$4.5M neurology verdict

A jury awarded $4.5 million after a delayed stroke diagnosis left a 57-year-old man with locked-in syndrome, a paralysis condition caused by brainstem injury. (neurologyadvisor.com) The case, published April 13 by *Neurology Advisor*, centered on a basilar artery thrombus, a clot in a vessel that supplies the brainstem. The patient arrived at a hospital emergency department with headache, slurred speech, confusion, tremor, and left-arm weakness. (neurologyadvisor.com; ncbi.nlm.nih.gov) The emergency physician recognized possible stroke, ordered a non-contrast computed tomography scan around noon, and discussed tissue plasminogen activator with the on-call neurologist. They decided he was outside the treatment window and admitted him for observation with aspirin after assigning a National Institutes of Health Stroke Scale score of 2. (neurologyadvisor.com) When the neurologist examined him hours later, the record described acute gait instability, ataxia, headache, right mouth droop, impaired repetition, and a left-arm tremor. The neurologist ordered magnetic resonance imaging and magnetic resonance angiography, but the order was entered as routine rather than urgent, and the hospital scanner was not working. (neurologyadvisor.com) A basilar artery occlusion blocks blood flow through the main artery feeding the brainstem, which controls breathing, swallowing, movement, and consciousness. Symptoms can start with dizziness, headache, slurred speech, confusion, or double vision and then deteriorate quickly. (ncbi.nlm.nih.gov; pn.bmj.com) Clinical references describe basilar artery occlusion as a neurologic emergency that needs rapid imaging and stroke-team evaluation. Medscape says reopening the artery is the main predictor of survival and functional outcome. (ncbi.nlm.nih.gov; emedicine.medscape.com) *Neurology Advisor* said the case was presented as a lesson in malpractice risk for neurologists, with delayed diagnosis, communication failures, and poor documentation identified as recurring problems. The article also placed the verdict alongside recent filings and class actions over diagnostic errors and state limits on malpractice recoveries. (neurologyadvisor.com) Federal data show malpractice reporting remains a national system, with the National Practitioner Data Bank tracking medical malpractice payment reports through December 31, 2025. The database notes that reports can arrive after a 30-day filing window, which means recent activity can lag. (npdb.hrsa.gov) The verdict turns on a familiar stroke-law question: whether mild or fluctuating symptoms were treated as low urgency before a catastrophic decline. In this case, the patient’s early signs were documented hours before the missed imaging delay became central to the outcome. (neurologyadvisor.com; ncbi.nlm.nih.gov)