This case involved a 51-year-old man with a history of multiple myeloma, amyloidosis, hypertension, and hypercalcemia who awoke around 2:30 am unable to speak or hold himself up on his right side. His wife reported he had gone to bed at 11 pm the previous night after having a headache all day and, at that time, had been acting normally.
Emergency responders arrived at 2:38 am noting the patient was experiencing confusion and facial droop. He arrived at the defendant’s hospital by 3:30 am nonverbal with right-sided paralysis and was diagnosed with a stroke. Medical staff agreed he was not a good candidate for tPA treatment because he was outside the 3-hour safe window for the drug.
The plaintiff was transferred to another institution for further treatment of his stroke, multiple myeloma, and amyloidosis. There, his diagnosis was complete thrombotic occlusion of the left internal carotid artery and a symptomatic left middle cerebral artery infarction. Caregivers felt he was outside the treatment window for thrombolytic and thrombectomy care. Imaging showed moderate swelling of the brain with mild compression of the left lateral ventricle and midline shift with no bleeding. Several days later he was transferred to a rehabilitation center. Unfortunately, he did not recover and continues to have severe deficits in almost all aspects of life.