Terms of Use

1. Acceptance of Terms

By accessing or using EKG Cases ("Platform"), you agree to comply with and be bound by these Terms of Use. If you do not agree with any part of these terms, you may not access or use the Platform.

The Platform is owned and operated by Dr. José de Alencar Neto ("we", "our", or "EKG Cases"), a cardiologist registered with the São Paulo Regional Medical Council (CREMESP) under number 166889. EKG Cases is operated from São Paulo, Brazil. By using the Platform, you acknowledge that the service is provided by a Brazilian entity subject to Brazilian law, with servers and data processing that may occur in Brazil and other countries as described in our Privacy Policy.

2. Description of Service

EKG Cases is an educational platform designed for healthcare professionals and medical students to practice and improve their electrocardiogram (EKG) interpretation skills. All EKG tracings presented on the Platform have been <strong>de-identified in accordance with the HIPAA Safe Harbor method</strong> — all 18 categories of protected health information (PHI) have been removed. The clinical scenarios accompanying each EKG (such as patient age, sex, symptoms, and medical history) are <strong>entirely fictional</strong> and created solely to enhance the educational experience.

The Platform is NOT a medical diagnostic service. The EKGs presented are exclusively for educational purposes and should not be used for diagnosis or treatment of real patients. No real patient data is displayed at any point on the Platform.

3. Registration and Account

To use the Platform, you must:

• Be at least 18 years of age
• Provide true, accurate, and complete information during registration
• Maintain the confidentiality of your password and account
• Be responsible for all activities carried out on your account
• Notify us immediately of any unauthorized use of your account

4. Plans and Payments

The Platform offers:

• Free Plan: 10 EKG cases per month
• Premium Plan: Unlimited access to EKG cases
• Premium +AI Plan: Unlimited access + AI-powered feedback

Payments are processed securely through Stripe. By subscribing to a paid plan, <strong>you expressly consent to and authorize automatic recurring charges</strong> to your credit card on a monthly or annual basis (depending on the plan selected) until you cancel. The amount charged will be the price displayed at the time of subscription, unless we notify you of a change in advance. You will receive an email confirmation with the exact amount, billing frequency, and next charge date at the time of purchase.

You may cancel your subscription at any time through the Platform by going to <strong>"My Plan" → "Cancel Subscription"</strong>, or by contacting us at <strong>contact@ekgcases.com</strong>. Cancellation takes effect at the end of the current billing period — you will retain access to paid features until then, and no further charges will be made.

5. Cancellation and Refund Policy

5.1. Right of Withdrawal

Users who subscribe to any paid plan have the right to cancel within 7 (seven) calendar days from the date of subscription, without justification and without any penalty.

• The 7-day period begins on the date of payment confirmation
• Requests should be made by email to contact@ekgcases.com or through the Platform
• The refund will be full, including the total amount paid
• The amount will be refunded to the same payment method used for purchase
• The refund processing time is up to 10 (ten) business days after cancellation confirmation

5.2. Cancellation After the Withdrawal Period

After the 7-day withdrawal period, you may still cancel your subscription at any time, subject to the following conditions:

5.2.1. Monthly Subscriptions

• Cancellation may be requested at any time
• No prorated refund for the unused portion of the current month
• Access to premium features remains active until the end of the paid period
• No additional charges will be made after cancellation
• The user automatically returns to the free plan at the end of the period

5.2.2. Annual Subscriptions

• Cancellation may be requested at any time
• If requested within the first 30 (thirty) days: 80% refund of total amount
• If requested after 30 days: no refund, but access remains until the end of the contracted period
• The discount granted for annual subscriptions considers the commitment for the full period

5.3. Procedure for Cancellation or Refund Requests

To exercise your right to cancel or request a refund, you must:

1. Access the Platform and go to "My Plan" → "Cancel Subscription"; or
2. Send an email to contact@ekgcases.com with the subject "Cancellation Request"
3. Provide: full name, registered email, subscription date, and reason for cancellation (optional)
4. Wait for email confirmation within 48 business hours

5.4. Refund Processing Times

* The time for the refund to appear on your statement depends on your credit card company and is outside our control.

5.5. Situations That Do NOT Warrant a Refund

No refund will be granted in the following situations:

• Request after 7 days for monthly subscriptions (except service defects)
• Request after 30 days for annual subscriptions
• Proven use of premium services beyond the trial period (more than 10 interpreted cases)
• Suspension or ban for Terms of Use violations
• Inability to use due to external factors (no internet, incompatible device, etc.)
• Lack of awareness of platform features (available for review before subscription)

5.6. Service Defects

In case of quality defects that make the service unfit for use or diminish its value, the consumer has the right to:

• Re-execution of services, at no additional cost
• Immediate refund of the amount paid, with monetary adjustment
• Proportional price reduction

Quality defects include: prolonged platform unavailability (exceeding 72 consecutive hours), systematic errors in official reports, or serious security failures that compromise user data.

5.7. Undue Charges

In case of undue charges, the consumer has the right to restitution of double the amount overpaid, plus monetary correction and legal interest, unless justified error.

To report undue charges, contact us immediately at contact@ekgcases.com attaching proof of the charge.

5.8. General Refund Provisions

• All refunds are processed through Stripe, our payment platform
• Refunds are made exclusively to the same card/account used for purchase
• We do not issue refunds in cash, bank transfer, or other payment methods
• The user will receive proof of cancellation and refund by email
• Questions about refund status can be checked on the Stripe portal or with your card issuer

6. Intellectual Property

All content on the Platform, including but not limited to:

• EKG images
• Reports and interpretations
• Text, graphics, and design
• Source code and software
• Logos and trademarks
• Didactic and educational material

Are the exclusive property of EKG Cases or its licensors and are protected by copyright, trademark, and other intellectual property laws.

It is expressly prohibited to:

• Copy, reproduce, or distribute any content from the Platform
• Mass download EKG images
• Use web scraping, bots, or automated techniques to extract data
• Modify, adapt, or create derivative works from the content
• Remove copyright or proprietary notices
• Use the content for commercial purposes without prior written authorization
• Reverse engineer the software or source code

7. Acceptable Use

When using the Platform, you agree NOT to:

• Violate any applicable law or regulation
• Share your account or access credentials with third parties
• Attempt to access restricted areas of the Platform without authorization
• Interfere with the proper functioning of the Platform
• Transmit viruses, malware, or malicious code
• Collect information from other users
• Use the Platform for spam or unauthorized advertising

8. Medical Disclaimer

IMPORTANT NOTICE:

• The Platform is exclusively for educational and training purposes
• It does not replace professional medical evaluation, diagnosis, or treatment
• It should not be used to diagnose or treat real patients
• The EKGs presented have been de-identified and their clinical contexts are entirely fictional
• Always consult a qualified physician for clinical questions
• No doctor-patient relationship is created between you and EKG Cases, its operators, or any contributor by your use of this Platform

EKG Cases is not responsible for clinical decisions made based on the educational content of the Platform.

AI Features Disclaimer (EKG-AI): The Platform includes an optional AI-powered feedback feature ("EKG-AI"). EKG-AI is a large language model trained for educational purposes only. It is not an FDA-cleared or approved medical device. It does not provide medical advice, diagnoses, or treatment recommendations. EKG-AI responses may contain errors and should always be verified against established medical literature and clinical judgment. Do not rely on EKG-AI output for any real clinical decision.

9. Limitation of Liability

To the maximum extent permitted by law, EKG Cases shall not be liable for:

• Indirect, incidental, special, or consequential damages
• Loss of data, profits, or business opportunities
• Service interruptions or technical failures
• Third-party content or external links

10. Modifications to Terms

We reserve the right to modify these Terms of Use at any time. Significant changes will be communicated by email or through the Platform.

Continued use of the Platform after modifications constitutes acceptance of the new terms.

11. Termination

We may suspend or terminate your access to the Platform immediately, without prior notice, for:

• Violation of these Terms of Use
• Fraudulent or illegal conduct
• Non-payment of subscription
• Any reason at our sole discretion

12. Governing Law and Jurisdiction

These Terms of Use are governed by the laws of the Federative Republic of Brazil.

The courts of São Paulo, State of São Paulo, Brazil, are elected to resolve any disputes arising from these Terms. However, nothing in these Terms limits or waives any rights you may have under mandatory consumer protection laws in your jurisdiction, including but not limited to the laws of the state in which you reside in the United States.

13. Contact

For questions about these Terms of Use, cancellations, refunds, or any other inquiries, contact us:

• Responsible: Dr. José de Alencar Neto
• CREMESP: 166889
• Email: contact@ekgcases.com
• Website: ekgcases.com

Business hours: Monday to Friday, 9 AM to 6 PM (Brasília time, GMT-3). Requests sent outside these hours will be answered on the next business day.

14. Use of Aggregated Data for Scientific Research

By using the Platform, you agree that data generated by your interaction with electrocardiographic tracings may be used for scientific research purposes, under the following conditions:

14.1. Data that may be used

The Platform may collect and analyze, in an aggregated and anonymous manner, data related to the diagnostic properties of electrocardiographic tracings, including but not limited to:

• Interobserver kappa agreement index by diagnosis
• Agreement and disagreement rates by diagnostic category
• Tracing difficulty index
• Confusion matrices between electrocardiographic diagnoses
• Sensitivity and specificity by electrocardiographic finding
• Psychometric analysis of the platform's assessment items (difficulty index, discriminative power)

14.2. Nature of the research

Research conducted with this data has as its object of study the electrocardiographic signals and the diagnostic properties of the tracings, not the individual performance of users. Users act as evaluators who generate metrics about the signals — analogous to pathologists who classify slides to validate histological criteria, or faculty members who analyze psychometric indices of exams to validate assessment instruments.

As this involves analysis of diagnostic agreement of electrocardiographic tracings, without collection of identifiable respondent data, this type of study does not constitute human subjects research under applicable regulations.

14.3. User guarantees

• Absolute anonymity: no demographic data, personal identifier, level of training, year of residency, years of experience, or any individual characteristic of the user will be collected, stored, or published in the context of this research
• Exclusive focus on the signal: published data refers exclusively to the properties of electrocardiographic tracings, never to the performance of identifiable individuals
• Aggregated data: results will always be presented in aggregate form, making it impossible to identify any individual user
• No correlation with personal data: under no circumstances will research data be correlated with personal, demographic, or professional data of respondents

14.4. Examples of permitted use

By way of illustration, data may be used in scientific publications framed as:

• "Interobserver agreement in electrocardiographic diagnosis: analysis of real tracings"
• "Difficulty index and discriminative power of electrocardiographic tracings in an educational platform"
• "Confusion matrix between electrocardiographic diagnoses: agreement analysis"

14.5. Right of objection

If you do not wish your tracing interaction data to be included in aggregated analyses, you may request exclusion at any time by emailing contact@ekgcases.com. Exclusion will be processed within 30 business days and will not affect your access to the Platform.