Misdiagnosis of stroke in younger adults is likely to be a growing problem as the rate of ischemic stroke in this population continues to increase. A study published this month in the Journal of the American Heart Association showed that, while overall stroke rates have declined, strokes among individuals aged 25-44 increased by 44% during the ten-year study period. A separate study reported an increase in strokes among patients aged 15-30. Unfortunately, these studies were not designed to determine the cause behind the increased rates of stroke. Potential factors could include more accurate diagnosis, better reporting, drug- or diet-related, and an increase in trauma-related strokes (e.g., carotid artery dissection).
Factors Behind Risk of Stroke in Younger Population
There is an increased risk of a negligent diagnosis when diseases that are associated with an older population occur in a younger population. There are two factors behind this risk. First, doctors are surprisingly slow to recognize trends in medicine, both in terms of epidemiological trends and trends in treatment. As an Ohio medical malpractice attorney, I have seen this repeatedly in interviewing doctors from various medical specialties in the course of a deposition.
The second factor is that doctors fall victim to a variety of decisionmaking biases that lead to misdiagnoses. This phenomenon is well-studied and, frankly, quite scary. Biased decisionmaking might lead a physician to categorically rule out stroke in a younger patient even though the patient has classic symptoms of the condition and lacks another good reason for having the symptoms. We have seen this for years in the misdiagnosis of breast cancer in younger women. But jumping to conclusions like this is never acceptable, particularly when a young life is at stake.
Under Ohio law, delayed diagnosis of stroke may give rise to an actionable claim for medical negligence, depending on the circumstances. When any patient, young or old, presents with classic symptoms of a stroke, including facial drooping, slurred speech, and/or numbness or tingling in an arm and/or leg, there are well-established criteria for obtaining a prompt diagnosis. Most hospitals have a stroke team which follows a stroke protocol to promptly do a thorough neurological assessment and obtain imaging so that the diagnosis can be made. Once a stroke is confirmed and the type of stroke (hemorrhagic versus embolic) is determined, then treatment must started promptly. There is a narrow window within which treatment is effective. A significant delay can make treatment more harmful. Further, brain tissue begins to die without prompt treatment. Unlike other tissues in the body, brain tissue does not regenerate. So, once it is lost, it is lost for good. This where the slogan “time is brain” comes from.
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