A 29-year-old female from New York City comes in at 3 a.m. to an emergency department (ED) in California, complaining of severe acute abdominal pain that woke her up. She reports that she is visiting California to attend a wedding and that she has suffered from similar abdominal pain, most recently resulting in an appendectomy. The emergency physician performs an abdominal CAT scan and sees what he believes to be an artifact from the appendectomy in her abdominal cavity. He has no information about the patient's past history other than what she is able to tell him; he has no access to any images taken before or.