Your 1a and 1b say completely different things, and 2, 3, and 4 are even further away. In 1a, someone says something. In 4, you seem to have an objective fact

Your 1a and 1b say completely different things, and 2, 3, and 4 are even further away. In 1a, someone says something. In 4, you seem to have an objective fact about a patient.