Failure to Diagnose Stroke Lawsuit: $1.5 Million Settlement
2020 Medical Malpractice Settlement Report
By Attorney William J. Thompson
Barnstable Superior Court
Failure of ED physician to manage elevated blood pressure and glucose results in stroke of 51-year-old woman
The plaintiff, a 51-year-old woman with a past medical history of hyperlipidemia and hypertension, suffered a right pontine stroke resulting in permanent neurological injury.
On 3/10/14, at 8:37 a.m., she presented to a hospital with an elevated blood pressure and pulse. She was noted to have slurred speech and an unsteady gait. She was last seen well at 6:15 a.m. In the emergency department (ED), she stated she felt fine, and was just tired. She was alert and oriented and passed a feeding/swallow trial. Her NIH stroke scale score was 1 out of 15 due to mild to moderate dysarthria. On examination by the defendant ED physician, she had no focal motor, no focal sensory, and no cerebellar deficits noted. The doctor ordered a drug screen, alcohol level, complete blood count, basic metabolic profile, a head CT scan, and chest x-ray.
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The head CT scan showed a lacunar infarct in the right basal ganglia with no evidence of an acute territorial infarct and no evidence of an acute intracranial process. The plaintiff’s blood glucose level was significantly elevated at 481. Her drug and alcohol screens were negative.
The doctor noted she had improved since her arrival and had no evidence of meningitis, encephalitis, or cerebrovascular accident at the time of her discharge. He instructed her to follow-up with her primary care physician in the next 1-2 days and discharged her with a diagnosis of hyperglycemia and hypertension. He did not order or administer any medications to lower her blood pressure or glucose level prior to her discharge. She left the ED at 11:38 a.m.
On 3/12/14, she presented to her PCP with difficulty walking, an inability to stand, slurred speech, and hypertension. Her symptoms had significantly worsened over the last 24 hours. She was sent to the ED and diagnosed with a stroke. Four days later she was discharged to rehabilitation.
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Today the plaintiff has an unsteady gait, she has left sided weakness, and her speech remains difficult to understand. She requires some assistance with activities of daily living.
The plaintiff claimed the defendant doctor failed to manage her elevated blood pressure and glucose, which resulted in the plaintiff’s stroke. The defendant contended he complied with the applicable standard of care and nothing more was required regarding his treatment and discharge from the ED.
The case settled prior to trial for $1,500,000.
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