Review of tissue plasminogen activator, ischemic stroke, and potential legal issues.
The use of tissue plasminogen activator in ischemic stroke is controversial. Many practicing physicians believe that its usefulness is established, while others, including professional specialty societies, are less sanguine. A review of the literature appears to show that the use of tissue plasminogen activator is efficacious and can result in highly improved outcomes for a majority of eligible patients. These findings may implicate important potential legal issues. Informed consent concerns and, potentially, medical malpractice claims may result, particularly in the context of evidence-based practice, pay for performance, and the currently limited use of tissue plasminogen activator for eligible patients.
Liang
Bryan A
BA
Institute of Health Law Studies, California Western School of Law, San Diego, CA 92101, USA. baliang@alum.mit.edu
Lew
Robert
R
Zivin
Justin A
JA
D002545:Brain Ischemia / Q000150:complications*; D019317:Evidence-Based Medicine / Q000331:legislation & jurisprudence; D005343:Fibrinolytic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007258:Informed Consent; D008318:Malpractice; D018579:Patient Selection; D020521:Stroke / Q000188:drug therapy* / Q000209:etiology; D010959:Tissue Plasminogen Activator / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator