Stroke due to paradoxical embolism: could you have a negligence claim?

I represent people who have suffered a brain injury due to medical negligence or accidents that should not have happened.  As part of this, I’ve investigated claims where patients have suffered a stroke due to a paradoxical embolus – something which most people are unlikely to have heard of.

In this blog, I consider what this is, how it happens and what your legal rights are if you are affected by negligence.

What is paradoxical embolism?

A paradoxical embolism is when a clot travels from the venous system (i.e. the veins in your body) into the arterial system (i.e. the arteries in your body) and causes a stroke.

How does paradoxical embolism happen?

Most of the time, a paradoxical embolism occurs due to a hole in the heart that didn’t close the way it should after birth – officially known as a patent foramen ovale.

Around 25% of adults have this small defect.  This hole is part of normal development, however it usually automatically closes at birth.

For most of those who retain the hole in their heart, it will cause no problems.  Most people will be unaware they even have this defect.  However, in terms of stroke, a patent foramen ovale will allow blood clots to pass from the venous system into the arterial system.

Normally, if a clot forms in the veins, breaks off and moves, it will remain in the venous system and likely end up in the lungs.  However with a patent foramen ovale, the clot is given a passage way through the heart and into the blood circulation system.  From there, it can pass to the brain causing a stroke.

My experience in representing clients with paradoxical embolism

I have represented two patients who have suffered a paradoxical embolism due to negligence.  The circumstances of their cases were:

• Case one: the patient suffered a stroke after air was negligently let into the central venous system when blood was being taken
• Case two: the patient suffered a stroke when regular anti-coagulation was negligently stopped, allowing a clot to pass through a patent foramen ovale to the brain

In both cases, our clients only found out that they had a patent foramen ovale as a result of bringing their claims.  Initially, we investigated their cases on the basis that an unexpected and unexplained stroke had occurred whilst each patient was in hospital.  In the course of obtaining independent medical expert evidence, arrangements were made for each of our clients to undergo testing to see if they had this defect.

In both cases, a patent foramen ovale was confirmed.  This meant that we could put forward their cases alleging that negligence had caused an embolism to form and that it had caused a stroke when it travelled through the hole in their heart.  If we had not been able to prove that a hole in the heart existed, we would not have been able to prove how the clot had affected the brain.

Unfortunately, both our clients suffered significant lifelong injuries.  This meant that their ability to live an independent life was affected.  Both of our clients suffered physical impairments with pain, weakness and mobility, as well as cognitive injuries affecting their memory, fatigue, ability to understand and communicate.  Their injuries meant they would require specialist care, treatment, assistive equipment and adaptations to be made to their home.  Additionally, they both suffered from a loss of income because they could no longer hold down the jobs they had prior to their strokes.

Our involvement in securing compensation for our clients resulted in them having the funds to be able to pay for an enormous amount of support in their daily lives, such as:

• Daily care and support
• Specialist treatment and equipment for their rehabilitation needs
• The adaptations needed to be made to their existing home or in some cases, purchasing a new and more suitable property
• The lost income they would have otherwise been able to generate if they hadn’t suffered the stroke and consequential issues

A claim for compensation can give the injured person and their family and loved ones peace of mind that their needs will be taken care of for their rest of their life, relieving the pressure and worry of financial insecurity amidst a time of great upheaval and significant adjustment.  Compensation allows an injured person to be restored, as closely as possible, to the position they would have been in if they had not been injured.

Ipek Tugcu is an associate solicitor at Bolt Burdon Kemp specialising in Adult Brain Injury claims.  If you feel you may have a claim or are enquiring on behalf of a loved one, contact Ipek free of charge and in confidence on 020 7288 4849 or at ipektugcu@boltburdonkemp.co.uk.  Alternatively, complete this form and one of the solicitors in the Adult Brain Injury team will contact you.  Find out more about the Adult Brain Injury team.