Accounting for about 87% of all strokes, ischemic strokes occur when a vessel supplying blood to the brain is obstructed. When detected in a timely fashion, ischemic strokes may be treated with a tissue plasminogen activator (tPA), a protein involved in the breakdown of blood clots. Unfortunately, this treatment and other life-saving interventions are not readily available in many rural communities.
Inaccessibility is often devastating to those in need of tPA because it must be administered within 3 to 4.5 hours of when the stroke was experienced. Outside this time frame, physicians must weigh the benefits of administering this treatment against the risks. Thus, although the benefits of tPA are abundant, a recent study found that only 6% of stroke patients receive this form of treatment.
What’s more, alternative treatments may be limited for patients who are not able to receive treatment within this golden hour. Patients who obtain treatment between 6 and 16 hours of experiencing a stroke and who have anterior circulation large vessel occlusion, as well as meet other DAWN or DEFUSE eligibility criteria, may benefit from mechanical thrombectomy. Such a procedure calls for a trained physician to utilize specialized equipment to remove a clot from a patient’s artery.
Therefore, timing is of the utmost importance when dealing with a stroke. If a health care provider administers the wrong treatment at the wrong time, they may be considered guilty of medical malpractice.
How Stroke Hospitals Impact Rural Communities
Understanding the significance of timing, the Joint Commission established Michigan Stroke Centers and created various levels of care and classification in 2012. As of October 2020, there were 49 hospitals identified by the state of Michigan as stroke hospitals.
While the majority of these hospitals are certified by the state, 7 facilities have not received such classifications:
- Aspirus Iron River Hospital
- Aspirus Ironwood Hospital
- Aspirus Keweenaw Hospital
- Aspirus Ontonagon Hospital
- Deckerville Community Hospital
- Marlette Regional Hospital
- Oaklawn Hospital
Nevertheless, these hospitals provide necessary medical services to rural communities. Often, a hospital is the only one serving an entire county. The counties in which these hospitals are located also tend to have the highest mortality rates. For instance, in 2018, Iron County —where Aspirus Iron River Hospital is located — reported 152.9 stroke-related deaths per 100,000 individuals. That same year, Wayne County reported 48.3 deaths, Washtenaw County reported 34.5, and Ingham County reported 32.8 deaths per 100,000.
Yet a recent study noted that the minute increase in accessibility that residents of rural areas have to neurologists has not been correlated with any improvement in the mortality and morbidity rates over the last decade. The study found that disparities in access to treatment (such as alteplase) and the outcome of these disparities persist, highlighting that there is still work to be done to improve care for rural communities. While patients are speaking to a neurologist, they may not be receiving the same level of timely access to life-saving treatments as urban patients. Moreover, this disparity highlights that some rural hospitals have not partnered with or are unable to partner with comprehensive stroke centers to benefit patients.
Disparities Have Real-World Consequences
If you were given the incorrect treatment for an ischemic stroke, you may have grounds to pursue a medical malpractice case against the hospital or medical professional responsible for administering that treatment. Don’t let the hospital make excuses. As a human being, you deserve attentive, adequate medical care.
Contact Grewal Law PLLC online today to arrange a free consultation with our medical malpractice attorney team.