Stroke Care in Westchester: How To Tell If It Was Malpractice?
Trusted and Award-Winning Representation
Our firm is experienced in evaluating stroke care, including the nuances of stroke care in our Westchester hospitals.
A common fact pattern of stroke care malpractice is a delay in evaluation or treatment beyond the time periods recommended in guidelines from the American Heart Association and American Stroke Association (AHA/ASA). These guidelines, in most cases, have created a national standard of care in stroke treatment.
There are, in addition, factors unique to Westchester area providers that help us evaluate whether care met, or fell below, applicable medical standards. We are based in Westchester County, with our local office in Scarsdale. Our knowledge of the hospitals and the levels of stroke care they provide helps us examine the quality of care given, including whether hospital staff should have arranged higher-level care at other area institutions.
Key Takeaways
Recurring Malpractice Scenarios In Stroke Care:
- Delays in calling “Code Stroke,” obtaining imaging or involving a neurologist can cost a patient an opportunity for effective treatment.
- Some patients may qualify for treatment beyond the usual medication time window, depending on imaging results and whether advanced stroke center care was available nearby.
- Westchester stroke cases often require close examination of communications and transfers between hospitals with different capabilities, given that institutions providing different ‘levels’ of stroke care are in close proximity.
Stroke Care Requires a Coordinated, Rapid Response
Stroke care follows a highly structured, time-critical pathway. “Code Stroke” activates the hospital’s emergency response to a suspected stroke. The AHA/ASA’s Get With The Guidelines–Stroke and Target: Stroke initiatives have evolved over time. But in all recent versions, the general function of these guidelines is to provide a structured approach to evaluation and care, to bring effective stroke care to patients suffering from stroke as soon as possible.
Recurring failures occur when a hospital is too slow to call the “code stroke” or too slow in obtaining imaging or obtaining a neurologist consultation after the “code stroke.” Our investigation examines the guidelines and the surrounding factual circumstances and goes through a detailed analysis of the chart to determine whether all phases of timely care were rendered.
Key Metrics
Some key metrics defined by the AHA/ASA guidelines that often come into play include:
- The 2026 AHA/ASA guideline calls for emergency brain imaging as rapidly as possible, which in most cases should occur within 25 minutes after arrival.
- In most cases, timely diagnosis and treatment should result in administration of effective stroke medications within 60 minutes from initial presentation to the hospital (typically referred to as “60-minute door-to-needle”).
- AHA has metrics applicable to all phases of assessment, imaging, interpretation of imaging and treatment.
When Does the “Clock Start” for Stroke Response?
Sometimes the hospital record is silent on when the patient actually first presented to the hospital. We are experienced at evaluating all the evidence that may be brought to bear, including the ambulance “Prehospital Care” reports and initial nursing observations.
Imaging Delays and Malpractice
Ordering a scan is only one step. We examine when staff completed it, when a clinician interpreted it and when the findings reached the treating team.
Was the “On-Call” Neurologist Available? Did They Timely Respond?
We look for the actual consultation and treatment recommendation. For example, an unanswered call to the on-call neurologist may leave an urgent decision unresolved.
Did Someone “Drop the Ball” After Initial Evaluation?
Sometimes, unfortunately, a hospital will do a good job in initial evaluation. A timely “Code Stroke” was called, and imaging was done and interpreted. An “on-call” neurologist gave an initial assessment. But from there, the “ball may have been dropped” and effective treatment did not follow.
To evaluate these issues, we compare repeat assessments with the initial findings. New or worsening deficits should prompt reassessment, rather than continued reliance on an earlier impression.
How Does the “Stroke Scale” Apply?
The National Institutes of Health Stroke Scale (NIHSS) records neurological deficits and their severity. Trained nurses, physician assistants and other clinicians use it, but the score does not replace the full assessment. A low score can accompany disabling problems. Likewise, a CT scan showing no bleeding does not necessarily “rule out” an ischemic stroke (a blockage of blood flow). Our review considers whether clinicians distinguished bleeding, a blockage and other possible explanations without losing necessary time.
The Treatment Window Depends on the Patient and Procedure
“Thrombolytic” drugs dissolve clots. Alteplase, commonly called tPA, and tenecteplase can restore blood flow and limit brain injury in eligible patients with an ischemic stroke. They are not treatments for a hemorrhagic stroke caused by bleeding. The current AHA/ASA recommendations support prompt intravenous treatment within 4.5 hours of symptom onset or the last time the patient was known to be well, when the patient qualifies.
Some patients remain eligible later based on advanced imaging and specialist assessment. Separately, “mechanical thrombectomy” removes a clot through a catheter passed into the affected blood vessel. This endovascular treatment can benefit selected patients up to 24 hours after symptoms begin. The distinction matters when a hospital tells a family that the patient arrived “too late.” We examine which treatment staff considered and whether the available findings supported another option.
“Time Is Brain”
Earlier treatment in most cases offers a better opportunity to limit injury. A longer window for selected patients is not permission to delay. We evaluate past care using the medical evidence, available treatments and standards applicable when the patient was treated.
Westchester Hospitals Provide Different Levels of Stroke Care
The New York State Department of Health’s stroke-center directory identifies different levels of capability. Examples from the local network, checked in October 2026, include:
| Level | Westchester Facilities | Why the Distinction Matters |
|---|---|---|
| Primary Stroke Centers | NewYork-Presbyterian Westchester (formerly Lawrence Hospital), NewYork-Presbyterian Hudson Valley Hospital, Northern Westchester Hospital (Northwell Health), Montefiore New Rochelle, Montefiore Mount Vernon, and St. John’s Riverside Hospital’s Andrus Pavilion | Initial stroke assessment and eligible clot-dissolving treatment, with transfer when the patient needs services unavailable there. |
| Comprehensive Stroke Centers | Westchester Medical Center (WMCHealth) and White Plains Hospital (Montefiore Einstein) | Advanced stroke care, including catheter-based treatment and management of complex cases. |
| Thrombectomy Capable Stroke Center | Phelps Hospital (Northwell Health) | Catheter-based clot removal is not limited to the two comprehensive centers. |
White Plains Hospital announced its Joint Commission Comprehensive Stroke Center certification in April 2026. We check the services available at the time of the patient’s care rather than assume today’s designation applied years earlier. Our separate White Plains Hospital malpractice page discusses our experience investigating that institution.
Transfer Decisions Must Follow the Patient’s Needs
If a patient needs treatment at a Comprehensive Stroke Center that the initial hospital cannot provide, the standard of care may require early communication with that center and prompt transport. In our area, Westchester Medical Center is often the closest Comprehensive Stroke Center available. So if a nearby primary center lacked sufficient expertise to treat a stroke, we will evaluate whether there was prompt recognition of the need for higher-level care.
Our knowledge of the relationships between Westchester hospitals helps us examine if there was a failure to effect a timely transfer. We look at the initial neurology recommendations and communications between institutions (or lack of such communication). For example, a note simply saying “transfer discussed” leaves unanswered whether anyone secured an accepting physician or transport was requested on a timely basis.
Our Investigation Connects the Delay to the Injury
We have a depth of experience successfully litigating stroke cases. In addition, we have a developed body of knowledge of our local institutions and relationships with world-class experts in the field of stroke care, including experts from emergency medicine, nursing and stroke neurology. Our work in the Westchester County Supreme Court, our Scarsdale office and our familiarity with local hospital care help us bring supported claims.
We Start With the Patient/Family Story
First, we listen to the patient and family. Their recollection can identify concerns or requests for help missing from the chart. We obtain emergency medical services (EMS) and 911 records, hospital records, the actual imaging and the hospital’s stroke protocols. Our timeline compares symptoms, arrival, assessments, consultations, medication and any transfer. Those records help establish whether a delay occurred before or after the hospital recognized the problem.
The Legal Definition of Malpractice In Stroke
New York medical malpractice requires a departure from accepted medical practice that was a substantial factor in causing injury (NY Pattern Jury Instruction 2:150, discussed in Morris v. Queens-Long Island Medical Group, P.C., 43 A.D.3d 394 [2d Dep’t 2007]). Our experts address both questions: what proper care required, and whether timely action would have prevented or reduced injury to a reasonable degree of medical likelihood. The clinical circumstances matter, not just a missed time target.
Compensation Addresses Lost Independence and Ongoing Care
Stroke-related brain injury can take away speech, mobility and the ability to manage daily life. We evaluate the additional harm attributable to improper care, including rehabilitation costs, assistance at home, lost earnings and loss of enjoyment of life. Even for someone who was retired or not gainfully employed, the loss of independence can be substantial.
When needed, we retain life care planners to identify future therapy, equipment and assistance, and economists to calculate financial losses.
Sometimes the largest component of an award can be best understood as loss of dignity and independence. Legally, these concepts can be grouped under “loss of enjoyment of life” and “conscious pain and suffering.” But we are particularly sensitive, and juries are attentive, to injuries that actually compromise a person’s dignity and independence. If such losses are due to true malpractice, we find that these injuries can be particularly compelling when supported by the evidence.
Westchester Medical Center Requires Early Attention to Deadlines
Westchester Medical Center is operated by Westchester County Health Care Corporation. For a malpractice personal-injury claim against that corporation, a notice of claim ordinarily must be served within 90 days after the claim arises. Public Authorities Law § 3316(1)(a) incorporates the notice requirements of General Municipal Law § 50-e. The separate lawsuit ordinarily must begin within one year and 90 days under Public Authorities Law § 3316(1)(c).
For private-provider malpractice claims, the usual period is two years and six months under Civil Practice Law and Rules (CPLR) § 214-a. Continuous treatment and other exceptions require individual analysis. We check the responsible entities and dates promptly, including whether any late-notice relief remains available. Do not assume the longer private-provider deadline applies to Westchester Medical Center.
Questions About Delayed Stroke Care in Westchester
Can a delay in calling Code Stroke be malpractice?
Yes, when staff should have recognized the need for the response and the resulting delay caused injury. We examine what staff knew before activation and whether that lost time affected an available treatment. A code eventually being called does not answer what happened beforehand.
What if the hospital said it was too late for tPA?
That explanation does not necessarily end the inquiry. We examine when the patient first qualified, whether hospital delay used up that opportunity, and whether imaging supported later treatment or thrombectomy. A reason for withholding one treatment is not automatically a reason to stop evaluating other options.
Can the first hospital be responsible for a transfer delay?
Yes, if its staff failed to arrange a medically indicated transfer promptly and that failure contributed to injury. We examine the communications from both hospitals to identify who needed to act and when. Responsibility can extend to more than one provider.
What should make us question the care?
Do you feel there was unreasonable delay? Did requests for reassessment go unanswered? Did any of the doctors tell you that you should “see a lawyer”? Bring those concerns to us. Your account helps direct the investigation, particularly where the written record leaves gaps.
Will you take a supported stroke case to trial?
Yes. We investigate the medical merits before recommending a claim and prepare supported cases for trial when indicated. If there is no suitable settlement, we can present the timeline, expert opinions and evidence of harm in court. Our work does not stop at requesting a settlement.
Request a No-Cost Stroke Case Evaluation
If you question delays in stroke diagnosis, treatment or transfer, contact us. Our Westchester malpractice practice combines local institutional knowledge with stroke-care investigation. We will evaluate your concerns and the deadlines that apply.