A medication error can carry serious consequences. A popular medical journal recently reported that physicians are frequently prescribing aspirin to reduce the risk of stroke in patients with atrial fibrillation (“Afib”). This is a medical mistake that can lead to a preventable stroke. Afib is a condition wherein erratic electrical impulses in the heart cause the heart to beat out of rhythm. As a result, blood can pool within the heart and solidify into blood clots. The pumping action of the heart can dislodge these blood clots which then travel to the brain. Blood clots that travel to the brain (“emboli”) can block blood flow within the brain and cause a stroke. Afib can affect anyone but it tends to be more common as people age.
Certain patients are a higher risk of having a stroke due to Afib. Patients with congestive heart failure, hypertension, age greater than 75, diabetes, and/or prior stroke or TIA, are at greater risk of a stroke related to Afib. These are the “CHADS2 criteria,” but there are other risk factors for stroke. Published recommendations promote the use of anticoagulants (e.g., Warfarin or Coumadin), also called blood thinners, to prevent blood clots from forming in high risk patients with Afib.
However, a recent study published by the New England Journal of Medicine shows that about 40% of patients who should have anticoagulation prescribed are instead being prescribed aspirin. Physicians who study stroke risk in Afib note that “aspirin is not an anticoagulant; aspirin is ineffective for prevention of thromboembolism related to nonvalvular atrial fibrillation.” Not only does aspirin offer virtually no protection against stroke, it carries a significant risk of bleeding, which itself can lead to a hemorrhagic stroke.
As an Ohio medical malpractice attorney, it is not uncommon to see doctors failing to keep up with ever-changing standards of care. However, there is no excuse. When a physician fails to keep up with modern practice standards, they put their patient at unnecessary risk. Currently, there are a variety of choices for anticoagulation (newer ones include Pradaxa, Xarelto, Savaysa and Eliquis), and the recommendations for use of these medications are well-known in the medical community. If a doctor is still prescribing aspirin to Afib patients who are at moderate- to high-risk for a cardioembolic stroke, and the patient suffers a debilitating or fatal stroke, this medication error may furnish the basis for a medical negligence lawsuit under Ohio’s laws.
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