Restart your computer and then do this:
Open the Security & Privacy window in System Preferences.
Choose Accessibility on the left.
Click the lock in the bottom left to make changes, if required.
Select PokerTracker 4 and click the "-" (minus) below to remove the permission.
Then try starting PokerTracker 4 again. If that doesn't change anything please press/hold the 'Alt/Option' key while starting PokerTracker 4 to enable logging, reproduce the issue and then attach your log file to a
Support Ticket:
\Users\{Mac Login}\Library\Application Support\PokerTracker 4\Logs\PokerTracker4.log