Stroke Mismanagement $40M
Justice Served: A Landmark $40.3 Million Verdict in Stroke Mismanagement Medical Malpractice
A recent medical malpractice case has resulted in a $40.3 million verdict, highlighting the devastating consequences of failing to follow established medical protocols in stroke mismanagement. The case involved a 45-year-old patient who was left permanently disabled after two hospitals failed to provide timely and accurate medical interventions.
The jury’s decision specifically includes over $7 million in life-care costs. This case serves as a somber reminder of how critical every second is when the brain’s blood supply is compromised.
What is a Stroke?
A stroke, often called a “brain attack,” occurs when the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Within minutes, brain cells begin to die.
There are two primary types of strokes:
- Ischemic Stroke: The most common type (about 87% of cases), caused by a blockage (blood clot) in an artery leading to the brain.
- Hemorrhagic Stroke: Caused by a ruptured blood vessel that bleeds into the brain.
In this case, the focus was on the mismanagement of an ischemic event where the window for treatment was missed due to procedural errors and there was stroke mismanagement.
Brain Anatomy and Stroke Impact
To understand why this verdict was so high, one must understand the anatomy involved. The brain has specific regions, each responsible for different functions:
- The Cerebrum: Controls higher functions like speech, emotion, and fine motor skills.
- The Brainstem: Controls vital life functions like breathing and heart rate.
- The Cerebellum: Manages balance and coordination.
When a stroke occurs in the Middle Cerebral Artery (MCA), for example, it can lead to paralysis on one side of the body and loss of speech. Because the 45-year-old plaintiff in this case was left “permanently disabled,” it suggests that a significant portion of functional brain tissue was lost due to the lack of intervention, and stroke mismanagement.
Causes and Risk Factors
Strokes don’t usually happen in a vacuum. They are often the result of years of cardiovascular “wear and tear.”
Common Causes:
- Thrombosis: A clot forms inside an artery in the brain.
- Embolism: A clot forms elsewhere in the body (often the heart) and travels to the brain.
Key Risk Factors:
- Hypertension (High Blood Pressure): The leading cause of stroke.
- Atrial Fibrillation (AFib): An irregular heart rhythm that allows clots to form.
- Diabetes: Damages blood vessels over time.
- Lifestyle Factors: Smoking, high cholesterol, and physical inactivity.
The Role of tPA: The “Clot Buster”
One of the central issues in this legal battle was the administration of tPA (tissue plasminogen activator).
What is tPA and How Does it Work? Why is Stroke Mismanagement Medical Malpractice Potentially Tragic?
tPA is an intravenous medication that treats acute ischemic stroke. It works by dissolving the blood clot that is blocking blood flow to the brain. By “busting” the clot, it restores blood flow and can significantly reduce the long-term disability associated with a stroke.
However, doctors must give tPA within a strict time window—traditionally 3 to 4.5 hours from the onset of symptoms. If given too late, the risk of brain bleeding (hemorrhage) outweighs the benefits.
The Importance of “Time of Onset” & Stroke Mismanagement Medical Malpractice
This case hinged on a dispute over the “last known normal” time. The plaintiffs argued that one hospital ignored precise EMS documentation regarding when the patient’s symptoms began. Instead, the hospital relied on a “last known normal” time provided by the patient’s wife, who had been away for hours.
By prioritizing a third-party report over the patient’s own reported onset time and EMS data, the hospital incorrectly deemed the patient ineligible for tPA and there was stroke mismanagement. This underscores a vital medical truth: Time is brain. Every minute a stroke goes untreated, the brain loses approximately 1.9 million neurons.
CT Perfusion Imaging: Assessing the Damage
When a patient is outside the standard tPA window or has a large vessel blockage, doctors use advanced imaging like CT Perfusion (CTP).
What is CT Perfusion Imaging?
CT Perfusion is a specialized scan that shows how much blood is reaching various parts of the brain. it helps doctors distinguish between:
- The Core: Brain tissue that is already dead (irreversibly damaged).
- The Penumbra: Brain tissue that is currently “starving” for blood but restoring blood flow quickly can still save it.
Misinterpreting the Data and Stroke Mismanagement Medical Malpractice
In this case, clinicians at the second hospital allegedly misread the CT perfusion imaging. They overestimated the “core” (dead tissue), concluding the patient wouldn’t benefit from a mechanical thrombectomy (the surgical removal of a clot).
However, expert testimony from an interventional neuroradiologist revealed that the patient’s true “core” damage was only 20–25%. This was well within the threshold where a thrombectomy could have saved significant brain function.
Conclusion on Stroke Mismanagement: A Lesson in Medical Malpractice
The $40.3 million verdict reflects the jury’s finding that the hospitals failed to adhere to national stroke guidelines. By ignoring accurate onset data and misinterpreting advanced imaging, the medical teams accordingly missed multiple opportunities to prevent permanent disability.
For the patient, the award provides the necessary funds for lifelong care, but it also serves as a landmark warning to healthcare facilities regarding the necessity of rigorous protocol adherence in emergency stroke care.
Mark Kopec is a top-rated Baltimore medical malpractice lawyer. Contact us at 800-604-0704 to speak directly with Attorney Kopec in a free consultation. The Kopec Law Firm is in Baltimore and helps clients throughout Maryland and Washington, D.C. Thank you for reading the Baltimore Medical Malpractice Lawyer Blog.