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  1. #1
    Join Date
    Jul 2015
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    Question Failure to Diagnose an Arterial Venous Malformation (AVM)

    My question involves medical malpractice in the state of: California

    My wife had severe headaches two years ago. Local hospital took a CT scan and the ER doc thought there was something unusual on the scan so he sent it to nearby Trauma Center at larger hospital 45 minutes away. Radiologist at larger hospital thought possible brain bleed and advised to move the patient carefully but immediately for further investigation.

    Wife spent 3 days at larger hospital, had MRI with contrast of her head and did a spinal tap to check for blood. Spinal tap was negative, "Head NeuroSurgeon" at hospital said the MRI should a "spot" but he thought it was just an old lesion or damage and didn't believe it was related to the headache. Headache faded and she was released and told to get the "spot" checked every year or so to see if it changes.

    Wife also has a painful kidney disease, where she passes one or two kidney stones per week. Since we were told the images looked good overall, we put the head issue on the back burner. This January, two years removed from first episode, wife has three events spaced one month apart where she sort of mumbles her words, has difficulty comprehending everything and some tingling/numbness in extremities...sort of like a stroke. She sees general practitioner, says sounds like seizure and refers to Neurologist. Runs blood work, EEG and MRI and immediately refers to Neurosurgeon when she sees a mass on the MRI.

    See new Neurosurgeon who confirms a mass, probably AVM (Arterial Venous Malformation) in the brain. Pulls up MRI image from hospital two years prior and sees the exact same mass. I asked if this sort of mass/AVM would cause a severe headache and neurosurgeon says, "Absolutely."

    Wife now facing one or more procedures which could be life threatening to fix or neutralize condition. The failure to diagnose the condition two years ago has lead to multiple seizures and possible permanent loss of some cognitive ability and speach and constant seizures (small or more serious at times.) Had this been noted two years ago, she could have had the mass treated then and probably avoided the events over the last 6 months. Is there a case for Malpractice here for the failure to identify the condition and subsequent damage and possible permanent effect? The large hospital was San Jose Regional Medical Center, if this helps.

    Thanks for any advice.

  2. #2
    Join Date
    Apr 2009
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    Somewhere near Canada
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    35,894

    Default Re: Saw Neurosurgeon 2 Years Ago, Missed Avm in Brain Scan and Now Seizures. Can I Su

    The only thing to do would be to gather your wife's medical records and meet with a med-mal attorney to discuss the viability of a claim.

    I'm sorry - there's just no way we can say "Yea" or "Nay".

  3. #3
    Join Date
    Jun 2006
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    Massachusetts
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    Default Re: Saw Neurosurgeon 2 Years Ago, Missed Avm in Brain Scan and Now Seizures. Can I Su

    she was released and told to get the "spot" checked every year or so to see if it changes.

    And did she?

  4. #4
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    Jul 2015
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    7

    Default Re: Saw Neurosurgeon 2 Years Ago, Missed Avm in Brain Scan and Now Seizures. Can I Su

    Quote Quoting cbg
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    she was released and told to get the "spot" checked every year or so to see if it changes.

    And did she?
    Due to challenges with her kidney disease, the follow up was delayed. She followed up two years after, but the point being the mass is the same as it was two years ago. It is believed to be an AVM, they don't really grow or shrink, they can rupture which is typically catostrophic. Had the AVM been diagnosed then, it would have been treated due to it causing severe headaches and minor seizures.

  5. #5
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    Apr 2009
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    Default Re: Saw Neurosurgeon 2 Years Ago, Missed Avm in Brain Scan and Now Seizures. Can I Su

    Quote Quoting twf
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    Due to challenges with her kidney disease, the follow up was delayed. She followed up two years after, but the point being the mass is the same as it was two years ago. It is believed to be an AVM, they don't really grow or shrink, they can rupture which is typically catostrophic. Had the AVM been diagnosed then, it would have been treated due to it causing severe headaches and minor seizures.
    Ah, I missed that. That likely reduces the amount (if any) of fault assigned to the providers.

    Given the comparative rarity of AVMs occurring in the brain, you may also have a hard time arguing that the provider deviated from the standard of care.

  6. #6
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    Jul 2015
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    Default Re: Saw Neurosurgeon 2 Years Ago, Missed Avm in Brain Scan and Now Seizures. Can I Su

    That doesn't seem realistic. As it turns out, the last neurosurgeon to whom we were referred works at the same hospital as the one who missed the diagnosis two years ago. When we sat at his desk to review the latest MRI he saw the mass, immediately said it appears to be an AVM based upon shape and consistency and then he pulled up the image from two years ago and said it looks the exact same, about 3.5 cm in size.

    Sounds like we need to hope for the best during the process and possibly see a local Malpractice attorney later if we want to pursue it. Thanks for the advice.

  7. #7
    Join Date
    Jan 2006
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    Default Re: Saw Neurosurgeon 2 Years Ago, Missed Avm in Brain Scan and Now Seizures. Can I Su

    Quote Quoting twf
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    Had the AVM been diagnosed then, it would have been treated due to it causing severe headaches and minor seizures.
    yet even with the severe headaches and minor seizures your wife ignored those issues and refused to attend a follow up.

    while I understand your point, you also need to realize that had your wife followed up in a years time when it apparently was not causing any issues great enough to demand attention, she would not have experienced the issues she is now having. Which is the greater error?

  8. #8
    Join Date
    Jul 2012
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    So Cal
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    854

    Default Re: Saw Neurosurgeon 2 Years Ago, Missed Avm in Brain Scan and Now Seizures. Can I Su

    Quote Quoting jk
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    yet even with the severe headaches and minor seizures your wife ignored those issues and refused to attend a follow up.

    while I understand your point, you also need to realize that had your wife followed up in a years time when it apparently was not causing any issues great enough to demand attention, she would not have experienced the issues she is now having. Which is the greater error?
    This. And truth be told, she should have taken that scan to another neurologist at the time for a second opinion, although the fact that she didn't wouldn't impact a potential case.

    Go speak to a med mal lawyer and find out what s/he has to say, but IMO her failure to follow up per his recommendation could devastate any malpractice suit.

    I hope her health improves.

  9. #9
    Join Date
    Jul 2015
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    7

    Default Re: Failure to Diagnose an Arterial Venous Malformation (AVM)

    Really? Who made the "greater" error? Lets think about that, the professional surgeon who specializes in that area and has what 8-12 years education and 15 years work exp. Or the untrained patient with no exp in that area. Thanks to those who provided well thought responses and responses based on training and experience. Take care

  10. #10
    Join Date
    Jan 2006
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    38,867

    Default Re: Failure to Diagnose an Arterial Venous Malformation (AVM)

    if your wife had gone back in a year, especially given it sounds like there were continuing symptoms, she would have received no additional injury due to the lack of diagnosis.

    It's a lot like going to a mechanic who says he thinks you have a bad wheel bearing but not certain. Sends you on your way with the caution; come back immediately if it gets worse but even if it doesn't, come back in a year so I can check it again.


    The the noise is still there but doesn't get worse but 2 years down the road your wheel falls off becUse the wheel bearing fell apart. You break your back in the accident.


    Whose error caused your broken back?

    you can argue the mechanic because he didn't tell you it was bad but the truth is you failed to follow instructions and return. The doc can't make you come back in so ultimately your failure is why there is additional injury.

    I would surely speak with a medmal attorney. Personally I wouldn't be surprised to be turned away but honestly I wouldn't be too surprised to hear an attorney picked it up either.




    but one thing your post proves; our country is in crap shape as shown by so many that simply refuse to accept fault when they screw up and something happens. It is "always try to place the blame elsewhere".

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