Stroke Treatment Causes Patient Death

This case takes place in Kansas and involves a female patient who suffered a stroke. She presented to the hospital with symptoms indicating a stroke and was immediately administered tPA. Neurology exams note that the patient had poor attention and concentration, as well as facial weakness. At some point, the patient was found face-down on the floor of her room. It appeared that the stroke treatment had caused a hemorrhage in her brain, which was later confirmed by CT scan. The patient was reevaluated by neurology and reversal of tPA was initiated. Over the course of the hospital stay, the patient’s neurological symptoms worsened, eventually causing the patient to pass away.

Question(s) For Expert Witness

1. Do you routinely treat patients similar to the one described in the case?

2. Have you ever had a patient develop the outcome described in the case?

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?

5. Please tell us why you’re qualified to serve as an expert reviewer of this case.

Expert Witness Response E-008630

I have been practicing for 20+ years in a primary stroke center and have treated numerous patients with iv tpa, including the complications both inherent and provoked in this case. I personally manage approximately 60-80 patients per year for acute intervention and I have seen patients with subsequent hemorrhage either directly related to tpa, or unrelated. I have testified in about 10 cases involving acute stroke intervention and I believe that if a different approach was administered in this patient's care, a better outcome was probable.