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Medico-legal aspects of using tissue plasminogen activator in acute ischemic stroke
Nhu T Bruce1, William P Neil, Justin A Zivin
1San Diego VA Healthcare System, Neurology Service (127), 3350 La Jolla Village Drive, San Diego, CA, 92161, USA.
Opinion Statement:
Intravenous alteplase or tissue plasminogen activator (tPA) has been the standard of care with proven efficacy for acute ischemic stroke for over a decade. Despite this, only a small fraction of potentially eligible stroke patients receive this medication. There seems to be a fear among practitioners of legal repercussions as a result of an increased risk of intracerebral hemorrhage due to tPA. This review of legal cases involving tPA will show that instead, physicians are often found liable as a result of not treating with tPA.
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