195 incidents on record · 2026 Headlights Incident reports by Ellie Harris · Melbourne
11 new this week Library last updated 12 September 2026
← The incident library
HD-INC-189
Healthcare technology · United States · 2024 · Accuracy metrics were advertised for generative AI products used in clinical drafting, and the assurance required future metric claims either to disclose each metric's meaning and calculation method or to be consistent with and substantiated by an independent auditor's findings

A clinical AI vendor advertised hallucination rate figures of <.001% and <1 per 100,000, and Texas alleged its representations may have violated the Texas Deceptive Trade Practices and Consumer Protection Act because they were false, misleading or deceptive

By Ellie Harris · Filed Assurance of Voluntary Compliance filed 21 August 2024 at 4.24pm, cause number DC-24-13476; announced 18 September 2024

Alleged: Pieces Technologies, Inc. developed or deployed the AI system implicated in this incident. Details are drawn from public reports; parties are presumed innocent of any wrongdoing not established by an official finding.

A clinical AI vendor advertised hallucination rate figures of <.001% and <1 per 100,000, and Texas alleged its representations may have violated the Texas Deceptive Trade Practices and Consumer Protection Act because they were false, misleading or deceptive

What happened

In September 2024, the Texas Attorney General announced a settlement with Pieces Technologies, a company that develops generative AI products used in healthcare, including tools that help medical staff summarise and draft clinical notes.

The state alleged that the company marketed the accuracy of its products using the terms “critical hallucination rate” and “severe hallucination rate”, with figures of “<.001%” and “<1 per 100,000”. However, the state alleged that the company had not adequately explained how those figures were calculated.

The state’s allegation was that representations about its generative AI products “may have violated the DTPA because they were false, misleading, or deceptive”.

The company denied violating the law and maintained that it had accurately represented its hallucination rate.

Under the settlement, the company agreed to requirements around how it represents the accuracy and performance of its AI products, including greater transparency about how metrics are defined and calculated.

What an auditable version would have shown

It was reported that the company advertised very low hallucination rates for its generative AI products. The problem is that a number like “fewer than one per 100,000” means very little unless we know what was counted, how it was tested, over what period and who decided whether an output was wrong.

An auditable version should have made that clear. It should have shown how the hallucination rate was calculated, what data was used, what counted as a hallucination and how the results could be checked independently.

It was also reported that the settlement required the company, when making claims about metrics or benchmarks, to explain what those measurements mean and how they were calculated. Alternatively, the company could use an independent third-party auditor to assess and substantiate its claims.

The important distinction is that the settlement did not require the company to prove that its earlier figures were wrong or right. The requirements applied to how these types of claims would be supported and communicated going forward.

Where the gap was

The gap was between the accuracy figures being reported and the evidence explaining how those figures were calculated.

It was reported that the company used very low hallucination rates when marketing its generative AI products, but the meaning behind those rates and the method used to calculate them were not clearly explained.

The settlement addressed this by requiring future claims about metrics or benchmarks to include what the measurement means and how it was calculated, or to be supported by an independent third-party auditor.

The gap was not simply whether the AI produced hallucinations. It was whether a customer could understand, verify and independently assess the accuracy claims being made about the system.

A MetricRecord is designed to compute an aggregate over signed records of what a system actually produced, with the chain of those records bound to the figure, so a rate carries its own denominator and period. A VerificationGate is designed to check a proposed output against a trusted source rather than against the model that produced it, here the drafted note against the encounter it summarises.

The settlement requires neither. MetricRecord and VerificationGate are Headlights designs.

What governance should have looked like

Good governance would have meant being clear about how the accuracy claims were reached in the first place.

It was reported that the settlement required the company to be transparent about its accuracy claims, testing methods, what its metrics mean and the data used to train its products. Customers must also be given information about intended use, known limitations and risks, and how to monitor for inaccurate outputs.

If a vendor gives a clinical customer an accuracy figure, best practice would be for the method behind it to come with the number. What counts as an error? What was tested? Over what period? And who decided whether an output was right or wrong?

A clinical buyer should be able to ask where an accuracy figure came from and get a clear answer. Without that, it is very difficult to know whether the number is meaningful.

Failure Pattern: it was reported that a vendor advertised hallucination rate figures to clinical buyers, that the state alleged the representations may have violated the deceptive trade practices act because they were false, misleading or deceptive, and that the remedy it took was to require future metric claims to carry their meaning and their method of calculation, or an independent auditor’s substantiation. Governance Principle: a published accuracy figure should be traceable to the outputs it was computed over, with its definition, its denominator and its period stated, so that a buyer can check the number rather than take it on trust. The reference implementation of MetricRecord and VerificationGate is open source. It lives at github.com/saffronandindia/headlights-oss, Apache 2.0 licensed and free to install. The repository is public now.

Sources

The mailing list

Fresh incident reports every week. One email to match.

We add new incidents to the library regularly, and send a single short email each week with what's new. The library stays free and open; this is just how you keep up with it.

No tracking. Unsubscribe in one click.

The record

An auditable system would have produced a signed, tamper-evident record the moment this happened: what the system did, the version that did it, the basis it acted on, and the action taken, and Pieces Technologies, Inc. could have produced it on demand.

This is the record the system as deployed did not produce in a signed, auditable form.

What this teaches
Capture what happened when it happens
What the system did, the version that did it, the basis it acted on, and the action taken, recorded at the moment, not reconstructed after.
Sign it, so no one has to trust the record-keeper
A tamper-evident entry. Edit it later and the signature breaks. The record does not ask for the benefit of the doubt.
Make it verifiable by anyone
A court, a regulator, a customer's lawyer can check the record themselves, without taking the company, or us, at our word.

Headlights summarises publicly reported AI incidents. All summaries are independently written, attributed to their original sources, and intended for research and educational purposes. Allegations are identified as such until established through official findings.

Last reviewed September 2026. This report is based on the sources listed above and reflects information available at the time of review; later developments may not be captured. Where a person is described as charged with or alleged to have done something, that allegation is unproven unless a conviction or a court or regulatory finding is stated. Headlights publishes journalism and commentary, not legal advice.

Want to write back?

Direct to my inbox.

ellie@useheadlights.com →