The claim that AI creates “unprecedented opportunities” in health care, was discussed at the American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting town hall in March 2025 held at the San Diego Convention Center in San Diego, reflects a growing consensus among medical professionals about AI’s transformative potential.

Key A-1 Medical Topics:

– – Diagnostics: AI is revolutionizing diagnostics by enabling faster and more accurate analysis of medical imaging, such as X-rays, MRIs, and CT scans, which are critical in orthopaedics for assessing fractures, joint conditions, and spinal deformities. Machine learning models can detect subtle patterns in imaging that may elude human eyes, improving early diagnosis and treatment planning. For example, a 2023 study in The Lancet Digital Health demonstrated that AI algorithms achieved a 94% accuracy rate in detecting hip fractures from X-rays, surpassing the average performance of radiologists (89%). This precision reduces misdiagnoses and optimizes patient outcomes.

Additionally, AI-powered predictive analytics can forecast patient outcomes, such as the likelihood of postoperative complications or the success of joint replacements. A 2024 report by the Journal of Orthopaedic Research highlighted AI models that predict periprosthetic joint infections with 87% accuracy, allowing surgeons to tailor preoperative strategies.

– – Personalized Treatment Plans: AI enables personalized medicine by analyzing vast datasets, including patient genetics, medical history, and lifestyle factors, to recommend tailored treatment plans. In orthopaedics, this is particularly valuable for optimizing surgical approaches, such as selecting the best implant for a knee replacement based on patient-specific biomechanics. A 2025 article in Nature Medicine described AI-driven platforms that integrate 3D modeling and patient data to simulate surgical outcomes, improving implant fit and reducing revision rates by 15%. At the AAOS 2025 Annual Meeting, sessions like the Innovation Theater likely showcased such advancements, emphasizing AI’s role in customizing care.

– – Surgical Assistance and Robotics.AI is enhancing surgical precision through integration with robotic systems, which are increasingly common in orthopaedic procedures like total knee and hip arthroplasties. AI-guided robots, such as those displayed in the AAOS Exhibit Hall, use real-time data to assist surgeons in achieving optimal alignment and minimizing tissue damage. A 2024 study in The Journal of Bone and Joint Surgery found that AI-assisted robotic surgeries reduced operative time by 12% and improved implant placement accuracy by 18% compared to traditional methods. The AAOS 2025 OrthoDome, an immersive theater showcasing surgical techniques in 4K resolution, likely highlighted such AI-driven innovations, aligning with the town hall’s optimism about AI’s impact.

– – Postoperative Care and Rehabilitation: AI is transforming postoperative care by powering remote monitoring tools and wearable devices that track patient recovery in real time. These tools can detect early signs of complications, such as infection or implant failure, and alert clinicians. A 2025 Health Affairs study reported that AI-enabled wearables reduced hospital readmissions for orthopaedic patients by 22% through continuous monitoring of mobility and vital signs. Furthermore, AI-driven rehabilitation platforms, like those discussed at the AAOS 2025 meeting, use gamified interfaces and machine learning to personalize physical therapy regimens, improving patient adherence and functional outcomes.

– – Administrative Efficiency and Cost Reduction: Beyond clinical applications, AI streamlines administrative tasks, such as scheduling, billing, and electronic health record management, freeing up time for clinicians to focus on patient care. A 2024 McKinsey & Company report estimated that AI could save the U.S. health care system $350 billion annually by automating routine processes and optimizing resource allocation. In orthopaedics, this translates to more efficient practice management, as highlighted in AAOS sessions on health policy and practice optimization.

While AI offers immense potential, it’s not a panacea. Challenges include data privacy concerns, algorithmic bias, and the need for robust validation to ensure AI tools are safe and equitable. For instance, a 2023 NEJM article cautioned that AI models trained on non-diverse datasets may underperform for underrepresented populations, potentially exacerbating health disparities.

Corbin Williams worked as an insurance adjuster for Alacrity Solutions Group, LLC starting in 2014. While employed, Williams “typically” worked 84-hour weeks – that is, 12 hours a day, seven days a week. He was an hourly employee. As a result, he was entitled to overtime pay whenever he worked more than eight hours in a day or 40 hours in a workweek, and was also entitled to overtime pay whenever he worked a seventh consecutive day.

But defendant did not pay Williams any overtime pay. As a result, defendant violated the Labor Code by not paying Williams all the wages he was owed and by issuing Williams inaccurate wage statements. (§§ 201- 203, 510 et seq., 226, 1174, 1174.5.

Williams’s employment with defendant ended in January 2022.It was not until March 7, 2023 – more than a year after his employment ended – that Williams provided written notice to California’s Labor & Workforce Development Agency (the Agency) of his intent to pursue a PAGA action for defendant’s Labor Code violations.

A few days later, on March 10, 2023, Williams sued defendant. In the operative first amended complaint, Williams asserted a single claim under PAGA seeking civil penalties “on behalf of the State of California and other current and former employees” – but, critically, not on his own behalf – for the alleged overtime and wage statement violations occurring in the “one year prior” to the written notice Williams filed with the Agency on March 7, 2023.

Defendant demurred to the complaint, arguing Williams failed to state a cause of action because (1) his PAGA action was barred by the one-year statute of limitations, and (2) he lacked standing to assert a PAGA action.

In his opposition, Williams effectively conceded that any individual claim he might assert under PAGA was “barred by the statute of limitations,” but maintained that this untimeliness was irrelevant because the PAGA action he alleged sought only to recover civil penalties on behalf of other aggrieved employees and the State.

The trial court issued an order sustaining the demurrer without leave to amend. The Court of Appeal affirmed in the Published case of Williams v. Alacrity Solutions Grp. – B335445 (April 2025).

The Private Attorneys General Act (PAGA) (Lab. Code, § 2698 et seq.) authorizes an “aggrieved employee” to step into the shoes of the State of California and sue for civil penalties premised on certain violations of the Labor Code “on behalf of himself or herself and other current or former employees.”

In this case, a former employee was barred by the statute of limitations from suing his former employer for civil penalties on his own behalf under PAGA. (Code Civ. Proc., § 340, subd. (a) [one-year limitations period].) So the former employee sued solely to recover penalties “on behalf of . . . other current and former employees.”

Is this allowed? The Court of Appeal held it is not. To be a PAGA plaintiff (under the statutes in effect prior to July 1, 2024), a private individual must, among other things, seek to recover civil penalties on his own behalf for that violation (Leeper v. Shipt, Inc. (2024) 107 Cal.App.5th 1001, 1008-1010 (Leeper), review granted Feb. 18, 2025), and must establish that this so-called “individual claim” is timely as to at least one Labor Code violation (Arce v. The Ensign Group, Inc. (2023) 96 Cal.App.5th 622, 630 (Arce); LaCour v. Marshalls of California, LLC (2023) 94 Cal.App.5th 1172, 1184- 1185 (LaCour); Hutcheson v. Superior Court (2022) 74 Cal.App.5th 932, 939 (Hutcheson); Esparza v. Safeway, Inc. (2019) 36 Cal.App.5th 42, 59 (Esparza); Brown v. Ralphs Grocery Co. (2018) 28 Cal.App.5th 824, 839 (Brown)).

“Because the employee in this case has not and cannot satisfy these requirements, the trial court properly sustained a demurrer to the PAGA action without leave to amend.”

Vincent Albano joined the Los Angeles Police Department in 1997. He developed chronic fatigue syndrome caused by a Coxsackie B4 virus in 2003, leading to severe fatigue, insomnia, and body aches. In 2004, he took medical leave, returned with restrictions for “desk duties/low stress” and “day shifts only,” and was assigned to the detectives’ desk at Harbor Division, where he worked from 2004 to 2018 with positive performance reviews.

In 2018, despite plans to transition Albano to the Property Disposition Coordinator role, which suited his medical restrictions, the LAPD reassigned him to a night shift patrol desk position, violating his restrictions. This decision followed a meeting with Teresa Chin, who inquired about his condition but did not discuss accommodations or inform him of the reassignment. The new captain, Greg McManus, reportedly believed Albano was faking his illness and eliminated the detectives’ desk position.

No further interactive process occurred to address Albano’s restrictions or explore alternative accommodations, despite his long-standing medical documentation and prior engagement with the department.

The reassignment exacerbated Albano’s symptoms, causing severe hypertension, chronic fatigue flare-ups, and emotional distress, leading to medical leave in December 2018. Feeling targeted and unable to work night shifts, Albano retired in June 2019 after 21.5 years of service, incurring financial hardship due to a reduced pension and medical subsidy.

He filed a lawsuit in 2020, alleging FEHA violations. At trial, the jury rejected the failure-to-accommodate claim but found the City liable for failing to engage in the interactive process, awarding Albano $700,000 in past noneconomic damages and $300,000 in future noneconomic damages for physical pain, emotional distress, and loss of identity.

The City’s motion for a new trial was denied, and the Court of Appeal affirmed the judgment, finding substantial evidence supported the jury’s verdict and damages award in the unpublished case of Albano v. City of Los Angeles – B329165 (April 2025).

On appeal, the City of Los Angeles raised two primary arguments challenging the jury’s verdict and damages award in Vincent Albano’s case.

The City contended that substantial evidence did not support the jury’s finding that it failed to engage in the interactive process under the Fair Employment and Housing Act (FEHA). Specifically, the City argued that Albano failed to initiate the interactive process after learning of his reassignment to the night shift patrol desk position in December 2018, asserting that he bore the burden of reinitiating the process. Albano’s medical leave starting December 11, 2018, halted the interactive process because LAPD policy prohibited engaging in the process until he returned to work.

It also argued that Albano could not prevail because he failed to identify a reasonable accommodation that would have been available during the interactive process. The jury’s verdict was inconsistent, as the finding that the City failed to engage in the interactive process could not be reconciled with the jury’s finding that the City did not fail to provide a reasonable accommodation. (Note: This argument was referenced in the trial court motion but not developed in the City’s opening brief on appeal, leading the court to consider it abandoned or forfeited.)

In its second primary argument the City claimed that the jury’s award of $700,000 in past noneconomic damages and $300,000 in future noneconomic damages was excessive and not supported by substantial evidence.

The Court of Appeal rejected these arguments, finding substantial evidence supported both the jury’s finding of liability for failing to engage in the interactive process and the damages award, and that the award did not shock the conscience or suggest passion, prejudice, or corruption by the jury.

The California Attorney General along with 38 attorneys generals, which includes those representing United States territories and the District of Columbia, urge Congress to pass an act prohibiting pharmacy benefit managers, their parent companies or affiliates from owning or operating pharmacies, according to an April 14 letter to Congress.

According to this letter, “PBMs have overtaken the market and now wield outsized power to reap massive profits at the expense of consumers. The rise of PBMs as middlemen in the prescription drug market has resulted in patients facing fewer choices, lower quality care, and higher prices.3 PBMs’ use of affiliated pharmacies—pharmacies owned by either the PBM itself or the PBM’s parent company—has exacerbated the problem of manipulated prices and unavailability of certain prescription medications.”

“Over the past few decades, horizontal consolidation and vertical integration have transformed PBMs from useful administrative service providers into market-dominating behemoths that control the industry. The three largest PBMs process 80% of the nation’s prescriptions and bring in 70% of the specialty drug revenue. Furthermore, these same PBMs, along with the next largest three, are vertically integrated both upstream and down. Each of the top six PBMs operate their own affiliated pharmacies, while five of the top six are also a part of parent conglomerates that operate insurance companies and health care clinics.”

“The PBMs then use their place as middlemen to exert this power in ways that harm independent pharmacies, forcing these small businesses to accept contractual terms that are ‘confusing, unfair, arbitrary, and harmful.’ PBMs’ position further allows and incentivizes them to provide their affiliated pharmacies with more favorable contract terms, steer consumers away from independent pharmacies to their own affiliated pharmacies, and otherwise engage in tactics aimed at forcing their competition out of business. Over the course of the last decade, approximately ten percent of rural independent pharmacies in the United States have closed.”

“The control of the pharmaceutical ecosystem by PBMs has resulted in decreased access, affordability, and choice for many Americans seeking prescription healthcare. Congressional action is warranted to restore a free market and protect consumers and small businesses.”

“As self-designated middlemen, PBMs should not be permitted to own or operate affiliated pharmacies. Further, they should not be able to skirt such a prohibition by having a parent company or other affiliated healthcare conglomerate own a pharmacy. PBMs should be prohibited from having direct ownership ties to the parties they purport to be bridging. This requirement would allow pharmacies to compete on fair terms and create a market that is more accessible to consumers.”

A Hearst Newspapers investigation, published on April 16, 2025, revealed that surgeons across the United States have inadvertently left surgical materials – such as sponges, wires, needles, drill bits, instruments, and broken tool fragments – inside patients’ bodies over the past decade. The full article is available on Hearst Newspapers’ platforms, such as the San Francisco Chronicle or Houston Chronicle

These incidents, known as retained surgical items (RSIs) or “never events,” are rare but can have severe consequences, including infections, organ damage, additional surgeries, and, in extreme cases, death. The investigation, conducted by reporters Emilie Munson and Leila Merrill, highlights the persistence of these medical errors despite protocols designed to prevent them, such as mandatory counting of surgical items and the use of radiopaque sponges visible on X-rays.

While exact numbers vary due to underreporting, studies cited in related sources estimate RSIs occur in approximately 1 in every 5,500 surgical procedures, with around 1,500 cases annually in the U.S. The Hearst investigation emphasizes that these incidents often require additional surgeries, extend hospital stays, and cause significant patient harm, such as infections, abscesses, or organ damage. For example, retained sponges, which account for 48% to 69% of RSIs, can lead to “gossypiboma,” where the body forms a mass around the foreign object, causing pain or complications like fistulas or bowel obstructions.

The investigation notes a range of items left behind, including:

– – Surgical sponges and gauze (most common, often used in large quantities during procedures).
– – Needles, wires, and drill bits.
– – Surgical instruments like clamps or retractors.
– – Broken fragments of tools, such as catheter tips or parts of wire cutters.These items are typically left in the abdomen, pelvis, or chest, but cases have been reported in vaginas, spinal canals, and even brains

The investigation points to human error as a primary cause, often due to:

– – Inaccurate manual counting of surgical items, which can be disrupted by complex procedures, shift changes, or distractions.
– – Poor communication among surgical teams.
– – Complacency or overconfidence in counts reported as correct, even when items are missing.
– – Inadequate documentation or failure to follow protocols like the World Health Organization’s surgical safety checklist.

The investigation references specific cases to illustrate the human toll:

– – A 2021 case where a woman suffered for 18 months after a plastic wound retractor (the size of a dinner plate) was left inside her abdomen following a C-section. An abdominal CT scan eventually
– – A 2018 case in Japan where a woman experienced abdominal bloating for six years due to two gauze sponges left during a C-section, which had adhered to her connective tissue and colon
– – A California man who suffered infections and septic shock from two retained surgical clamps, leading to a stroke.

The investigation underscores systemic challenges, including:

– – Underreporting of RSIs due to inconsistent definitions, varying reporting requirements, and fear of litigation.
– – Limitations of manual counting processes, which are prone to error in high-stress, complex surgeries, especially those involving obese patients or trauma cases requiring numerous instruments
– – Resistance to adopting new technologies, such as RFID-tagged sponges or barcode systems, due to cost or integration challenges, despite their potential to reduce errors.
– – RSIs lead to significant costs for hospitals, with a single case potentially costing up to $600,000 due to corrective surgeries and legal fees. Malpractice claims are common, with a 2003 study noting an average of $52,000 in compensation and legal expenses per case.

Hospitals employ several strategies to prevent RSIs, including:

– – Surgical teams count sponges, instruments, and other items before and after procedures. However, studies show that counts are often recorded as correct even when items are left behind.
– – Sponges and some instruments are embedded with X-ray-detectable materials to aid identification if left inside a patient.
– – The WHO surgical safety checklist and National Safety Standards for Invasive Procedures aim to standardize safety checks, but compliance varies.
– – Systems like ORLocate’s Surgical Counting and Detection System use RFID or barcode technology to track items more accurately, but adoption is not widespread.

Despite these measures, the investigation notes that errors persist due to the complexity of surgical environments, staff fatigue, and organizational pressures, such as high workloads or frequent staff changes during procedures.

The Hearst investigation aligns with prior studies and reports highlighting RSIs as a persistent patient safety issue. For instance, a 2008 study at the Mayo Clinic found RSIs in 1 in 5,500 surgeries, with most counts incorrectly reported as accurate. A 2017 article from the National Center for Biotechnology Information (NCBI) notes that RSIs can be life-threatening, often requiring further operations. The investigation also reflects Hearst Newspapers’ history of award-winning investigative journalism, as seen in their Polk Awards for reporting by the San Antonio Express-News and San Francisco Chronicle.

Discover Magazine on RSIs discusses real-world cases, such as the 2021 C-section retractor case and the 2018 Japanese gauze case, with broader implications. Washington Post on Never Events Reports 4,857 objects left in patients over two decades, with insights into malpractice claims and systemic issues. Times Union on New York Cases details specific RSI incidents, including a surgical sponge missed during a hysterectomy due to incorrect counting. PSNet on RSI Epidemiology offers data from California’s reporting system (2007–2011), noting 58% of RSI cases involved sponges or towels. Minnesota Department of Health reports 270 retained objects since 2003, emphasizing sponges and clamps as common items.