With symptoms of stroke or transient ischemic attack, call 911 immediately

As a Texas medical malpractice lawyer, I have represented a number of clients who have serious lifelong injuries because of strokes that were misdiagnosed and, thus, not treated in emergency room.

Symptoms of stroke

The symptoms of a stroke usually start suddenly and unexpectedly. In a case that I handled against Houston Methodist Hospital, I discovered that they use the abbreviation “FAST” to help people remember stroke symptoms:

∙ F — Face Drooping. Is one side of the face drooping or numb? Ask the person to smile. 

∙ A — Arm Weakness. Is one arm or leg weak and numb, especially on one side? Ask the person to raise both arms. 

∙ S — Speech Difficulty. Is the speech slurred? Can they speak clearly or do they seem confused? Ask them to repeat a simple phrase. 

∙ T — Time to call 911 with even one of these signs, and even if the symptom goes away. Get to the hospital immediately. 

Transient ischemic attack

Sometimes people can have stroke symptoms that come and go, and may actually be having a transient ischemic attack (TIA). Depending on the area of the brain that is affected by the TIA, the symptoms include one-sided numbness or weakness, difficulty speaking, vision problems, difficulty walking, dizziness or loss of balance, and a severe headache.

It is still important to get to the hospital immediately, even if some or all of these symptoms go away. Hospitals, and in particular stroke centers, have tools, like the ABCD2 score, which help predict a patient’s short-term stroke risk.

Call for help immediately

If a person has symptoms of a stroke or TIA, it is a medical emergency that requires an immediate call to 911 for help.

The U.S. Food & Drug Administration (FDA) has only approved one drug treatment for acute ischemic stroke (the type of stroke caused by a blood clot), and it should be given within three hours of when the symptoms begin (and up to 4.5 hours in certain eligible patients). The drug is called tissue plasminogen activator (tPA) is given via an intravenous line (IV) and dissolves the clot and improves blood flow to the part of the brain being deprived of blood flow. tPA should be given within three hours (and up to 4.5 hours in certain eligible patients) of the time symptoms first started.

Even with this limited time window, though, there is not a minute to waste.

According to a stroke doctor at the Cleveland Clinic, “For every minute that passes, a stroke patient can lose about two million neurons, so the sooner we can treat stroke, the more brain we can save, which can reduce the chances of being left with a permanent disability.”

Whoever calls 911 should jot down some notes while waiting for the emergency medical technicians (EMTs) to arrive, including the exact time that the symptoms started, whether the person is on blood thinners, and any recent medical conditions, surgeries, or medications that the person has been taking. This will help the EMTs and hospital to do their jobs more quickly.

We are here to help

In two recent cases that I have handled, the patients went to hospital emergency rooms in the Houston are that are designated as primary or comprehensive stroke centers. One patient was quickly discharged with a diagnosis of psychogenic reaction—in other words “it is all in your mind.” The other was given blood pressure and pain medications for what the doctors concluded was just a bad headache.

Both cases are tragic and surprising to me, considering that the signs of stroke are so well-known and that stroke centers have detailed standards in place and staff with specialized stroke training. Yet, they still botched the diagnosis and these patients will never be the same.

If you or someone you care for has been seriously injured by a stroke that was not properly diagnosed or treated at the hospital, then call Painter Law Firm, at 281-580-8800, for a free consultation with an experienced medical malpractice attorney.


Robert Painter is a medical malpractice lawyer at Painter Law Firm PLLC, in Houston, Texas. He has represented multiple clients in stroke cases and is well-aware of the unique legal challenges under Texas law for handling stroke cases, particularly those where treatment begins and ends in a hospital emergency room. In 2003, Texas politicians passed a tort reform measure that requires medical malpractice plaintiffs suing over care in a hospital emergency room to prove willful and wanton negligence, which is equivalent to gross negligence. Because of this standard, many lawyers are unwilling to take on emergency room cases. Robert Painter is different, though, and continues to tackle emergency room cases, and has written two articles on emergency medicine that were published in The Houston Lawyer magazine.

Robert Painter
Article by

Robert Painter

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm Medical Malpractice Attorneys in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him for a free consultation and strategy session by calling 281-580-8800 or emailing him right now.