Most strokes are caused by a blood clot that forms and then travels to block a blood vessel that supplies the brain.
If you ask 100 people in a shopping mall to identify the warning signs of a stroke, I bet at least 90 percent could do it. These symptoms include things like the sudden appearance of one-sided facial droop, one-sided muscular weakness, and not being able to speak clearly or at all. Most people also know that if you experience or see someone with these symptoms, it is a medical emergency that requires immediate treatment at a hospital.
We represented a client in a Harris County, Texas lawsuit recently who had all of these symptoms and got to a Houston comprehensive stroke center within 40 minutes of the symptoms starting. She was seen by a resident neurologist (a doctor who is still in training) and discharged with no treatment for stroke and a diagnosis of a psychogenic reaction. That diagnosis basically means that "it's all in your head."
Sadly, a few days later, our client went to another hospital, which was a primary stroke center. They quickly diagnosed her as having had a severe stroke. Now, years later, she has largely lost her ability to speak and communicate.
Painter Law Firm's Texas medical malpractice attorneys hired medical experts to review the case. These experts determined that if the client had been given the clot-busting drug t-PA at the first hospital, it would have likely dissolved the clot blocking blood float to the brain, leading to a full recovery. There is a very narrow time window for giving this life-saving drug, and the doctors at the first hospital missed it.
In order to prevent this from happening to you or someone close to you, we will first discuss the types of stroke care currently available.
Stroke Center Certifications
There are different types of hospitals that treat strokes.
Comprehensive stroke centers have special certification and are equipped to handle even the most difficult stroke cases. In the Houston area, the following hospitals area comprehensive stroke centers: Houston Methodist Hospital, Memorial Hermann Hospital Texas Medical Center, CHI St. Luke’s Health Baylor College of Medicine Medical Center, Ben Taub Hospital, Kingwood Medical Center, and St. Luke’s The Woodlands Hospital.
Primary stroke centers have the capability to treat many types of strokes. In the Houston area, the following hospitals are primary stroke centers: Bayshore Medical Center in Pasadena, Conroe Regional Medical Center, Cypress Fairbanks Medical Center, East Houston Regional Medical Center, Houston Methodist San Jacinto Hospital, Houston Methodist West Hospital, Houston Methodist Willowbrook Hospital, Houston Northwest Medical Center, Memorial Hermann Katy Hospital, Memorial Hermann Memorial City Medical Center, Memorial Hermann Northeast Hospital, Memorial Hermann Greater Heights Hospital, Memorial Hermann Southeast Hospital, Memorial Hermann Southwest Hospital, Memorial Hermann The Woodlands Hospital, V.A. Medical Center, Oakbend Medical Center, St. Joseph Medical Center, Tomball Regional Hospital, University of Texas Medical Branch in Galveston, and West Houston Medical Center.
Both comprehensive and primary stroke centers are required to have policies in place, including adequate staffing with fully-trained stroke neurologists, nursing staff, and radiology techs. They also have policies in place that should result in quick evaluation of patients so t-PA can be given quickly, if it is indicated.
Hospitals with no stroke certification often have a lesser ability to do so. It really just depends on what doctors are on duty when a patient arrives at the emergency room with stroke symptoms.
Stroke Symptoms Must Be Treated Quickly
In reality, though, the same thing is true even at a comprehensive or primary stroke center. Frequently, these hospitals are affiliated with a medical school or have a residency program to teach young doctors straight out of medical school.
Depending on the time of day, the day of the week, or if it is a holiday, if a patient arrives at a stroke center's hospital emergency room, the only doctor on-site for the neurology stroke team is a resident, rather than a fully trained doctor.
In the case of our recent stroke client, the only stroke team member who saw her was a junior resident, still in his training and about 17 months out of medical school. Even when presented with complaints of classic stroke symptoms that had been observed by a family member and even the emergency room doctor, the young stroke team doctor botched the diagnosis and discharged the patient.
In that case, the family member voiced skepticism at the diagnosis, but was repeatedly (and incorrectly) reassured that it was not a stroke.
If you find yourself in that situation, I recommend that you politely, but firmly, insist on an evaluation by--and here are the magic words--a "stroke team attending neurologist." And remember, time is critical.
Having an experienced, fully/trained stroke doctor involved in person may make a big difference in the treatment in some situations.
Legal Hurdles in Stroke Cases
In general, medical malpractice cases in Texas face what I have described as a legal minefield as a result of so-called tort reform. That is why I recommend hiring someone with significant experience in handling this type of case.
But, for two reasons, stroke cases are even more daunting, so it is a good idea to look for an attorney with stroke-specific experience.
The first reason that stroke cases are extra challenging is that most of the time the evaluation, diagnosis, and treatment occur in a hospital-based emergency room. Under Texas Civil Practice & Remedies Code Section 74.154, a "wilful and wanton negligence" standard applies to such care. The Texas Supreme Court has interpreted that standard as being equivalent to gross negligence. This is a much higher standard than the ordinary negligence that a plaintiff must prove in most medical malpractice cases.
In addition, stroke cases involving the failure to give a patient the clot-buster t-PA in a timely fashion is subject to extreme legal scrutiny. From a practical perspective, this standard makes all but a small portion of stroke cases very, very difficult to prove. The key factor is how quickly was the t-PA decision made in relation to when the stroke symptoms first started.
Texas Stroke Lawyers
The Houston-based stroke and medical malpractice lawyers at Painter Law Firm understand how to handle stroke cases. If you or someone you care for has been harmed because of a misdiagnosed or mistreated stroke, call us at 281-580-8800 for a free evaluation of your potential case.