Stroke Patient Hears Doctors Discuss Organ Donation
Case reveals difficulty in diagnosing stroke patients.
April 5, 2014— -- A Swedish man who was paralyzed by a massive stroke has filed a complaint against the hospital that cared for him because he claimed he could hear doctors discussing whether to donate his organs just before they gave him a sedative that put him under.
Jimi Fritze said was unable to alert the medical staff that he was conscious and could hear and he feared he would be unable to save himself as they sedated him.
"I went to sleep … I couldn’t be awake. I thought I was going to die then,” Fritze told ABC News.
Fritze, 42, suffered his stroke two years ago in Sweden where he lives. He recently filed a complaint about the medical care he received at the Sahlgrenska University Hospital in Göteborg, Sweden, with the Swedish National Health and Welfare Board, which oversees quality of healthcare in Sweden. Calls to the Swedish National Health and Welfare Board were not immediately answered.
Learn More About the Symptoms of Stroke
A spokesperson for the Sahlgrenska University Hospital sent a translated statement and said the hospital was investigating the incident.
"We cannot say much. We cooperate with the [Health and Social Care Inspectorate] about this investigation,“ read the statement. “We take it very seriously, as with all notifications."
Fritze still has difficulty talking, but said he clearly remembers the moment he heard doctors talking about his dire prognosis as he lay nearby, unable to move but able to hear and understand sounds around him. Experts say that is not uncommon in stroke patients.
As Fritz was in his hospital bed, he said he remembers he heard doctors discuss the possibility of organ donation, although Fritze had not yet been declared brain dead.
Fritze had been on vacation with his now ex-girlfriend when he suddenly collapsed due to a stroke. A nurse, she sprang into action and kept his airway open as help arrived. However, once he arrived in the hospital, Fritze said doctors were discouraged by scans.
According to Fritze, they told his then-girlfriend to get his family and say their goodbyes.
Fritze said doctors even discussed the possibility of organ donation with his family. However, before further steps were taken to remove medical care, another doctor gave a second opinion and found that the swelling in Fritze's brain might be a sign that he could recover, Fritze's complaints details. Doctors were able to help bring down the swelling and Fritze eventually was able to “wake-up” and communicate with his family weeks later.
Fritze is still recovering both mobility and speech, and is still unable to walk.
“When I woke up the first time I could only move my finger. Now I can move every part of my body. I cannot walk yet,” said Fritze. “That is my wish is to walk again.”
Experts say Fritze’s case, while rare, shows the difficulty in treating stroke patients.
Dr. Cathy Sila, director of the Comprehensive Stroke Center at University Hospitals Case Medical Center, said doctors have to be very careful about the possibility that a patient can understand them even if they appear unresponsive.
“We are very careful what we say … in front of a patient. You need to always assume there is some level of consciousness when you are having bedside conversations,” said Sila. “They may look like they’re not comprehending you and they might be.”
Dr. Michael DiGeorgia, professor of neurology and director for the Center for Neurocritical Care at University Hospitals Case Medical Center in Cleveland, Ohio, said in similar cases the brain can appear to have more permanent damage due to swelling, but that as the swelling subsides there is a chance for a patient to recover.
“Often patients can look really bad early on, but can improve over the next couple of days. Most of us have been very humbled by experience where it looks really bad after the first couple of days,” said DiGeorgia, who did not treat Fritze.
Additionally patients can suffer from “locked-in” syndrome, a widely recognized condition where a body is paralyzed, but the brain’s “executive functions” or consciousness remains intact. In the early hours and days after a stroke, experts say it can be difficult to figure out if a patient is locked-in, permanently brain damaged or something in between.
Sila said it can be difficult to fully understand a patient’s prognosis from certain scans. Particularly in the case of strokes affecting the brain stem, which can lead to "locked-in" syndrome.
"The brain stem is notoriously difficult to visualize with a CT scan because it’s at the very base of the skull and there’s all this bone from where your ears are," said Sila.
Sila, who did not treat Fritze, said another complication can be a person's age. A younger person may have a better chance at recovering from a massive stroke.
“The age of the patient is an incredibly important determinate for recovery,” said Sila. “We have neural connections that are like the branches of the trees and it’s pretty incredible how young people can survive what seem to be devastating neurological injuries."