Hospital Technology Helps Save Patient More Than 50 Miles Away

 

By: Michelle Brubaker   |   November 02, 2015

Lori Hoopingarner was excited to go on a getaway with her husband. The 41-year-old mom was standing in her kitchen coordinating last-minute details for the trip when her vision suddenly became blurry and she was no longer able to speak. The weekend would prove very different from the one she had planned.

“My husband was asking me questions and I couldn’t respond. I tried to walk, but I was paralyzed on my right side,” Hoopingarner recalled.

stroke patient Hoopingarner

Her husband, Darren, a fire captain with the California Department of Forestry and Fire Protection, called 9-1-1. Lori was taken to Temecula Valley Hospital, just a few miles from their home.

“When every minute counts, that 9-1-1 call helped save Lori’s life,” said Monika Gupta, MD, medical director for stroke and neurology at Temecula Valley Hospital and neurologist at UC San Diego Health. “I was right next to Lori’s side when she was wheeled through the emergency room doors at Temecula Valley Hospital. She was not able to communicate or follow our commands when she arrived.”

A computed tomography (CT) scan revealed Hoopingarner had a blood clot in a major blood vessel in her brain and was in the midst of a stroke.

Enter the first critically important technology element, telemedicine.

Fifty miles from where Hoopingarner lay in a hospital bed, Brett Meyer, MD, co-director of the Comprehensive Stroke Center and medical director of telemedicine at UC San Diego Health, sat in front of a computer monitor in San Diego and was able to speak face-to-face to Hoopingarner, review scans and immediately evaluate her condition.

The telestroke program at UC San Diego Health virtually transports stroke specialists via computer desktop or laptop to the patient’s bedside, using highly sophisticated video, audio and Internet technologies.

“The technology can be dialed up in seconds and has an immediate, profound and proven impact on treatment decisions for acute stroke patients like Lori,” said Meyer. “Telestroke gives 24-7 access to experts via computer or even an iPad, tablet or smartphone regardless of geographic limitations.”

“We are proud to have developed innovative telemedicine initiatives at UC San Diego Health,” said Lawrence Friedman, MD, director of the telemedicine program at UC San Diego Health and physician champion for the UC Health Tele-health program. “Telemedicine is an amazing addition to already excellent care provided throughout our health system. Lori’s story is exactly why we do what we do.”

Gupta and Meyer collaboratively concluded Hoopingarner was having a stroke that required immediate attention with multiple levels of acute care.

Hoopingarner was given tissue plasminogen activator (tPA), a first level of treatment for stroke that dissolves clots and improves blood flow to the part of the brain being deprived. Per Food and Drug Administration guidelines, the medication needs to be administered within three hours of stroke onset.

“In this case, the clot may have dissolved slightly from tPA, but a higher level of neurological intervention was clearly needed,” said Gupta.

Hoopingarner needed to be transferred to UC San Diego Medical Center in Hillcrest, a designated Comprehensive Stroke Center.

“It was imperative that Lori receive an endovascular surgical intervention to remove the large blood clot,” said Robert Claycomb, MD, a fellow in the Department of Neurosciences at UC San Diego School of Medicine. “That intervention needed to happen at UC San Diego Health.”

Hoopingarner remembers “seeing and hearing the doctors on the computer screen and being so grateful I live in a community where this type of advanced technology and care is available.”

An ambulance transported Hoopingarner from Temecula Valley Hospital to UC San Diego Health, where Meyer and Claycomb awaited.

“When I saw the line of experts outside the hospital entrance as we arrived, I was overcome with emotion,” said Hoopingarner. “I don’t remember my gurney ever stopping once I got out of the ambulance. I was rolled right into surgery.”

Enter the second critically important technology element, embolectomy.

Scott Olson, MD, endovascular neurosurgeon at UC San Diego Health, performed the procedure – an emergency surgical removal of blood clots.

“Using a new stent retrieval device, we were able to go through the groin area with a catheter and rapidly remove the blood clot in Lori’s brain to restore blood flow,” said Olson. “It was so rewarding for the team when Lori immediately started moving her hand.”

“There were a lot of cheers in the waiting room when Dr. Olson walked in and told our family the procedure was successful,” said Darren. “The flawless coordination of care between Temecula Valley Hospital and UC San Diego Health, combined with the most advanced technology, saved my wife’s life. I’ve been in fire services for 25 years, and I’ve never experienced such exceptional patient care.”

“From Temecula to San Diego, I received the most comprehensive stroke care that gave my kids their mom back,” said Hoopingarner through tears. “Every physician and nurse was truly compassionate, and Dr. Meyer had outstanding bedside manner, even checking on us after we left the hospital.”

“It was an honor to care for Lori. Her case exemplifies the importance of strategic partnerships and the use of technology to save lives beyond San Diego County lines and in our collaborative backyards,” said Meyer. “I have told her many times that ‘she did the impossible’ by recovering so quickly. It really was amazing to witness.”


Care at UC San Diego Health

Neurology

Stroke and Neurovascular Surgery