A Delaware federal court ordered Guardant Health to pay roughly $245 million in damages, royalties and interest to TwinStrand Biosciences and the University of Washington for duplex sequencing patent infringement. The ruling included supplemental damages, a 6% ongoing royalty on multiple Guardant products and services, and an obligation for quarterly US sales accounting. The court referenced earlier findings including 2023 liability and noted PTAB invalidation outcomes for certain claims, while other aspects remain under review. This decision raises near-term economic risk for Guardant and reinforces the value of duplex-consensus sequencing IP in next-generation sequencing error-reduction strategies.