What is Ischemia?

Person with no LegsIschemia is a condition in which the blood flow is restricted or reduced in a part of the body. This means certain parts of the body are not getting adequate blood and oxygen. This restriction can happen in any part of the body including the brain, arms, and legs.

Causes of Ischemia

A main cause of ischemia is atherosclerosis. Atherosclerosis is a condition that occurs when the arteries harden and narrow, silently and slowly blocking or restricting blood flow. This makes it difficult for blood and oxygen to get through the arteries and circulate to certain areas of the body.

Although atherosclerosis is the most common cause of ischemia, blood clots can also cause ischemia. Plaque buildup in arteries or blood vessels can gradually prevent blood from flowing but when the plaque in the blood bursts open and forms a clot, this can cause a sudden and serious stoppage to your blood flow.

Types of Ischemia

Ischemia is an umbrella term used to describe the general condition of the absence of blood supply to a certain area of the body. However, there are different subtypes of ischemia depending on the specific part of the body that is affected.

  • Myocardial Ischemia (Heart) - occurs when the blood flow to your heart is reduced. As a result, the heart does not receive enough oxygen. The reduced blood flow is often caused by a partial or complete blockage of the heart's arteries. This can lead to a heart attack or abnormal heart rhythms.
  • Cerebral Ischemia (Brain) - occurs when there is an insufficient amount of blood flow to the brain. A temporary deficit in oxygen supply can impair the function of the brain. If the brain cells are deprived of oxygen for more than a few seconds, severe damage can occur. This can result in the death of the brain tissue.
  • Critical Limb Ischemia (hands, feet, and legs) - severe obstruction of the arteries which reduces blood flow to the extremities and has progressed to the point of severe pain and skin ulcers or sores.
  • Mesenteric Ischemia (Intestines) - when arteries that supply blood to the small and large intestines and so cannot receive adequate oxygen.
Problems Caused by Ischemia

Different problems and health conditions can arise as a result of ischemia and some can be fatal, depending on the part of the body. Examples of medical events and health conditions that can result from ischemia include:

  • Heart attack
  • Irregular heartbeat
  • Heart Failure
  • Chest pain or angina
  • Sudden cardiac death
  • Stroke
  • Amputation
  • Death
Symptoms of Ischemia

Not everyone feels or gets symptoms with ischemia. Some people have silent ischemia in the heart or brain. This is often very dangerous because if you have ischemia and feel no pain or show any other signs, the resulting stroke or heart attack can seem very sudden. If you do get symptoms, they will likely vary based on the part of the body that is affected. Below are some common symptoms of ischemia.

  • Heart: Chest pain, irregular heartbeat, pain in neck, jaw, shoulder, or arm, upset stomach, fatigue, and/or shortness of breath
  • Brain: headache, dizziness accompanied by throwing up, passing out, difficulty moving body, and/or slurred speech and difficulty understanding others.
  • Legs: coldness and weakness in legs, pain in feet or legs, shiny and smooth skin your legs and feet.
  • Intestines: belly pain, bloating, blood in feces, diarrhea, throwing up, and/or upset stomach
Risk Factors for Ischemia

Certain factors increase your likelihood of getting ischemia. Below are a few common risk factors of ischemia

  • History of smoking
  • High cholesterol level
  • Low blood pressure
  • Congestive heart failure
  • Excessive Stress
  • Unusual disorders of the blood vessels
Ischemia and Medical Malpractice

Ischemia can have detrimental and even fatal consequences. Therefore, it is very important for health care providers to properly diagnose and treat the condition very early. However, when healthcare providers fail to promptly diagnose and treat ischemia, patients are often left with permanent and irreversible health conditions.

Medical malpractice claims involving ischemia usually involve some type of failure to diagnose or misdiagnosis theory. Failure to diagnose and identify a blood clot is a common example of a diagnostic error resulting in ischemia. A 2016 malpractice case from Easton, Maryland offers a good example of blood clot misdiagnosis. It is important to know the healthcare laws of your jurisdiction and get adequate legal and medical help when faced in such situations.

Ischemia Jury Verdicts and Settlements

Below are example verdicts and settlements from medical malpractice cases involving ischemia.

  • Menapace v Memorial Hosp (Wyoming 2018) $10.5 million: plaintiff goes to the hospital with leg pain and difficulty walking and he is initially diagnosed with diabetes and peripheral vascular disease. He receives treatment and is discharged. Four days later he is back in the hospital and this time he is diagnosed with acute limb ischemia, sepsis, and renal failure. An emergency amputation of both his legs is performed immediately. He sued the hospital and doctors for failing to properly diagnose and treat his ischemia on his initial visit to the hospital, which resulted in the loss of his legs. Defendants deny wrongdoing but jury awards $10.5 million in damages.
  • Patient v. Defendant Nurse Practitioner (Massachusetts 2017) $4 million: plaintiff suffered spinal cord ischemia which resulted in total paralysis. The plaintiff alleged that the defendants were negligent in failing to act quickly when an aortic dissection was a part of a differential diagnosis. Defendants denied the allegations of negligence and contended that there was a narrow window of time to transfer the patient and therefore, they were not responsible for her damages. Nevertheless, the parties agreed to resolve the plaintiff's claim for the sum of $4 million in a confidential settlement.
  • Allen v. University of Maryland Medical Center (Maryland 2016) $10,000,000: A man goes to the University of Maryland Medical Center complaining of general weakness. is diagnosed with rhabdomyolysis. His medical history includes liver disease, stage IV renal failure, and hypertension. A week later while still in the hospital, he becomes lightheaded with a decreased heart rate (bradycardia). An EKG shows a prolonged PR interval with markedly peaked T waves that was not present upon his initial admission to the hospital. He is diagnosed with hyperkalemia (elevated potassium levels) and prescribed Kayexalate even though he could have been treated with the condition with dialysis.  The man has numerous bloody bowel movements. An operation reveals that he had severe ischemic bowel as a result of the Kayexalate.  Ultimately, he dies. His wonderful family filed suit in Baltimore City and the jury awarded $10 million, finding that the doctor should have considered dialysis instead of Kayexalate.  Our law firm, Miller & Zois, handled this case.  
  • Benson v. Jerry Thomas and St. Clair Hospital (Pennsylvania 2016) $575,000: 72-year-old male went to the hospital with acute onset abdominal pain and vomiting. Defendant radiologist read and interpreted the plaintiff's CT scans as normal and discharged him. The next morning the regular staff radiologist reread the CT scan and determined that it showed abnormalities consistent with ischemia. The hospital contacted the plaintiff to return to the hospital where they performed surgery. However, the plaintiff's condition had deteriorated and he later died. Plaintiff's estate sues for malpractice alleging that the initial misdiagnosis and delay in treatment caused the defendant's wrongful death. The parties settled their dispute for $575,000.
  • May v. Roth, Central Illinois Radiological Associates (Illinois 2014) $2.7 million: 37-year-old female undergoes MRI of the brain and CT angiogram of the neck. Plaintiff contended that defendants negligently interpreted and reported the MRI of the brain as showing ischemia in the left basal ganglia when the ischemia was in the left thalamus and interpreted and reported the CT angiogram of the neck as normal. As a result, she suffered a second ischemic stroke, resulting in a drop foot, paralysis of her right arm, cognitive issues, and expressive aphasia. The plaintiff contends the misinterpretation of plaintiff's scans caused the plaintiff to forego treatment. The parties settled for $2.7 million.
  • Plaintiff v. Defendant OB/GYN (Massachusetts 2013) $3 million: plaintiff mother alleged that the defendant ob/gyn and the defendant nursing staff were negligent in failing to appreciate the severity of the infant's distress and perform an emergency C-section in a timely manner. As a result of the defendant's negligence, the plaintiff infant suffered a hypoxic-ischemic brain injury. The defendants denied the allegations and maintained that there was no deviation from acceptable standards of care in the labor and delivery of the infant. The parties settled the matter for $3 million.
Contact Miller & Zois About Ischemia Malpractice

The medical malpractice lawyers at Miller & Zois can help investigate and pursue your medical malpractice claim for ischemia and related conditions. Call us today at 800-553-8082 or request a consultation online.

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