I recently had a call that I'm feeling pretty guilty about. My crew was dispatched to an elderly man who tripped while going for a walk. He was alert and oriented and had no loss of consciousness. There was a small hematoma on the side of his forehead, but he did not report any head pain, dizziness, or nausea. His vitals were absolutely normal. The pt expressed that he did not want to go to the hospital, so like I'd done with many simple fall victims before, I allowed my patient to refuse care. Only four hours later, my agency received a call for a stroke victim. It was my patient from that morning and he apparently lost consciousness after experiencing an excruciating head ache. The hospital said he had a brain bleed, most likely due to his fall that morning. I'm definitely feeling horrible about this. I think my assessment could've been much more thorough, and I can't stop thinking about how I could've done something different to prevent his poor outcome. Has anyone else had a refusal call go bad?