Child Birth Injuries — Cerebral Palsy and Avoidable Birth Injuries

It is still a chilling memory.

I still remember the moment my wife and I met with the maternal-fetal medicine specialist when my wife was pregnant with our second child.  She was in her second trimester and “we” were classified as a high risk pregnancy.  I remember my wonderful wife on the examination table and I remember her smiling while answering the doctor’s questions.  As we met with doctor, I could see through her smile what no one else in the room could see — fear and anxiety.

Would everything be okay with our precious baby?

Everything went well with our son’s birth and we are very thankful for the excellent medical care we received from skilled doctors and nurses.  The birth of our second child was a joyous occasion.  The miracle of life and the gift of parenthood is a humbling experience full of struggles and rewards.

Sadly, and far too often, babies suffer devastating injuries during labor and delivery.  Unfortunately, these injuries are often avoidable, but are caused by negligence by the medical providers.  There are several types of birth related injuries and there are many different causes.

Trained medical professionals must recognize the signs and symptoms of complications and the standard of care requires them to make the necessary adjustments in treatment or intervene to avert the baby from suffering an avoidable injury.   As a lawyer that has handled many medical negligence cases, two common birth related injuries are: (1) Cerebral palsy and (2) Erb’s palsy.

Cerebral palsy is a serious condition affecting your child’s brain and nervous systems.  Oxygen deprivation, or intrapartum asphyxia (during the labor and delivery process) or intrauterine asphyxia (before labor and delivery) can cause cerebral palsy.  A very common brain damage caused by oxygen loss is called hypoxic-ischemic encephalopathy or (HIE).  “Hypoxic” means a lack of oxygen.  “Ischemic” means a lack of blood flow. And “encephalopathy” means damage to the brain that alters brain function.

When HIE occurs, it often leads to severe developmental or cognitive delays and motor skill impairment that become more apparent as a child continues to develop and grow.  The effects can range in severity from mild, moderate, to crippling.  The impairment can include tremors seizures, developmental delays, motor skill impairment (difficulty crawling, walking, speaking) cognitive impairment (difficulty learning or making decisions that affect basic everyday life).  The risk factors and causes of HIE during the pregnancy, labor, and delivery are well known to medical providers.  Using ultrasound technology and fetal monitoring provide critical information about the wellbeing of the baby.  Unfortunately, when obstetricians, nurses, or mid-wives fail to recognize the signs of a developing problem and fail to begin or delay appropriate treatment, the baby can suffer an avoidable brain injury.  When this happens, the baby’s brain injury results from medical negligence.

An example of medical negligence resulting in a baby suffering brain damage include when doctors fail to recognize transfusion problems with the placenta or umbilical cord interrupting the maternal fetal exchange of oxygen to the baby.  Another example is when doctors or nurses misread fetal monitoring strips or fail to read and assess the fetal monitoring strips with the frequency necessary to properly evaluate the wellbeing of the baby.

A baby’s hart rate (fetal heart rate) inside the womb is the best way to evaluate his or her wellbeing.  During labor, a baby can experience distress.  The fetal heart rate monitor must be checked and evaluated.  When signs of fetal distress or a problem appears on the fetal heart rate monitor, such as fetal bradycardia (low fetal heart rate), or prolonged decelerations in the fetal heart rate, (a troublesome drop in the fetal heart rate from the average baseline), or the absence of fetal heart rate variability (healthy fluctuations in the baseline fetal heart rate) a doctor or nurse has a duty to determine what the appropriate response should be.  Often, these signs of fetal distress warrant immediate action and in some cases, an emergency Cesarean section are required to safely deliver the baby before a brain injury occurs.  When the doctor delays delivery, the baby can suffer oxygen deprivation.  When this happens, an otherwise healthy baby will suffer acidosis (increasing acidity of the blood) caused by the lack of oxygen, which can lead to asphyxia injury and HIE.

Erb’s Palsy also referred to as Shoulder Dystocia and Brachial Plexus Injury are injuries occurring to babies during delivery caused by the doctor, nurse, or mid-wife pulling, twisting, and stretching the baby’s arm, shoulder or head.  This trauma can cause the baby to suffer permanent irreversible injury.  These injuries can be minor, a fracture of the clavicle (collarbone), but often are far worse, including fracturing the spine, damaging the spinal cord, or causing a brachial plexus injury resulting in paralysis to an effected arm.

The birth canal is very narrow, so narrow that, women must push hard to deliver babies and often doctors must perform an episiotomy to cut part of the vaginal wall in order to safely delivery the baby without injury..  Newborn babies come in all sizes and babies can get stuck at the shoulders during birth when the baby’s shoulder gets stuck on the mother’s pelvic bone.  This is a common problem and all doctors and mid-wives are trained to handle it when it happens.  There are techniques used to free the baby from being stuck that will cause no harm to the baby when done correctly.  The McRoberts maneuver (pulling the mother’s legs towards her abdomen) and the Wood’s Corkscrew maneuver (rotating the baby’s shoulder) will free the baby and allow for a safe vaginal delivery.  In certain circumstances, a scheduled Caesarian section is warranted.

Examples of medical negligence occur when the medical providers wait too long to begin the manual techniques or maneuvers and the baby suffers a lack of oxygen.  Other examples of medical negligence occur when the delivery doctor does the manual techniques or maneuvers incorrectly by pulling or pulling on the baby’s head or otherwise applying force to the neck.  This can cause severe injury to the baby’s brachial plexus, which is a bundle of nerves that control the muscles from neck, through the shoulder and down through the forearm, wrist, hand, and fingers.  When an injury occurs to the brachial plexus, a baby can suffer loss of function in the affected arm, paralysis, and altered positioning of the rotator cuff and shoulder blades caused by atrophy.  This can and more often is a lifelong impairment.

If you or a loved one has concerns about a potential medical negligence case involving a birth related injury, please contact the attorneys at Searcy Denney.  We have handled many cases and we would be honored to answer questions you may have.