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Legal implications – civil:

Non-traumatic intracranial hemorrhage (stroke):

  • For cases involving warfarin or Coumadin- was the patient’s lab work such as PT/INR adequately monitored? If the patient was suffering from Coumadin toxicity, what was the treatment?
  • Was the blood pressure controlled according to guidelines?
  • Did the patient develop hemorrhage after receiving treatment for ischemic stroke? If so, was the blood pressure controlled according to guidelines?  The most common cause of hemorrhagic conversion after giving a patient intravenous tPA (clot busting medications) for ischemic stroke is due to uncontrolled blood pressure.

Traumatic hemorrhage due to fall in an institution:

  • Did the hospital or nursing home have a fall prevention program in place as required by The Joint Commission?
  • Did the Nursing Home or Hospital staff follow the fall prevention guidelines in the institution?
  • Was a fall assessment completed?
  • Was the fall assessment accurate?
  • Was an accurate and complete admission assessment and health history completed and communicated?

Legal implications – criminal

Intracranial hemorrhages are seen in many cases ranging from child abuse to domestic violence and assault. The cause of the hemorrhage is typically associated with the trauma but there may be contributing factors such as drug or alcohol use, medical diagnoses or medications. Any of these may increase the likelihood of bleeding and make a person more prone to a bleed or a bleed more severe than it would be otherwise. A review of the victim’s past medical history is needed to determine if any contributing factors exist.

This month we are discussing head trauma and the types of bleeds that can result. The blog topics for this month are:

  • ICH Defined (2/6/15)
  • Causes: Non-Traumatic & Traumatic (2/13/15)
  • Types of Hemorrhages (2/20/15)
  • Legal Implications (2/27/15)

Note: To see all posts in this topic, click here

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