by Needle & Ellenberg, P.A.
If you believe a Florida emergency department missed or delayed the diagnosis of a stroke, or if a loved one suffered catastrophic injury after inadequate post-procedure neurological monitoring, you may have a malpractice claim.
Stroke care can be time sensitive. Treatment options may narrow by the minute. When a provider fails to recognize the signs, order timely imaging, transfer the patient to the right facility, or escalate after a post-thrombectomy deterioration, the harm can be permanent. Not every missed diagnosis is malpractice, but cases that fall below the standard of care may support a claim.
Both founding partners at Needle & Ellenberg, P.A. have handled Florida stroke malpractice cases for decades.
Why Choose Needle & Ellenberg, P.A.
Founding partners Andrew Needle and Andrew Ellenberg bring more than 70 years of combined experience in Florida medical negligence and plaintiffs’ injury law. Both handle plaintiffs’ injury and death cases exclusively.
Practice Focus
Andrew Ellenberg focuses on plaintiffs’ injury and medical negligence cases, with practice concentrations that include stroke, brain injury, misdiagnosis, anesthesia errors, and obstetrical malpractice. He earned his J.D. cum laude from the University of Miami School of Law in 1988. Martindale-Hubbell rates him AV Preeminent. Florida Super Lawyers has listed him every year since 2005, and The Best Lawyers in America has listed him every year since 2009 for plaintiffs’ medical malpractice and personal injury work.
Andrew Needle is Board Certified in Civil Trial Law by The Florida Bar. His practice concentrations include stroke and neurological injury cases, complex medical negligence, and cases involving post-procedure monitoring failures. He holds a J.D. cum laude from the University of Miami School of Law (1977) and a B.S. from Cornell University (1974). He is a charter member of the Miami chapter of the American Board of Trial Advocates. Best Lawyers in America named him “Lawyer of the Year” for Medical Malpractice Law, Plaintiffs, in Miami for 2020 and 2025.
Verdicts and Settlements
Needle & Ellenberg, P.A. has recovered hundreds of millions of dollars for clients across all practice areas, including multiple eight-figure results in medical malpractice matters. Many of the healthcare cases involved birth injuries, delayed diagnosis, surgical errors, anesthesia complications, and health system negligence. Our fees are contingent. You pay nothing unless we recover compensation for you.
What Our Clients Say
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“If you ever feel like you are in a dark place, and you feel that something wrong happened with your loved one and need help to correct it and feel that they were treated unfairly and missed informed. I would 1000 percent recommend this firm!! They helped me with my father after a horrible life event happened to him and I’m forever grateful for them!!”
– Julie Dreams
Types of Stroke Malpractice Cases We Handle in Florida
Stroke malpractice may not always look like a missed diagnosis in the classic sense. It can look like a patient being sent home, being admitted for the wrong condition, being held in the emergency department while the treatment window closes, or being inadequately monitored after a thrombectomy procedure. The categories below reflect the patterns we see most often in Florida cases.
- Stroke misdiagnosed as another condition. Ischemic strokes can be mistaken for migraine, inner ear problems, anxiety, or intoxication, especially when the patient is young or presents outside the classic FAST criteria. The consequence may be a discharge home while the brain continues to infarct.
- Missed posterior circulation stroke. Strokes in the back of the brain may often present with dizziness, nausea, unsteady gait, or vision changes rather than the one-sided weakness most providers associate with stroke. These atypical presentations may be missed more often than anterior circulation strokes.
- Delayed CT or MRI imaging. A CT scan can be the first-line imaging study for suspected stroke. When imaging is delayed for hours, the treatment window may close before the diagnosis is made.
- Failure to activate the stroke protocol. Hospitals that treat stroke are expected to have a standing protocol for suspected cases including rapid triage, neurology consultation, imaging, and labs on a compressed timeline. Skipping that cascade for a patient with classic signs can have clinical consequences that may be irreversible.
- Failure to give thrombolytics to an eligible patient. Some patients who arrive within the guideline window, with no contraindications, never receive thrombolytic therapy. That failure, documented in the records, may support a claim when a qualified medical professional confirms the patient would have been a candidate.
- Failure or delay in transfer to a thrombectomy-capable center. A hospital that cannot perform mechanical thrombectomy should recognize a large vessel occlusion quickly and transfer the patient to a facility that can. Delayed transfers may close off an otherwise available option.
- Post-thrombectomy monitoring failures. After mechanical thrombectomy, patients may require intensive neurological monitoring for reperfusion injury, hemorrhagic transformation, cerebral edema, and progressive herniation. In one documented Florida AHCA investigation at Brandon Regional Hospital, nursing documented deteriorating pupillary response in a post-thrombectomy patient. Three CT scan orders were entered and subsequently cancelled. No stroke alert was activated. When imaging was finally obtained, it revealed a 2.2 centimeter midline shift, a finding associated with severe, frequently fatal cerebral herniation. The patient died. Cancelling imaging orders on a deteriorating post-procedure patient without documented clinical justification can be a recognized departure from the standard of care.
Florida Legal Requirements for Stroke Malpractice
Standard of Care and the AHA/ASA Treatment Windows
Florida law defines the standard of care as what a reasonably prudent health care provider would have done under the circumstances. The standard is specialty-specific. What is expected of a radiologist reading a scan is not what is expected of a primary care physician, and neither is what is expected of an emergency physician evaluating acute symptoms. That specialty framing matters when multiple providers across multiple encounters contributed to the injury.
In ischemic stroke (cases that involve blood clots, as opposed to brain bleeding) healthcare providers are expected to treat eligible patients within 3-4.5 hours with medication that can “bust clots,” unless they are documented to be ineligible for well accepted reasons. Mechanical thrombectomy may be available for certain patients with large vessel occlusions under imaging-based criteria, and these treatment windows may extend up to 24 hours.
The Florida Agency for Health Care Administration lists hospitals that have chosen to obtain stroke center certification, from the basic known as Acute Stroke Ready, up a level to Primary Stroke Center, up another level to Thrombectomy-Capable Stroke Center and with the highest level being a Comprehensive Stroke Center, and EMS transport protocols may be tied to those designations. Hospitals that chose to become certified for stroke care must comply with the standards for the level of care set forth by the organization from which they seek and maintain such stroke center certification, the two most common being The Joint Commission and DNV.
Post-Thrombectomy Monitoring Standards
Cerebral edema typically may peak 24 to 72 hours after a large ischemic stroke. Hemorrhagic transformation can occur in the first 24 to 36 hours. These time windows can mean that post-thrombectomy patients may require intensive neurological monitoring for at least 72 hours after the procedure. The NIH Stroke Scale is the standardized examination used to track neurological improvement or deterioration. Clinical signs of developing herniation, including decreasing level of consciousness, asymmetric or non-reactive pupils, loss of previously present motor function, abnormal posturing, and vital sign changes consistent with Cushing’s triad, may require immediate physician notification in a post-stroke or post-thrombectomy patient.
Why Every Delayed Stroke Does Not Equal a Case
Published guidelines describe treatment windows for eligible patients. They do not define the moment a claim becomes viable. Diagnoses can be missed or delayed by healthcare providers acting reasonably under the circumstances. Some patients may not safely receive tPA because of contraindications such as recent surgery or a bleeding disorder. Some may arrive with an unclear last-known-well time. Some may present with atypical symptoms that do not immediately suggest a stroke, and some imaging findings may change the calculus entirely. Florida law requires proof that the provider’s conduct fell below what a reasonably prudent provider would have done under the circumstances.
Statute of Limitations and Presuit Notice
Florida imposes strict deadlines on medical malpractice claims, and missing the deadlines can result in a potentially viable case being barred from court. Our lawyers can help you determine whether your potential case is within Florida’s statute of limitations.
Before any medical malpractice lawsuit can be filed in court, Florida law requires that the Claimant send the potential defendant healthcare providers a Notice of Intent, after which there is a 90-day presuit screening period for the exchange of information between the parties. With rare exception, the Claimant’s attorney must include with the Notice of Intent a verified affidavit(s), from a qualified expert(s), who under oath says what were the actions and/or omissions of the potential defendant healthcare provider(s) that caused injury and damage to the Claimant.
What Damages Are Recoverable in Florida Stroke Malpractice Cases?
Economic Damages
Economic damages can include the financial losses that were sustained and/or that reasonably will be suffered in the future, due to the malpractice. These can include lost wages, diminished earning capacity, past and future care, treatment, therapies and services. Stroke survivors with significant deficits may need care for the rest of their lives, and life-care planning testimony may typically be required to quantify future care costs in serious cases.
Non-Economic Damages
Non-economic damages include pain, suffering, mental anguish, loss of enjoyment of life, scarring and disfigurement since the time of the alleged malpractice and into the future. While there was once a limit on the amount that could be recovered for this category of damages, those caps were overruled by Florida’s highest court. Some healthcare providers claim that the caps on non-economic damages still apply to a certain category of claimants who receive health insurance through Medicaid, but this is regularly disputed by lawyers for victims of malpractice. Florida’s high court has not yet ruled on this issue.
Wrongful Death Damages
Stroke can cause death as well as disability. Under Florida’s Wrongful Death Act, surviving spouses, children under the age of 25, and a small category of other family members may pursue damages including lost support, lost companionship, and mental pain and suffering.
Florida’s Wrongful Death Act contains a significant restriction that applies only to medical negligence cases. Under Florida’s wrongful death statute, children of the deceased who are not under 25, and parents of a child who is not under 25 and unmarried, cannot recover non-economic damages when the death was caused by medical malpractice. This law often referred to as Florida’s “Free Kill” law is a sad and unfortunate reality for people who have lost loved ones due to malpractice, but fall within a legal protection that exists only for healthcare providers.
Contact Needle & Ellenberg, P.A.
If you believe a Florida healthcare provider caused serious harm to you or a family member through a missed or delayed stroke diagnosis or post-procedure monitoring failure, the first step is a free case evaluation. Medical malpractice cases are fact-intensive and deadline-driven. Early review by experienced counsel makes a difference in what the records show and what the timeline preserves.
We offer free, no-obligation case evaluations. Our staff speaks Spanish, and we represent clients in Miami, Fort Lauderdale, Orlando, Tampa, and throughout Florida. Contact us to schedule your consultation. There is no fee unless we recover compensation for you.