Elias sat in the inquiry room with a bottle of water and a closed folder. Before the recorder started, Zawadi told him he could refuse any question outside the consent he had given.
“This is not an interrogation. We record facts that complicate your account as well as facts that support it.”
“I want that on the record.”
“It is now.”
Elias confirmed that Nocturne had helped when his episodes first began. “I don't want anyone writing that everything was bad from the start.”
The problem, he said, came when the care plan and the debt became harder to separate.
His contract contained an extension clause: repeated qualifying episodes or increased refill frequency could extend the continuation period and roll unpaid balances forward.
“What did that mean to you?” Zawadi asked.
“When I tried to leave, they told me the debt was still tied to continuity services.”
He produced billing messages offering stabilized repayment through continued care.
Zawadi then asked the questions that made his testimony less convenient.
“How many appointments did you miss?”
“Three.”
“Did you ever use a dose differently from instructions?”
“Once. I was late.”
Elias looked uncomfortable but did not withdraw.
“Yes, I missed appointments. Yes, I was angry. But refill frequency increased after the new formula, and the debt followed the refills.”
The older contract appendix used longer refill intervals. A later version shortened review intervals for patients with repeated episodes.
“Recommendation is not automatically coercion,” Leila said from the observer chair.
“Correct,” Zawadi replied. “That is why the clause and its implementation need review, not a headline.”
They also examined late fees, missed reminders and Elias's own fear that every appointment created another bill. When he admitted that fear had been his inference rather than a direct statement by Nocturne, Zawadi recorded the distinction.
“You're putting that in too?”
“Yes. A statement becomes stronger when its limits are visible.”
They reviewed payment messages and account closure records. Some refill charges appeared inside the continuation balance after the plan revision, but a finance reviewer would have to reconcile the amounts against Nocturne's ledger.
Elias received a receipt for every document he supplied and a route to correct his testimony later.
“What happens to my debt?” he asked.
“Review does not erase it today,” Zawadi said. “But the clause can be examined without forcing you to rejoin the care plan just to challenge it.”
The coercive-care review opened a route for other patients as well.
After Elias left, Zawadi tagged the financial evidence NOT YET RECONCILED. Then she showed Leila the two refill-frequency appendices.
Their version history still had to be verified.
But the copies Elias received showed the change clearly.
Before closing the inquiry, Zawadi read Elias a complete summary that included the inconvenient parts: missed appointments, one mistimed dose, the benefits he had received from Nocturne, the closure mismatch and the debt concern. Elias said he preferred that version to being turned into a perfect victim.
Leila left with a new question for later system design: had care identity and debt identity been fused so tightly that leaving one threatened access to the other? Zawadi made her write it as a question, not a finding. Version history and ledger reconciliation would decide what the record could support.
Zawadi then asked the legal reviewer to separate three questions that had been tangled in the room: whether the debt calculation was correct, whether continuation terms could pressure patients to remain in care, and whether refill frequency changed after the formulation change. A finding on one would not automatically answer the others.
Elias's evidence opened the review, but it would not be the only patient account. The Board planned a voluntary notice so other patients could submit contracts without making Elias the public face of everyone affected.
The contract itself, the billing ledger and the patient experience would therefore be reviewed on separate tracks before any final regulatory conclusion was written.
No final conclusion would be allowed to collapse those separate questions into one accusation.
As written, refill frequency increased after the new formula.