This may be slightly off-topic, but a the definition of “alone” may vary. Florida law requires that PA’s and NP’s be within 25 miles of a physician’s main office, and that he may not have sattellite offices that are more than 75 miles from each other. In the past, ‘telephone distance’ (whatever that means) was sufficient.

In this case, the physician was located in the ER with the PA. Not to blame the PA, but cases like this are the reason some ER’s aren’t taking PA’s anymore.

When I post a detailed entry on a weblog, I do a Google News search for the best coverage of the story, and will go into court records if they’re readily available on line (which they weren’t here).

When ProAssurance releases its next 10-Q, it will have a paragraph about this case, and we’ll know more then.

Has it not occurred to ANYONE that the newspaper may have gotten it wrong? It is known to occur.

My suspicion is that the offer was in fact Three Hundred Thousand Dollars. No one in a major malpractice case will offer $300 to settle it.

If I were posting an entry on a weblog, I would have tried to track this information down before posting it. This may be a good example of proliferation of misinformation.

Then again, I could be wrong. Tell me if I am.

Quick primer on “strokes”.

Two types–ischemic and hemorrhagic. Ischemic are caused by occlusions of blood vessels by either plaques that have ruptured and scabbed over or travelling blood clots (and more rarely from other things). “Clot-busting drugs” or plasminogen activators are only used with ischemic strokes.

From what I can discern from the media, this person had a subarachnoid hemorrhage, which is where a blood vessel breaks and blood spills into the brain. It is bad when blood actually touches brain tissue, instead of just supplying an oxygen source through the walls of the capillaries (small vessels).

If we could travel back in time and help the ER doctors do everything correctly, let me tell you what would be the best outcome. He would have had a lumbar puncture, not to look for meningitis, but to look for red blood cells in the CSF or cerebrospinal fluid as evidence that he had a hemorrhage. THen if that was positive, he would have been admitted to the neuro ICU and given medications to reduce his blood pressure. A neurologist and neurosurgeon would have come by and the nurses would frequently check his neuro exam. Next he would either bleed more or stop bleeding, I’ve seen both. If he bled more he likely (not my field) would have gone for neurosurgey, but not to regain the lost brain tissue. After that he STILL WOULD HAVE HAD DEFECTS. That is what infuriates doctors about this. The outcome could have very well been the same.

This case seeks to make the standard of care absolute perfection with perfect knowledge and 100% flawless outcomes. We do not live in perfectland. We live in reality. I agree with Samson, doctors will be leaving Florida (I am one of them regrettably) and then someone will sue the hospitals for failing to provide “coverage”.

Perhaps if the public thinks they deserve flawless free care or else, they should just burn down all of the hospitals as none of them are perfect.
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This is the second case that I know off where doctors did tests responsibly, but were still punished for not curing the illness.

Still, the doctor did miss the stroke despite the plaintiff having described a “pop” in his head and a family history of strokes. It’s not clear to me that it’s any great loss if this particular doctor is driven out of practice. And contra Ted’s comment above, the fact that the plaintiff is alive today is attributable purely to luck; medical science may have made great strides in treating strokes, but because of the negligence by the doctor and the failed PA, none of that treatment was ever prescribed to the plaintiff until after the damage was done.

The issue, based on the information provided, may be that the physicians in question didn’t provide appropriate oversight to the PA. PAs make diagnoses but they have to be reviewed by an MD/DO.