AI false-positive pneumothorax alert after pacemaker: CT confirms phantom finding

AI chest radiograph flagged right apical pneumothorax after left-sided pacemaker; chest CT definitively excluded pneumothorax. Alert was clinically discordant: left-sided access, normal oxygen saturation, hemodynamic stability. AI is decision support, not autonomous diagnosis.

• Single case report: 81-year-old man after uncomplicated left-sided dual-chamber pacemaker implantation.
• Primary finding: AI-assisted chest radiograph positive alert for right apical pneumothorax was false positive, confirmed by chest CT; no additional intervention and uneventful recovery.
• Clinical discordance anchors: left-sided venous access, normal oxygen saturation, hemodynamic stability, no respiratory symptoms; AI should be physician-supervised decision support.

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