Safety posture + IRB trajectory
GOATnote Prism42 is a synthetic-fixture public demo. It is not a medical device, not FDA-cleared, not CDS-exempt, not a substitute for calling 911 on a real phone.
Safety preambles (SP-001 through SP-010)
Every voice-facing agent is bound to ten preambles rooted in the repo's docs/safety-preambles.md:
- SP-001 — simulation disclosure + terminal refusal on real-emergency claim
- SP-002 — scope: GEDP v0.1 (MIT) only; no MPDS / IAED content
- SP-003 — PHI refusal (no SSN, no insurance, no full DOB)
- SP-004 — no dosing, no diagnosis, no medication advice
- SP-005 — no fabrication under uncertainty (defer instead)
- SP-006 — structured-JSON self-verify gate on every turn
- SP-007 — 12-minute session budget + latency-breach alert
- SP-008 — 988 guided-redirect for suicidal ideation (3-step script)
- SP-009 — verbatim refusal templates
- SP-010 — post-session audit consent disclosed during intake
Cross-vendor grader independence
Every voice turn is graded against five HealthBench Hard-aligned criteria by a different-vendor model so the voice-facing agent can't grade itself. Primary: gpt-5-5 (OpenAI, runtime chat-completion call outside Managed Agents). Fallback: gpt-5-4. Emergency shim: claude-opus-4-7 (raises self_grade_flag; session score becomes non-load-bearing for published baselines).
IRB trajectory
- Phase 0 — Synthetic fixtures (now). No PHI. 42-scenario red-team battery runs in CI; all voice-facing agents emit structured JSON under
schemas/psap-turn.schema.json. - Phase 1 — IRB pilot. Protocol
2026-GN-PSAP-001(drafted). One PSAP, clinical director on every shift, AI surfaces logged but not load-bearing. - Phase 2 — Prospective outcome study. Paired pre/post at 2–3 PSAPs. Secondary outcomes: time-to-determinant, T-CPR delivery rate, GEDP adherence, OHCA first-minute recognition.
- Phase 3 — Pre-submission + SaMD filing. FDA 510(k) or De Novo depending on clinical-decision-support classification. Class II SaMD target.
Clinical direction
Developed under the direction of Brandon Dent, MD (emergency medicine) as clinical director of GOATnote Inc. Clinical-content changes to docs/dispatch-protocol-v0.1.md require physician re-signature; the CI safety-expert agent enforces this gate.
Responsible-disclosure posture
Model-behavior observations route through docs/clinical-handling.md: physician review first, Anthropic feedback channel second, research venue third. Never public-issue-tracker, never social media.