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She lived alone. She was admitted at 5:30pm that afternoon. Feeling well when I left. At12:01am droop in mouth noted. 4:00am sent down to ER. I was called at 6:30am to go to ER. She had suffered a massive left brain She was admitted at 5:30pm and was feeeling well when I left around 7:30pm At 12:00am it was noted she had a droop in her face. She was carried down to the ER around 4:30am and it was discovered she had suffered a massive ischemic stroke leaving her completely bedridden, no speaking and i need of 24 hr care for all ADLs for almost a yr now. She is home with me and we have Hospice. Her DR was LIVID when I arrived at the ER that morning. She said they waited to late to get a rat team to her for any chance of ever having independence again. Later confirmed by her Neurologist. Anyone had or heard of an experience such as this? Any advise? I said nothing during all of the events that morning but I noted all as well as the "suits" around.

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Are you wondering if you have a case against the hospital? I think you would need to discuss that with a lawyer experienced in suing hospitals or medical professionals. Getting some compensation for this error would certainly help you take care of your mother, wouldn't it?

I am so terribly sorry about what happened to your mother.
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As I read your post, you are concerned about the gap between midnight and 4:30 am, when immediate care may have prevented the unhappy outcome. (I don't know if it would have or not, of course.) If you were willing to simply let happen whatever was going to happen, you wouldn't have taken her to the hospital in the first place, right? They are not perfect and they make mistakes. If this was a mistake that caused this outcome, I can see why you'd want them to help with the consequences. Not as a punishment, but as a way to take responsibility for the consequences of their mistake.

An experienced attorney can advise you whether you have a legitimate case.
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pneumonia is not a contraindication to thrombolysis
(ps - a little knowledge, especially extrapolated, can be a dangerous thing!)

wikipedia's list includes:
Stroke
Absolute Contraindications to Thrombolysis
Uncertainty about time of stroke onset (e.g. patients awakening from sleep).
Coma or severe obtundation with fixed eye deviation and complete hemiplegia.
Hypertension: systolic blood pressure over 180mmHg; or diastolic blood pressure over 110mmHg on repeated measures prior to study. (if reversed, patient can be treated)
Clinical presentation suggestive of subarachnoid haemorrhage even if the CT scan is normal.
Presumed septic embolus.
Patient having received a heparin medication within the last 48 hours and has an elevated Activated Prothrombin Time (APTT) or has a known hereditary or acquired haemorrhagic diathesis
INR over 1.5
Known advanced liver disease, advanced right heart failure, or anticoagulation, and INR over 1.5 (no need to wait for INR result in the absence of the former three conditions).
Known platelet count under 100,000 uL.
Serum glucose is under 2.8 mmol/l or over 22.0 mmol/l. (very low or very high)

Relative Contraindications to Thrombolysis
Severe neurological impairment with NIHSS score over 22.
Age over 80 years.
CT evidence of extensive middle cerebral artery (MCA) territory infarction (sulcal effacement or blurring of grey-white junction in greater than 1/3 of MCA territory).
Stroke or serious head trauma within the past three months where the risks of bleeding are considered to outweigh the benefits of therapy.
Major surgery within the last 14 days (consider intra-arterial thrombolysis).
Patient has a known history of intracranial haemorrhage, subarachnoid haemorrhage, known intracranial arteriovenous malformation or previously known intracranial neoplasm
Suspected recent (within 30 days) myocardial infarction.
Recent (within 30 days) biopsy of a parenchymal organ or surgery that, in the opinion of the responsible clinician, would increase the risk of unmanageable (e.g. uncontrolled by local pressure) bleeding.
Recent (within 30 days) trauma with internal injuries or ulcerative wounds.
Gastrointestinal or urinary tract haemorrhage within the last 30 days or any active or recent haemorrhage that, in the opinion of the responsible clinician, would increase the risk of unmanageable (e.g. by local pressure) bleeding.
Arterial puncture at non-compressible site within the last 7 days.
Concomitant serious, advanced or terminal illness or any other condition that, in the opinion of the responsible clinician would pose an unacceptable risk.
Minor or Rapidly improving deficit.
Seizure: If the presenting neurological deficit is deemed due to a seizure.
Pregnancy is not an absolute contraindication. Consider intra-arterial thrombolysis.

the other thought would if an expert neurologist was not available even by teleconsultation, or if this was long enough ago it really was not a standard of care...TPA for stroke is still "kind of" cutting edge, but can work as advertised and prevent a lot of disability when it does
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Macrolide antibiotics like Z-pak can lead to stroke, but they save the elderly from pneumonia where other antibiotics may not work. These choices are agonizing for the physician. Her MD may have been livid or he may have been frightened about a lawsuit or fault-finding by hospital review. Often patient care involves imperfect answers. Medicine good for glaucoma is bad for constricted arteries. Warfarin prevents clots but eventually destroy skin and kidneys. Statins reduce cholesterol but eventually kill memory. The list goes on and on.
Would you have withheld the antibiotics, meaning certain death, or take a slight chance the patient might have a stroke? They did the best they could. They cannot preserve life forever. If she had been home with you that night she might not have survived at all. Be thankful for that extra year. Leave the rest to God, He has a Plan.
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Please don't feel that YOU could have prevented this. The massive stroke was probably going to happen sometime. You do not have the medical knowledge to prevent this outcome. The hum,an body decays and stops working. This is life and death - nature.

If a lawyer tells you you have a case, it would be a good idea if you can get some money to get better care for her and some relief for you. Just don't torture yourself.
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Her first round of antibiotics given 10 days prior to the day her Dr did admit her had not made her feel better or worse she stated she simply did not feel any better. Her Dr was not going to admit her, then decided to admit her. The x ray did show some clearing (at Dr office) but was still present. Even with this knowledge from xray the Dr did not say she was going to admit her. Mother would start a second protocol of antibiotics and after a lengthly conversation (I was present) the Dr said she thought she would go ahead and admit her, she knew she was weak and did not want her to fall should she get sick from 2nd antibiotic. We left the Dr's office and went to hospital.
No, the hospital did not cause the stroke. My concern is the lapse in time and if something could have been done to stop the damage. Wheelchair, ability to speak etc with some rehabilitation etc would be better than a total loss. True I feel this for her but more importantly she has been aware, is extremely independent all her life and the ability to maintain some independence is better than nothing if possible.
She went to an acute rehab center, she did not qualify for and spent 30 days, then to sub acute rehab for 3 months. All was tried and i did not have to ask or argue for any attempts for any rehab. Smooth sailing --and thankful. Accountability is my concern here. Mistakes (if this is one) happen. I know many fine Dr's, nurses, cnas. Nurses were upset that morning. Dr's told me this regarding the time. I did not figure it out if there is anything to figure out.
Regarding Faith, it is what has and will continue to sustain us. I appreciate your comments.
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What could have been done by the Rapid Assessment Team? The first line of defense in an ischemic stroke would have been a clot-buster. But wait a minute, the patient has pneumonia. The lungs are already clogged with pus. What is pus? white blood cells. clotted. in the lungs. Add a clot buster and you get pulmonary hemorrhage, but save the brain from a clot. What will you gain?
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I have a similar concern. My elderly brother had a pretty severe case of shingles with the accompanying pain. His doctor gave him oxycodone; brother took two doses and began having delusions and confusion. Stopped it immediately; however, he has not been cognitively the same. It has affected his memory which is keeping him anxious too much of the time. This was almost a year ago. I would appreciate any input, thank you.
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You have every right to wonder what happened and to discuss it openly with the facility that was caring for her---they should have nothing to hide. Bad things happen for unknown reasons. We must be able to talk about it. All good institutions review situations such as you have described in order review the care they provided and learn (if there is an opportunity to strengthen process/practice).
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As stated above I was notified quickly by my mothers physician as well as her Neurologist (she had been by treated for several years for essential tremors. Parkinson's ruled out by numerous other Neurologis) while essential tremors are not alway "a walk in the park" they are not life threatening. She handled them very well I did not put her in the hospital her Dr decided to because she lived alone, and if the side effects as in (diarrhea, nausea) started she wanted her in hospital to risk her falling as she was week. Earlier in this same appt her Dr said the x ray showed clearing of the pneumonia, but still present. She wanted her to start PT as she knew she was weak.
Also a Third Party Nurse was hired and she sees negligence. We will now have a third party Neurologist review her files. We shall see.

I just don't know what to do, it has not been on my "front bunner" so to speak only my Mother.
My mother passed last Sunday morning. She had a beautiful service.
I loved her so. She had suffered enough. I have grieved for a year now and will continue. She is with Him and His grace provides peace to us all.
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