For all the promise that artificial intelligence holds for medtech, the technology has reportedly had horrific patient outcomes when used in the operating room.
A special report from
Reuters
, published Monday, paints a rather grim picture in its headline:
As AI enters the operating room, reports arise of botched surgeries and misidentified body parts
.
Among other medical devices highlighted in the article, the article places a heavy amount of scrutiny around the TruDi Navigation System, which uses a machine-learning algorithm to assist ear, nose, and throat specialists in surgery.
Integra LifeSciences acquired the TruDi system in late 2023 when it bought Acclarent from Johnson & Johnson for $275 million
.
According to the report, the device had been on the market for about three years before artificial intelligence was added to it. In those three years, FDA received unconfirmed reports of seven instances in which the device malfunctioned and another report of a patient injury. However, since AI was added to the device, the agency has received unconfirmed reports of at least 100 malfunctions and adverse events, Reuters reported.
Allegedly, cerebrospinal fluid leaked from one patient’s nose. Another two patients suffered strokes after a major artery was accidentally injured, according to the report. It is not clear what role AI may have played in these events, the report cautions, as FDA device reports may be incomplete and are not meant to determine causation. The two stroke victims each filed a lawsuit in Texas alleging that the TruDi system’s AI contributed to their injuries.
Integra told
Reuters
the FDA device reports “do nothing more than indicate that a TruDi system was in use in a surgery where an adverse event took place.” The company added that “there is no credible evidence to show any causal connection between the TruDi Navigation System, AI technology, and any alleged injuries.”
Missed heart arrythmias and mislabeled body parts
Medical device makers have been racing to incorporate AI into products for several years now. At least 1,357 medical devices using artificial intelligence are now authorized by FDA. In addition to the TruDi system,
Reuters
found that the agency has received reports involving dozens of devices that have been enhanced by AI.
The report also mentions Medtronic’s Linq family of implantable cardiac monitors. At least 16 reports claimed that the AI-assisted heart monitors failed to recognize abnormal rhythms or pauses. None of the reports mentioned injuries, and Medtronic told FDA that some of the incidents were caused by “user confusion.”
The company told
Reuters
it reviewed all the reports and concluded its device only missed one abnormal heart-rhythm event. Some of the incidents were related to problems with data display, not the AI technology used in the device, Medtronic noted.
Another medical device mentioned in the article, the Sonio Detect from Samsung Medison, a unit of Samsung Electronics, uses AI to assist with prenatal ultrasounds. Allegedly, the AI software mislabeled fetal structures and associated them with the wrong body parts, according to an FDA device report filed in June 2022.
Samsung Medison told
Reuters
the FDA report “does not indicate any safety issue, nor has the FDA requested any action from Sonio.”
AI in medtech: use responsibly
Over the past three decades, FDA authorized at least 1,357 medical devices that use AI,
Reuters
reported. More than half were added in the last three years, showing the rapid acceleration of the technology’s use in medtech.
Maria Palombini, healthcare and life sciences global practice lead at the IEEE Standards Organization, a nonprofit group that establishes global technology standards for the medtech industry, spoke with
MD+DI
about
the role of responsible AI in medtech
.
She said it will take some time to assess performance before comprehensive strategies can be taken to move AI forward effectively and safely.
“Integrating AI responsibly and being able to validate the results is going to be a challenge for everybody,” Palombini said. “But if all pieces fall into the right place with consistent progress in showing that AI can be ethically or responsibly deployed, and we're able to validate outcomes on a consistent and continuous basis, AI can significantly impact the healthcare industry. But it's too early to tell. AI offers a lot of promise, but we have to take it with an extremely large grain of salt before we get too overly excited about it.”
Regulatory challenges with AI in medtech
Image credit: Kevin Dietsch/Getty Images
The report also highlights the fact that about four years ago, FDA expanded its roster of scientists who specialize in AI, particularly for reviewing medical imaging and radiology devices that use it. But early last year things at the agency changed drastically as the Trump administration began to dismantle the AI team as part of Elon Musk’s Department of Government Efficiency (DOGE).
About 15 of the 40 scientists in the Division of Imaging, Diagnostics and Software Reliability were either laid off or quit,
Reuters
reported, citing unnamed FDA insiders (current and former employees of the agency). Around the same time, the Digital Health Center of Excellence lost about a third of its staff of around 30.
In February 2025,
AdvaMed President and CEO Scott Whitaker raised concerns about the widespread cuts to FDA’s workforce
.
He cited the industry's latest user-fee agreement with FDA that, for the first time ever, created private sector-like incentives for FDA to be more efficient, transparent, and predictable in its review process. The idea behind this was to make leading-edge medical technologies and treatments available to American patients sooner while still ensuring the safety of the products being approved.
"Working together, we can achieve a more efficient and effective FDA. But, on behalf of our members, I am concerned that the cuts made over the weekend will not accomplish that. I am also concerned that it puts at risk our nation's status as the top medtech market in the world — as the global leader in medtech innovation, manufacturing, and jobs."
Whitaker also pointed out that eliminating FDA's recent critical hires in the AI space would dramatically slow review times and require reassigning non-experts that remain on staff to review these technologies. These non-experts in AI will, Whitaker says, "inevitably make slower and potentially inappropriately conservative decisions."
AI silver linings
On the bright side, AI does have the potential to impact medtech and the broader healthcare industry in positive ways. We’re already seeing companies like
Johnson & Johnson leverage artificial intelligence to boost manufacturing productivity
. We’re also hearing design and engineering experts talk about
ways AI can have an impact at the design and engineering level
.
In terms of devices in the pipeline that are AI-powered, we’re seeing
AI being used to help with early detection of stroke
;
enhance usability of wheelchairs
;
analyze pre-operative imaging to generate patient phenotypes for surgeons
; and so much more.
However, medtech companies must place patient safety at the forefront by conducting thorough testing, validating AI algorithms, and ensuring transparency in device functionality.