Stroke After an Aortic Valve Replacement Surgery Lawsuit

White v. Sinai Hospital of Baltimore

Brain BleedThis wrongful death claim was filed in Baltimore City when a woman suffered a devastating stroke and died after receiving inadequate postoperative care from her cardiologist. It was filed in Health Claims Arbitration on January 16, 2018, and it is the 26th medical malpractice case filed in Maryland this year.

Summary of Plaintiff's Allegations

After her first aortic valve replacement in 1993, a woman took Warfarin for approximately twenty-two years. Warfarin is a blood thinner used to prevent thromboemboli - blood clots that break free and travel through the bloodstream to block another vessel in the lungs, brain, gastrointestinal tract, kidneys, or leg.

In 2015, the woman underwent a redo aortic valve replacement surgery at Union Memorial Hospital. She developed a complete heart block postoperatively, requiring the placement of a permanent pacemaker. Her Warfarin prescription had been discontinued before the redo surgery and it was not restarted after the procedure was completed.

Two months after the redo surgery, the woman presented to her cardiologist with complaints of shortness of breath and fatigue. The cardiologist failed to perform a complete cardiac workup, failed to check the woman's pacemaker, and failed to restart the woman on Warfarin or prescribe any appropriate antiarrhythmic medication. Several days later, the woman was admitted to the hospital with difficulty breathing and shortness of breath. Cardiologists at the hospital also failed to perform a complete cardiac workup and prescribe the appropriate medications. Shortly thereafter the woman returned to her cardiologist, who again failed to provide the woman with the appropriate care.

Approximately one month later, EMS transported the woman to Sinai Hospital of Baltimore. She was complaining of dizziness, lethargy, face drooping, a decreased level of consciousness, vomiting, and nausea. Her physicians at the hospital did not perform a transient ischemic attack evaluation or recognize that she was at increased risk for experiencing a major stroke. The care provided by staff at Sinai was lacking in general, and there is a litany of necessary and potentially life-saving imaging studies, tests, and consultations that the woman never underwent.

After spending the night in the hospital, the woman suffered a stroke which resulted in permanent neurologic injury and ultimately her death.

Additional Comments
  • The medical community universally recognizes that patients are at an increased risk of developing thromboemboli for the first three to six months following a bioprosthetic aortic valve replacement surgery, particularly if they are not taking an anticoagulant (blood thinner). The woman in this claim suffered a stroke because a thrombus (blood clot) obstructed the blood flow to her brain.

  • An article published in Current Cardiology Reviews confirms that cardioembolic stroke (occurring when the heart pumps materials into the brain circulation that block a brain blood vessel) is the most severe type of ischemic stroke. They are largely preventable with proactive care, but once a cardioembolic stroke has occurred, the likelihood of mortality or recurrence is high.

  • The symptoms of ischemic stroke include nausea, dizziness, blurred vision, headache, lethargy, confusion, weakness, difficulty walking, and facial droop. As soon as this woman began to exhibit stroke symptoms, her doctors should have immediately performed the appropriate diagnostic procedures and provided her with appropriate treatment.

Jurisdiction
  • Baltimore City
Defendants
  • Two cardiologists
  • Sinai Hospital of Baltimore, Inc.
  • Maryland Provo-I Medical Services, P.C.
  • Emcare, Inc.
  • An ER doctor
  • An internist/hospitalist
  • A hematologist/internist
  • An internist
Hospitals Where Patient was Treated
  • Union Memorial Hospital
  • Sinai Hospital of Baltimore
Negligence
  • Failing to timely and properly suspect and treat the claimant's life-threatening predisposition to thromboemboli.
  • Failing to prescribe the appropriate cardiac medications and to re-prescribe a blood thinner.
  • Failing to recognize, investigate, and treat the claimant's symptoms.
  • Failing to adequately inform the claimant about the risks of her condition.
Specific Counts Pled
  • Wrongful Death
  • Survival Action
  • Failure to Obtain Informed Consent
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