Premier Neurological Care complaint alleges delayed diagnosis of cerebral venous thrombosis
The complaint alleges that Premier Neurological Care and Saima Khurram, M.D. failed to diagnose cerebral venous sinus thrombosis despite symptoms including repeated fainting, papilledema, severe headaches, nausea, vomiting, and weakness. Dr. Khurram did not obtain or review a March 4, 2019 MRI report during March 2019 treatment and did not order MR venography or other appropriate imaging despite allegedly considering it. The patient suffered an acute ischemic infarction on April 10, 2019, with permanent neurological injuries.
Overview
This page concerns a public complaint alleging that Premier Neurological Care and Saima Khurram, M.D. failed to diagnose cerebral venous sinus thrombosis after neurological symptoms and an earlier MRI report.
Chronology
The complaint alleges as follows:
- The patient presented to Northside Hospital Cherokee in February and March 2019 with symptoms including syncopal episodes, headaches, weakness, nausea, vomiting, and visual symptoms.
- An optometrist ordered MRI imaging on March 4, 2019 and referred the patient to Dr. Khurram for neurological evaluation.
- Dr. Khurram evaluated the patient on March 6, diagnosed pseudotumor cerebri and increased intracranial pressure, noted that MRI results had been requested, but did not obtain or review the March 4 MRI report during treatment.
- Dr. Khurram referred the patient for lumbar puncture but did not order MR venography or other imaging on March 6, March 8, or March 27 despite continued symptoms.
- The patient presented to Wellstar Kennestone Hospital on April 10, 2019 with stroke symptoms, and CT angiogram revealed acute ischemic infarction related to acute cerebral venous sinus thrombosis.
Alleged failures
The complaint alleges the following failures:
- Dr. Khurram failed to review the March 4 MRI report during March 2019 treatment.
- Dr. Khurram failed to order appropriate imaging, including MR venography she allegedly considered.
- Premier Neurological Care failed to request or obtain the MRI report or images during treatment.
- Premier Neurological Care maintained disorganized administrative systems that interfered with timely retrieval of diagnostic records.
- Timely MR venography or other imaging would likely have detected the cerebral venous thrombosis and allowed anticoagulant treatment before infarction.