Case# 4007: Misdiagnosis Resulting In Brain Injury And Paraplegia
On September 1, the Plaintiff, a 52-year-old male, awakened unable to lift his right foot. He proceeded to the emergency department of the Defendant Hospital where he presented with a foot drop. Thereafter, a CT scan of the head was performed which revealed a hyperdense left parietal lobe mass of the brain. The Plaintiff was admitted to the service of the Defendant Neurosurgeon.
A MRI of the brain was performed the same day. The Defendant Radiologist read the MRI as showing a “small meningioma,” which is a small, benign (non‑malignant) lesion which is essentially harmless. In reality, however, the MRI demonstrated a vascular malformation of the brain which was responsible for the foot drop.
Further, the Defendant Neurosurgeon never saw the Plaintiff during his three day admission and did not review the CT or MRI himself. Had he done so in accordance with the standards of care, he would have diagnosed the vascular malformation, performed an angiogram and/or other suitable studies to confirm the diagnosis, and would have operated to remove the malformation to prevent a tragic hemorrhage.
On September 3, the Defendants simply discharged the Plaintiff from the Defendant Hospital with instructions to follow-up with the Defendant Neurosurgeon on September 6.
At the time of the discharge, the Plaintiff sent a copy of the MRI to his brother who is a board-certified neuroradiologist in another State. The brother reviewed the film and told the Plaintiff that it confirmed a vascular malformation — rather than a meningioma. The treatment of a vascular lesion is completely different than treatment of a meningioma.
The Plaintiff saw the Defendant Neurosurgeon in follow-up on September 6. At that meeting, the Plaintiff told the Defendant Neurosurgeon of his brother, his specialty, and his diagnosis — that the lesion was a vascular lesion and not a meningioma. The Defendant Neurosurgeon simply gave the Plaintiff a prescription for a MRA/MRV (magnetic resonance angiography/magnetic resonance venography) and told him to find an appointment for the studies which he was first able to schedule on September 13. The Defendant negligently failed to expedite the studies.
In the interim, the Plaintiff’s brother personally telephoned the Defendant Neurosurgeon on September 7, and personally advised the Defendant that the lesion was vascular. The Plaintiff’s brother went on to specifically request an angiogram so that the lesion could be dealt with immediately on a surgical basis prior to any hemorrhage. However, the Defendant Neurosurgeon negligently ignored that request.
On the morning of September 13, BEFORE the scheduled appointment for the MRA/MRV, the Plaintiff suffered a large left frontal parietal intracerebral hemorrhage. Due to the extent of the bleed, the Plaintiff required intubation for airway protection and was transferred to a tertiary hospital for specialized care and treatment.
The Plaintiff suffered severe brain damage requiring tracheostomy for airway management, a percutaneous endoscopic gastrostomy (PEG) placement for feeding and an Inferior Vena Cava (IVC) filter. He required hypothermia due to increased intracranial pressures which also required him to be medically paralyzed for a period of time.
On October 11, the Plaintiff was transferred to an acute rehabilitation facility where he remained for two months before ultimately being discharged at home for further specialized care and treatment. The Plaintiff suffered massive and irreversible brain injury resulting in permanent paraplegia as well as speech deficits.