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Judge Marstons August 15, 2025 ruling clarified: Clinical diagnosis based solely on symptoms is not sufficient You must have objective diagnostic testing Specifically: gastric emptying scan (4-hour scintigraphy study) Alternative tests: gastric emptying breath test or wireless motility capsule (SmartPill, though discontinued) Why this matters: Many patients were told they had gastroparesis based only on symptoms Without objective testing, defendants will challenge the diagnosis Court ruled that symptom-based diagnosis isnt reliable enough Need scientific proof of delayed gastric emptying What if you have symptoms but no formal testing