Pain Management Procedure Causes Stroke

ByMichael Talve, CEO

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Updated onOctober 13, 2017

Pain Management Procedure Causes Stroke

This case involves a sixty-two-year-old male who underwent a pain management procedure for chronic lumbar radiculopathy with associated lumbar disc herniation. The procedure was a fluoroscopically guided, contrast controlled left L5 and S1 transforaminal epidural steroid injection with epidurogram done under local anesthesia plus IV sedation. The pre-operative notes reflect that the patient had a blood pressure over 200 on several readings, but the physician still chose to conduct the procedure. The procedure was performed uneventfully and the operative notes make no mention of any difficulty. Shortly after, however, the patient displayed stroke-like symptoms in the recovery room. A CAT scan performed after surgery showed a right internal capsule lacunar infarct with a subtle area of low attenuation.

Question(s) For Expert Witness

1. Should the patient’s high blood pressure been given more attention before the surgical procedure?

Expert Witness Response E-000116

inline imageOperating while the patient has such high blood pressure is certainly not within the standard of care. If a patient has high blood pressure, and 200 is certainly high, then the blood pressure needs to be controlled before a procedure like this is done. Whenever I have a patient with 200+ blood pressure, I promptly administer currently accepted medical therapy for hypertension, and only push for surgery when it is a medical emergency.

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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