Failure to Recognize Impending Stroke

The Weimer Case

Although Nanette Weimer, a then 45-year old post-menopausal woman, had a known and documented condition of hypertension, her gynecologist prescribed birth control pills to treat a left ovarian cyst. This was done despite that fact that birth control pills are relatively contraindicated for patients like Mrs. Weimer who have a known history of hypertension (because birth control pills increase the risk of high blood pressure and increase the risk of a stroke). Therefore, once the gynecologist prescribed these pills, the standard of care mandated that she closely monitor Mrs. Weimer or blood pressure elevation and/or warnings of an impending stroke.

On February 20, 2002, after taking the birth control pills for approximately three weeks, Mrs. Weimer telephoned the gynecologist’s office with complaints of a severe headache, which she feared was related to the birth control pills. The gynecologist’s staff-person advised that she would speak to the doctor and get back to Mrs. Weimer.

Over four hours passed before the staff-person called Mrs. Weimer back. Despite the gynecologist acknowledging in her deposition that birth control pills and hypertension are high risk factors for a stoke and that headaches can be the first sign of an impending stroke, the staff-person advised Mrs. Weimer that the gynecologist was not concerned and, per the gynecologist’s directions, advised Mrs. Weimer to continue the prescription of the birth control pills.

The next morning, Mrs. Weimer attempted to get ready for work but still did not feel well. When she looked in the mirror, she realized that she could only see out of ½ of her visual fields in both eyes and immediately advised her husband that something was seriously wrong. At that point, her husband realized that her speech was also gargled.

Mrs. Weimer was then taken to Armstrong County Memorial Hospital’s emergency department where her PCP coincidently was treating another patient. The PCP immediately recognized that something was critically wrong with Mrs. Weimer and ordered a head CT. Instead of waiting for the CT to be read, the PCP went to radiology and noted that Mrs. Weimer had a large bleed in her brain. Without hesitation, the PCP ordered Mrs. Weimer to be life-flighted to Allegheny General Hospital in Pittsburgh. At AGH, Mrs. Weimer underwent emergency surgery to evacuate the clot from her brain.

Although the operation was successful, the stroke left Mrs. Weimer with severe cognitive deficits, including dysphasia (an inability to speak words which one has in mind or to think of correct words, or inability to understand spoken or written words), memory and problem solving skills, and an inability to comprehend numbers and dates. As a result, Mrs. Weimer is unable to work her previous job as a supervisor in customer service at a federal government job. Mrs. Weimer also suffers from a loss of vision in the right field of both eyes.

Our firm retained an expert gynecologist who opined that the Defendant gynecologist was negligent by failing to pause for a moment, review and consider Mrs. Weimer’s medical history of hypertension, advise Mrs. Weimer of the potential for an imminent stroke, and instruct Mrs. Weimer to visit her office and/or an emergency room for an examination on the day she called the office.

The Defendant gynecologist’s negligence was likely the result of having seen an excessive number of patients on the date of the alleged negligence:

• The error in this case is the type which would not have occurred had the gynecologist taken the time to consider Mrs. Weimer’s history (hypertensive patient recently started on birth control pills) and chief complaint (headache) at the time that Mrs. Weimer called the gynecologist’s office. (The gynecologist acknowledged in her deposition knowing that birth control pills and hypertension are high risk factors for stoke. The gynecologist also acknowledged that headaches can be the first sign of an impending stroke).
• The gynecologist’s staff person acknowledged in her deposition that the doctor’s office practice was very busy.
• Although practicing in the context of an apparent private office, the gynecologist was actually an employee of a local hospital, and may not have had control over the number of patients she was required to see by her employer on a daily basis.
• Through discovery, it was determined that the gynecologist treated “50” patients on the day in question (the gynecologist refused to provide the information of how many patients she was treating. It was only by Court Order that the gynecologist provided this information). After reviewing the gynecologist schedule for that day, Plaintiffs’ expert gynecologist opined that this was “an extremely crowded, hurried, and stressful schedule, leaving little, if any, time to do much else.”

Weeks before trial, this case settled for a substantial amount.