Strokes in children and young adults are frequently misdiagnosed
Stroke treatment must start quickly to prevent permanent injuries
As a Houston, Texas medical malpractice lawyer, I have represented and filed lawsuits on behalf of clients who suffered life-changing injuries because of a misdiagnosed stroke.
Tough legal standards for stroke malpractice cases
Every time that I meet with a potential stroke malpractice client, I advised them up-front about the significant differences between medical and legal standards when it comes to strokes.
In the medical community, stroke experts agree that the clot-busting drug tPA should be given as soon as possible within 3.5 to 4 hours of the beginning of stroke symptoms, because it optimizes the patient’s chance for a meaningful recovery.
In the courtroom, though, legal-epidemiological standards prevent many cases from ever getting to trial. In my experience, only patients who got to the emergency room and were being evaluated within two hours of the onset of stroke symptoms would possibly be able to meet the court-imposed legal standards of proof. While I find these legal standards to make no scientific, mathematical, or statistical sense, they are consistently applied by the courts.
In addition, Texas tort reform laws protect healthcare providers in hospital emergency rooms by requiring plaintiffs to prove their cases to a standard of willful and wanton negligence, which is equivalent to gross negligence.
These standards are why it is important for patients who are victims of stroke misdiagnosis, or any type of medical malpractice, for that matter, to hire an attorney with extensive experience in handling medical negligence claims.
Strokes in children
In my practice, I have represented a variety of stroke patients, from young adults to more mature adults. Recently, though, I met with the parent of an 11-year-old boy who was a stroke victim.
This boy was playing around his family pool one summer evening, when he started complaining of a severe headache. His mother noticed that his face was drooping on the left side, and immediately called 911. By the time the paramedics arrived, he was throwing up, having difficulty moving the left side of his body, and losing consciousness.
Within an hour of the stroke symptoms beginning, the ambulance arrived at a suburban Harris County hospital emergency room. The mother remembers the emergency room physician immediately telling her that this young patient might be having Bell’s palsy or a stroke, but that there was not a neurologist on call that evening. I found this quite shocking, considering that this hospital advertises itself as having a stroke center.
The emergency room doctor ordered CT scans of the little boy’s head and neck, but did not see anything wrong. Through my experience in handling stroke cases, Painter Law Firm has hired top-notch stroke experts, who have explained during the cases that a CT scan is ordered as a part of the stroke evaluation for the purpose of ruling out some other medical condition that could be causing the symptoms, instead of a stroke. In other words, having a CT scan coming back negative does not necessarily mean that the patient is not having a stroke. Neuroradiology experts agree that most strokes will not show up on a CT scan for hours.
Unfortunately, the emergency room doctor did not order tPA to this boy’s stroke symptoms, but rather kept him in the hospital for observation. When his symptoms did not seem to be improving after about three hours of waiting, the doctor transferred him to a hospital in the Texas Medical Center, where he was immediately imaged with the head MRI and diagnosed with stroke. At that point, though, he was outside the treatment window for tPA.
Because of brain swelling caused by the stroke, this young patient was taken to surgery to have part of his skull removed, until the swelling went down. All in all, he spent three months in the hospital for surgery, recovery, and rehabilitation. To this day, he still cannot use his left arm or hand, his left leg is very weak, his face appears lopsided, and it is harder for him to process verbal information.
What you can do
If there is one thing that I have learned from all the stroke cases that I have handled, it is that strokes can happen to anyone, but they are often misdiagnosed when it comes to younger people. This is true for young adults, and is certainly true for children.
The American Stroke Association invented this shortcut to spot stroke symptoms, using the acronym FAST. F stands for face drooping, A stands for our weakness, S stands for speech difficulty, and T stands for time to call 911.
If you find yourself in a situation where these stroke symptoms are present, be sure to give a clear, complete, and relevant history to 911, paramedics, nurses, doctors. I add the word “relevant” because I believe that healthcare providers sometimes pounce on irrelevant information that clouds their judgment in terms of making the correct diagnosis and treatment decisions. The most important information, in my opinion, includes a description of symptoms, the time the symptoms began, and what the person’s normal health baseline is.
In an emergency room setting, be sure to repeat this information to the healthcare providers there, rather than depending on paramedics to convey information accurately.
If the emergency room doctors and nurses seem to discount the stroke symptoms or show no urgency and getting a neurology consult or treatment, then assertively ask to see a supervising nurse or physician, to request the help and assistance that are urgently needed. When it comes to a possible stroke, time is important and you cannot afford to be passive.
We are here to help
If you or someone you care for has been seriously injured as a result of botched stroke diagnosis and treatment, call Painter Law Firm, in Houston, Texas, at 281-580-8800, for a free consultation about your potential case. Our Texas medical malpractice attorneys are experienced in evaluating and handling stroke negligence cases.
Robert Painter is an award-winning medical negligence attorney at Painter Law Firm PLLC, in Houston, Texas. He represents plaintiffs and their families in medical malpractice and wrongful death cases arising from hospital, nursing, surgical, anesthesia, stroke, and other mistakes.
Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC.
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Academic/teaching hospitals do not consistently supervise still in their training, which can put patients at risk
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Published in the July/August 2018 edition of "The Houston Lawyer" magazine