Failure To Obtain Neurology Consult Allegedly Causes Patient’s Stroke


Stroke ExpertThis case involves an 80-year-old female patient in Maryland with a past medical history of a stroke who went into the hospital for hip replacement surgery. The patient was taking daily ibuprofen but was told to discontinue the medication one week prior to the procedure. The hip replacement surgery was successfully completed and the patient was discharged home. Less than 2 hours after being discharged from the hospital, the patient collapsed. The patient’s granddaughter called 911 and EMS arrived within 15 minutes. The patient presented to the emergency room and was ordered a state CT. The CT revealed hemorrhaging but no area of infarct. However, an MRI was never obtained and no neurologist was consulted. The patient was transferred to a stroke center but passed away en route. It was alleged that a timely neurology consult could have changed the patient’s outcome.

Question(s) For Expert Witness

  • 1. Do you routinely treat patients similar to the one described in the case? Please explain.
  • 2. What could have been done for the patient to avoid such an outcome?

Expert Witness Response E-007096

I have 25+ years of experience in vascular neurology. As the director of the stroke unit at a major hospital, I routinely treat stroke patients. Patients with high-risk profiles should be treated with a high level of suspicion to avoid such an outcome. I can certainly speak to the efficacy of administering anticoagulants or tPA for the patient as soon as possible. The quicker the intervention, the better the outcome. I have reviewed similar cases in the past and would be happy to review this case on behalf of the plaintiff.

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