Delay in Diagnosis of Stroke

The Badgley Law Group is an Orlando personal injury law firm that has been helping victims of medical malpractice in Florida for over thirty years. Among those cases, are victims of a delay in diagnosis of stroke. According to research conducted by physicians from the Department of Neurology Medicine and Emergency Medicine at Yale University, the failure to recognize an ischemic stroke in the emergency department is a missed opportunity for acute interventions and prompt treatment with secondary prevention therapy. Their study examined the diagnosis of acute ischemic stroke in the emergency department of an academic teaching hospital and a large community hospital. The current guidelines recommend intravenous recombinant tissue-type plasminogen (TPA) within about 4 hours in select patients. Patients that have large vessel occlusion may benefit from early recanalization with stent-retrieval devices. Also, patients with missed strokes may not be monitored appropriately for the neurological progression of stroke syndromes or stroke-related complications. There are many forms of compensation for medical malpractice victims, which include lost wages, payment of medical bills, pain, and suffering, and more. You can learn more about your options by contacting our medical malpractice lawyer.

Why a Timely Diagnosis Matters in Stroke Patients

Early diagnosis is critical to treatment and for the best long-term outcomes. Even so, a subset of acute ischemic strokes will go unrecognized in the emergency department. It was documented that there is a significant subset of patients who present to the emergency department within 30 days before their stroke is diagnosed with having another medical condition or stroke look-a-likes. The most common one of these look-a-likes is hypertensive emergency, syncope, or infection. The outcome of such studies was primarily a missed stroke. A stroke was “missed” if practitioners in the emergency department did not initially consider stroke in the differential. The diagnosis was delayed, which caused the patient to miss the therapeutic window for thrombolytic therapy. A stroke can also be missed if emergency department physicians consulted neurology for possible stroke diagnosis. Neurology felt that the patient did not have a stroke and admitted the patient to medical services.

The conclusion that can be considered is that a significant proportion of ischemic strokes are strokes that are misdiagnosed or delayed in diagnosis, which leads to missed opportunities for intervention. Symptoms such as acute nausea and vomiting, dizziness, and difficulty walking should be considered as triggers for ischemic stroke in the emergency room, especially if the patient has a history of hypertension or currently has elevated blood pressure. It is crucial to perform a systematic neurological examination on all patients with these complaints as basic steps for ensuring a stroke diagnosis is not missed. A patient that is accurately diagnosed is six times more likely to be triaged as an acute stroke code.

Stroke Victims Do not Get Timely Diagnoses

When strokes occur, time is everything. A stroke blocks the flow of blood to the brain, and brain cells die off. It is known that a critical diagnostic step of brain imaging does occur too slowly at many hospitals. Research published in the journal Stroke shows that only 41 percent of stroke patients underwent brain imaging within the recommended 25 minutes of their arrival at the hospital. It was found that certain individuals, including those with diabetes, persons over 75, women, those that did not arrive by ambulance, non-whites, and those with certain cardiac conditions were less likely to receive a timely brain scan. These delays in diagnosis of stroke mean that treatment will be either too late or not at all. “We were struck by the fact that less than half of patients with acute stroke symptoms did not receive a brain scan within the recommended guidelines.” Said University of Rochester Medical Center neurologist Adam Kelly, M.D., lead author of the study. “Brain imaging is an essential tool in the diagnosis of stroke and will determine the treatment options physicians will take. Despite the strides that have been made in stroke care, it is clear that there is significant room for improvement in the evaluation of patients suspected of stroke,” said Kelly. “Time is too precious, and hospitals cannot be the reason for delay.”

The blood clots in the brain that cause strokes can irreversibly change who we are and burden our families. According to the Centers for Disease Control and Prevention, strokes strike nearly 800,000 Americans each year, killing 140,000 and costing $34 billion annually.

Are You a Victim Of A Delayed or Missed Diagnosis of Stroke in Florida?

If you or a loved one have been the victim of a medical missed or delayed diagnosis of stroke, you should contact a skilled and experienced Orlando medical malpractice attorney.  The Badgley Law Group has extensive experience in assisting clients to get compensation for their medical bills and suffering. Call us for a consultation to discuss your situation and your options.  Call the Badgley Law group for a free consultation at (407) 487-4154. We serve all of Central Florida.

Sources:, Missed Ischemic Stroke Diagnosis in the Emergency Department by Emergency Medicine and Neurology Services

LiveScience, Stroke Victims Don’t Get Timely Diagnosis

AHA Journals, Delay in Presentation and Evaluation for Acute Stroke|Stroke

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