Medical Malpractice in Stroke Diagnosis

Medical malpractice in stroke diagnosis is a situation in which the signs of a stroke were not identified, were interpreted as another condition, or were treated later than was reasonable, in circumstances where a reasonable medical team should have suspected a stroke and acted to investigate it, and as a result the patient suffered harm that could have been prevented or reduced.

A stroke is one of the medical conditions in which the most critical variable is time. Many families come to us with the same difficult question: would the damage have been avoided had the team acted differently, and faster? It is a legitimate question, and it can be examined in a professional and orderly way.

It is important to say this up front: not every stroke that ended in damage is the result of malpractice. Some events are so severe and fast that even optimal treatment would not have changed the outcome. The professional examination exists precisely to tell the cases apart.

Concerned that the stroke was not identified in time and that the damage could have been avoided? An initial consultation at no cost and with no obligation: 077-4075002 | also available on WhatsApp

What is a stroke and why is time critical?

A stroke (CVA) is caused by a disruption of the blood supply to an area of the brain. The two main types are an ischemic stroke, in which a blood vessel is blocked by a clot, and a hemorrhagic stroke, in which a blood vessel ruptures. These are two fundamentally different conditions whose treatment is entirely different, so a rapid distinction between them by imaging is a necessary step.

Brain cells that do not receive oxygen are gradually damaged. The longer the time that passes until the blockage is opened, the greater the extent of the irreversible damage. For this reason, dedicated treatments were developed for the acute stage, eligibility for which is limited to a time window from the onset of symptoms, including clot-dissolving medication (tPA) and brain catheterization to remove the clot.

What should happen along the treatment chain, and where does it break?

Stage	What should happen	The failure examined in the case
Initial recognition	Recognizing suspicious symptoms and calling for help	Symptoms attributed to fatigue, stress or drinking, which did not lead to an urgent call
Emergency room intake	High-urgency triage and an immediate neurological assessment	A patient triaged as non-urgent who waited for hours until the treatment window passed
Imaging	A CT or MRI without delay, to distinguish ischemic from hemorrhagic	Imaging that was not performed or was performed with significant delay
Interpretation	Correct reading of the imaging	A finding that was missed, or an interpretation that ruled out the diagnosis
Treatment decision	Activating the treatment suited to the acute stage	A delay in making the decision, or failure to give a treatment the patient was a candidate for
Referral and transfer	Transfer to a stroke unit or to a center that performs catheterization	An institution that could not provide the treatment and did not transfer the patient in time
Follow-up after a TIA	Workup and follow-up after a transient ischemic event	Discharge home without a workup, followed by a full stroke
Prevention in the community	Controlling known risk factors	Atrial fibrillation not treated with anticoagulants, hypertension, or carotid artery narrowing left without follow-up

Risk factors such as atrial fibrillation and hypertension are also discussed on the page about medical malpractice in cardiology, and a missed cancer diagnosis raises similar questions, as described in medical malpractice in cancer diagnosis.

If you recognize your case in one of the rows, it is worth checking. The first conversation with us is free of charge and with no obligation. Call 077-4075002 or contact us on WhatsApp.

When is a failure to diagnose a stroke considered malpractice?

As in every medical malpractice claim, the question is not whether in hindsight it was possible to act differently, but whether there was a deviation from the accepted level of care and skill. The symptoms that should raise a red flag include one-sided weakness, facial drooping, difficulty speaking, blurred vision, unusual dizziness, and a sudden, unusual headache.

Two points recur in particular. The first is a transient ischemic attack, TIA, whose symptoms pass on their own and which is often a warning before a full stroke. The second is misdiagnosis in certain population groups: a stroke in young people, and in women during pregnancy and after childbirth, is sometimes mistakenly diagnosed as a migraine, benign dizziness, anxiety or the effect of alcohol.

What happens when the event occurs in children or around birth?

A stroke is not a condition of adults alone. It also occurs in newborns, premature babies and children, and there the diagnostic challenge is particularly great: a baby does not complain, and the symptoms may appear as seizures, reduced alertness, difficulty feeding, or asymmetry in movement, signs that are easy to attribute to other causes.

In these cases additional questions are examined: whether appropriate monitoring was carried out, whether risk factors were identified in time, and whether brain imaging was performed when suspicion arose. Our firm has a unique specialization in medical malpractice in pregnancy, in childbirth and in newborn care, which is directly relevant to cases of this kind.

What damage remains after a stroke that was not treated in time?

Brain damage following an event that was not treated in time may appear as permanent paralysis or weakness on one side of the body, speech and comprehension disorders, swallowing difficulties, cognitive and memory impairment, blindness or loss of part of the visual field, post-stroke epilepsy, and psychological harm. In severe cases full-time nursing care is needed for life, and the injury changes the life of the entire family.

How is a claim examined, step by step?

1. Building an accurate timeline. This is the heart of the case. When exactly the symptoms appeared, when the ambulance service was called, when the patient arrived at the emergency room, when the imaging was performed, when the treatment decision was made, and when the treatment was actually given.
2. Collecting the full medical records. The emergency room chart with time stamps, the ambulance report, the raw imaging, nursing records and monitoring records. We help with the collection.
3. A preliminary review by a lawyer who specializes in medical malpractice, to identify the possible points of failure.
4. An expert medical opinion, usually from a neurologist, and sometimes also an emergency physician or a neuroradiologist, who will determine whether there was a deviation from the standard of care and what effect it had on the outcome.
5. Proving causation. This is the central challenge. It is not enough that treatment was delayed; it must be shown that the delay caused the damage or made it worse, and that the patient was indeed a suitable candidate for the life-saving treatment.
6. Filing the claim and managing the proceeding against the defendants and their insurers.

What damages can be claimed and what parallel rights exist?

The scope of compensation derives from the circumstances of the specific case and the extent of the disability that remains, and cannot be predicted in advance. The heads of damage examined include loss of earnings in the past and future, medical and rehabilitation expenses, third-party assistance and nursing care, housing adaptations and mobility aids, and pain and suffering.

Alongside the civil proceeding, and sometimes in parallel to it, it is important to exhaust rights before other bodies: a general disability claim with the National Insurance Institute, special services and mobility, and claims against private health, disability and loss-of-work-capacity insurance. There are offset rules between the tracks, so it is important to coordinate them from the outset. If the event occurred at work or in the circumstances of a road accident, additional compensation tracks may be available.

How much time do I have to act?

In tort claims, the limitation rules set out in the Prescription Law and the Torts Ordinance apply. Personal circumstances change the calculation of the deadlines, among other things when the injured person is a minor, when a question arises as to when the damage was discovered, or when the injured person's cognitive condition affects their ability to act.

Alongside the legal consideration there is a practical one: in stroke cases the decisive evidence is often a time stamp in the record. The closer to the event you act, the easier it is to locate the full documentation.

We can begin collecting the documentation even before a decision is made to file a claim. Call 077-4075002, initial consultation at no cost.

Why contact the Ron-Festinger law firm?

Our firm specializes in medical malpractice claims and has been active in the field for decades, accompanied by first-rate medical experts. We understand that a family coping with the sudden disability of a loved one has to reorganize in every respect, and so we accompany the case from the first stage of collecting the material, through exhausting rights with the National Insurance Institute and private insurers, to the conclusion of the proceeding.

The initial consultation is free of charge, and in medical malpractice cases we work on a contingency fee basis. We are available from our offices in Jerusalem and Tel Aviv.

Leave your details in the form at the bottom of the page, call 077-4075002 or contact us on WhatsApp. The initial consultation is free, and legal fees are paid only if the claim succeeds.

Examples of stroke malpractice claims handled by our firm

Below are several cases of delayed diagnosis and treatment of a stroke that our firm handled. Each case is examined according to its specific circumstances.

Delayed diagnosis of a cerebral infarction and misinterpretation of an imaging test

Our firm filed a claim on behalf of a man about 47 years old at the time of the events, who had a background of metastatic melanoma.

Rapid arrival at the hospital with clear signs

The plaintiff arrived at the hospital in the morning with clear signs of a cerebral infarction: paralysis of the left side of the body, a visual field deficit and a language disorder.

Although the plaintiff arrived at the hospital very quickly, the medical team did not act as required. The necessary tests were not performed in time, and he was not given the medication that the circumstances required. In addition, the imaging test performed on him was misinterpreted.

Diagnosis the next day, after the treatment window had closed

The plaintiff's condition continued to deteriorate. The cerebral infarction was diagnosed only the next day, on a repeat test, with a significant and fateful delay.

By then the time window for giving the medication had already closed, and the plaintiff suffered extensive, irreversible brain damage.

The damage caused

As a result of the acts of negligence, the plaintiff suffers complete paralysis of the left side of his body and is confined to a wheelchair. He also suffers severe cognitive damage that affects his functioning in all areas of life.

Repeated discharge from the emergency room despite neurological symptoms

Our firm handled the claim of a woman about 40 years old who went to the emergency room several times and was discharged home again and again.

Symptoms that continued for days without a diagnosis

The woman suffered from headaches, dizziness, nausea and vomiting, and for these she went to the emergency room several times. The symptoms continued over days.

Instead of admitting her and diagnosing the cause of the symptoms, she was discharged home time after time, with various diagnoses that did not fit her condition. This was despite significant neurological symptoms, and without being properly examined by the appropriate physicians.

Admitted only on the third visit

Only after the third time she went to the emergency room, and after a further severe deterioration in her condition, was she admitted. Only then, with a significant delay, was her illness diagnosed and the treatment she should have received days earlier begun.

The damage caused

As a result of the delay in diagnosis and in giving the appropriate treatment, she suffered extremely severe neurological damage. The damage is expressed, among other things, in an inability to walk (she is confined to a wheelchair) and in severe speech problems.

Delay in the workup of a cerebral infarction and failure to give tPA or endovascular treatment

An urgent case that was managed slowly and by physicians who were not neurologists

A young woman about 48 years old arrived at the hospital with clear signs of a cerebral infarction: weakness of the right side of the body and a language disorder.

This was an urgent case requiring an immediate workup by a neurologist. Despite this, the case was managed with unacceptable and outrageous slowness, by physicians who were not neurologists, and with an extreme failure to understand her condition.

A series of acts of negligence

During her treatment many acts of negligence were committed, including:

• Failure to take an accurate medical history
• Unreasonable delays, of hours, in performing the tests that were required
• Misinterpretation of the tests that were performed
• An error in assessing the findings of the clinical examination
• Failure to give medical treatments, including tPA and/or endovascular treatment, treatments that are customarily given in exactly such cases and that could have prevented the neurological damage

The treatment window closed

Because of the significant, fateful and incomprehensible delay in performing the necessary tests, the time window for giving the treatment the plaintiff needed closed.

The damage caused

The plaintiff was left with extremely severe neurological damage, including paralysis of the right side of her body, visual disturbances and cognitive disturbances. She was also left with significant psychological harm that affects every area of her life.

Delayed diagnosis of a brain aneurysm and subarachnoid hemorrhage

Four visits to the health fund within nine days

Our firm handled the case of a woman who began to suffer, for the first time in her life, from tremendous and unbearable headaches.

Because of this pain she went to the health fund 4 times over 9 days. She complained of severe headaches, mainly on the left side and in the back of the head down to the neck.

Attributing the pain to upper respiratory infections

The health fund physicians did not address her complaints, and attributed them to various upper respiratory illnesses: a cold, tonsillitis and sinusitis.

They did so without performing even a single basic examination as part of a workup of an acute headache, such as measuring blood pressure, pulse and temperature, testing for meningeal signs and a fundus examination. In addition, they did not perform, and did not refer her for, an urgent neurological workup.

Hemorrhage and severe neurological damage

The plaintiff's condition deteriorated, and at the hospital it turned out that she had suffered from an aneurysm and a subarachnoid hemorrhage that caused her severe neurological damage.

What could have been prevented

The plaintiff claimed that had the family physicians treated the severe headaches properly and sent her in time for further workup in the emergency room, the aneurysm could have been diagnosed and treated in time, by surgery or catheterization, before it bled. The hemorrhage would thus have been prevented, and with it the severe neurological damage.

Frequently asked questions

What is medical malpractice in stroke diagnosis?

A situation in which the signs of a stroke were not identified, were interpreted as another condition, or were treated later than was reasonable, in circumstances where a reasonable medical team should have suspected and investigated, and as a result harm was caused that could have been prevented or reduced.

How do you know whether the delay in the emergency room is what caused the damage?

This is a medical question examined in an expert opinion. The examination cross-checks the documented timeline against the clinical guidelines in force, and examines whether the patient was a suitable candidate for treatment in the acute stage and what the chance was of avoiding the damage had treatment been given in time.

A doctor said it was a migraine and the next day it turned out to be a stroke. Is that malpractice?

Not necessarily, but it is a pattern worth examining. The question is whether, in the circumstances presented to the doctor, meaning the symptoms, the patient's age, the risk factors and the duration of the symptoms, a reasonable doctor would have referred for further workup. A review of the documentation is required.

What is a TIA and can missing it support a claim?

A transient ischemic attack is a temporary disruption of the blood supply to the brain, whose symptoms pass. It is often a warning before a full stroke. Failure to investigate and follow up after a TIA is a ground that is examined in cases of this kind, subject to an expert opinion.

Who is the claim filed against?

Depending on the circumstances: against the hospital, the treating physician, the health fund or the rescue services, and sometimes against several parties at once. The identification is made after reviewing the full documentation.

What documents is it worth collecting right now?

The emergency room chart with time stamps, the ambulance report, the imaging itself and not only the interpretation, the discharge letter, and the nursing and monitoring records. Independent documentation, such as the times of messages or calls, may also help in building the timeline. We help with the collection.

Can the National Insurance Institute be claimed from in parallel?

Yes. The civil claim and the claims before the National Insurance Institute are separate tracks, and it is usually worthwhile to pursue both. There are offset rules between the tracks, so it is important to coordinate them from the outset.

Can a claim be filed if the patient died?

Yes. In the event of death there are two separate causes of action, the estate's claim on behalf of the deceased and the dependants' claim by the family members. Each is subject to its own limitation rules.

Contact us

If you suspect that a stroke or a TIA was not diagnosed or treated in time, call 077-4075002 or contact us on WhatsApp. The first conversation is free of charge and with no obligation.

The content on this page is general information only and does not constitute legal or medical advice, and should not be relied on as a substitute for individual advice. Every case is examined on its own merits and according to its unique circumstances. Nothing stated here is a promise of any result. In a medical emergency, seek treatment immediately.