The claim arises from the decision of D2 not to offer C thrombolysis to treat a stroke on 16 November 2016, which it is alleged has caused him serious disability. C had already suffered a stroke on 26 September 2016 when he was treated with thrombolysis. He had made a good recovery and returned to work on 15 November 2016. [1]
In the Emberson paper the proportion of patients treated with thrombolysis was greater than those who had not been treated with it. The example put by D in cross-examination of Dr Baldwin was that if out of 100 patients, 33 had a better outcome with thrombolysis within 3 hours than 23 who had not been treated with it, then it could not be said that, on the balance of probabilities, C would have had a better outcome. [84]
I have concluded that thrombolysis would probably not have altered the outcome in this case, in circumstances where C has made a very good, if imperfect, recovery from his second stroke. I am also inclined to accept Dr Hassan’s evidence that thrombolysis did not alter the outcome of his first stroke on 26 September 2016. In my view the evidence regarding treatment with thrombolysis for lacuna strokes is lacking. I accept D’s submission that at best C lost the chance of a better recovery. If I am wrong about that, C’s Modified Rankin Scale of 2 is within the range of a good outcome from his second stroke whether he was treated with thrombolysis or not. [97]
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