Young man suffers permanent brain damage when UC Davis ER docs fail to evaluate for stroke. $15.3M. Sacramento County.

Facts and Background

• Facts and Background:

  Plaintiff was a 23-year-old college student who became unresponsive at home and was taken by ambulance to the ER at UC Davis Medical Center, a certified advanced-primary-stroke center. He was admitted to the ICU, and his stroke was not diagnosed until the next day. He suffered permanent brain damage to the left hemisphere of his brain involving the left middle cerebral artery distribution.

• Plaintiff's Contentions:

  Plaintiff contended that the UC Davis medical providers were negligent in diagnosing and treating plaintiff's stroke. The emergency physicians recognized that plaintiff was unable to speak and that he had neurologic symptoms on the right side but not the left. They testified that stroke was low on their list of possible diagnoses and so they chose not to activate the Emergency Department Stroke Protocol.

  Plaintiff contended that had the emergency doctors activated the stroke protocol as required by the standard of care, a CT angiogram would have been performed and plaintiff's stroke would have been diagnosed within one hour of entering the Emergency Department. Plaintiff further contended that the failure to activate the stroke protocol delayed the stroke diagnosis by 26 hours, resulting in plaintiff's permanent brain damage, loss of speech, cognitive dysfunction, and loss of earning capacity. Plaintiff contended that he requires full-time supervision.

• Defendant's Contentions:

  Defendant contended that the emergency medicine doctors acted within the standard of care at all times in evaluating plaintiff and maintaining a broad differential diagnosis, including brain infection, seizure, toxic ingestion and cerebrovascular accident, for plaintiff’s critical illness. Defendant contended that plaintiff had a very rare presentation for an ischemic stroke as he was barely responsive and moving all extremities when he arrived in the emergency department. Although stroke was on the differential diagnosis list, it was low as his symptoms were much more likely due to other equally life-threatening conditions.

  Defendant also contended that there was no reliable time when plaintiff was last known to be well, and it was unclear if he was even seen well the morning in question. Although a stroke alert was not activated, the neurology providers who would have been involved had a stroke alert been activated did not diagnose a stroke when they evaluated plaintiff. Defendant also contended that, based on review of the initial head imaging, plaintiff’s stroke started more than six hours earlier. Therefore, even if the stroke had been diagnosed shortly after plaintiff arrived, he would not have been a candidate for acute stroke treatment and it would not have made a difference. Plaintiff’s experts agreed that plaintiff would not have made a full recovery even if he had been diagnosed earlier with a stroke.