Discussions By Condition: Medical Errors

Where to find a case history?

Posted In: Medical Errors 12 Replies
  • Posted By: gaijin
  • June 1, 2008
  • 00:36 PM

The situation at hand is a misdiagnosis of a patient who had a
stroke, did not regain consciousness, and developed pneumonia
from which she died.

I am looking for a documented case history where a patient
regained consciousness following treatment given 'after' the
'Golden Time' for treatment of a stroke patient had passed.

Thank you for any information you may kindly provide.

Reply Flag this Discussion

12 Replies:

  • Hi MikeEvery CVA/stroke is of course different in terms of location and severity. It would be difficult to use a case history of another patient who survived following treatment after the optimum time, because it could be argued that no comparisons could be made in terms of severity and prognosis.Are you able to say a bit more about what happened exactly? Some strokes are catastrophic, and some are survivable and there is a grey area in between. Very generally speaking, failure to recover consciousness following a stroke is not a good sign. How long was the person unconscious and when did pneumonia begin?Sorry to be so unhelpful!Elisa
    ElisaDoolittle 20 Replies Flag this Response
  • Good morning Elisa,Thank you very much for your reply and interest.I'm sorry,I should have provided more details of the situation. Actually I amtrying to help a Japanese friend of mine here in Japan who speaks little English.Her mother is the one who passed away after their private doctor failed to diagnose the condition as being a stroke. When the mother failed to regain consciousness, sheadmitted her into a large hospital where they found that she had had a stroke butby that time it was too late to save her.The daughter felt that their private doctor should admit his mistake and apologize.But when he wouldn't, she took him to court to seek, not monetary compensation, but just a simple apology. The judge is now asking for documented evidence, in the form of an actualcase history, showing that if treatment had been given even after the optimum time that there was a chance that her mother could have regained consciousness. Apparently the judge is not specifying what kind of treatment, or that the case history be one of a patient whose stoke was equal in severity. Just a case where the patient did regain consciousness after receiving treatment sometime passed theoptimum time.The daughter tried to find such a case history here. But it does not seem that case historiesare readily available in Japan. That is why I am trying to locate such that might be availableover the internet from the U.S. I have no experience with anything such as this and thus have no idea where to look or even if it is possible to acquire such case histories. That is why I havecome to this site looking for help.I hope this is a little clearer. And I would like to thank you for taking the time to read this.If you are able to even just point me in the right direction, I would be very greatful.Yours respectfully,Mike
    gaijin 4 Replies Flag this Response
  • Hi MikeI'm really sorry to hear of the sad loss of your friend's mother. I've had a think about what you said, but the only suggestion I could make would be to email the Stroke Association (maybe UK or US?), explain your query and ask if they can help? It may be that they have members who would be willing to offer their experiences as evidence, although I guess that the Judge will need more than that. Other than that suggestion, is your local hospital able to help? The problem from an evidence point of view, is that (in the UK at least), cases such as this become whats known as case law, whereby decisions are made in the courts when assessing liability and quantum. These cases can be accessed generally, but this isn't what your Judge is asking for - merely evidence of survival in your friend's mother's situation.I can well understand why this is proving to be a tough one and I'm sorry I can't offer anything useful to you. I wish you well in your search.Take careElisa
    ElisaDoolittle 20 Replies Flag this Response
  • Hi Mike, I just want to tell u the little bit i know only from experience. I'm sure Elisa is much more qualified than i am, as what she has said to u is very true & her knowledge is greater than mine......here it is ! My mum died of a subarachnoid brain haemorrhage which was catastrophic this is another form of stroke as far as i am aware. She receieved medical attention very very quickly, they done everything possible for her but she never stood a chance of survival.....there was a point where they where really doing their best to stabilise her so they could do the CT scan but she was just to ill, eventually they knew they where fighting a loosing battle when her organs where starting to fail, I think at this point they then decided to let her go to CT scanner i think more for our sakes than hers, it was to prove to us theyre not going to win this battle & for us to agree to take her off life support.....which we did, she made no atempt at all to breath for herself at all. As far as i am concerned i truely believe that my mum was dead right from the word go, and the way it all panned out saved us the trauma of her going through an autopsy. I dont see how any judge anywhere in the world could look at a case study, as no two cases would be the same. I have friends who's parents have had similar strokes, some survived some didnt, some done well & some never regained any quality of life again & now recieving 24/7 care. As far as i am concerned it was better for mum to go than live like that. Also regarding pneumonia u will find that a lot of deaths will be recorded this way. I think people confuse it with viral pneumonia which is different.But pneumonia in someone who is crictically ill is basically the heart starting to fail along with other organs, therefore fluid then builds up in the lungs. It really is a natural process of dying. Many people with cancer or the crictically ill, their death will most likely be recorded as death by pneumonia. I do hope this information is correct, i think it is, as it was a doctor who explainded it to me many years back when my gran mother had cancer & died & on the death certificate it was recorded as cause of death, pneumonia. I think the chances are that ur friends mum really didnt have much of a chance but really its hard to tell as we can not know all the facts. Anyway i hope this maybe helps a bit & if anything is wrong in what ive said that Elisa can correct it for me. Kind regards :)
    Tootsie 628 Replies Flag this Response
  • Hi Tootsie & Mike Tootsie - I'm really sorry to hear about your dear Mum. I recently lost my Dad so know how difficult it is. I think you are absolutely spot on in what you say.Loosely speaking there are two types of strokes - one caused by an embolism from, say, lung, neck or leg which travels to a part of the brain and stops blood flow, resulting in brain tissue damage/death. One of the treatments for this would be clot-busting drugs to thin the blood and dissolve the clot, allowing blood to flow again. Rarely, surgery is attempted to remove the clot. Any clot-busting drugs usually need to be administered within a certain time frame to stop further damage.The other type is the one which your Mum had Tootsie, the brain haemmorhage (or berry aneurysm), whereby a vessel bursts, often with catastrophic results. In this instance, clot-busting drugs cannot be used because it would cause further bleeding. The treatment for this would sometimes be the tie off the bleeding vessel asap.I'm guessing Mike that your friend's mother had the first type of stroke caused by an embolism?Elisa
    ElisaDoolittle 20 Replies Flag this Response
  • Hello Elisa,Thank you very much for your suggestion that I contact the StrokeAssociation. I will do just that.With what you wrote to me and to Tootsie it is obvious that you have a vast knowledge of this subject, and it is so kind of you totake the time to share your thoughts and advise others.Very grateful,Mike
    gaijin 4 Replies Flag this Response
  • Hi Tootsie,Thank you for sharing your experiences. In doing so you answered a question that I had always wondered about. That being why so manyelderly people develop and die from pneumonia following a separateillness. Now I know, thanks to you.All the best,Mike
    gaijin 4 Replies Flag this Response
  • Hi Tootsie,Thank you for sharing your experiences. In doing so you answered a question that I had always wondered about. That being why so manyelderly people develop and die from pneumonia following a separateillness. Now I know, thanks to you.All the best,Mike
    gaijin 4 Replies Flag this Response
  • Hi Mike & Elisa, I'm glad I helped helped a bit. Elisa is more the expert than I, thank you for ur appreciation, i appreciate it.....lol:) .......its nice to get a reply. Thank you Elisa for your kind thoughts regarding mum. My condolences to you also for the loss of your father. Here's a quote i read one time & it always stuck with me. To loose a parent you loose your past,To loose a partner you loose your present.And to loose a child you loose your future. I don't know who the author was, but it is very true. Anyway, Kind regards to you both.:)
    Tootsie 628 Replies Flag this Response
  • HI MikeIt sounds like you are a great support to your friend, and I hope you get the info you need to help her find some peace and resolutiion. Grief is so hard to bear with a "natural" death and where there is a suggestion that it could be avoided, then it must make it doubly hard. Hi TootsieThanks for your understanding about Dad and your lovely poem, which is so true isn't it. I'm just getting into the swing of things on this site, and joined basically to try and help others decipher medical info which is often taken for granted by many in the medical professions. I think its great that everyone here can share information and experiences for the benefit of others, and I don't think its necessary to have expertise. Sometimes just a kind word or shared experience is enough to help, as you have done for Mike.Anyway, am rambling now! Best wishes to you bothElisa
    ElisaDoolittle 20 Replies Flag this Response
  • Hi again Mike, I do hope ur well.......i also hope u don't mind me chatting to Elisa here......it would be great if members had a place to chat to one another here. Hi Elisa, Its fantastic that u have come on board & decipher medical info, there are some very wise & helpful members here, but alas... if u don't already know u will soon find out there are some not so wise or comforting members, so u will see some very inapproiate advice/information given. Don't be afraid to speak up if need be, we all have & will continue to step in where necessary. Unfortuantely as all kinds have access to the www ya just can't stop them........You will see some members actually diagnosing illnesses, which is totally wrong. And unfortuantly again when some unsuspecting person has asked for help & they are bomarded with nonsense or scare mongering, some don't come back, this is sad & frustrating for us who want to help where we can in whatever way we can. We all have subjects that we have stronger knowledge on than others, so u get to know who will be good at helping with a paticular problem, for others we can offer a kind word & support where needed. So don't be shy and its great to have u on board ! Regards:)
    Tootsie 628 Replies Flag this Response
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  • Hi TootsieYes, I do know what you mean about some of the posts. Lay diagnosis (and internet diagnosis) causes the medical profession a massive headache at times! There will be many people on this site who are genuinely convinced that others have the same illness as them and will tell them so. The problem, as you know, is that even a qualified doctor could not diagnose from an email. If life were that simple then we'd all be out of work! Anyway, I'll do my best where I can. Thanks for the great advice and welcome.Elisa PS Sorry to hijack your thread again - hope you are doing OK with your search.
    ElisaDoolittle 20 Replies Flag this Response
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