This case involves a stroke following a visit to the hospital in Montana. The patient had no significant medical history, and had presented to the ER after experiencing discomfort and pain in her chest. In response to the patient’s symptoms a cardiac catheter was placed, with the understanding that additional tests and procedures would be performed. During the catheterization a clot was formed, which induced a stroke. Initially, the treating physicians opted to wait and monitor the patient’s condition rather than address the clot. However, her condition quickly deteriorated, and she was transferred to another part of the hospital where she underwent a procedure to eliminate the clot. The patient was brought to stable condition but left with neurological defects. The plaintiff alleges the catheterization was mishandled, and that the patient should have been transferred earlier for her stroke treatment.
Question(s) For Expert Witness
- 1. Do you routinely treat patients similar to the one described in the case? Please discuss your background in catheterization procedures.
- 2. How are you able to determine if a patient is a good candidate for the procedure? Have you ever had a patient develop the outcome described in the case? If so, please explain.
- 3. Do you believe this patient may have had a better outcome if the care rendered had been different?
- 4. Have you ever served as an expert witness on a case similar to the one described above? If so, please explain.
- 5. Please tell us why you’re qualified to serve as an expert reviewer of this case.
Expert Witness Response E-009749
I am the cath lab director at a major university hospital and have almost 15 years of experience. A patient with this presentation is always a good candidate for catheterization. I would like to know additional details, but this is a patient that we would take to the cath lab to perform a cardiac cath right away. When a stroke occurs, the treatment is usually decided by the neurologist. Some prefer to be aggressive and others prefer to be conservative as in this case. I do not think that there are established guidelines for management of stroke in the cath lab. At my institution we are working with our neurologists in order to develop new institutional guidelines with neurology to standardize the management of these unfortunate cases.