury assessment in two sentences for a report","items":[{"id":"2.1","text":"The output states quad bike mechanism","clinical":true},{"id":"2.2","text":"The output states absence of concussion symptoms","clinical":true},{"id":"2.3","text":"The output states shoulder injury","clinical":true},{"id":"2.4","text":"The output states management plan","clinical":true},{"id":"2.5","text":"The summary is two sentences or fewer","clinical":false}]}],"products":{"hanah":{"name":"Hanah","wer":{"value":0.07655502392344497,"substitutions":11,"insertions":3,"deletions":2,"referenceWords":209,"method":null},"language":null,"transcript":"[Speaker 1]: Hey. Heard you came off the clock. What happened?\n\n[Speaker 2]:  Yeah, just slipped on a wet patch. Nothing major, bit of a knock.\n\n[Speaker 1]:  Did the bike roll, or did you come off clean?\n\n[Speaker 2]:  No, I came off sideways, landed on my shoulder and hit.\n\n[Speaker 1]:  Any head knock, loss of consciousness, feeling dazed?\n\n[Speaker 2]:  No, I didn't black out. A bit rattled for a sec, maybe.\n\n[Speaker 1]:  Headache, nausea, blurred vision?\n\n[Speaker 2]:  No, none of that.\n\n[Speaker 1]:  Okay. Show me where it's sore.\n\n[Speaker 2]:  Shoulder, here. And hip's a bit stiff.\n\n[Speaker 1]:  Shoulder's worse. I'm going to check range. Lift your arm up.\n\n[Speaker 2]:  Yeah, that catches about there.\n\n[Speaker 1]:  Painful arc. Hold it there. I'm adding resistance.\n\n[Speaker 2]:  Bit weak there, yeah.\n\n[Speaker 1]:  Likely rotator cuff strain or contusion. I'm not seeing signs of dislocation. I'll check your hip. Stand up.\n\n[Speaker 2]:  Yeah, just stiff. I can walk it off.\n\n[Speaker 1]:  Don't push through it yet. Any sharp pain, or just stiffness?\n\n[Speaker 2]:  Mostly stiffness.\n\n[Speaker 1]:  Shoulder needs low rush. No overload.\n\n[Speaker 2]:  Hip?\n\n[Speaker 1]:  Keep it moving, but easy.\n\n[Speaker 2]:  I've got stuff to do though.\n\n[Speaker 1]:  Get someone else on the heavy slope. If you aggravate that shoulder, you lose more time.\n\n[Speaker 2]:  Yeah, alright.\n\n[Speaker 1]:  Ice tonight. Gentle movement. If pain worsens, weakness increases, or you get any headache or dizziness, get checked straight away.\n\n[Speaker 2]:  I'll document this.","notes":[{"prompt":1,"available":true,"text":"Subjective\nSlipped on a wet patch and came off bike sideways, landing on shoulder. Shoulder sore and worse than hip; hip stiff. Shoulder catches when lifting arm and feels weak with resistance. Hip symptoms are mostly stiffness; feels able to walk it off.\nNo LOC. Felt briefly rattled. No headache, nausea or blurred vision.\nConcerned about work to do. Plans to document the incident.\nObjective\nPainful arc with shoulder elevation. No signs of dislocation seen.\nAssessment\nLikely rotator cuff strain or contusion, consistent with shoulder pain and painful arc after the fall. No signs of dislocation seen. Hip stiffness also reported.\nPlan\nShoulder: low rush; no overload. Avoid pushing through symptoms. Hip: keep moving, but easy.\nAsk someone else to handle the heavy slope. Explained that aggravating the shoulder could mean more time lost; patient agreed.\nIce tonight and use gentle movement. Get checked straight away if pain worsens, weakness increases, or headache or dizziness develops.","items":[{"id":"1.1","verdict":"partial","why":"came off bike sideways landing on shoulder; hip omitted as a landing site"},{"id":"1.2","verdict":"yes","why":"no LOC, briefly rattled, no headache/nausea/blurred vision"},{"id":"1.3","verdict":"yes","why":"painful arc; catches on lifting; weak with resistance"},{"id":"1.4","verdict":"yes","why":"mostly stiffness"},{"id":"1.5","verdict":"yes","why":"likely rotator cuff strain or contusion"},{"id":"1.6","verdict":"partial","why":"'no overload' approximates load management but overhead restriction missing ('low rush' garbled)"},{"id":"1.7","verdict":"yes","why":"get checked straight away if pain/weakness/headache/dizziness"},{"id":"1.8","verdict":"yes","why":"Subjective/Objective/Assessment/Plan"}],"flags":[{"claim":"Plans to document the incident","severity":"minor","why":"misattributed; clinician said 'I'll document this'"},{"claim":"Shoulder: low rush","severity":"minor","why":"garbled mishearing, meaningless instruction"},{"claim":"Ask someone else to handle the heavy slope","severity":"minor","why":"mishearing of 'heavy stuff'"}]},{"prompt":2,"available":true,"text":"After slipping on a wet patch and falling sideways off a bike onto the shoulder, the patient reported shoulder soreness, hip stiffness and feeling briefly rattled, but no LOC, headache, nausea or blurred vision. Shoulder movement showed a painful arc, with weakness reported against resistance; rotator cuff strain or contusion was considered likely, with no signs of dislocation seen, and advice was to avoid shoulder overload, move the hip gently, use ice tonight, delegate heavy slope work despite the patient’s concern about tasks, and seek prompt assessment for worsening pain, increasing weakness, headache or dizziness.","items":[{"id":"2.1","verdict":"partial","why":"'off a bike', quad bike not specified"},{"id":"2.2","verdict":"yes","why":"no LOC, headache, nausea, blurred vision"},{"id":"2.3","verdict":"yes","why":"painful arc, weakness, rotator cuff strain or contusion"},{"id":"2.4","verdict":"yes","why":"avoid shoulder overload, hip gentle, ice, delegate, safety-net"},{"id":"2.5","verdict":"yes","why":"two (long) sentences"}],"flags":[{"claim":"delegate heavy slope work","severity":"minor","why":"mishearing of 'heavy stuff'"}]}],"defaultNote":null,"capturedAt":"2026-10-06T00:16:39.782Z","significantTranscriptErrors":[{"id":"F3","category":"laterality","reason":"Hip lost as a landing/injury site ('shoulder and hit').","reference":"hip.","transcribed":"hit."},{"id":"F16","category":"dropped-content","reason":"'No overhead work' restriction became generic 'no overload'.","reference":"overhead work.","transcribed":"overload."}],"significantPerRun":[2]},"heidi":{"name":"Heidi","wer":{"value":0.1291866028708134,"substitutions":24,"insertions":3,"deletions":0,"referenceWords":209,"method":null},"language":{"mode":"manual","requested":{"code":"en","label":"English"},"input":"English","output":"English","verified":true,"verification":"Saved session reloaded; persisted input and output language labels checked"},"transcript":"Hey, heard you came off the bike. What happened? Yeah, just slipped on a wet patch. Nothing major, bit of a knock. Did the bike roll?\n\nOr did you come off pain? No, I came off sideways, landed on my shoulder and hip. Any head knock? Loss of consciousness? Feeling pain? No, I didn't black out. Bit rattled for a second, maybe. Headache, nausea, lower vision? No, none of that. Okay, show me where it's here. Shoulder here, and hip's a bit stiff. Shoulder's worse. I'm going to check range.\n\nLift your arm up. Yeah, that catches about there. Painful arm. Hold it there. I'm adding resistance. Bit weak there. Yeah. Likely rotator cuff strain or contusion. I'm not seeing signs of dislocation. I'll check your hip. Stand up. Yeah. Just stiff. I can walk it off. Don't push through it yet. Any sharp pain or just stiffness? Mostly stiffness. Shoulder needs no rush to foot. No open hip. Keep it moving but easy. You've got stuff to do, though. Get someone else who will ever start it. If you aggravate that shoulder, you lose more time. Yeah. Alright. Isolate. Gently move it. If pain worsens, weakness increases\n\nOr you get any headache or dizziness, get checked straight away. I'll document this.","notes":[{"prompt":1,"available":true,"text":"Subjective\n\n- Fell off bike after slipping on a wet patch; landed on shoulder and hip\n\n- Denies LOC, headache, nausea, vision changes\n\n- Primary complaint: shoulder pain, worse than hip stiffness\n\n\n\n\nObjective\n\n- Shoulder:\n\n  - Pain with AROM, catching at approx [DEGREE] abduction/flexion\n\n  - Weakness with resisted movements\n\n  - No signs of dislocation\n\n- Hip:\n\n  - Stiffness reported\n\n  - Able to bear weight and ambulate\n\n\n\n\nAssessment\n\n- Likely rotator cuff strain or contusion of shoulder\n\n- Hip stiffness\n\n\n\n\nPlan\n\n- Avoid pushing through pain\n\n- Gentle movement of shoulder within pain-free range\n\n- Isolate shoulder movements\n\n- If pain worsens, weakness increases, or headache/dizziness occurs, seek immediate medical attention\n\n- Documentation completed","items":[{"id":"1.1","verdict":"yes","why":"fell off bike after slipping, landed on shoulder and hip"},{"id":"1.2","verdict":"yes","why":"denies LOC, headache, nausea, vision changes"},{"id":"1.3","verdict":"yes","why":"pain with AROM, catching, weakness on resisted movement"},{"id":"1.4","verdict":"yes","why":"hip stiffness"},{"id":"1.5","verdict":"yes","why":"likely rotator cuff strain or contusion"},{"id":"1.6","verdict":"no","why":"no load management, overhead restriction or delegation"},{"id":"1.7","verdict":"yes","why":"seek immediate attention if pain/weakness/headache/dizziness"},{"id":"1.8","verdict":"yes","why":"Subjective/Objective/Assessment/Plan"}],"flags":[{"claim":"Isolate shoulder movements","severity":"major","why":"invented management instruction"}]},{"prompt":2,"available":true,"text":"Following a fall from a bicycle after slipping on a wet patch, landing on the shoulder and hip, assessment revealed a likely rotator cuff strain or contusion of the shoulder with pain on active range of motion, catching, and weakness on resisted testing, with no signs of dislocation, alongside hip stiffness with preserved weight-bearing and ambulation. Management advised gentle movement of the shoulder within pain-free range, avoiding pushing through pain, and seeking immediate medical attention if pain or weakness worsens or if headache or dizziness develops.","items":[{"id":"2.1","verdict":"no","why":"stated as a bicycle fall"},{"id":"2.2","verdict":"no","why":"absence of LOC/concussion symptoms not stated (headache only as safety-net)"},{"id":"2.3","verdict":"yes","why":"likely rotator cuff strain or contusion with painful AROM, catching, weakness"},{"id":"2.4","verdict":"partial","why":"gentle movement and safety-net, no load/overhead restriction"},{"id":"2.5","verdict":"yes","why":"two sentences"}],"flags":[{"claim":"fall from a bicycle","severity":"major","why":"wrong vehicle/mechanism; quad bike"}]}],"defaultNote":null,"capturedAt":"2026-10-06T00:18:27.115Z","significantTranscriptErrors":[{"id":"E3","category":"red-flag","reason":"Head-injury screen item 'feeling dazed' replaced by 'feeling pain'.","reference":"dazed. Nah didn t","transcribed":"pain No I didn't"},{"id":"E16","category":"dropped-content","reason":"'No overhead work' restriction lost.","reference":"overhead work.","transcribed":"rush to foot. No open"},{"id":"E18","category":"dropped-content","reason":"Advice to avoid heavy work today lost.","reference":"on the heavy stuff today.","transcribed":"who will ever start it."},{"id":"E20","category":"dropped-content","reason":"'Ice tonight' instruction lost ('Isolate').","reference":"Ice tonight. Gentle movement.","transcribed":"Isolate. Gently move it."}],"significantPerRun":[4]},"freed":{"name":"Freed","wer":{"value":0.0861244019138756,"substitutions":9,"insertions":2,"deletions":7,"referenceWords":209,"method":null},"language":{"mode":"automatic","requested":{"code":"en","label":"English"},"manualOverride":false,"verification":"Recorder and Scribe preferences inspected; automatic multilingual workflow documented by vendor","source":"https://www.getfreed.ai/resources/ai-scribe-multilingual-visits","languageExplicitlyListed":true,"limitation":null},"transcript":"Hey, heard you came off the quad, what happened?\nYeah, just slipped on a wet patch, nothing major, bit of a knock.\nDid the bike roll, or did you come off clean?\nNah, I came off sideways, landed on my shoulder and hip.\nAny head knock, loss of consciousness, feeling dazed?\nNah, didn't black out, bit rattled for a sec maybe.\nHeadache, nausea, blurred vision?\nNah, none of that.\nOkay, show me where it's sore.\nShoulder here, and hips a bit stiff, shoulders worse.\nI'm going to check range.\nLift your arm up.\nYeah, that catches about there.\nPainful part.\nHold it there.\nI'm adding resistance.\nA bit weak there, yeah.\nLikely rotator cuff strain or contusion.\nI'm not seeing signs of dislocation.\nI'll check your hip.\nStand up.\nYeah, just stiff.\nI can walk it off.\nDon't push through it yet.\nAny sharp pain or just stiffness?\nMostly stiffness.\nShoulder meets lobe.\nKeep it moving, but easy.\nGot stuff to do, though?\nGet someone else heavy stuff to do.\nIf you aggravate that shoulder, you lose more time.\nYeah, alright.\nI stand.\nGentle movement.\nIf pain worsens, weakness increases, or you get any headache or dizziness, get checked straight away.\nI'll document this.","notes":[{"prompt":1,"available":true,"text":"Here is the SOAP note in bullet format:\n\nSubjective\n\nShoulder & hip pain after quad bike fall (sideways impact)\nShoulder: pain ↑ with elevation/lifting\nHip: stiffness, able to ambulate, \"walk it off\"\nNo LOC, headache, nausea, blurred vision, dizziness\nROS: HEENT/Neuro negative\n\nObjective\n\nShoulder: ↓ ROM (painful arc), weakness w/ resistance, catching\nHip: stiffness, gait intact\nNo signs of dislocation\n\nAssessment\n\nRotator cuff strain/contusion (shoulder): post-fall, painful arc, weakness, no dislocation\nHip soft tissue contusion/muscular stiffness: post-impact, no sharp pain, ambulation preserved\n\nPlan\n\nShoulder: gentle movement, avoid heavy lifting/aggravating activity, delegate heavy tasks, reassess if pain/weakness ↑ or new neuro sx\nHip: gentle movement, avoid pushing through pain, monitor for worsening\n\nLet me know if you want this added directly to the record.","items":[{"id":"1.1","verdict":"yes","why":"quad bike fall, sideways impact, shoulder and hip"},{"id":"1.2","verdict":"yes","why":"no LOC, headache, nausea, blurred vision"},{"id":"1.3","verdict":"yes","why":"painful arc, weakness with resistance, catching"},{"id":"1.4","verdict":"yes","why":"hip stiffness"},{"id":"1.5","verdict":"yes","why":"rotator cuff strain/contusion"},{"id":"1.6","verdict":"partial","why":"avoid heavy lifting/aggravating activity and delegate heavy tasks, but no overhead restriction"},{"id":"1.7","verdict":"yes","why":"reassess if pain/weakness increase or new neuro symptoms; monitor hip"},{"id":"1.8","verdict":"yes","why":"Subjective/Objective/Assessment/Plan"}],"flags":[{"claim":"Hip soft tissue contusion/muscular stiffness","severity":"major","why":"new hip diagnosis not said by clinician"},{"claim":"No ... dizziness","severity":"minor","why":"dizziness never asked"},{"claim":"ROS: HEENT/Neuro negative","severity":"minor","why":"overstates; no broader ROS or neuro review done"},{"claim":"gait intact","severity":"minor","why":"gait not examined; patient only stood and said he could walk it off"}]},{"prompt":2,"available":true,"text":"Injury assessment summary updated in the report:\n\nPatient sustained shoulder and hip pain after a lateral fall from a quad bike.\nExam findings support rotator cuff strain and hip contusion; gentle movement advised, with reassessment for worsening symptoms.","items":[{"id":"2.1","verdict":"yes","why":"lateral fall from a quad bike"},{"id":"2.2","verdict":"no","why":"concussion symptoms not mentioned"},{"id":"2.3","verdict":"yes","why":"shoulder pain, rotator cuff strain"},{"id":"2.4","verdict":"partial","why":"gentle movement and reassessment only; no load/overhead restriction"},{"id":"2.5","verdict":"yes","why":"two sentences (plus a preamble line)"}],"flags":[{"claim":"Exam findings support rotator cuff strain","severity":"major","why":"collapses clinician's open 'strain or contusion' to strain"},{"claim":"hip contusion","severity":"major","why":"new hip diagnosis not said"}]}],"defaultNote":null,"capturedAt":"2026-10-06T00:21:05.350Z","significantTranscriptErrors":[{"id":"A11","category":"dropped-content","reason":"'No overhead work' restriction and load-management advice lost.","reference":"needs load management. No overhead work. Hip","transcribed":"meets lobe."},{"id":"A14","category":"dropped-content","reason":"'Ice tonight' treatment instruction lost.","reference":"Ice tonight.","transcribed":"I stand."}],"significantPerRun":[2]},"lyrebird":{"name":"Lyrebird","wer":{"value":0.11483253588516747,"substitutions":19,"insertions":4,"deletions":1,"referenceWords":209,"method":null},"language":{"mode":"manual","requested":{"code":"en","label":"English"},"input":"English","output":"English","verified":true},"transcript":"Hey. Thought you came off the bike. What happened? Yeah. Just slipped on a wet patch. Nothing major. Bit of a knock. Did the bike roll, or did you come off clean? No. I came off sideways, landed on my shoulder and hip. Any head knock, loss of consciousness, feeling dazed? No. I didn't black out. A bit rattled for a sec maybe. Headache, nausea, blurred vision? No. None of that. Okay. Show me where it's sore. Shoulder here and hips a bit stiff. Shoulders worse. I'm going to check range.\n\nLift your arm up. Yeah. That catches about there. Painful part. Hold it there. I'm adding resistance. Bit weak there. Yeah. Likely rotate a cuff strain or contusion. I'm not seeing signs of dislocation. I'll check your hip. Stand up. Yeah, just stiff. I can walk it off. Don't push through at the end, Any sharp pain or just stiffness? Mostly stiffness. Shoulder needs no push. No overhead. Yep. Keep it moving, but easy. Got stuff to do, though.\n\nGet someone else with the heavy stuff today. If you aggravate that shoulder, you lose over time. Yeah. Alright. Eyes tight. Gentle movement. If pain worsens, weakness increases, or you get any headache or dizziness, get checked straight away. I'll document this.","notes":[{"prompt":1,"available":true,"text":"Subjective:\n\nMotorcycle fall on wet surface, landed on right shoulder and right hip\n\nRight shoulder pain worse than hip\n\nRight hip stiffness, able to ambulate\n\nDenied loss of consciousness\n\nDenied headache, nausea, or blurred vision\n\nReported feeling briefly rattled immediately post-fall\n\n\n\n\nObjective:\n\nRight shoulder: reduced range of motion with pain on abduction, weakness on resisted movement\n\nRight hip: stiffness only, no sharp pain, able to walk\n\n\n\n\nAssessment:\n\nRotator cuff strain or contusion\n\n\n\n\nPlan:\n\nAvoid overhead activities and heavy lifting\n\nGentle range of motion exercises\n\nAdvised to seek assistance with heavy tasks\n\nReturn if pain worsens, weakness increases, or develops headache or dizziness","items":[{"id":"1.1","verdict":"partial","why":"landing on shoulder and hip correct, but vehicle stated as motorcycle (quad bike) and side invented"},{"id":"1.2","verdict":"yes","why":"no LOC; no headache/nausea/blurred vision; briefly rattled"},{"id":"1.3","verdict":"yes","why":"pain on abduction + weakness on resisted movement"},{"id":"1.4","verdict":"yes","why":"hip stiffness only, no sharp pain"},{"id":"1.5","verdict":"yes","why":"rotator cuff strain or contusion"},{"id":"1.6","verdict":"yes","why":"avoid overhead activities and heavy lifting; seek help with heavy tasks"},{"id":"1.7","verdict":"yes","why":"return if pain/weakness worsen or headache/dizziness"},{"id":"1.8","verdict":"yes","why":"Subjective/Objective/Assessment/Plan"}],"flags":[{"claim":"Motorcycle fall on wet surface","severity":"major","why":"wrong vehicle/mechanism; it was a quad bike"},{"claim":"landed on right shoulder and right hip / Right shoulder ... Right hip","severity":"major","why":"side never stated; invented laterality"}]},{"prompt":2,"available":true,"text":"The patient sustained a motorcycle fall on a wet surface on 06/10/2026, landing on the right shoulder and hip with no loss of consciousness. Examination revealed reduced range of motion and weakness in the right shoulder consistent with rotator cuff strain or contusion, and hip stiffness without sharp pain; the patient was advised to avoid overhead activities and heavy lifting, perform gentle range of motion exercises, and return if symptoms worsen or neurological symptoms develop.","items":[{"id":"2.1","verdict":"no","why":"stated as motorcycle fall"},{"id":"2.2","verdict":"partial","why":"no LOC only; other concussion symptoms not stated"},{"id":"2.3","verdict":"yes","why":"shoulder ROM/weakness, rotator cuff strain or contusion"},{"id":"2.4","verdict":"yes","why":"avoid overhead and heavy lifting, gentle ROM, return if worse"},{"id":"2.5","verdict":"yes","why":"two sentences"}],"flags":[{"claim":"motorcycle fall","severity":"major","why":"wrong vehicle/mechanism; quad bike"},{"claim":"right shoulder","severity":"major","why":"side never stated"},{"claim":"fall ... on 06/10/2026","severity":"minor","why":"injury date not stated; session date asserted as injury date"}]}],"defaultNote":null,"capturedAt":"2026-10-06T02:54:44.103Z","significantTranscriptErrors":[{"id":"D18","category":"laterality","reason":"'Hip' lost so 'keep it moving' instruction no longer attached to the hip.","reference":"work. Hip","transcribed":"Yep."},{"id":"D21","category":"dropped-content","reason":"'Ice tonight' instruction lost ('Eyes tight').","reference":"Ice tonight.","transcribed":"Eyes tight."}],"significantPerRun":[2]},"patientnotes":{"name":"PatientNotes","wer":{"value":0.10047846889952153,"substitutions":14,"insertions":3,"deletions":4,"referenceWords":209,"method":null},"language":{"mode":"manual","requested":{"code":"en","label":"English"},"input":"English","verified":true,"verification":"Selected language confirmed after reopening recording settings"},"transcript":"Hey Heard you came off the quad what happened? Yeah, just slipped on a wet patch Nothing major bit of a knock did the bike roll or did you come off clean? No I came off sideways landed on my shoulder and hip Any head knock? Loss of consciousness? Feeling dazed? Nah, didn't black out Bit rattled for a sec maybe Headache, nausea, blurred vision? Nah, none of that okay show me where it's slow Shoulder here and hips a bit stiff Shoulders worse I'm going to check range Lift your arm yeah that catches about there Painful part Hold it there I'm adding resistance Bit weak there yeah likely rotator cuff strain or contusion I'm not seeing signs of dislocation I'll check your hip Stand up yeah just stiff I can walk it off don't push through it yet Any sharp pain or just stiffness? Mostly in stiffness Shoulder needs no rubbish no overhead hip Keep it moving but easy Got stuff to do that.\nGet someone else on the hips. If you aggravate that shoulder, you lose all the time. Yeah. Or eyeballs. Eyes tilt. Gentle movement. If pain worsens, weakness increases, or you get any headache or dizziness, get checked straight away. I'll document this.","notes":[{"prompt":1,"available":true,"text":"Subjective\nChief Complaint (CC)\n\nPatient slipped on a wet patch, fell sideways onto the shoulder and hip, and now experiences stiffness.\n\nHistory of Present Illness (HPI)\n\nIncident occurred when patient slipped on a wet surface and landed on left shoulder and hip.\n\nStiffness in shoulder and hip present since fall.\n\nNo sharp pain, only stiffness and mild discomfort on resisted shoulder movement.\n\nNo aggravating factors other than movement; gentle movement tolerated.\n\nNo alleviating factors reported beyond gentle movement.\n\nNo radiation of symptoms.\n\nSeverity described as mild to moderate stiffness.\n\nHistory\n\nNot discussed\n\nReview of Systems (ROS)\n\nNo headache, nausea, blurred vision, dizziness, or loss of consciousness reported.\n\nCurrent Medications, Allergies\n\nNot discussed\n\nObjective\nAssessment\n\nLikely rotator cuff strain or contusion of the shoulder.\n\nHip stiffness likely secondary to soft tissue strain.\n\nPlan\n\nAdvise gentle range of motion exercises for shoulder and hip, avoiding painful movements.\n\nInstruct patient to monitor for increased pain, weakness, headache, or dizziness and seek medical review if these occur.\n\nRecommend not to push through stiffness and to allow gradual activity as tolerated.\n\nNo immediate imaging or testing required at this time.\n\nNo specialist referral indicated currently.","items":[{"id":"1.1","verdict":"partial","why":"slipped and fell sideways onto shoulder and hip, but no quad bike (reads as ground-level fall) and HPI invents left side"},{"id":"1.2","verdict":"yes","why":"no headache, nausea, blurred vision or LOC"},{"id":"1.3","verdict":"no","why":"Objective empty; shoulder described as stiffness with mild discomfort; no painful arc or weakness"},{"id":"1.4","verdict":"yes","why":"hip stiffness"},{"id":"1.5","verdict":"yes","why":"likely rotator cuff strain or contusion"},{"id":"1.6","verdict":"no","why":"no load management or overhead restriction; only gentle ROM/avoid painful movement"},{"id":"1.7","verdict":"yes","why":"monitor for pain, weakness, headache, dizziness; seek review"},{"id":"1.8","verdict":"yes","why":"all four headings present (Objective empty)"}],"flags":[{"claim":"landed on left shoulder and hip","severity":"major","why":"side never stated; invented laterality"},{"claim":"Stiffness in shoulder ... No sharp pain, only stiffness and mild discomfort on resisted shoulder movement","severity":"major","why":"misstates shoulder picture: it was painful (worse than hip) with catching and weakness; 'no sharp pain/only stiffness' was the hip"},{"claim":"Hip stiffness likely secondary to soft tissue strain","severity":"major","why":"new hip diagnosis with cause, not said"},{"claim":"No immediate imaging or testing required at this time","severity":"major","why":"invented management decision; imaging never discussed"},{"claim":"No specialist referral indicated currently","severity":"major","why":"invented disposition; referral never discussed"},{"claim":"No aggravating factors other than movement; gentle movement tolerated / No alleviating factors beyond gentle movement","severity":"minor","why":"not asked or established"},{"claim":"No radiation of symptoms","severity":"minor","why":"unasked negative"},{"claim":"Severity described as mild to moderate stiffness","severity":"minor","why":"severity never described"},{"claim":"No ... dizziness ... reported","severity":"minor","why":"dizziness never asked; only in safety-net advice"}]},{"prompt":2,"available":true,"text":"Subjective\nChief Complaint (CC)\n\nPatient slipped on a wet patch, fell sideways onto the shoulder and hip, and now experiences stiffness.\n\nHistory of Present Illness (HPI)\n\nIncident occurred when patient slipped on a wet surface and landed on left shoulder and hip.\n\nStiffness in shoulder and hip present since fall.\n\nNo sharp pain, only stiffness and mild discomfort on resisted shoulder movement.\n\nNo aggravating factors other than movement; gentle movement tolerated.\n\nNo alleviating factors reported beyond gentle movement.\n\nNo radiation of symptoms.\n\nSeverity described as mild to moderate stiffness.\n\nHistory\n\nNot discussed\n\nReview of Systems (ROS)\n\nNo headache, nausea, blurred vision, dizziness, or loss of consciousness reported.\n\nCurrent Medications, Allergies\n\nNot discussed\n\nObjective\nAssessment\n\nLikely rotator cuff strain or contusion of the shoulder.\n\nHip stiffness likely secondary to soft tissue strain.\n\nPlan\n\nAdvise gentle range of motion exercises for shoulder and hip, avoiding painful movements.\n\nInstruct patient to monitor for increased pain, weakness, headache, or dizziness and seek medical review if these occur.\n\nRecommend not to push through stiffness and to allow gradual activity as tolerated.\n\nNo immediate imaging or testing required at this time.\n\nNo specialist referral indicated currently.","items":[{"id":"2.1","verdict":"no","why":"no quad bike/vehicle mentioned"},{"id":"2.2","verdict":"yes","why":"no headache, nausea, blurred vision, LOC"},{"id":"2.3","verdict":"yes","why":"likely rotator cuff strain or contusion of shoulder"},{"id":"2.4","verdict":"partial","why":"gentle ROM and monitoring, but no shoulder load/overhead restriction"},{"id":"2.5","verdict":"no","why":"repeats the full SOAP note, not a two-sentence summary"}],"flags":[{"claim":"landed on left shoulder and hip","severity":"major","why":"side never stated; invented laterality"},{"claim":"Stiffness in shoulder ... No sharp pain, only stiffness and mild discomfort on resisted shoulder movement","severity":"major","why":"misstates shoulder picture: painful with catching and weakness"},{"claim":"Hip stiffness likely secondary to soft tissue strain","severity":"major","why":"new hip diagnosis with cause, not said"},{"claim":"No immediate imaging or testing required at this time","severity":"major","why":"invented management decision"},{"claim":"No specialist referral indicated currently","severity":"major","why":"invented disposition"},{"claim":"No aggravating factors other than movement; gentle movement tolerated / No alleviating factors beyond gentle movement","severity":"minor","why":"not asked or established"},{"claim":"No radiation of symptoms","severity":"minor","why":"unasked negative"},{"claim":"Severity described as mild to moderate stiffness","severity":"minor","why":"severity never described"},{"claim":"No ... dizziness ... reported","severity":"minor","why":"dizziness never asked"}]}],"defaultNote":null,"capturedAt":"2026-10-06T00:21:45.375Z","significantTranscriptErrors":[{"id":"C13","category":"dropped-content","reason":"Shoulder load-management instruction replaced by 'no rubbish'.","reference":"load management.","transcribed":"no rubbish"},{"id":"C16","category":"dropped-content","reason":"Advice to have someone else do the heavy lifting today lost.","reference":"heavy stuff today.","transcribed":"hips."},{"id":"C19","category":"dropped-content","reason":"'Ice tonight' instruction replaced with eye-related garble.","reference":"alright. Ice tonight.","transcribed":"Or eyeballs. Eyes tilt."}],"significantPerRun":[3]},"cliniscripts":{"name":"CliniScripts","wer":{"value":0.11004784688995216,"substitutions":13,"insertions":5,"deletions":5,"referenceWords":209,"method":null},"language":{"mode":"default","requested":{"code":"en","label":"English"},"manualOverride":false,"selected":["English"]},"transcript":"Hey.\nNo, you came off the clock. What happened?\nYeah, I just slipped on a wet patch. Nothing major, bit of a knock. Did the bike roll, or did you come off clean? No, I came off sideways, landed on my shoulder and hit. Any head knock, loss of consciousness, feeling dazed? No, I didn't black out. A bit rattled for a sec, maybe.\nHeadache, nausea, blurred vision? No, none of that. Okay.\nShow me where it's sore. Shoulder, here.\nAnd hip's a bit stiff. Shoulder's worse. I'm going to check range.\nLift your arm up. Yeah, that catches about there. Painful part.\nHold it there. I'm adding resistance. A bit weak there, yeah.\nLikely rotator cuff strain or contusion. I'm not seeing signs of dislocation. I'll check your hip.\nStand up. Yeah, just stiff.\nI can walk it off. Don't push through it yet. Any sharp pain, or just stiffness? Mostly stiffness.\nShoulder needs low rotation.\nNo overhead. Hip? Keep it moving, but easily.\nI've got stuff to do, though. Get someone else on the heavy side. If you aggravate that shoulder, you'll lose more time. Yeah, alright. Iced it. Gentle movement. If pain worsens, weakness increases, or you get any headache or dizziness, get checked straight away.","notes":[{"prompt":1,"available":true,"text":"S (Subjective):\n- Pt reports slipping on wet patch, coming off bike.\n- Landed on shoulder and hit hip.\n- Denies LOC, feeling dazed, headache, nausea, blurred vision.\n- Shoulder catches with movement, painful.\n- Hip pain described as mostly stiffness.\n- Pt states shoulder is worse than hip.\n\nO (Objective):\n- Arm catches with lifting, pain noted.\n- Weakness with resisted arm movement.\n- Hip stiff on standing.\n- No signs of shoulder dislocation on exam.\n\nA (Assessment):\n- Likely rotator cuff strain or contusion, shoulder.\n- Hip stiffness, likely secondary to impact.\n\nP (Plan):\n- Ice affected shoulder.\n- Gentle shoulder movement, avoid low rotation and overhead.\n- Keep hip moving easily, avoid pushing through pain.\n- Avoid heavy lifting; delegate tasks.\n- Advised to seek immediate medical attention if pain worsens, weakness increases, or headache/dizziness occurs.","items":[{"id":"1.1","verdict":"yes","why":"slipped on wet patch, came off bike, landed on shoulder and hip"},{"id":"1.2","verdict":"yes","why":"denies LOC, headache, nausea, blurred vision"},{"id":"1.3","verdict":"yes","why":"catches with lifting, painful; weakness on resisted movement"},{"id":"1.4","verdict":"yes","why":"mostly stiffness"},{"id":"1.5","verdict":"yes","why":"likely rotator cuff strain or contusion"},{"id":"1.6","verdict":"yes","why":"avoid overhead, avoid heavy lifting, delegate tasks"},{"id":"1.7","verdict":"yes","why":"seek immediate attention if pain/weakness/headache/dizziness"},{"id":"1.8","verdict":"yes","why":"S/O/A/P headings with full names"}],"flags":[{"claim":"Denies ... feeling dazed","severity":"minor","why":"patient said 'bit rattled for a sec maybe'"},{"claim":"avoid low rotation","severity":"major","why":"restriction not said (likely mishearing of 'load management') [harmonised: plan-flag rule]"},{"claim":"Hip stiffness, likely secondary to impact","severity":"minor","why":"causal attribution not said"}]},{"prompt":2,"available":true,"text":"The patient presented with a shoulder injury and hip stiffness after falling from a bike, denying head trauma symptoms. Examination indicated a likely rotator cuff strain or contusion of the shoulder and impact-related hip stiffness.","items":[{"id":"2.1","verdict":"partial","why":"'falling from a bike', quad bike not specified"},{"id":"2.2","verdict":"yes","why":"denying head trauma symptoms"},{"id":"2.3","verdict":"yes","why":"shoulder injury, likely rotator cuff strain or contusion"},{"id":"2.4","verdict":"no","why":"no management plan"},{"id":"2.5","verdict":"yes","why":"two sentences"}],"flags":[{"claim":"impact-related hip stiffness","severity":"minor","why":"causal attribution not said"}]}],"defaultNote":null,"capturedAt":"2026-10-06T01:48:38.239Z","significantTranscriptErrors":[{"id":"B4","category":"laterality","reason":"Hip lost as a landing/injury site ('shoulder and hit').","reference":"hip.","transcribed":"hit."},{"id":"B16","category":"other","reason":"Shoulder plan changed from load management to 'low rotation'.","reference":"load management.","transcribed":"low rotation."},{"id":"B21","category":"dropped-content","reason":"Ice instruction turned into 'Iced it', a past action.","reference":"Ice tonight.","transcribed":"Iced it."}],"significantPerRun":[3]},"preve":{"name":"Preve","wer":{"value":0.5454545454545454,"substitutions":22,"insertions":0,"deletions":92,"referenceWords":209,"method":null},"language":null,"transcript":"Hey. Thought you came off the park. What happened? Yeah. Just slipped on the wet patch. Nothing major. Bit of a knock.\n\nDid the bike roll, or did you come off? No. I came off sideways, landed on my shoulder and hip.\n\nShoulder here and hips a bit stiff. Shoulders worse. I'm going to check-in.\n\nLift your arm. Yeah. That catches about that. Angel. Hold on.\n\nI'm not sure you'll find the location. I'll check your hip. Stand up. Yeah. Just stay.\n\nIf you aggravate that shoulder, you move from time. Yeah. Alright. I start. Gentle movement. If pain worsens, weakness increases, or you get any headache or dizziness, get checked straight away. I'll document this.","notes":[{"prompt":1,"available":false,"text":null,"items":[{"id":"1.1","verdict":"no","why":"no output"},{"id":"1.2","verdict":"no","why":"no output"},{"id":"1.3","verdict":"no","why":"no output"},{"id":"1.4","verdict":"no","why":"no output"},{"id":"1.5","verdict":"no","why":"no output"},{"id":"1.6","verdict":"no","why":"no output"},{"id":"1.7","verdict":"no","why":"no output"},{"id":"1.8","verdict":"no","why":"no output"}],"flags":[]},{"prompt":2,"available":false,"text":null,"items":[{"id":"2.1","verdict":"no","why":"no output"},{"id":"2.2","verdict":"no","why":"no output"},{"id":"2.3","verdict":"no","why":"no output"},{"id":"2.4","verdict":"no","why":"no output"},{"id":"2.5","verdict":"no","why":"no output"}],"flags":[]}],"defaultNote":{"text":"Presenting Condition\n\nMechanism/date: Slipped on wet patch during play today, came off sideways landing on shoulder and hip\n\nPain: Shoulder pain worse than hip; hip feels stiff\n\nLocation: Shoulder and hip\n\nAggravating: Lifting arm causes a catch\n\nReasons for visit: Sideline check-in after fall\n\n\n\n\nObjective\n\n(Consent obtained)\n\nObservation: Protective with shoulder\n\nROM:\n\nShoulder elevation catches part-way through range when lifting arm\n\nFunctional tests: Able to stand; hip stiffness noted\n\n\n\n\nRed Flag/Screening Questions\n\nEd: advised to seek urgent review if pain worsens, weakness increases, or headache/dizziness occur\n\n\n\n\nDiagnosis\n\nAcute shoulder contusion/sprain suspected after fall\n\nHip soft tissue soreness/stiffness likely\n\n\n\n\nTreatment\n\n(Consent obtained)\n\nEd:\n\nGentle shoulder and hip movement within comfort\n\nMonitor symptoms; if pain worsens, weakness increases, or headache/dizziness occur, get checked immediately\n\nAvoid provoking movements that aggravate shoulder\n\n\n\n\nPlan\n\nShort-term monitoring over next 24–48 hrs\n\nIf symptoms escalate or do not improve, seek medical assessment within 24–48 hrs","items":[{"id":"1.1","verdict":"yes","why":"came off sideways landing on shoulder and hip"},{"id":"1.2","verdict":"no","why":"no LOC / concussion-symptom negatives recorded"},{"id":"1.3","verdict":"partial","why":"catch on elevation present; weakness on resisted testing absent"},{"id":"1.4","verdict":"yes","why":"hip stiffness"},{"id":"1.5","verdict":"partial","why":"contusion present; rotator cuff not named, 'sprain' instead of strain"},{"id":"1.6","verdict":"partial","why":"'avoid provoking movements' only; no load management or overhead-work restriction"},{"id":"1.7","verdict":"yes","why":"seek review if pain/weakness worsens or headache/dizziness"}],"flags":[{"claim":"If symptoms escalate or do not improve, seek medical assessment within 24-48 hrs","severity":"major","why":"invented follow-up instruction; clinician said get checked straight away if worse"},{"claim":"Observation: Protective with shoulder","severity":"major","why":"invented exam finding"},{"claim":"Slipped on wet patch during play today / Sideline check-in after fall","severity":"minor","why":"invented sporting context; this was a quadbike fall"},{"claim":"Acute shoulder contusion/sprain suspected","severity":"minor","why":"'sprain' is a different tissue injury from the stated rotator cuff strain"},{"claim":"Hip soft tissue soreness/stiffness likely","severity":"minor","why":"diagnostic label on hip not given by clinician"},{"claim":"Short-term monitoring over next 24-48 hrs","severity":"minor","why":"generic monitoring line with invented timeframe"}]},"capturedAt":"2026-10-06T00:22:35.631Z","significantTranscriptErrors":[{"id":"G4","category":"red-flag","reason":"Entire head-injury screen (LOC, dazed, headache, nausea, vision) dropped.","reference":"Any head knock. Loss of consciousness. Feeling dazed. Nah didn t black out. Bit rattled for a sec maybe. Headache. Nausea. Blurred vision. Nah none of that. Okay. Show me where it s sore.","transcribed":""},{"id":"G10","category":"symptom-or-finding","reason":"'Painful arm' exam finding lost.","reference":"there. Painful arm.","transcribed":"that. Angel."},{"id":"G11","category":"dropped-content","reason":"Resisted-test weakness and rotator cuff strain/contusion diagnosis dropped.","reference":"it there. I m adding resistance. Bit weak there yeah. Likely rotator cuff strain or contusion. I m","transcribed":"on. I'm"},{"id":"G12","category":"negation","reason":"'Not seeing signs of dislocation' turned into unrelated sentence; negative finding lost.","reference":"seeing signs of dislocation. I ll","transcribed":"sure you'll find the location. I'll"},{"id":"G13","category":"dropped-content","reason":"Hip findings, no-overhead/load management plan and activity advice dropped.","reference":"stiff. I can walk it off. Don t push through it yet. Any sharp pain or just stiffness. Mostly stiffness. Shoulder needs load management. No overhead work. Hip keep it moving but easy. Got stuff to do though. Get someone else on the heavy stuff today.","transcribed":"stay."},{"id":"G15","category":"dropped-content","reason":"'Ice tonight' instruction lost ('I start').","reference":"Ice tonight.","transcribed":"I start."}],"significantPerRun":[6]}},"notCaptured":{}}