An epidural hematoma is a serious brain injury that occurs when blood collects between the skull and the protective covering of the brain (dura mater). This medical emergency requires immediate diagnosis and treatment. When healthcare providers in New York fail to promptly recognize and treat an epidural hematoma, the consequences can be devastating—and may constitute medical malpractice.
What Is an Epidural Hematoma?
An epidural hematoma (EDH) is a collection of blood that forms between the skull bone and the dura mater, the outermost membrane covering the brain. Unlike subdural hematomas that form beneath the dura, epidural hematomas typically result from arterial bleeding, most commonly from the middle meningeal artery.
Types of Epidural Hematomas
Acute Epidural Hematoma
Develops within hours of injury. The most dangerous type, requiring emergency surgery. Often associated with skull fractures and arterial bleeding.
Subacute/Chronic Epidural Hematoma
Develops over days to weeks. Less common and typically involves venous bleeding. May present with gradually worsening symptoms.
Causes of Epidural Hematoma
The most common causes of epidural hematomas include:
- Motor vehicle accidents – The leading cause, responsible for approximately 50% of cases
- Falls – Particularly common in elderly patients and young children
- Assaults – Blunt force trauma to the head
- Sports injuries – Contact sports, cycling accidents
- Workplace accidents – Construction sites, industrial settings
In many cases, epidural hematomas occur alongside skull fractures. Research indicates that 85-95% of epidural hematomas are associated with skull fractures, particularly fractures crossing the path of the middle meningeal artery.
The “Lucid Interval” – A Critical Warning Sign
One of the most dangerous aspects of epidural hematomas is the “lucid interval”—a period where the patient appears to recover or remain stable after the initial injury, only to deteriorate rapidly as the hematoma expands.
Classic Presentation Pattern
- Initial injury with brief loss of consciousness
- Lucid interval – Patient appears to recover
- Rapid deterioration – Decreasing consciousness, pupil changes, neurological deficits
- Coma and death – If untreated
Symptoms of Epidural Hematoma
Recognizing the symptoms of epidural hematoma is critical for timely intervention:
| Early Symptoms | Late/Severe Symptoms |
|---|---|
| Severe headache | Decreasing level of consciousness |
| Confusion or drowsiness | Unequal pupils (anisocoria) |
| Nausea and vomiting | One-sided weakness or paralysis |
| Dizziness | Seizures |
| Slurred speech | Abnormal posturing |
| Vision changes | Respiratory changes |
Diagnosis and Standard of Care
The standard of care for diagnosing epidural hematoma requires:
Immediate CT Scan
Non-contrast CT scan is the gold standard for diagnosis. Should be performed immediately for any patient with significant head trauma or neurological changes.
Neurological Monitoring
Serial neurological examinations using the Glasgow Coma Scale (GCS). Any deterioration requires immediate re-imaging.
Rapid Surgical Consultation
Neurosurgical consultation should be obtained immediately upon diagnosis. Time to surgery is directly correlated with outcomes.
When Does an Epidural Hematoma Become Medical Malpractice?
Medical malpractice occurs when a healthcare provider’s negligence causes harm to a patient. In the context of epidural hematomas, common forms of malpractice include:
Failure to Diagnose
- Not ordering a CT scan for patients with head trauma
- Misinterpreting CT scan results
- Failing to recognize the lucid interval pattern
- Attributing symptoms to intoxication, drug use, or other causes
Delayed Treatment
- Excessive wait times for CT imaging
- Delayed neurosurgical consultation
- Failure to transfer to a facility with neurosurgical capabilities
- Surgical delays after diagnosis
Inadequate Monitoring
- Failure to perform serial neurological examinations
- Premature discharge from emergency department
- Inadequate discharge instructions
- Failure to recognize deterioration
Surgical Errors
- Improper surgical technique
- Failure to adequately evacuate the hematoma
- Post-operative complications from negligence
New York Medical Malpractice Legal Requirements
To pursue an epidural hematoma lawsuit in New York, you must prove four elements:
1. Duty of Care
A doctor-patient relationship existed, establishing the healthcare provider’s duty to provide competent care.
2. Breach of Duty
The provider failed to meet the accepted standard of care for diagnosing and treating epidural hematomas.
3. Causation
The breach of duty directly caused or contributed to the patient’s injuries or death.
4. Damages
The patient suffered actual harm, including medical expenses, lost wages, pain and suffering, or death.
New York Statute of Limitations
Under New York CPLR § 214-a, medical malpractice claims must be filed within 2 years and 6 months (30 months) from the date of the alleged malpractice. Important exceptions include:
- Continuous treatment doctrine – The statute may be tolled while ongoing treatment continues
- Foreign object rule – One year from discovery for cases involving foreign objects left in the body
- Minors – Tolled until the child turns 18, but capped at 10 years from the malpractice
- Mental incapacity – May be tolled under CPLR § 208 if the patient lacks capacity to bring suit
Certificate of Merit Requirement
New York requires plaintiffs to file a Certificate of Merit (CPLR § 3012-a) stating that a medical expert has reviewed the case and believes there is a reasonable basis for the lawsuit. This expert must confirm that the healthcare provider deviated from accepted standards of care.
Compensation in Epidural Hematoma Lawsuits
Victims of epidural hematoma malpractice may recover:
Economic Damages
- Past and future medical expenses
- Rehabilitation and therapy costs
- Lost wages and earning capacity
- Home modifications and assistive devices
- Long-term care expenses
Non-Economic Damages
- Pain and suffering
- Emotional distress
- Loss of enjoyment of life
- Loss of consortium (for family members)
Settlement and Verdict Examples
| Case Type | Amount | Details |
|---|---|---|
| Delayed diagnosis – Death | $4.5 million | ER failed to order CT scan; patient died |
| Missed lucid interval | $3.2 million | Discharged during lucid interval; severe brain damage |
| Surgical delay | $2.8 million | 12-hour delay to surgery; permanent deficits |
| Misread CT scan | $5.1 million | Radiologist missed hematoma; catastrophic outcome |
Who Can Be Held Liable?
Multiple parties may be responsible in an epidural hematoma malpractice case:
- Emergency room physicians – For failure to diagnose or order appropriate testing
- Radiologists – For misreading CT scans
- Neurosurgeons – For surgical errors or delays
- Hospitals – For systemic failures, understaffing, or inadequate protocols
- Urgent care facilities – For failure to refer to emergency department
Steps to Take If You Suspect Malpractice
1. Obtain Medical Records
Request complete copies of all medical records, including CT scans, nursing notes, and physician documentation.
2. Document Everything
Keep detailed notes about symptoms, treatments, communications with providers, and how the injury has affected daily life.
3. Consult a Medical Expert
An independent medical review can help determine whether the standard of care was breached.
4. Contact an Attorney
An experienced brain injury attorney can evaluate your case and guide you through the legal process.
Why Time Is Critical in Epidural Hematoma Cases
Research published in the Journal of Neurosurgery demonstrates that outcomes in epidural hematoma cases are directly tied to the time between injury and surgical intervention:
- Surgery within 2 hours: Mortality rate approximately 5-10%
- Surgery between 2-4 hours: Mortality rate approximately 15-20%
- Surgery after 4 hours: Mortality rate can exceed 50%
These statistics underscore why delays in diagnosis and treatment can be so devastating—and why they often form the basis for medical malpractice claims.
Frequently Asked Questions
What is the survival rate for epidural hematoma?
With prompt diagnosis and surgical treatment, survival rates for epidural hematoma can exceed 90%. However, delays in treatment dramatically worsen outcomes. Patients who receive surgery within 2 hours of injury have the best prognosis, while delays beyond 4 hours are associated with mortality rates exceeding 50%.
How long do I have to file an epidural hematoma lawsuit in New York?
Under New York law (CPLR § 214-a), you generally have 2 years and 6 months from the date of the alleged malpractice to file a lawsuit. However, exceptions may apply for continuous treatment, minors, or patients with mental incapacity. Consulting an attorney promptly is essential to preserve your rights.
Can I sue if my family member died from an undiagnosed epidural hematoma?
Yes. New York allows wrongful death lawsuits when medical malpractice causes a patient’s death. The personal representative of the deceased’s estate can file a claim to recover damages including medical expenses, funeral costs, lost financial support, and loss of companionship.
What is the average settlement for an epidural hematoma malpractice case?
Settlement amounts vary widely based on factors including the severity of injury, extent of negligence, and economic losses. Cases involving death or severe permanent disability often settle for $1-5 million or more. An experienced attorney can evaluate your specific case to estimate potential compensation.
How do I prove the hospital was negligent in diagnosing my epidural hematoma?
Proving negligence requires demonstrating that the hospital or healthcare providers failed to meet the standard of care. This typically involves expert medical testimony, review of medical records, and evidence of what a competent provider would have done under similar circumstances. Common evidence includes delayed CT scans, misread imaging, or failure to monitor neurological status.
What is the “lucid interval” and why is it important in malpractice cases?
The lucid interval is a period after head trauma where a patient with an epidural hematoma appears to be stable or recovering, only to deteriorate rapidly as the hematoma expands. Healthcare providers are trained to recognize this pattern. Failure to maintain suspicion for epidural hematoma during the lucid interval—such as by prematurely discharging the patient—is a common basis for malpractice claims.
Do I need a medical expert to file an epidural hematoma lawsuit in New York?
Yes. New York requires a Certificate of Merit (CPLR § 3012-a) stating that a medical expert has reviewed the case and found reasonable basis for the malpractice claim. Additionally, expert testimony is typically necessary at trial to establish the standard of care and prove that it was breached.
Can I sue if the epidural hematoma was caused by a car accident?
If the epidural hematoma was caused by a car accident, you may have claims against the at-fault driver. However, if healthcare providers then failed to properly diagnose or treat the hematoma, you may also have a separate medical malpractice claim against those providers. An attorney can help identify all potentially liable parties.
What compensation can I receive for an epidural hematoma injury?
Compensation may include medical expenses (past and future), lost wages and earning capacity, rehabilitation costs, pain and suffering, emotional distress, and loss of enjoyment of life. In wrongful death cases, families may recover funeral expenses, lost financial support, and loss of companionship.
How long does an epidural hematoma lawsuit take in New York?
Medical malpractice cases in New York typically take 2-4 years to resolve, depending on complexity, whether the case settles or goes to trial, and court schedules. Some cases settle within months of filing, while others may take longer if liability is disputed or damages are substantial.
Connect With an Experienced NY Brain Injury Attorney
Epidural hematoma cases require attorneys who understand both the medical complexities and New York’s specific legal requirements. Our free service connects families with qualified medical malpractice attorneys who have experience handling brain injury cases.
There is no cost to use our service. The attorneys we work with handle cases on a contingency fee basis, meaning you pay nothing unless they recover compensation for you.
