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The Pitt is an American medical drama television series set in the fictional Pittsburgh Trauma Medical Hospital. It follows one 15-hour shift in real time and explores the professional and personal issues faced by its doctors and medical staff.
In The Pitt, Dr. Cassie McKay, portrayed by Fiona Dourif, is a second-year emergency medicine resident. She wears an ankle monitor as part of her probation stemming from an incident with her ex-husband's girlfriend, Chloe, who obtained a restraining order against her.
Both McKay's history of substance abuse and having lost custody of her son contributed to the court ruling against her. In The Pitt, season 1, episode 14, during a mass casualty incident at PittFest, Mckay's ankle monitor malfunctions and disrupts the ER.
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To prevent further distraction and continue treating patients, she disables it using medical tools, violating her probation and resulting in her arrest.
Dr. McKay's backstory and personal struggles in The Pitt
In The Pitt, season 1, Dr. McKay appears in every episode wearing an ankle monitor, an unusual visual detail for a doctor in an emergency setting. McKay reveals to one patient in episode 5 that she has had drug addiction issues in her past that directly resulted in the loss of custody of her son, Harrison.
McKay's complicated past with her ex-husband Chad (played by Rob Heaps) is one prominent point in her plot. The confrontation escalates when Chad's new girlfriend, Chloe (played by Jonetta Kaiser), appears on the scene.
Chloe and McKay have a history of fighting that mounted to legal action, with McKay facing a restraining order filed against her.
The legal incident behind the ankle monitor
In The Pitt season 1, the incident that resulted in McKay's ankle monitor is not shown in detail but is suggested within dialogue and character interaction. According to an article published on Screen Rant on April 8, 2025, Chloe references an encounter when she felt threatened enough to obtain legal protection.
Given McKay's prior drug record on her part, the court issued a stricter sentence, mandating probation with the stipulation of wearing an electronic monitoring device. McKay received harsher penalties compared to Chloe because she had a history of drug addiction.
Workplace challenges and technical malfunctions
The ankle monitor becomes a recurring tension in the hospital. McKay's device malfunctioned repeatedly across several episodes, including falsely reporting her location and making loud, disruptive beeping sounds.
Such technical malfunctions interrupt the flow of critical medical procedures and stress McKay and her colleagues in the high-pressure emergency department.
During regular shifts, McKay has to deal with emergency responsibilities amidst interference from the monitor. In episode 14, these challenges culminate during a PittFest shooting mass casualty incident. Suddenly, the monitor starts its siren amid the response to multiple emergencies and disrupts the emergency team.
As the patients were in critical condition and time-sensitive decisions needed to be made, McKay decided to deactivate the device with an IO (intraosseous) drill, a medical equipment usually employed to access bone marrow.
Consequences of tampering and ethical conflict
McKay's action to deactivate the monitoring ankle represented an overt breach of her probation. She was arrested shortly after the incident, despite having acted to maintain the operational efficiency of the ER during an emergency.
The arrest highlights the legal consequences of tampering with court-ordered monitoring equipment under any circumstances. McKay values patient well-being and hospital safety more than strict legal adherence.
Her fellow staff members who witnessed the scenario defended her action, saying she knew her choice had to be made under extreme conditions. However, the law did not consider the situation, resulting in immediate legal consequences.
The episodes of The Pitt season 1, can be streamed on Max.
