Stroke Lawsuit Settles for $1 Million
2012 Medical Malpractice Trial Report
Failure of Physician Office Staff to Recognize Significance of TIA and Schedule Immediate Evaluation Leads to Stroke
This medical malpractice action involves a delay in diagnosis of carotid stenosis, resulting in a stroke. The plaintiff was on a business trip approximately 2-3 hours away from home when he experienced an acute onset of lightheadedness, vertigo and nausea in his hotel room. The plaintiff also experienced numbness and tingling of his left arm for approximately one minute. The plaintiff called 911 and he was taken to the Emergency Room (ER) via ambulance.
The plaintiff was seen in the ER by a doctor who ordered testing including a brain CT scan. All relevant tests were normal. The plaintiff was discharged with the diagnosis of benign transient labyrinthitis verses transient ischemic attack (TIA). The plaintiff was told to have “close follow up” with his primary care physician when he returned home. He specifically mentioned that follow up include a “duplex study of the carotids, consider MRI or CTA in follow up. ” The next day, the plaintiff drove back to his home.
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As instructed, the plaintiff telephoned the office of his family practice physician and explained to the receptionist what occurred at the ER, including that there was a question of a TIA. The employee of the Family Practice office scheduled an appointment for the following Tuesday (4 days later). Two days after speaking with the Family Practice office and two days before his scheduled follow up visit, the plaintiff’s wife noted a left facial droop and left sided weakness. He was sent emergently to the hospital where he was diagnosed with a right MCA stroke and given tPA. Testing showed infarction of his brain with occlusion of his right carotid artery. By the time of discharge, the plaintiff required a straight cane to ambulate and was subsequently noted to have a chronic pain syndrome as a result of his stroke.
The defense argued that the fact that he had been discharged from the emergency department and was not kept overnight for observation implies in and of itself a lack of urgency for an appointment and that further testing was clearly meant to be done on an outpatient basis and doing so within one week met the standard of care. The plaintiff countered that the emergency room doctor expressly recommended close follow-up with the family practice physician for the patient and that the receptionist was not the person who should be making the determination of timing.
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