Birth Injuries: Extending Beyond Cerebral Palsy
Legally Reviewed and Edited by: Terry Cochran
The birth of our children may be the most magical moment in our lives. Nine months of waiting and planning finally coming to culmination in labor and delivery. But, sadly, things do not always go smoothly. If mistakes have been made in prenatal care, or even during the delivery, then there is a risk of birth injuries occurring.
While some of those injuries may be relatively minor, many others can have lifelong repercussions and the child will need ongoing medical and personal care.
What are the main types of birth injury and what are your rights when an injury is due to medical malpractice?
Most birth injuries are caused by some form of medical malpractice. The statistics as to type of injuries and cases can vary greatly but some general ones includes:
- Approximately 7 in every 1,000 births will suffer a birth injury. That equates to around 28,000 birth injuries per year or 76 every day.
- Most birth injuries occur in mothers between the ages of 25 and 34 where instruments such as forceps were used.
- Mothers who deliver their baby without the use of any birthing tools have around 30% fewer birth injuries.
- Birth injury rates are lower in Hispanic and black mothers
- Birth injury rates in rural areas can be as much as 33% higher than in urban areas.
Main Types of Birth Injury
Many minor conditions or injuries will only need limited treatment. But others can be far more serious. The most common types of birth injuries are:
- Brain Damage. Brain injuries in newborns are almost always related to a medical error. Mistakes may occur in the prenatal stage (failing to notice a potential issue, misdiagnosing an issue, or some form of medication error) or during delivery. Delivery mistakes can include over physicality during the delivery process, a delay in performing a caesarean section when needed, or failing to notice when a fetus is in distress. A very common cause of birth trauma leading to brain damage is a lack of oxygen.
- Hypoxia or Hypoxic Ischemic Encephalopathy. HIE is another condition caused by oxygen deprivation to the baby’s brain. The hypoxia causes brain cells to die and brain damage is permanent. HIE can also lead to cerebral palsy. There can be various causes for HIE, including; baby left in the birth canal for too long, failure to monitor the baby’s heartbeat and other vital signs, failing to spot that the baby’s umbilical cord has become wrapped around the baby’s throat, breech birth, and low blood pressure.
- Cerebral Palsy. Cerebral palsy is not an all encompassing term. There are three different types of CP:
- i. Spastic cerebral palsy. The most common type and around 80% of all CP diagnoses are this type. Sufferers have restricted mobility and difficulty moving. They also find it difficult to hold any objects.
- ii. Athetoid cerebral palsy. Speech is often slurred, they may have difficulty swallowing food or drink, involuntary jerky movements, and may be unable to maintain posture.
- iii. Sufferers of Ataxic cerebral palsy may experience tremors, have problems with balance and depth perception, and may also have issues with coordinating muscle movement.
- Brachial Plexus injuries. These are injuries that usually occur during delivery and affect the upper part of the arm. It may lead to symptoms such as weakness in the arm and losing the ability to use certain muscles. In some cases, the effects may extend to the shoulder and hand.
- Erb’s Palsy. Erb’s Palsy is a specific type of brachial plexus injury where the nerves of the upper arm are affected. In mild cases, infants may lose feeling in the area and the arm will be weak. In severe cases, they may experience complete paralysis of the arm.
- Klumpke’s Palsy. This is another type of brachial plexus injury. With this type, the damage is nerve injuries in the lower arm and can affect the arm, wrist, and fingers. It is usual for a child with this form to have total paralysis in the area and the hand contracts into a claw shape.
- Shoulder Dystocia occurs during labor and delivery when the baby’s head and shoulders get caught behind the mother’s pelvic bone. This can happen in around 1% of pregnancies and in some cases, the effects can be severe. The risks to the mother include hemorrhaging and uterine rupture. The risks to the baby include cerebral palsy, breathing problems, fractured bones (most often the collarbone), brachial plexus injuries, and in severe cases, death.
- Spinal cord injury and paralysis. While infant spinal cord injuries are 5% of all spinal injuries in the U.S., the effects of such a devastating injury to a baby can result in lifelong medical needs. These injuries usually result from blunt force trauma to the baby’s spine during labor and delivery but can also result from the failure to diagnose a condition such as spina bifida. Some 60-75% of all infant spinal cord injuries happen in the neck area, around 20% in the upper back or chest area, and 5 to 20% in the lower back. Symptoms of spinal cord birth injury can vary greatly from recoverable to lifelong. This type of injury can cause paralysis, impaired motor skills, intellectual disabilities, or death, but most cases will need ongoing medical care.
- Infant Torticollis is an injury caused by trauma to the muscles in the neck area. It can be caused during labor and delivery by the doctor – or midwife – being over physica, because of forceps use, breech birth, or by spinal misalignment in utero. It may lead to the head always leaning in one direction, head tremors, pains, stiffness or muscle swelling in the neck, one shoulder being higher than the other, and the infant’s chin pointing upwards.
- Ptosis. This condition is also known as Horner’s Syndrome and may be caused by birth trauma events such as forceps use, over physicality during delivery, shoulder dystocia, failing to deal with fetal distress promptly, delays in performing a C-section, or failing to notice a breech baby. It can lead to mitosis in one eye. The affected eye appears sunken and the eyelid drooping, bloodshot eye, and different colored irises.
What Happens Next?
Not only are birth injury cases extremely upsetting, they are also very difficult cases to pursue. When the experienced birth injury attorneys at our law firm are pursuing a birth injury claim, there are several facts they need to prove:
- The defendant owed a duty of care to the plaintiff.
- The defendant in some way breached that duty of care.
- The infant suffered injuries.
- The actual and proximate cause of those injuries was the breach of the duty of care.
In most cases, the plaintiff’s case revolves around the testimony of an expert witness. Our attorneys review the infants, and mothers’ medical records, give their opinion on severity of the injuries and the long-term prognosis, what medical and other care needs the infant will have in the short- or long-term, and state whether the defendant acted in a way that was inconsistent with their duties and that another medical professional would have acted differently.
Who is Liable?
Liability in a birth injury case depends on what factors are identified as being the cause of the injury or injuries. Where it is identified that the injuries were caused during the delivery process, then primary liability will lie with the attending doctor (and in some cases, the hospital).
Where there were errors in medication, either during pregnancy or during labor, then liability may lie with the pharmacist or even the drug manufacturer.
Cochran, Kroll & Associates, P.C. are one of Michigan’s leading law firms in the area of medical malpractice. Senior partner, Eileen Kroll is also a Registered Nurse so you can rest assured your case will be handled with compassion and a thorough knowledge of the medical and legal field. Eileen works tirelessly to maximise the outcome of each case, and recently negotiated a $3.8 million settlement for a brain injured child. She is also a member of the Birth Trauma Litigation Group of the American Association for Justice and advocates on their behalf to Congress.
Our law firm offers a no-obligation case evaluation. We operate on a contingency basis, so we never charge you a fee unless we win your case. You can call us at 866-MICH-LAW to schedule your free appointment or complete our online contact form.
Disclaimer : The information provided is general and not for legal advice. The blogs are not intended to provide legal counsel and no attorney-client relationship is created nor intended.