{"pk":681,"title":"To tPA or Not to tPA: Two Medical-Legal Misadventures of Diagnosing a Cerebrovascular Accident as a Stroke Mimic","subtitle":null,"abstract":"We present two recent successfully litigated malpractice cases in which patients with cerebrovascular accidents were misdiagnosed as stroke mimics. The first was diagnosed as a hemiplegic migraine, which occurs in only 0.01% of the population. The second was diagnosed as a conversion disorder, which ultimately has a neurologic etiology in 4% of cases. In both cases, issues of poor patient communication and poor documentation were paramount in the legal outcome. We discuss caveats of stroke mimics, tissue plasminogen activator administration liability, and pitfalls in patient and family interactions.","language":"en","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[],"section":"Medical Legal Case Report","is_remote":true,"remote_url":"https://escholarship.org/uc/item/7b00v5kn","frozenauthors":[{"first_name":"Malia","middle_name":"J.","last_name":"Moore","name_suffix":"","institution":"Carl R. Darnall Army Medical Center, Department of Emergency Medicine, Fort Hood, Texas","department":"None"},{"first_name":"Jonathan","middle_name":"","last_name":"Stuart","name_suffix":"","institution":"Madigan Army Medical Center, Department of Emergency Medicine, Tacoma, Washington","department":"None"},{"first_name":"Alexandra","middle_name":"","last_name":"Humphreys","name_suffix":"","institution":"Wharton Aldhizer & Weaver, Harrisonburg, Virginia","department":"None"},{"first_name":"James","middle_name":"A.","last_name":"Pfaff","name_suffix":"","institution":"San Antonio Military Medical Center, Department of Emergency Medicine, San Antonio, Texas","department":"None"}],"date_submitted":"2019-05-20T15:40:17-07:00","date_accepted":"2019-05-20T15:40:17-07:00","date_published":"2019-07-08T14:42:17-07:00","render_galley":null,"galleys":[{"label":"","type":"","path":"https://journalpub.escholarship.org/uciem_cpcem/article/681/galley/440/download/"}]}