Stroke Medical Negligence Inadequate Stroke Screening
STROKE MEDICAL NEGLIGENCE INADEQUATE STROKE SCREENING
John Whelan Solicitor with specialist expertise in Stroke Medical Negligence gives a case example of Inadequate Stroke Screening.
An example of a case where inadequate stroke screening in a high risk patient led to a severe outcome:
Case Example: Inadequate Stroke Screening in a High Risk Patient
A Patient with a history of hypertension, Type 2 diabetes, and smoking, visits GP for a routine checkup. The Patient has no significant complaints other than mild fatigue and occasional headaches, which the Patient attributes to stress at work.
Medical History:
a) Hypertension: Diagnosed 10 years ago, but poorly controlled despite medication. The Patient’s blood pressure readings have often been high during previous visits (ranging from 150/95 to 165/100 mm Hg).
b) Type 2 diabetes: Diagnosed 5 years ago, with suboptimal glycemic control (HbA1c of 8.5%). The Patient is on oral hypoglycemic agents but does not consistently monitor the blood sugar.
c) Smoking: 20 year pack history, with no current plan to give up smoking.
d) Family history: The Patient’s father suffered a fatal stroke in his late 60s.
Office Visit:
a) During this visit, the Patient’s blood pressure is 160/95 mm Hg, and reports feeling "fine" overall. The Patient is given advice to manage diet and exercise more, but no additional stroke risk screening is performed.
b) No imaging or vascular studies are ordered, despite high risk profile for stroke (hypertension, diabetes, smoking, and family history).
c) The GP focuses primarily on adjusting the diabetes medication and advises the Patient to return in six months for a follow up.
Missed Opportunity for Screening:
a) Despite multiple high risk factors, the Patient does not receive a carotid artery ultrasound, lipid panel, or more aggressive management of his hypertension.
b) The Patient is not referred to a cardiologist or vascular specialist, and stroke prevention strategies (such as aspirin therapy, better hypertension control, or smoking cessation programs) are not emphasised.
Stroke Event:
a) Six months later, the Patient suddenly develops weakness on the right side of the body and slurred speech while at home. The Patient is taken to the hospital.
b) CT scan reveals a large ischemic stroke in the left hemisphere, resulting in significant right sided paralysis (hemiplegia) and difficulty speaking (aphasia).
c) The Patient is outside the time window for thrombolytic therapy (tPA), and although the Patient receives supportive care and rehabilitation, the Patient is left with permanent disability.
Important Points of the Case:
- Inadequate Screening for Stroke Risk.
- Missed Preventive Opportunities.
- Failure to Follow Guidelines for High Risk Patients.
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/