Delayed Diagnosis of Stroke Results in Total Left-Side Paralysis

ByMichael Talve, CEO

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Updated onJanuary 25, 2022

Delayed Diagnosis of Stroke Results in Total Left-Side Paralysis

This case involves a sixty-three-year-old male patient who presented to his family physician complaining of light-headedness and dizziness. The doctor examined the patient without doing a full neurological exam and sent him home with a prescription to treat an inner ear infection. The patient returned to the office the next day with the same symptoms but, during his visit, he displayed facial drooping. The patient was rushed to the emergency room where it was determined that he was having an ischemic stroke. An emergent CT scan was performed and showed a small, old, right, perifrontal lacunar infarct. An MRI/MRA performed the following day revealed that there was no blood flow to the patient’s right vertebral and basilar arteries. The patient was determined to be beyond the window period for the administration of thrombolytics and no clot-busting intervention was initiated. The delay in diagnosis for more than twenty-four hours allowed for a significant amount of neural tissue death, which resulted in total paralysis on the patient’s left side. Following the incident, he required around the clock nursing assistance and no improvement occurred after six months of rehabilitation.

Question(s) For Expert Witness

1. Is it ever acceptable for a physician to not perform a neurological exam when a patient exhibits neurological symptoms?

Expert Witness Response E-000689

inline imageStroke mimics commonly confound the clinical diagnosis of stroke. One study reported that 19% of patients diagnosed with acute ischemic stroke by neurologists before cranial CT scanning actually had noncerebrovascular causes for their symptoms. It is never acceptable for physicians to skip their physical exam when the first plausible diagnosis makes sense. This patient deserved a more complete workup for obvious reasons.

About the author

Michael Talve, CEO

Michael Talve, CEO

Michael Talve stands at the forefront of legal innovation as the CEO and Managing Director of Expert Institute. Under his leadership, the Expert Institute has established itself as a vital player in the legal technology arena, revolutionizing how lawyers connect with world-class experts and access advanced legal technology. Michael's role involves not only steering the company's strategic direction but also ensuring the delivery of unparalleled intelligence and cutting-edge solutions to legal professionals. His work at Expert Institute has been instrumental in enhancing the capabilities of attorneys in case preparation and execution, making a significant impact on the legal industry's approach to expert consultation and technological integration. Michael's vision and execution have positioned the Expert Institute as a key facilitator in the intersection of law and technology.

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