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An elderly woman named Liza, who showed symptoms of near syncope, was admitted via ambulance to a small community hospital. She experienced an inability to move on her own and almost lost consciousness while watching her grandson play basketball. Her symptoms occurred during a visit to her daughter's home, which is approximately 150 miles from Liza's home. When Liza was admitted to the hospital, her daughter explained the numerous types and dosages of medications her mother was taking. She also mentioned that for the past week or so, Liza had not been taking her Coumadin for atrial fibrillation as directed by her physician. She expressed concern about Liza possibly having a stroke. Liza was admitted to the intensive care unit for evaluation. Over the course of hospitalization, Liza's condition worsened. Approximately 18 hours after her admission, the nursing staff began performing nervous system checks on Liza and contacted the physician-on-call to obtain an order for a CT scan. The scan showed evidence that a cerebral infarction (stroke) had occurred, and the symptoms Liza was experiencing at the basketball game were due to the stroke. After the results of the CT scan were received, the on-call physician then began treatment for the infarction.
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