Stroke #2: Diagnostic Error and Risk Reduction

Course overview

Strokes, new or recurrent, affect about 700,000 Americans every year. Stroke is the third leading cause of death in the United States and the number one cause of adult disability. With more than a million hospitalizations occurring in the U.S. each year, the importance of stroke as a major cause of morbidity and mortality cannot be overemphasized. Medical errors in this high-risk area may lead to profound disability or death. In addition, lawsuits in this arena are exceptionally costly. TSG continues to monitor the frequency and severity of medical errors, adverse outcomes and medical malpractice litigation. In recent years, stroke has emerged as a high-risk diagnosis for emergency physicians and other learners providing acute or episodic care. The recent increase in litigation is in part related to the alleged failure to use or inappropriate use of thrombolytic agents, which will be reviewed in depth in this activity. This activity is the second part of our two-part program on stroke. In this activity, Stroke Part 2, we explain the most common reasons why the diagnosis of stroke is missed, delayed, or inappropriately managed, as well as the common medical errors and allegations of malpractice; we also provide risk and documentation guidelines. We present and discuss cases related to delays in management, the use and misuse of thrombolytic agents, and medication errors. After completing this activity, learners should be able to: analyze reasons for medical error and litigation as it relates to the stroke patient; devise documentation elements related to the management of the stroke patient; and examine risk management recommendations for the stroke patient.