In a deposition, the plaintiff’s expert, Frank Baker, MD, made the following statements:
1. He works single coverage in a hospital that sees approximately 19,000 patients per year. He works approximately eight 12–hour shifts per month, sees 10–12 stroke patients per month, and gives thrombolytic therapy 4–6 times per year.
2. Physicians should not administer tPA without speaking to a consultant because they need to have the agreement of someone who will care for the patient after the patient leaves the ER.
3. The symptom complex of dizziness, vomiting, and ataxia should not cause a physician to consider migraine headaches or inner ear problems in their differential diagnosis. Instead, this symptom complex is specific for a cerebellar stroke.
4. It is “rare” that a patient arrives and can get a CT of the head within 3 hours of symptom onset in a stroke.
5. The patient in this case would not have become neurologically worse if he had received tPA within three hours because the clot causing the stroke would have dissolved and would not have reformed.
6. A patient with improving or resolved weakness in the extremity but persistent facial numbness should still receive tPA because a focal finding was still present.
7. In 2002, no reasonably well–qualified emergency physicians would have disagreed as to whether this patient needed tPA
8. In 2001, no reasonably well–qualified emergency physicians would have disagreed on whether the risks of giving tPA outweighed the potential benefits of giving tPA to this patient.
2. Failing to consult the neurologist or neurosurgeon within three hours of the patient’s symptoms to discuss whether tPA should have been given.
3. Failing to expedite the CT scan of the patient’s head so that the results would have been available within 3 hours.
Did the emergency physician act within the standard of care?