What We Actually Do When You Call
The first thing we do is listen. We want to understand what happened. We want to know what symptoms were present, how the emergency room responded, what your family was told, and how things unfolded afterward.
From there, we gather the records:
- The medical chart
- Emergency department documentation
- Imaging studies
- Any discharge paperwork
- Notes from follow-up care
We do not rely on a summary. We want the full picture.
Once we have the records, we coordinate a review with independent medical experts, i.e., physicians who are qualified in the relevant specialties and have no connection to the providers involved. Their job is to examine the care your loved one received and compare it against what a reasonable, qualified provider would have done under the same circumstances.
This is the standard of care analysis, and it forms the foundation of everything that follows.
One thing we want to be transparent about: sometimes this review concludes that the providers acted appropriately, even in cases with devastating outcomes. Strokes cause serious harm even when everything is done correctly. If the review reaches that conclusion, we will tell you because we believe that clarity still has value for families who have been carrying unanswered questions.
What a Medical Review Examines, and How Strokes Get Missed
Stroke misdiagnosis is more common than most people realize, and it happens in ways that are not always obvious. The review process examines these patterns:
- Brainstem and posterior circulation strokes: These strokes do not always present with the classic warning signs most people associate with stroke, such as sudden facial drooping, arm weakness, and slurred speech. They can produce dizziness, balance problems, nausea, or vision changes that are easy to attribute to something benign. They are disproportionately missed in emergency settings.
- Symptoms mistaken for something else: Stroke symptoms can mimic other conditions, such as vertigo, migraines, inner ear problems, anxiety, or intoxication. When a provider anchors on an alternative diagnosis too quickly and does not pursue stroke as a possibility, critical time is lost.
- Failure to order imaging: CT and MRI imaging are the standard tools for identifying stroke. When imaging is not ordered, or when imaging is ordered but not read correctly, a stroke can go undetected. The review looks at whether imaging was done, when it was done, and whether the results were acted on appropriately.
- Early discharge: One of the most consequential patterns is when a patient is discharged from the emergency department with stroke symptoms still present or unexplained. If a patient left the hospital in a condition consistent with stroke and no one recognized it, that decision will be examined carefully.
- Failure to consult neurology: Stroke care requires neurological expertise. When a patient presents with symptoms that warrant specialist involvement and that consultation does not happen, the question is whether a neurologist’s involvement would have changed the outcome.
When the review identifies a departure from accepted standards of care, it does not necessarily mean a lawsuit is the next step; it means your family now has real information and can make a decision from a place of understanding rather than uncertainty.
What a Missed Stroke Can Mean for a Patient
The range of outcomes when a stroke is not identified and treated promptly is wide. Some patients recover partially with residual deficits. Others sustain catastrophic, permanent injury, such as paralysis, loss of speech, or cognitive impairment. In severe cases, a patient may develop locked-in syndrome, a condition in which a person is fully conscious but unable to move or speak, typically requiring lifelong total care. And in some cases, a missed stroke is fatal.
| Type of Care | Estimated Cost in Oklahoma |
| Private duty nurse (hourly rate) | $86/hour |
| Private duty nurse (visit rate) | $170/visit |
| Long-term care facility, e.g., nursing home (semi-private room) | $84,315/year |
| Long-term care facility, e.g., nursing home (private room) | $93,075/year |
Source: CareScout Cost of Care Survey
The Stroke Landscape in Oklahoma
Oklahoma families carry a particular burden when it comes to stroke. Forty-one of Oklahoma’s 77 counties are rural. That geography shapes what happens when a stroke occurs: patients may arrive first at a facility without a neurologist on staff, without 24-hour imaging capability, or without the infrastructure to identify and treat a complex stroke quickly.
This matters for families reviewing a potential misdiagnosis or failure to diagnose because where a patient is when symptoms begin affects what care is realistically available, and the review process takes that context into account. What a rural emergency department can offer is different from what a comprehensive stroke center can offer.
When a patient needs to be transferred to a higher-level facility, timing becomes critical. According to JAMA, the national guideline for the door-in-door-out time (i.e., how long a transfer to a better-equipped stroke center takes) is fewer than 120 minutes. Oklahoma’s median transfer time is:
- 98 to 118 minutes for acute ischemic stroke eligible for endovascular therapy
- 168 to 193 minutes for other acute ischemic stroke
While Oklahoma’s DIDO time is within the guideline for strokes eligible for endovascular therapy, with strokes, minutes matter.
What Comes Next If the Review Finds Something
Not every review results in a legal case, and beginning this process does not commit your family to one. But when the review does identify a departure from the standard of care, understanding what a case looks like is a reasonable next step.
- What has to be established: A stroke misdiagnosis case requires showing that the care a patient received fell below the accepted standard, that this departure caused harm, and that the harm resulted in damages, e.g., medical costs, lost income, pain and suffering, and the cost of ongoing care. The medical review builds the evidentiary foundation for each of these elements.
- Who may bear responsibility: Responsibility in these cases does not always rest with a single provider. It may lie with an emergency physician, a hospitalist, a radiologist who reviewed imaging, an emergency department that lacked appropriate protocols, or a hospital system whose staffing and procedures contributed to the outcome. The review examines the full chain of care.
- What families are trying to secure: A successful case is not about punishment. It is about ensuring a family has the resources they need for ongoing medical care, rehabilitation, in-home support, home modifications, and the financial stability that a catastrophic injury can otherwise destroy.
- What you can do right now to preserve information: If you are not yet ready to take any further steps but want to protect your options, there are things worth doing now. Request and keep copies of all medical records and imaging discs. Write down a timeline of what happened, including conversations with providers and what you were told at discharge. Keep any paperwork given to you at the hospital. These materials become the foundation of a review if you decide to proceed.
Why Families Trust the Newsome Law Team
We do not take every case. We take the cases where we believe the review has identified something real and where we can be genuinely useful to a family.
When you reach out, you will speak with an attorney, not a case intake coordinator, not a screener. We keep our caseload manageable, specifically so that every family gets direct access to the people working on their matter.
We start by listening. We coordinate the medical review with qualified, independent experts. We are honest about what the review finds, even when the answer is not what a family was hoping to hear. We have worked on complex stroke and catastrophic injury cases, and we understand how much is at stake for the families in them. And we do not charge anything unless we recover compensation.
Start Getting the Answers You’re Looking for Today
Getting answers is what the consultation is for. If you have questions about what happened to your loved one, this is where that process starts.
The conversation is free, it is confidential, and there is no obligation to move forward. We are here to help families understand what happened. Call Newsome Law when you are ready.
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