STROKE MEDICAL NEGLIGENCE FAILURE TO TREAT STROKE COMPLICATIONS
John Whelan Solicitor with specialist expertise in Stroke Medical Negligence gives a case example of Failure to treat Stroke Complications.
An example of a case where failure to treat stroke complications led to worsened outcomes for the Patient:
A Patient a history of hypertension and atrial fibrillation, suffered an ischemic stroke that affected the left hemisphere of his brain, resulting in right sided paralysis (hemiparesis) and aphasia (difficulty speaking). He was treated promptly with tPA (tissue plasminogen activator) within the recommended time window and was transferred to a stroke unit for further management.
Initial Treatment and Recovery:
a) After the acute stroke treatment, the Patient showed some improvement. He regained partial movement in his right arm and leg but still had significant weakness and speech difficulties.
b) He was enrolled in a rehabilitation programme that included physical therapy, occupational therapy, and speech therapy.
c) His vital signs were stabilised, and he was on appropriate medications for his atrial fibrillation and high blood pressure.
Post Stroke Complications:
Aspiration Pneumonia:
a) Four days after the stroke, the Patient began showing signs of respiratory distress, including fever, coughing, and difficulty swallowing (dysphagia). The Patient’s speech therapist had flagged some mild swallowing difficulties during a session, but no immediate action was taken to address the problem.
b) The Patient respiratory symptoms worsened, and the Patient became more lethargic and febrile. An Xray revealed signs of aspiration pneumonia, likely due to swallowing difficulties, which had caused food or liquid to enter the Patients lungs.
c) Despite this, the hospital staff did not initiate appropriate treatment for pneumonia immediately. The Patient was only given antibiotics after the infection had already progressed significantly.
Deep Vein Thrombosis (DVT):
a) The Patients right leg remained immobile due to his hemiparesis, and no preventive measures for deep vein thrombosis (DVT), such as early mobilisation or subcutaneous anticoagulation (e.g., low molecular weight heparin), were implemented.
b) After several days of immobility, the Patient developed significant swelling and pain in the right leg. A doppler ultrasound confirmed the presence of a deep vein thrombosis (DVT) in the right leg.
c) No immediate interventions were made to address the DVT, and anticoagulation therapy was started only after the condition had become more severe, increasing the risk for a pulmonary embolism.
Pressure Ulcers:
a) Due to the Patients immobility, the Patient developed pressure ulcers (bedsores) on the sacrum and heels. These ulcers were not addressed early, and the nursing staff failed to provide adequate repositioning or the use of pressure relieving devices like special mattresses.
b) The pressure ulcers became infected, leading to systemic infection (sepsis), further complicating his recovery.
Failure to Treat Complications:
a) The pneumonia went untreated for several days, allowing the infection to spread and causing a worsening of the Patients overall health. The Patient developed difficulty breathing, low oxygen saturation, and required more intensive respiratory support.
b) The DVT was not treated with proper anticoagulation therapy immediately, increasing the risk of the clot dislodging and traveling to the lungs (pulmonary embolism). Fortunately, the DVT did not progress to a pulmonary embolism, but the delay in treatment increased the severity of the leg swelling and pain.
c) The pressure ulcers worsened, requiring long term wound care and increasing the overall length of stay in the hospital.
Outcome:
a) Despite the Patient surviving the initial stroke, the complications of pneumonia, DVT, and pressure ulcers led to significant delays in recovery. The Patient required extended hospitalisation, multiple interventions, and rehabilitation to address these complications.
b) The prolonged bed rest and infections significantly hindered rehabilitation progress. The Patients functional recovery was slower than expected, and had to be transferred to a long term care facility for further rehabilitation and wound care.
c) The complications also led to a higher risk of mortality and decreased the Patients quality of life. The Patient continued to experience chronic weakness, pain from the DVT, and respiratory issues from the pneumonia.
Key Points of the Case:
Failure to Recognise and Treat Aspiration Pneumonia.
Inadequate DVT Prevention.
Failure to Prevent Pressure Ulcer.
For more detailed insights into how Stroke Medical Negligence and Patient Safety impacts you and how Whelan Law can support you, please visit our Patient Safety Rights Legal Advice https://www.whelanlaw.ie/news/stroke-medical-negligence-claims-what-you-need-to-know/