Case #1017: Stroke
On July 24, the Plaintiff was brought to the Defendant Hospital via ambulance. She arrived at approximately 1:30 p.m. with complaints of significant right-sided weakness and a change in mental status. She was confused and shortly thereafter became drowsy, clumsy, and was slurring her speech.
She was seen by a resident at the Defendant Hospital who noted facial asymmetry with a right drift. She continued with the slurred speech. Accordingly, the resident attempted to obtain a neurology consultation. However, none was forthcoming for approximately four hours in violation of the standards of care.
At approximately 2:00 p.m., the Plaintiff had a CT scan of the brain, which revealed a previous posterior right Middle Cerebral Artery (MCA) infarction. At 4:50 p.m., duly authorized agents and employees of the Defendant Hospital noted that they were still awaiting a neurology consultation, which did not occur until approximately 5:30 p.m. At that time, the neurologist noted the positive history of cerebral vascular accident and confirmed the right droop and slurring speech that the Plaintiff continued to experience. Subsequently, the neurologist documented that a follow-up examination revealed a worsening of her condition, including slurred speech, increased right facial droop with a right upper extremity drift. However, notwithstanding the Plaintiff’s serious condition and ongoing evidence of an evolving stroke, duly authorized agents and employees of the Defendant Hospital simply arranged to transfer the patient to another facility for insurance purposes.
It is alleged that transfer of the Plaintiff under these circumstances for insurance purposes violates the standards of care. The Plaintiff certainly was not stable, had signs and symptoms of an evolving stroke, and required treatment at the Defendant Hospital. However, it is alleged that the Plaintiff, who arrived at the Defendant Hospital at 1:30 p.m., had received absolutely no treatment whatsoever through the time that the neurologist finally saw her at 5:30 p.m. Thereafter (at 5:45 p.m.), the Defendant’s personnel noted that the Plaintiff’s speech remained garbled. At 6:15 p.m., her speech was garbled; yet, she received no intervention whatsoever. By 7:15 p.m., the Plaintiff’s blood pressure had become elevated to 190/90 (baseline was 132/69) with continuing garbled speech. At 8:30 p.m., the Plaintiff was transferred to another facility after receiving absolutely no treatment whatsoever for 7 hours.
It is alleged that over the 7-hour period that the Plaintiff remained in the Defendant hospital, she continued to demonstrate signs and symptoms of an evolving stroke which required intra-arterial therapy, and/or other treatment, which was withheld.
By the time she arrived at the second institution, she was noted to be somnolent, difficult to arouse, and was not communicating appropriately. It is asserted that personnel at the second hospital had no difficulty determining that the Plaintiff was suffering with an evolving stroke. As such, she was admitted to the Intensive Care Unit and begun on Heparin. Further, the hospital records confirmed that the Plaintiff’s condition had worsened over hours at the Defendant Hospital prior to the transfer. Finally, it was confirmed that the Plaintiff had suffered a left hemispheric stroke resulting in right-sided hemiplegia, decreased sensation and inability to speak.
In sum, it is alleged that the Defendant Hospital violated the standards of care over the 7 hours they kept her at the emergency department. First, it is asserted that the Plaintiff was not in a condition to be transferred to another hospital for any reason — certainly not for insurance purposes. Second, it is alleged that the Plaintiff had a stroke in evolution while at the Defendant Hospital, which required intra-arterial therapy. Third, it is alleged that the request for neurological consultation, which was made at 1:30 p.m., did not occur until approximately 5:30 p.m. — a breach in the standards of care. Finally, it is alleged that Defendant hospital personnel failed to provide any of the medications and therapy which were required in conformity with the standards of care.
As a direct and proximate result, it is alleged that the Plaintiff’s stroke evolved, resulting in severe and permanent disability which would have been avoided had the Defendants conformed with the applicable standards of care.
It is asserted that the Plaintiff has in the past, is presently and will in the future continue to suffer severe physical pain, emotional anguish as well as fear and anxiety over her condition. She has been rendered totally disabled and in need of care provided by others due to the negligence of hospital personnel. Further, she has in the past, is presently and will in the future continue to incur hospital, surgical, pharmacological, physiotherapeutic and other losses and expenses for which claim is made.
It is alleged that the quality of the Plaintiff’s life has been essentially destroyed through the negligence of this Defendant. She has been unable to engage in activities which she previously enjoyed, and will be essentially bedridden and/or chair-ridden for the remainder of her life.