Philadelphia Birth Injury Lawyer
Medical Malpractice is a frequent cause of traumatic injuries during birth. At Rosenbaum & Associates our team of injury lawyers and expert medical consultants pride themselves on helping families uncover whether medical errors were responsible for their devastating injuries. Improper prenatal care and negligent medical professionals can cause error during the delivery process leading to birth injuries such as cerebral palsy, erb’s palsy and many others. If a doctor or nurse fails recognize fetal distress or responds too slowly, your child could suffer a life long and irreversible disabilities. Our Philadelphia birth injury attorneys have experience in handling and understanding these complex medical issues.
Common delivery errors by medical professionals include:
- Failure to monitor fetal strips
- Misread fetal strips
- Improper use of forceps or vacuum
- Failure to perform caesarean section
Was There Medical Malpractice?
Certainly there are instance where child’s condition is the result of genetics, such as a chromosomal disorder, however far to often these life altering conditions are the result of malpractice. For example, significant injuries can occur when the doctor or nurse fails to read (or inaccurately reads) the fetal monitory strips. If the strips indicate fetal distress then the doctor must act immediately, otherwise the fetus could be deprived of its vital oxygen supply. As result this delay the baby can sustain brain damage that could have been avoided. In other cases, the misuse of forceps or vacuum during delivery can cause traumatic brain injury. The newborns skull is still very soft, there if too much pressure is applied there can be a direct trauma to the brain.
The most common injuries resulting from an error during the delivery process are cerebral palsy, erb’s Palsy, and Brachial Plexus Palsy. While physical therapy or speech therapy can help improve a child’s development, the impact of cerebral palsy and other birth injuries are typically permanent.
How Does Birth Injury Occur?
The brain is the primary center for regulating and coordinating all body activities. Essential to the regulation and coordination of these body activities is the transmission to the brain of oxygen obtained through air inhaled and exhaled during the act of respiration. Traumatic birth injuries is a broad description which is used to describe both avoidable and unavoidable mechanical and anoxic trauma to the brain of an infant during labor and delivery.
- Anoxic trauma involves a situation in which there is diminished oxygen in the arterial blood supply despite the infant’s otherwise-normal ability to carry oxygen. The diminished oxygen in the blood supply may be due to a reduced oxygen supply, respiratory obstruction, or inadequate respiratory movements. This can result in serious conditions, including cerebral palsy.
- Mechanical trauma involves some physical act to the body, usually the skull of the infant, which prevents the needed transmission of oxygen to the brain of the infant.
Types of Birth Injuries
Cerebral Palsy, or CP, is a medical term used to describe a group of disorders affecting body movement and muscle co-ordination. Cerebral Palsy is caused by damage to the brain during pregnancy, delivery or childhood. This damage interferes with messages from the brain to the body, and from the body to the brain with effects ranging from slight awkwardness of movement or hand control to virtually no muscle control greatly affecting movement and speech.
The location of the brain injury influences the effects of the disorder, which can include:
- Mental Retardation
- Impairment of Speech, Hearing or Sight
- Abnormal Perception and Sensation
- Problems in Gait and Mobility
- Involuntary Movement
- Muscle Spasm or Tightness
How Cerebral Palsy Occur
Any damage to the developing brain, whether caused by genetic or developmental disorders, injury or disease, may produce cerebral palsy. Often medical malpractice plays an unfortunate role in the injury of a fetus during pregnancy of an infant during delivery. The failed diagnosis of complications during pregnancy resulting in the harm to a baby is one example of medical malpractice. Another common example of malpractice is a labor which is allowed to last too long that often results in brain damage as poor oxygen supply destroys brain tissue. Additional examples of malpractice are side effects of anesthetics and analgesics can negatively impact an infant causing brain injuries.
Types of Cerebral Palsy
There are four types of Cerebral Palsy:
- Spastic Cerebral Palsy
- Athetoid or Dyskinetic Cerebral Palsy
- Ataxic Cerebral Palsy
- Mixed Cerebral Palsy – which combines the three types of Cerebral Palsy
Spastic Cerebral Palsy. With Spastic Cerebral Palsy, the muscles are very stiff, and permanently contracted. Doctors can tell which type of Spastic CP a person has by which limbs are affected. The term PLEGIA, which means paralyzed, or weak, is tacked on the end of each form of Spastic CP. Examples are HemiPLEGIA (one side of the body is affected) and QuadriPLEGIA (all 4 limbs affected). In some people BOTH legs can be affected. They can turn in and cross at the knees. This is called scissoring, and can interfere with their walking ability. Some with Spastic CP may experience hemiparetic tremors. Hemiparetic tremors are uncontrollable shaking, affecting the limbs on only one side of a person’s body. Sometimes the tremors are severe, and can affect movement.
Athetoid or Dyskinetic Cerebral Palsy. People with Athetoid Cerebral Palsy will have uncontrolled, slow, writhing movements. These movements will often affect the hands, feet, arms, or legs. Sometimes the muscles in a persons face or tongue will be affected, causing drooling. These movements a person with Athetoid CP has, will often increase during stressful times, and will most likely disappear while sleeping. Also, people with this particular type of CP may have problems coordinating muscle movements that are needed for speech. This is called dysarthria.
Ataxic Cerebral Palsy. This type of CP is very rare, and affects balance and coordination. A person with Ataxic CP may walk unsteady and have a wide step. They could place their feet far apart, and may have difficulty with quick or exact movements, like buttoning a shirt, or writing. Also, they could have “intention tremors.” This type of tremor will start with a voluntary movement, for example, reaching a book. This may cause trembling in the body part that is being used. The tremor will get worse as the person gets near that object?in this case, the book.
Mixed Type Cerebral Palsy. A combination of the types of cerebral palsy detailed above. The most common type of mixed types is a mix of Spastic CP and Athetoid CP. But, however, other combinations are very much possible.
Brachial Plexus Palsy
The brachial plexus is a group of nerves that run from the shoulder to the spine. These control muscle movement in the hands, arms and shoulder. Sometimes when a doctor is negligent by not providing proper obstetrical care, damage to the nerves can result. These injuries usually occur during the natural delivery of a larger infant. When the baby is too large to pass through the mother’s pelvis, his or her shoulder may become lodged behind the mother’s pubic bone after the head has been delivered. Many times the doctors attempt to continue with a natural delivery, as opposed to a C-section and can stretch the neck excessively causing nerve damage.
There Are Three Types of Brachial Plexus Injuries
- Stretch – which vary in degrees of intensity, however nerves in plexus are often compressed due to swelling or bruising from birth trauma of shoulder getting caught on the pelvic bone. Stretch injuries will spontaneously recover in 1-2 years of age with 90-100% return of function. neuroma which is scar tissue that compresses the nerves may occur also and surgical intervention is needed to remove it.
- Rupture – nerves are torn at either one or several places in the plexus requiring surgery for the nerves to recover.
- Avulsion (most severe injury) – nerves are pulled from the spinal cord as evidenced by a totally flaccid extremity, which requires surgery and possibly muscle transfer to gain function. Horner’s syndrome may be present if this is involved.
Erb’s Palsy and Klumpke’s Palsy
This is an injury to the nerves in infants. Erb’s refers to damage to the upper plexus ( C5 to C7) , Klumpke’s Palsy is damage to the lower plexus (C8 to T1). Both conditions result in weakness or paralysis generally caused by stretching of the nerves delivery.
Doctors can be negligent when they don’t properly identify a large baby and perform a C-section, or use inappropriate delivery techniques once they encounter shoulder dystocia.
Children with Erb’s Palsy have lack of movement in the arm and shoulder, while children with Klumpke’s Palsy have diminished movement in the wrist and hand. Doctors should be able to identify the potential for a large baby by the following factors:
- Gestational diabetes – which generally is associated with larger babies. A doctor should always prenatally timely screen and treat for this condition.
- Excessive weight gain during pregnancy – The chance of a large baby is greatly increased if there is excessive weight gain, especially for mothers over 30 years old.
- Obesity – An obese mother has a greater risk of giving birth to a large infant.
- Maternal history – If a mother has previously delivered a large infant, there is a greater chance that the next infant will also be very large.
- The fundal height or McDonald measurement – These measurements recorded during pre-natal visits to her doctor is an external measurement from the top of the pubis to the top of the uterus. If these measurements are too large the physician should be able to determine if there is a large baby.
Doctors should recognize the above indicators of a probable large baby and confirm his suspicion through the use of ultrasound. Accordingly, the doctor may be liable if he doesn’t use the correct delivery technique, including the McRoberts maneuver, Wood’s corkscrew maneuver, as well as suprapubic pressure. A cesarean section should also be done where appropriate.
Proving Negligence in Philadelphia
By reviewing the prenatal and delivery records we can often establish the doctors were negligent in preventing cerebral palsy and brain damage. We typically, review lab results and fetal monitoring strips with the assistance of our expert medical consultants. If a child suffers a period of oxygen deprivation, this can result in fetal distress which, if a doctor doesn’t act quickly, may lead to permanent damage or death.
Trained staff must be available to activate the fetal heart monitor, inspect and analyze the strip continuously and intervene where fetal distress is observed. Cardiac arrhythmia (irregular heartbeat), bradycardia (slow heartbeat), and tachycardia (rapid heartbeat) are all signs of fetal distress.
Meconium or the fetal feces, can also cause fetal distress. A lawyer must determine if there is resulting fetal hypoxia which is insufficient oxygen to the tissues. A doctor must always determine if there is an abnormal blood pH. There is a decrease in the blood pH, or acidosis, when there is a buildup of acid level in the blood due to the fetus not receiving enough oxygen. There is a long history of linking oxygen deprivation and the pH reading to babies born with brain damage. Too low a pH level will establish fetal distress and in many cases an immediate C-section should follow.
Contact our Experienced Philadelphia Birth InjuryAttorney
By carefully evaluating and studying all medical records, an injury lawyer can determine if there was a deviation from the standard of care by the doctors or medical staff resulting in unnecessary injury and brain damage to a child. Our Philadelphia medical malpractice lawyers are dedicated to helping injury victims make a full monetary recovery to ease the financial stress that is often associated with significant personal injury. For questions regarding your legal injury case or for a free case evaluation please call our Philadelphia office at 1-800-7-LEGAL-7, or click here.