The second-largest malpractice award in US history involved a PA who misdiagnosed cerebellar stroke as sinusitis in a man at a hospital ED in 2000. The 44-year-old mechanic entered the hospital with a headache, nausea, dizziness, confusion, and double vision. He had a history of hypertension, diabetes, and elevated cholesterol and had a family history of stroke. The PA ordered blood tests and CT scans, which were approved by the ED physician. Two CT scans came back negative for stroke, so the PA diagnosed sinusitis, prescribed a painkiller and an antibiotic, and discharged the patient. The next day, the man awoke with a severe headache, slurred speech, nausea, confusion, and trouble walking. A new CT scan showed that he had suffered a stroke. A shunt was inserted into his brain, but the damage was irreversible. The man was left a paraplegic. During an investigation, lawyers found out that the PA was unlicensed and had failed the state licensure test for PAs 4 times. The ED physician claimed that he assumed the PA was licensed and that he didn’t need to redo the history and examination on the man. In 2007, a jury awarded the man $217 million, including $100 million in punitive damages.