In stroke care, failing to order imaging like CT scans or MRIs can lead to severe consequences, including permanent disability or death. Imaging is essential to determine the type of stroke – ischemic or hemorrhagic – and guide timely treatment. Without it, doctors risk misdiagnosing symptoms, delaying critical interventions such as clot-busting drugs or thrombectomy.
Key takeaways:
- Imaging is vital to distinguish stroke types and decide treatment.
- Delays or failures in ordering imaging often breach the standard of care.
- Recent malpractice cases highlight the devastating outcomes of imaging failures, with payouts averaging $1.8M–$9.7M.
- To pursue a claim, you must prove duty of care, breach, causation, and damages, supported by expert testimony and detailed evidence.
If you or a loved one suffered harm due to delayed or missed imaging, consulting an experienced attorney can help you navigate legal complexities and secure compensation.
Legal Consequences of Not Ordering Imaging
Failing to order imaging in suspected stroke cases violates the standard of care expected of physicians. Doctors are trained to identify stroke symptoms using the FAST criteria (Face drooping, Arm weakness, Speech difficulty, Time) and must act swiftly to arrange neurological evaluations and imaging tests. When they fail to do so, it can lead to medical malpractice claims.
How Skipping Imaging Becomes Negligence
Negligence arises when physicians misinterpret stroke symptoms as less serious conditions and neglect to order critical imaging tests. Courts often hold doctors accountable for delays in care that result in preventable brain damage.
A breach of duty occurs when a physician delays imaging or fails to transfer a patient due to unavailable equipment. One example comes from Texas, where a neurologist settled a malpractice case after discharging a 58-year-old patient who exceeded the weight limit for an MRI machine. Instead of arranging alternative imaging – like a CT angiogram or carotid arteriogram – the doctor scheduled an outpatient MRI for the next day. Tragically, the patient suffered a major stroke before the appointment, leading to permanent cognitive and visual impairments.
Patient Harm and Legal Responsibility
The financial consequences of these cases are immense. On average, plaintiff verdicts in stroke malpractice cases result in payouts of $9,705,099, while settlements average $1,802,693. Cases involving severe, permanent injuries often yield higher payouts than those involving fatalities. Additionally, 60% of cases tied to a failure to transfer patients for imaging have resulted in payouts. These numbers highlight how delays in imaging can lead to devastating and legally preventable outcomes.
Such financial stakes underline the real-world impact of these failures, as evidenced by recent courtroom decisions.
Court Cases Involving Imaging Failures
Recent high-profile cases reveal the direct link between legal responsibility and courtroom outcomes.
In November 2023, a jury in Westchester County awarded $120 million to 41-year-old William R. Lee. Lee arrived at the hospital with stroke symptoms at 3:00 a.m., but his initial CT scan was misinterpreted. Residents failed to detect a basilar artery occlusion, and an attending radiologist did not review the images until three hours later. The delay caused massive brain damage, leaving Lee in need of full-time care in a memory facility. His attorney, Ben Rubinowitz, remarked:
"I’ve been a lawyer for 40 years now, and I’ve never heard of a malpractice verdict like this".
In January 2024, a similar case involving a 54-year-old woman was settled for over $500,000. She arrived at the emergency department with lethargy and aphasia. Her initial CT scan was misread as normal, and although a subsequent CTA was performed, it was labeled "sub-optimal" and never communicated to the treating team. This delay in diagnosis led to a massive stroke and her eventual death. Such cases demonstrate how failures in ordering and interpreting imaging can jeopardize patient outcomes and lead to prolonged legal battles, with cases taking an average of 4.9 years to resolve.
These examples emphasize the importance of promptly addressing imaging needs and establishing liability in malpractice claims. Clear accountability is a critical foundation for building a strong case.
How to Build a Medical Malpractice Claim
To successfully pursue a malpractice claim, you need to prove four key elements that tie a doctor’s failure to order imaging directly to the harm you experienced. Evidence and expert testimony play a critical role in establishing these connections.
What You Must Prove in a Malpractice Case
When medical imaging failures lead to severe consequences, building a strong malpractice claim becomes crucial. Such claims hinge on proving four essential elements: duty of care, breach of duty, causation, and damages.
First, you need to establish that a doctor-patient relationship existed, meaning the doctor had a professional obligation to properly assess your neurological symptoms. Next, you must demonstrate that the provider deviated from the accepted standard of care in similar situations. For instance, in stroke cases, failing to follow the 2019 American Heart Association (AHA) guidelines for rapid assessment and imaging often constitutes a breach of duty.
The third element, causation, focuses on showing a direct link between the failure to order timely imaging and your injury. This often involves proving that the delay caused you to miss critical treatment windows, such as the 3 to 4.5-hour window for clot-busting drugs (tPA) or the extended 24-hour window for mechanical thrombectomy. Finally, you must provide evidence of actual damages, which could include permanent brain damage, paralysis, cognitive impairment, loss of speech, or even death. Some states also recognize the "loss of chance" doctrine, arguing that the failure to act deprived you of a meaningful opportunity for a better recovery.
Once these elements are clear, the next step involves gathering solid evidence to back your claim.
Collecting Evidence to Support Your Case
A well-documented case relies on strong evidence. Start by obtaining complete medical records, including emergency department notes, physician orders, nursing logs, and the actual imaging files – not just summaries or reports. Create a detailed timeline that tracks everything from symptom onset to imaging order times and any communication gaps between staff, such as ER personnel and radiologists. Request the electronic health record (EHR) audit trail to verify when providers accessed imaging results.
Witness statements can also be invaluable. Family members who observed symptoms like slurred speech or facial drooping can help highlight any instances where medical staff may have dismissed or downplayed critical signs. If symptoms were misattributed to migraines, vertigo, anxiety, or intoxication without ruling out stroke through imaging, these misjudgments become important red flags.
Why Expert Witnesses Matter in Imaging Cases
After gathering evidence, expert testimony becomes essential to strengthen your claim. Medical experts help establish the standard of care and demonstrate how timely imaging could have prevented further harm. Attorney Lawrence J. Buckfire emphasizes this point:
"A powerful advocate will hire top medical experts to prove that timely care and treatment would have prevented serious harm to the patient".
Experts review your medical records to connect the delay in imaging to your injury, showing how timely intervention could have altered the outcome. They also address defense arguments, such as claims that the brain damage was unavoidable regardless of timing. In imaging-related cases, specialists like neuroradiologists play a key role in explaining why specific tests (e.g., CT angiography or perfusion MRI) were necessary and how they could have changed the treatment plan.
Because stroke cases involve intricate details in both neurology and radiology, expert testimony is often critical when presenting your case to medical review boards or juries. In some states, like New Mexico, you must submit expert reports to a Medical Review Commission before the claim can proceed to court.
Obstacles in Imaging Malpractice Cases
Even with strong evidence, claimants face challenges in proving that imaging errors directly caused harm and in adhering to strict legal deadlines.
How Doctors Defend Against These Claims
Healthcare providers often argue that stroke symptoms – like confusion, dizziness, or weakness – mimic less severe conditions such as migraines, vertigo, or intoxication. This defense is especially common when younger patients are involved, as providers may claim the individual did not fit the "typical" stroke profile.
In some cases, facilities may point to physical constraints, such as a patient exceeding the weight limit of an MRI machine, as a reason for delays or failures in imaging. Another common defense is that earlier imaging wouldn’t have significantly changed the patient’s treatment plan. Expert testimony can be critical to counter these claims, demonstrating how timely imaging could have led to different and potentially better outcomes.
On top of these provider defenses, claimants must also navigate strict filing deadlines, which can be a significant obstacle.
Time Limits for Filing Your Claim in South Carolina
South Carolina imposes firm deadlines for medical malpractice claims. You generally have three years from the date of the negligent act – or its discovery – to file your claim. However, the statute of repose bars any claims filed more than six years after the incident, regardless of when it was discovered.
If the imaging center or hospital involved is government-owned, the filing window shrinks to just two years. Before filing a lawsuit, claimants must first submit a Notice of Intent to File Suit, along with an affidavit from a qualified medical expert. Following this, mandatory mediation must occur within 90 to 120 days. Missing any of these steps or deadlines can result in losing the right to seek compensation, making it crucial to act promptly.
Conclusion: Getting Legal Help for Your Case
What to Remember About Imaging Failures and Malpractice
When it comes to stroke cases, failing to order critical imaging like CT scans or MRIs can lead to devastating outcomes. Each year, 795,000 Americans suffer a stroke, with 87% of those being ischemic strokes. With a narrow treatment window of just 3 to 4.5 hours, timely imaging can mean the difference between recovery and life-altering disability – or even death.
Proving malpractice in these situations requires showing that healthcare providers deviated from standard protocols. This process often involves combing through detailed medical records and presenting expert testimony. However, hospitals and doctors frequently argue that the damage was inevitable, regardless of when the diagnosis was made. This makes it essential to have skilled legal representation to build a strong case.
How Johnston Law Firm, LLC Can Help
Johnston Law Firm, LLC brings over 40 years of trial experience to South Carolina medical malpractice cases. Led by Andrew J. Johnston, the firm has a deep understanding of the medical and legal complexities involved in cases where healthcare providers fail to order necessary imaging. Their ability to work with top medical experts ensures that imaging-related failures are thoroughly examined and challenged.
From collecting critical medical records to conducting depositions and navigating South Carolina’s legal requirements, the firm handles every detail of your case. Based in Spartanburg and serving the surrounding areas, Johnston Law Firm offers personalized legal support tailored to your situation. Reach out today for a free consultation to discuss your claim and ensure you meet all necessary deadlines for seeking compensation.
FAQs
What imaging should be ordered when a stroke is suspected?
When a stroke is suspected, doctors typically use imaging tests like a non-contrast CT scan or an MRI of the brain. These tests help determine if there’s an intracranial hemorrhage and assess for any ischemic changes. While both are effective, MRI is usually better at spotting brain abnormalities. These imaging tools play a key role in making a quick and accurate diagnosis, which is essential for starting treatment promptly.
How can a delay in a CT or MRI change stroke outcomes?
Delaying a CT or MRI in stroke cases can have serious consequences. Without timely imaging, critical treatment is postponed, increasing the likelihood of permanent brain damage and long-term disability. Quick access to these scans is essential for accurately diagnosing and treating strokes, helping to reduce harm and improve patient outcomes.
What records should I request to prove an imaging delay?
To demonstrate an imaging delay, gather medical records for all relevant imaging studies. This includes results from MRI, CT scans, Doppler, or MRA. Be sure to obtain radiology reports and their interpretations to clearly outline the timeline of care and pinpoint any delays in diagnosis or treatment.