Heart Attack & Stroke Misdiagnosis

New York Attorneys: Fatal Misdiagnosis and Treatment of Heart Attack and Stroke

Powers & Santola · Emergency Department Misdiagnosis and Malpractice Lawyers

Claims against hospital emergency departments frequently involve the death of an individual who came to the emergency room complaining of symptoms of heart attack or stroke that were ignored. Examples include:

• Failure to diagnose a heart attack in a patient who presents with chest pain
• Failure to diagnose a cerebral aneurysm in a patient who presents with "the worst headache of my life"
• Failure to properly treat a patient with ischemic stroke
• Misdiagnosis of heart attack as gastritis
• Negligence in obtaining necessary tests to rule out heart attack or stroke

Patients presenting within 3 hours of stroke onset should be evaluated by a physician within 10 minutes and receive a CT scan within 25 minutes of arrival in the Emergency Department;

1. Intravenous tissue plasmic activator (tPA) should be administered within 3 hours of the onset of ischemic stroke symptoms and less than 60 minutes of arrival at the Emergency Department to those patients who meet strict inclusion and exclusion criteria. Inclusion criteria are that: the patient is 18 years old or older; there is a clinical diagnosis of ischemic stroke causing a measurable neurologic deficit; the time of symptom onset is well established to be less than 180 minutes before treatment would begin. Exclusion criteria are: evidence of intracranial hemorrhage on noncontrast head CT; only minor or rapidly improving stroke symptoms; high clinical suspicion of subarachnoid hemorrhage even with normal CT; active internal bleeding (e.g., gastrointestinal bleed or urinary bleeding within last 21 days); known bleeding diathesis, including but not limited to: platelet count <100,000/mm; patient has received heparin within 48 hours and had an elevated activated partial thromboplastin time (greater than upper limit of normal for laboratory); recent use of anticoagulant (e.g., warfarin sodium) and elevated prothrombin time >15 seconds; within 3 months of intracranial surgery, serious head trauma, or previous stroke; within 14 days of major surgery or serious trauma; recent arterial puncture at noncompressible site; lumbar puncture within 7 days; history of intracranial hemorrhage, arteriovenous malformation, or aneurysm; witnessed seizure at stroke onset; recent acute myocardial infarction; on repeated measurements, systolic pressure <185 mm Hg or diastolic pressure <110 mm Hg at time of treatment, requiring aggressive treatment to reduce blood pressure to within these limits
   1. Patients presenting with stroke onset who are not candidates for intravenous tPA should promptly be given an initial dose of 325 mg of aspirin;
   2. Education regarding early stroke symptoms, diagnostic procedures and treatment options should be offered to the patient and family. This should be documented in the patient's chart;
2. Prevention of complications for medical management within the initial 24 - 48 hours of diagnosis and treatment of ischemic stroke include:
1. continue to treat hyperthermia or hyperglycemia;
2. continue IV fluids;
3. initiate deep vein thrombosis prophylaxis;
4. perform swallow evaluation;
5. initiate early rehabilitation.

Contact Powers & Santola in upstate New York to schedule a free consultation regarding serious injury or death due to a misdiagnosed heart attack or delayed stroke diagnosis. Please continue reading to learn more about common emergency room errors.