Acute Ischemic Stroke

The Verdict Issue 175 - Wnter 2022

This is the fourth article in our series aimed at providing a detailed examination of the challenges and pitfalls in different types of medical negligence lawsuits and approaches to overcoming them. Each article will focus on specific injuries and will highlight the obstacles a plaintiff faces in bringing their case to a successful conclusion. By comparing cases involving similar injuries, we hope to illustrate how the plaintiff succeeded, and when they did not, strategies that may have been available to improve their chance of success.

This article will focus on a recent stroke case in which the plaintiff was successful, Hasan v. Trillium Health Centre Mississauga, 2022 ONSC 3988 (CanLII) (Hasan) to illustrate a number of successful strategies used by plaintiff’s counsel, and point out some problems experienced by the defence as they presented their case. With damages agreed on a global basis in advance, the court was left to determine standard of care and causation over the course of this 21-day trial.

Introduction

Delayed diagnosis leading to delayed treatment are often at play in stroke cases, and given that there is a relatively short window for the successful treatment of a stroke, the plaintiff’s lawyer must embark on a methodical and thorough work-up and presentation of the case in order to persuade the court that but for the negligence, the diagnosis would have been made in time to administer appropriate therapy and achieve recovery.

In 2011 Syed Hasan was a 40-year-old man with no pre-existing serious health conditions. Early on December 3, 2011, he felt dizzy and nauseous and he began to vomit. He was unsteady on his feet and feared he would fall if he didn’t hold on to somebody’s hand. He attended Milton District Hospital where he was diagnosed with probable peripheral vertigo and discharged home. Later that day he was still unwell and saw his family doctor who examined him, gave him a referral note and directed him to go to Trillium Health Partners – Mississauga Hospital, the Regional Stroke Centre (“Trillium”) with the request to “rule out organic cause (brain lesion or stroke).”

Later that day Mr. Hasan was seen by the defendant Dr. Campbell at Trillium. Dr. Campbell took a history, examined him, and ordered medications and a CT of the head which showed no evidence of intracranial hemorrhage. His diagnosis was “Dizzy — Bell’s Palsy – Peripheral Vertigo.” Mr. Hasan was sent him home with a prescription for dizziness and instructions to follow-up with his family doctor in 3-4 days and return to the emergency department if he got worse.

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Brenda Osmond

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