Woman Suffers Undiagnosed Stroke After Childbirth

Joseph O'Neill

Written by
— Updated on March 21, 2017

Stroke Expert Witness This case involves a middle-aged female who suffered a post-partum stroke within hours of giving birth to her fifth child. Shortly after giving birth, the woman reported a general loss of feeling in her right arm, noting that the weakness was so pronounced that she was unable to hold her baby. Over the course of several hours, the woman experienced increased weakness on her right side, which eventually progressed to total hemiplegia during the night. A consultation with neurology as well as a CT scan was ordered immediately, and the CT scan revealed the presence of a small, localized area of dead tissue within the patient’s brain, as well as swelling. However, at this point doctors elected to monitor the patient with no immediate treatment being given. Several hours later, a follow-up CT revealed a now-significant intracerebral hemorrhage along with swelling, at which point the patient was transported emergently to a major medical center. On arrival, additional imaging studies revealed a slight progression of her stroke. The woman continued to deteriorate before eventually undergoing a craniectomy to reduce intracranial pressure. The patient continues to suffer from permanent injuries sustained during her stroke, including permanent paralysis of her left side. It was eventually determined that the woman was suffering from a complication of childbirth that made her hypercoagulable, which initially went undiagnosed.

Question(s) For Expert Witness

  • 1. What are the necessary steps to take for someone who suffers from a postpartum stroke?

Expert Witness Response E-001495

Once the CT determined that there was a dural sinus thrombosis, the patient should have been immediately transferred to the ICU with frequent – every two hours minimum – Neurochecks. The fact that this was a venous stroke should have alerted those caring for this woman that she was hypercoaguable, and that she likely needed a higher level of care immediate rather than waiting for several hours after the initial scan to see what happened to her. Managing risk factors such as hypertension would be a bare minimum step, and being prepared for other organ injuries, eclampsia, and additional complications should have been part of their immediate plan pending transfer; this would go far beyond a simple instruction to continue monitoring her condition. Serious sequelae can and did occur to this woman and the hospital was not setup to manage this complicated case. I have experience in a University Hospital managing such cases, and have treated several similar patients over the years.

Contact this expert witness

Find a Medical Expert Witness Near You

What State is your case in?

AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY