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$5,000,000 Recovery in Failure to Diagnose Stroke Case

Silecchia v. The Ocean Eye Institute, et. al.

Daryl L. Zaslow of Eichen Crutchlow Zaslow, LLP (Edison, Red Bank and Toms River), obtained a $5.0 million settlement on behalf of a 50-year-old stroke victim and his soon to be ex-wife, with whom he has separated.

Paul Silecchia presented to the Ocean Eye Institute on June 25 and July 20, 2009, where he was seen by an optometrist. At both visits, Mr. Silecchia complained of recent headaches with monocular visual disturbances. The examinations by the defendant revealed no retinal pathology for the symptoms and his differential diagnosis included glaucoma and headache/migraine. At the second visit the optometrist recommended that Mr. Silecchia follow-up with his primary care provider if the headaches persisted and he was told return to The Ocean Eye Institute in one year. Neither the optometrist nor anyone from The Ocean Eye Institute expressed any urgency regarding Mr. Silecchia’s symptoms or his need for immediate treatment.

On July 20, 2009, Mr. Silecchia called his primary care physician, requesting prescriptions for several things, including an MRI of the head. Although Mr. Silecchia did not speak directly to his doctor Mr. Silecchia did speak to the staff and the phone message given to his physician from his staff stated that Mr. Silecchia had “headaches” and “left eye patches.” Notably, the phone message also informed the physician that according Mr. Silecchia had seen an optometrist and his “eyes were within normal limits.” With this information, the primary care physician wrote a prescription for an MRI of the head with and without contrast. The diagnosis written on the prescription states, “headaches and vision changes.” Dr. Lozowski did not call or ask to speak to Mr. Silecchia or to the optometrist regarding Mr. Silecchia’s situation and no one from his office expressed any urgency to Mr. Silecchia regarding the etiology of his symptoms or the need for immediate evaluation.

On August 3, 2009 Mr. Silecchia suffered a left hemisphere stroke involving the left middle cerebral artery distribution. The stroke resulted in permanent disability, including neurological deficits affecting the right side of his body, which have resulted in difficulties in walking and speaking. As a result of these deficits Mr. Silecchia never returned to work as a department manager at Pathmark.

Mr. Zaslow retained experts in ophthalmology, optometry, neurology, family medicine, internal medicine, life care planning and economics. With respect to the issue of liability, Zaslow and his experts maintained that the symptoms reported by Mr. Silecchia were secondary to amaurosis fugax, or ischemia to the ophthalmic artery from a carotid vascular lesion. Amaurosis fugax is a critical symptom that requires an emergent work up. Zaslow further maintained that an evaluation by a neurologist, primary care physician or one conducted in the emergency department at any time in the 6 weeks prior to his stroke would have prompted a carotid ultrasound which would have easily diagnosed his high-grade carotid disease. Mr. Silecchia would have then undergone carotid revascularization or carotid endarterectomy and this stroke would have been prevented. Click here to read more about the case.