Hemorrhage or Stroke Caused by Medication Errors

Hemorrhage & Stroke

A stroke occurs when blood flow to part of the brain is interrupted, either due to a blockage (ischemic stroke) or bleeding in the brain (hemorrhagic stroke). A hemorrhage, whether intracranial or elsewhere in the body, involves uncontrolled bleeding from blood vessels and can be life-threatening if not treated quickly. In medical settings, these catastrophic events are sometimes the direct result of errors in medication management, particularly the misuse of anticoagulants like warfarin, heparin, or DOACs (e.g., Eliquis, Xarelto).

What Causes a Hemorrhage or a Stroke?

Strokes and hemorrhages can result from a wide range of conditions, including uncontrolled high blood pressure, blood vessel abnormalities, or traumatic injury. However, in hospital settings, one of the most common and preventable causes is inappropriate use of anticoagulant medications. Anticoagulants—such as warfarin (Coumadin), heparin, and newer direct oral anticoagulants (DOACs) like Xarelto, Eliquis, and Pradaxa—are routinely used to prevent dangerous blood clots in patients at risk for conditions like deep vein thrombosis, pulmonary embolism, or atrial fibrillation. These medications are highly effective when used correctly, but they also carry significant risk. Even minor dosing errors, failure to adjust medication in patients with impaired kidney function, or neglecting to monitor clotting times (such as INR or aPTT) can result in catastrophic bleeding. Likewise, administering these drugs too soon before or after surgery—or failing to properly reverse their effects in the setting of trauma or emergency procedures—can lead to intracranial hemorrhage, spinal bleeding, or fatal strokes. In many of these cases, the harm could have been avoided with proper communication, monitoring, and adherence to established protocols.

Is It Always Medical Malpractice?

Not necessarily. Anticoagulation involves risks, and some bleeding or stroke events occur despite appropriate care. However, when a provider:

• Prescribes the wrong dose of an anticoagulant
• Fails to monitor clotting labs (e.g., INR, aPTT)
• Ignores drug interactions or kidney function
• Fails to reverse anticoagulation before surgery or after trauma

—then the resulting hemorrhage or stroke may be the result of medical negligence.

How Medication Errors Cause Preventable Harm

Common anticoagulant-related errors that lead to hemorrhage or stroke include:

• Excessive anticoagulation: Overdosing warfarin or heparin can cause spontaneous internal bleeding, especially in the brain or gastrointestinal tract.
• Failure to monitor INR/aPTT: Patients on blood thinners require regular lab tests. Without proper monitoring, dosing can become dangerously high.
• Failure to reverse anticoagulation: Before surgery, trauma care, or invasive procedures, anticoagulation often must be reversed using agents like vitamin K, protamine, or reversal drugs like Andexxa. Failure to do so can cause uncontrolled surgical bleeding or fatal strokes.
• Drug interactions and renal dosing errors: DOACs like Eliquis and Xarelto require caution with other medications and dose adjustments in patients with kidney impairment. Overlooking these risks may result in excessive blood levels and hemorrhage.

When Can You File a Malpractice Lawsuit?

A medical malpractice lawsuit may be warranted when:

1. The patient was on an anticoagulant
2. Providers failed to monitor, adjust, or reverse the medication appropriately
3. This failure led to a hemorrhagic or ischemic stroke, or other serious bleeding
4. The patient suffered measurable harm—permanent injury or death

Lawsuits typically rely on expert review of the medical records, medication logs, lab results, and surgical reports to establish that the standard of care was breached.

Real Case Examples of Settlements and Verdicts

1. New York – $2.875 Million Settlement (2024):
   A 23-year-old woman suffered an ischemic stroke after emergency room physicians misdiagnosed her symptoms as seizures. Delayed imaging and anticoagulation contributed to permanent speech and motor deficits. The lawsuit alleged failure to treat a known clotting condition promptly.
2. Massachusetts – $2 Million Settlement:
   An elderly woman experienced an intracranial hemorrhage after receiving heparin shortly after brain surgery. The medication was given without appropriate timing or reversal protocol. A confidential settlement was reached with the hospital for failure to account for bleeding risk and improper anticoagulation management.
3. Minnesota – $4 Million Settlement (Robins Kaplan):
   A middle-aged woman undergoing aneurysm coiling received anticoagulants, but poor coordination between surgical and medical teams led to clot formation and stroke. Experts testified the stroke could have been avoided with better medication management.

Why These Cases Matter

In each of these cases, the stroke or hemorrhage was not an inevitable outcome—it was a result of preventable errors involving powerful medications. When hospitals and doctors fail to follow well-established protocols for monitoring and reversing anticoagulants, patients are put at extreme risk.

What To Do If You Suspect Malpractice

If you or a loved one suffered a stroke or hemorrhage and were on blood thinners or anticoagulants:

• Request a copy of all medical records, especially medication administration records, lab results, and surgical notes
• Consult a qualified medical malpractice attorney to review the case
• Preserve documentation of recovery efforts, rehabilitation, or wrongful death damages

We Can Help

At Lupetin & Unatin, we focus exclusively on cases involving catastrophic injury or death due to medical negligence. If you believe improper management of anticoagulant therapy caused a hemorrhage or stroke, we may be able to pursue justice on your behalf. Contact our Pittsburgh medical malpractice team today for a free case evaluation.