Idaho awards second-largest medical malpractice settlement after a patient has a stroke in the ER

By Stephanie Srakocic | Fact-checked by Jessica Wrubel
Published April 7, 2023

Key Takeaways

  • An Idaho man was awarded $13.5 million after a local hospital failed to diagnose his stroke for over 12 hours.

  • The jury ruled that the emergency physician’s conduct was “reckless misconduct” allowing this case to break the standard $400,000 Idaho cap on awards for cases of this type.

A jury in Ada County, Idaho, has awarded $13.5 million, the second-largest medical malpractice award in the state’s history, to a stroke survivor in a case against a physician from Emergency Medicine of Idaho and the group itself.

The case revolves around an emergency room visit in 2016 when Carl B. Stiefel’s wife called an ambulance after he began experiencing a severe headache, nausea, and confusion. Stiefel arrived in the ER at 4:11 a.m. and was seen by a physician 11 minutes later. A CT was ordered, and the results did not reveal any signs of an intracranial concern. Stiefel was admitted to the hospital with a diagnosis of “benign positional vertigo.” His symptoms were not improving, and an MRI was considered.

However, the suit against Emergency Medicine of Idaho alleges that it then took three hours for Stiefel to be moved to a room for observation. The suit contends that Stiefel was delirious and disoriented by the time he was moved to a room and had received “no meaningful interaction” during hours spent in the ER. Once in a room, Stiefel was still left waiting. Records show he did not have an MRI until almost 6:00 p.m. The MRI revealed that Stiefel was having a stroke and an artery in his neck was torn. 

Stiefel had surgery over the next two days, but the lawsuit states that his condition had already worsened. He spent three weeks in the hospital and eventually developed bacterial meningitis. Although Stiefel was able to return home, he was not able to return to work and was disabled with limited movement capabilities. 

Stiefel and his wife have sued multiple parties involved with Stielfel’s care. In all but one instance, defendants have settled their cases over the past several years. Emergency Medicine of Idaho denies any responsibility for Stiefel’s injuries. They claim Stiefel’s condition upon returning home was a result of stroke complications, not negligence or improper care. However, this February, a jury sided with Stiefel and found the emergency department responsible in this case and reckless in their care.

Breaking the standard medical malpractice award cap

Typically, Idaho caps awards in medical malpractice cases at $400,000. It makes exceptions in cases when an injury is caused by “willful or reckless misconduct.” The emergency physician and emergency department were deemed reckless in this case. Stephen T. Mandelaris, Esq., a lawyer in Denver, Colorado, explains:[]

“In this recent trial, the jury found that the doctor’s failure to meet medical care standards amounted to reckless misconduct that caused the plaintiff’s injuries, thus falling under the exception to the cap. In cases where a plaintiff’s injuries are caused by such conduct, the cap on damages does not apply.”

Malpractice in the emergency room

Data shows that about 8.7 percent of emergency room physicians will face a malpractice suit each year, and about 75 percent will see a suit over the course of their careers.[] While most malpractice suits aren’t as large as the Stiefel case in Idaho, emergency physicians are sometimes sued for errors or assumed errors, such as misdiagnosis, delayed diagnosis, improper care, medication errors, or treatment delays. Unfortunately, due to the nature of the unit, malpractice suits originating in the emergency room are more likely to be related to death or serious injury. 

Complication or negligence?

It’s no secret that every minute counts when it comes to stroke care. It’s hard to deny that Stiefel might have had a better outcome if his care hadn’t been delayed. His symptoms, although not specific to a stroke, could have indicated a number of potentially serious conditions. Dr. S. Byers, MD, MPH, an internal medicine specialist with the University of Texas Medical Branch, says patients with severe headaches should always be evaluated quickly and watched for potential brain injuries. 

“Patients who present to emergency rooms with severe headaches are not uncommon. However, it is critical that the doctors evaluating these patients consider the diagnosis of a stroke,” says Dr. Byers. “Failure to diagnose a stroke in a hospital emergency department on time can have serious and fatal consequences. Delaying necessary treatment may allow the condition to worsen and cause permanent brain damage.”

However, as Emergency Medicine of Idaho contends, strokes and brain injuries are difficult to predict. Many people who do receive prompt care for a stroke event still experience lifelong complications. These complications aren’t something physicians can control. 

So what’s the line between complication and negligence? In this case, the length of time between admission and receiving an MRI, as well as the difference between his admitting diagnosis and the actual cause of symptoms, was too large for the jury to ignore.

They did not feel Stiefel’s condition was entirely the result of stroke complications or even that the emergency physician and department’s actions could be explained as simple mistakes.

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