This case involves an otherwise healthy patient that presented to his primary care physician with extreme shortness of breath in Utah. He was admitted and was discharged almost immediately with a prescription for Xarelto. Several days later, the patient suffered a stroke while at work. He presented to the emergency room within an hour of the onset of his symptoms. However, he was not given tPA or an IVC Catheter due to the fact that he was on blood thinners. The patient was then transferred to a larger hospital for surgical intervention; however, by the time he arrive the clot had grown too large to operate on. The patient died several days later while in the hospital.
Question(s) For Expert Witness
1. Could the delay for care by the neurosurgeon have caused the clot to increase in size and thus render it inoperable?
2. What is the required response time for attending to a patient that has a cerebral blood clot for intervention?
Expert Witness Response E-101595
It is possible for the delay for care by the neurosurgeon to have caused the clot to increase in size and thus render it inoperable. The images would determine if that may have caused it. If a patient has a cerebral blood clot, the required response time for intervention is critical. Time is brain; thus, the sooner the better. Currently, the AHA recommends a door-to-puncture of the groin of less than 90 min after hospital arrival. If everything goes right, the recanalization of the vessel should be completed within 120 min of arrival. I participate on Quality Improvement Committees at different institutions. As such, I review cases like this on a frequent basis, and have lectured on this topic before.
About the author
Joseph O'Neill
Joe has extensive experience in online journalism and technical writing across a range of legal topics, including personal injury, meidcal malpractice, mass torts, consumer litigation, commercial litigation, and more. Joe spent close to six years working at Expert Institute, finishing up his role here as Director of Marketing. He has considerable knowledge across an array of legal topics pertaining to expert witnesses. Currently, Joe servces as Owner and Demand Generation Consultant at LightSail Consulting.
