Group B Strep and other Maternal Infections
Labor And Delivery Complications And Newborns
Adverse outcomes for the newborn baby may sometimes result from maternal infection, such as intrauterine, cervical, vaginal, or in rare cases, non-pelvic infections. Maternal infections may be associated with many of the very early preterm (premature) births, and could be the underlying cause of birth injuries that result long-term neurologic or brain damage including cerebral palsy.
Protecting against maternal infections spreading to the child is critical to the child’s well-being. Alert and appropriate steps taken by the medical providers can prevent the infection transmission from the mother to the baby during pregnancy and labor and prevent devastating birth injuries.
How is a Maternal Infection Transmitted from the Mother to the Baby?
Maternal infections can lead to adverse pregnancy outcomes either due to a direct transmission of the infection to the fetus or a newborn, or due to indirect transmission that does not involve the fetus. When the infections directly infect the fetus, the transmission may take place intrauterine (within the uterus) or through transplacental infection (the placenta becomes the passage for the organism to travel to the baby.)
Direct transmission may also occur in the intrapartum period (during labor and delivery) with infected maternal blood or genital secretions. Postpartum transmission (after childbirth) may occur indirectly via breastfeeding or some other form of maternal contact.
Group B Strep
The most common and preventable infections transmitted by mothers to their babies is Group B strep. Babies that suffer from Group B strep and are not aggressively treated are at high risk for birth injury including brain damage and cerebral palsy.
Group B strep (Group B Streptococcus or GBS) is a very common bacterial infection occurring in the genitourinary (genital and urinary) or gastrointestinal (digestive) tract. About one in four pregnant women will have GBS. The vast majority of these women will have NO symptoms at all.
Genitourinary Tract: beginning at the kidneys, a retroperitoneal organ located at T12-L3 whose primary function is to filter blood and secrete waste products as urine.
Gastrointestinal Tract: also called digestive tract or alimentary canal, pathway by which food enters the body and solid wastes are expelled. The gastrointestinal tract includes the mouth, pharynx, esophagus, stomach, small intestine, large intestine, and anus.
In the US, GBS is recognized as the most common maternal infection causing invasive GBS (iGBS) disease in babies. Neonatal iGBS diseases include sepsis (blood infection) and meningitis (inflammation of the brain and spinal cord tissue).
Adverse outcomes of iGBS in babies include preterm birth, stillbirth, and neurodevelopmental impairment (NDI), such as, hearing, vision or cognitive impairment, or cerebral palsy.
How does Group B Strep Infect the Baby?
A pregnant woman infected with GBS can transmit the infection to her baby during vaginal delivery. The primary route of GBS in babies is vertical transmission during passage from the vagina during labor & delivery. The onset of GBS in babies may occur as follows:
- Early Onset iGBS (EOGBS) infection: In about 75% of all babies with GBS, the infection may present itself as EOGBS, which occurs in 0 to 6 days after birth. Colonization of the group B strep bacteria in the maternal genitourinary track is linked with EOGBS.
- Late Onset iGBS (LOGBS) infection: This infection is less commonly seen in babies, but it may present itself within 7 to 89 days after birth. These babies are at a risk of developing neurodevelopmental impairments (NDI) or cerebral palsy.
Risk Factors to Consider
The CDC recommends screening for all pregnant women for group B strep during the 35th to 37th week of pregnancy. This means this is the “standard of care” for obstetricians, MFM physicians and midwives caring for expectant mothers.
GBS testing involves obtaining a swab of the vaginal and rectal areas, which is then sent to a laboratory for analysis. The major risk factor for early onset iGBS (EOGBS) is colonization of the group B streptococcus bacteria in the maternal genitourinary tract during labor.
If the GBS culture test shows positive GBS at any stage of the pregnancy, the medical team should consider it a marker of heavy bacterial colonization. This means the baby is at high risk for contracting the Group B strep infection if appropriate steps are not taken.
Medical providers should also consider additional risk factors for early onset GBS, such as:
- Young maternal age
- Preterm labor (under 37 weeks)
- Maternal fever above 100.4 F during labor
- Premature rupture of membranes (PROM)
- History of a previous child with invasive EOGBS infection
- Hispanic or African-American descent
According to researchers, in absence of preventative action, early onset iGBS may infect about 2% of the babies born to mothers with GBS.
Diagnosis during pregnancy
A pregnant woman with GBS is usually asymptomatic, which makes it critical to test all expectant mothers for GBS in the third trimester. Swab samples tested in a lab to determine if the expectant mother is GBS “positive”. It can take two to three days to obtain the results because the GBS bacteria from the samples need time to grow (culture).
In a few cases, group B strep bacteria can cause urinary tract infections (UTIs), which can be diagnosed by testing a sample of urine.
Symptoms in a Pregnant Woman (in a few cases symptoms may appear but remember most women have NO signs or symptoms):
- Frequent urination or urge to urinate
- Pain during urination
- Vomiting and nausea
- Fever
- Pain in the back or side
- Soreness in the belly
- Increased heart rate
Preventative Clinical Measures
While a universal GBS culture-based screening between weeks 36 and 37 of gestation is the standard of care, another marker of GBS infection in the genital tract is GBS bacteriuria (infection of the amniotic fluid, placenta, or membranes.) All pregnant women should undergo screening for asymptomatic bacteriuria. When GBS bacteriuria is detected at any stage of the pregnancy, the woman should be administered preventative antibiotic treatment.
The principal clinical defense against the risk of early onset of iGBS infection is timely administration of prophylaxis (preventative) antibiotics to the pregnant woman during labor and delivery. As part of routine prenatal care, medical providers should identify patients that are more likely to benefit from administration of intrapartum (during the birthing process) antibiotics.
Antibiotics are usually administered intravenously (through the vein). One of the most commonly prescribed antibiotics is beta-lactams, which contains penicillin and ampicillin. If the woman has an allergy to these antibiotics, the obstetrician or maternal fetal medicine specialist may prescribe other antibiotics. Preventative antibiotics are the most critical measure to avoid the transmission of the GBS infection to the baby.
About 10% of the women will experience mild side effects after taking penicillin. Severe allergic reactions are rare (about 1 in 10,000 women), which makes the antibiotics treatment very safe.
During pregnancy and labor, the efforts to prevent GBS infection from being transmitted to the baby should be a coordinated inter-professional team effort. The team that is caring for the pregnant woman should diligently screen her for GBS. The medical team may include physicians like obstetricians or maternal fetal medicine specialists, physician assistants, nurse practitioners, nurses, and/or midwives.
Even if there is no positive GBS culture, preventative antibiotic treatment should be provided to women that:
- That are delivering their baby prior to the 37th week of their pregnancy and either have a low grade temperature or have not delivered for more than 18 hours after the rupture of their membranes
- Have delivered a previous baby with a GBS infection.
Diagnosis of Group B Strep after birth
Babies with early onset invasive GBS may reveal some or all of the following signs and symptoms:
During the first 24 hours after birth:
- Lethargic, sleepy, fussy, and having breathing difficulties (signs of sepsis)
- Breathing difficulties with long periods without breathing (signs of meningitis)
- Rapid breathing with grunting sounds (signs of pneumonia)
- Fluctuations in blood pressure levels
- Experiencing seizures (convulsions)
During the first week after birth:
- Reduced movement in a leg or arm
- Painful movement in a leg or arm
- Fever
- Breathing difficulties
- Redness in a part of the face or other body parts
If GBS is suspected in a baby after birth, the medical provider should obtain a sample of the baby’s blood and test it in a lab. If the baby shows signs of sickness, additional tests may be performed, such as urine culture and chest x-ray.
Management of Neonatal GBS Infection
Once the baby is suspected to have a group B strep infection they must given immediate supportive care and urgent antibiotic administration. The treatment must be done initially within the age-appropriate critical care setting. The gold standard is that the time lag between the decision to treat the baby and the actual administration of antibiotics should be no longer than one hour. This must occur even if the culture results have not come back from the lab to prevent serious complications.
In critical care settings for babies, this period is often considered as the “golden hour” for administering antibiotics, and is rightly seen as a key performance indicator. In case of early onset sepsis, amoxycillin/ampicillin (with a broader spectrum than penicillin) is generally prescribed.
If the baby is diagnosed with meningitis, cefotaxime or another cephalosporin drug is generally recommended because of its more optimal tissue penetration.
Other Types of Maternal Infections
- Chorioamnionitis
Intra-amniotic Infection (IAI) or chorioamnionitis is an obstetric infection that occurs in the amniotic fluid and fetal membranes. The bacteria that are known to cause this infection are It is more commonly found in preterm babies and may increase their risk of cerebral palsy. - Bacterial Vaginosis (BV)
About 25% of all pregnant women contract bacterial vaginosis, making it one of the predominant maternal infections leading to adverse pregnancy outcomes. This infection is caused by a bacterium called Gardenerella vaginalis. Marked by vaginal irritation, a “fishy” odor, and abnormal vaginal discharge, BV may contribute to miscarriage, premature membrane rupture, or cerebral palsy due to other complications. - Herpes Simplex Virus
Among all the sexually transmitted infections, herpes simplex virus is the most common one to affect pregnant women. Mother to baby transmission of this infection can cause serious complications in the baby, including birth injury and cerebral palsy. Medical providers can significantly reduce the risk of infection transmission to the baby with timely diagnosis, proper management with medications and/or caesarian section delivery. - Urinary Tract Infection (UTI)
Pregnant women often encounter urinary tract infections. One of the serious medical conditions that may occur because of inadequate treatment of UTI during pregnancy is pyelonephritis. This kidney infection is a major cause of preterm labor and may increase the risk of birth complications including cerebral palsy or hypoxic-ischemic encephalopathy. The medical team should be able to distinguish between normal and abnormal findings for UTI and kidney infections and treat the infection appropriately.
Diagnosis of Maternal Infections
A close evaluation of a pregnant woman’s medical history and a detailed physical examination using relevant diagnostic and lab work studies can help medical providers diagnose a maternal infection. When a pregnant woman presents with an infection, the medical team must consider the full spectrum of diseases. Even seemingly vague symptoms, such as upper respiratory discomfort should alert the doctors to the possibility of an infection.
Sometimes the pregnant woman may attribute a potentially severe infection to the normal course of pregnancy, but the doctors and nurses should investigate the signs and symptoms regardless of how common they seem until they rule out infection.
Appropriate lab studies may be required because the history and clinical signs alone may not suffice for an accurate diagnosis. For a differential or confirmatory diagnosis, many of the infection causing pathogens can be cultured under proper conditions from suitable blood specimens.
Serologic tests (blood tests to identify an increase in antibodies against a particular microorganism) can be an effective way to retrospectively confirm a maternal infection diagnosis.
Maternal infections, such as trichomoniasis (a sexually transmitted infection caused by a parasite), human papillomavirus (HPV) infection, candidiasis (fungal infection caused by yeast), herpes genitalis (caused by herpes simplex virus) and bacterial vaginosis may be indicated or diagnosed by cervical-smear cytology (pap smear test).
Bacterial infection diagnosis in the newborn should involve a culture test of the material from the gastric aspirate (residuals from the stomach) or from the external auditory canal (tube connecting the outer and inner ears). The newborn must be carefully observed for signs of sepsis (life threatening complication of an infection) when the history of maternal infection has been established. Serologic studies of the umbilical cord blood may reveal the baby was infected in the uterus, and intensive surveillance for sepsis must be applied.
Intra-uterine Growth Retardation
Growth retardation in babies is defined as a birth weight lower than the 10th percentile birth weight for the gestational age. This means the baby is smaller than at least 90% of the babies of the same gestational age. Apart from many other possible causes, fetal growth retardation may also occur because of intrauterine infection. Almost any type of viral or bacterial maternal infection could be associated with fetal growth retardation.
Maternal infections caused by CMV, T. gondii, varicella zoster virus (VZV), Treponema, and herpes simplex virus (HSV) are associated with intra-uterine growth retardation (IUGR), which eventually results in babies who are small for gestational age (SGA).
Maternal Covid-19 Infection and Risks to the Baby
According to the CDC, pregnant women diagnosed with Covid-19 are at an increased risk of complications that could adversely affect the pregnancy and the developing baby. Some researchers have stated there is scientific evidence to indicate that if a pregnant woman is infected with Covid-19, then SARS-CoV-2 (the virus which causes Covid-19 illness) may cross the placental and blood brain barriers to enter the placenta and the central nervous system of the baby.
Researchers say that although much remains unknown about Covid-19 that perhaps can came from a Chinese lab, if a woman is infected with SARS-CoV-2 during early pregnancy, there is an increased risk of congenital birth defects developing in the baby. The researchers call for an urgent need to collect more data on the pregnancy outcomes in women infected with Covid-19 in their first trimester or early second trimester to better understand the potential relationship between Covid-19 and birth defects.
Is Your Child’s Maternal Infection Related Complication the Result of Medical Malpractice?
Parents whose children suffer from maternal infection related complications deserve answers as to how their child developed this condition and whether the complications resulting from it were preventable. Were there signs during the pregnancy, labor, and delivery process that an infection or its related complication was occurring, but appropriate antibiotic treatment or an emergency c-section was either delayed or not performed at all? Did the doctors and nurses fail to quickly start antibiotic treatment for you prior to your pregnancy when signs of group B strep were present or after the diagnosis was suspected in your baby?
Our dedicated birth injury lawyers want to help you find those answers and obtain that coveted financial reward necessary to provide care and therapy that can help improve the quality of your child’s life. Winning a lawsuit in this way can improve the quality of your life for a number of reasons.
If your child has been diagnosed with a maternal infection related birth injury (including Hypoxic-Ischemic Encephalopathy (HIE) or cerebral palsy), and you suspect this may have been caused in part by medical mistakes, Miller Weisbrod Olesky will thoroughly investigate the facts and hold responsible medical providers accountable by pursuing medical malpractice claims against them. The compensation our clients receive helps them pay for their child’s current and future medical treatment, therapy and devices to help the child adjust to living with a permanent disability.
Sometimes families are hesitant to reach out to a medical malpractice attorney or law firm. Other parents feel overwhelmed by their circumstances and worried that they will not be able to help out in a lawsuit involving their child’s birth injury.
Registered Nurses and Nurse-Attorneys Are a Vital Part of Our Birth Injury Team … and Yours
Most national birth injury law firms will employ one or two nurses to assist the review of cases and medical research. But Miller Weisbrod Olesky offers an unmatched number of nurses and nurse-attorney employees support to both the birth injury attorneys and our clients.
Our team of registered nursing staff and nurse-attorneys bring a deep level of medical and personal insight to every client’s case. Our nursing team includes both an experienced labor and delivery nurse as well as an ICU nurse. Working closely with the rest of the team, they investigate the reasons behind a birth injury and how medical professionals breached their standard of care.
Meet our Legal Nursing Team
Linda Chalk
As a registered nurse, Linda practiced ICU nursing for 44 years while caring for a wide range of patient conditions. She has worked closely with founding partner Les Weisbrod for over 30 years, investigating and pursuing birth injury cases.
Along with DJ Weisbrod, Linda heads up the firm’s birth injury intake, screening, and medical literature research team. She personally screens all potential cases to ensure that medical issues have been addressed before we file lawsuits on behalf of birth-injured children and their families.
DJ Weisbrod
Before joining Miller Weisbrod, DJ practiced as a surgical nurse in various hospital and operative settings. She has been with the firm over 30 years.
DJ directs Miller Weisbrod’s birth injury intake and medical screening team. She has also served as firm founder Les Weisbrod’s trial nurse for all cases involving medical negligence and birth injury.
Linda Cuaderes
Linda Cuaderes is both a registered nurse and a licensed lawyer. Linda works exclusively in Miller Weisbrod’s Birth Injury and Medical Malpractice section. Linda acts as the firm’s patient advocate and liaison with our young clients and their parents.
Linda combines her legal and nursing experience along with her exceptional organizational talent and attention to detail to make sure each child we represent is provided the highest level of medical care and attendant care during the pendency of their case. Linda communicates with our parent clients regularly to monitor their birth injured child’s treatment, provide guidance as to additional care and therapies and when necessary assist them in obtaining specialized medical providers.
Linda was raised in Bartlesville, Oklahoma and completed her Bachelor of Science in Nursing with Honors at the University of Oklahoma. She started as an Oncology Nurse at Presbyterian Hospital in Oklahoma City, quickly becoming the Assistant Head Nurse of the Outpatient Endoscopy Unit. Linda then entered the University of Oklahoma College of Law.
Following graduation, Linda joined Les Weisbrod in the Medical Malpractice Section. After taking time off to raise her three lovely children, Linda returned to Miller Weisbrod and her passion of holding healthcare providers accountable for preventable errors. Linda is active in the American Association for Justice, Texas Trial Lawyers Association, Dallas Trial Lawyers Association, and the Texas Bar Association. Linda is an active member of the Birth Trauma Litigation Group and Medical Negligence Section of the American Association for Justice.
She is admitted to practice before the Texas Supreme Court and routinely works on cases pending throughout the United States. Linda has worked with child victims of birth injury, their parents and other victims of medical malpractice in Texas, New Mexico, Oklahoma, Arkansas, Louisiana, Iowa, Ohio, New York, Alabama, Georgia, Arizona, Utah and Missouri.
Education
- University of Oklahoma - School of Law, 1990, J.D. - Norman, Oklahoma
- University of Oklahoma - School of Nursing, 1985 - Norman, Oklahoma
Areas of Practice
- Birth Injury/Birth Trauma
- Medical Malpractice
Associations & Memberships
- Texas Bar Association
- American Association of Justice
- Texas Trial Lawyers Association
- Dallas Trial Lawyers Association
Kristin Jones
Kristin combines her medical and legal training to provide invaluable, passionate service to parents struggling to care for their birth-injured children.
Families often have questions as they go through the birth injury lawsuit process. Kristin diligently identifies and investigates all medical issues so the birth injury attorneys at Miller Weisbrod can answer those questions Kristin ensures that our birth injured children’s medical records are thoroughly reviewed and organized. Miller Weisbrod’s birth trauma litigation attorneys and medical experts retained by the firm need her services while pursuing justice for our clients.
Kelly Kunkel
Kelly Kunkel was born and raised in Dallas, Texas. She has 15 years’ experience in hospital based High Risk Obstetrics and Labor and Delivery bedside nursing care. Kelly graduated with an Associate’s Degree in Nursing from El Centro College in December of 1990 and received her Bachelor’s Degree in Nursing from West Texas A & M University in 2008; graduating with honors.
In addition, Kelly has over 25 years’ experience in medical malpractice case management and litigation and has worked with David Olesky for over 22 years. After many years of assisting in defending healthcare providers and hospital systems in medical malpractice cases involving complex litigation matters related to birth injury, catastrophic injury and death, Kelly has proudly joined David Olesky in the national birth injury and medical negligence practice at Miller Weisbrod Olesky.
Talk with the Knowledgeable Attorneys at Miller Weisbrod Olesky
The only way to find out if you have a birth injury case is to talk to an attorney who understands birth injuries leading to a delay or failure in developmental milestones including birth injuries that cause cerebral palsy. It’s not uncommon that a maternal infection related complication can be a preventable birth injury, but it takes a detailed expert review of the facts and circumstances of your child’s birth to determine the birth injury was the result of medical malpractice.
At Miller Weisbrod Olesky, a team of committed attorneys, nurses and paraprofessionals uses our detailed medical negligence case review process to assess your potential birth injury case. We start by learning more about you and your child and the status of meeting/missing developmental milestones. Then we gather medical records to determine what happened before, during, and after your delivery. We call in skilled medical experts who review your records and let us know if they think medical errors could have caused your child’s injuries.
If we feel medical negligence caused or contributed to your child’s injuries, we meet with you to discuss how you can receive compensation from the medical professionals who made the errors. Our birth injury attorneys have recovered millions of dollars in settlements for families of babies that have suffered a birth injury. At no point in our legal intake process will we ask you to pay anything. The medical review of your case and the consultation are free. We only receive payment when you do.
Contact Our National Birth Injury Lawyers
Our Birth Injury Attorneys
Les Weisbrod
Les Weisbrod has been on the cutting edge of the national birth injury litigation scene for almost 40 years.
As a national birth injury attorney, Les has settled over 204 medical negligence cases for more than $1,000,000. He also obtained settlements in 75 birth injury cases for over $1,000,000 each.
His $31 million verdict against Baylor University Medical Center in Dallas was one of the top 100 verdicts in the United States that given year.
Les is recognized nationally and internationally as one of the top plaintiff’s medical malpractice trial lawyers in the United States. But the recoveries for the clients and the differences made in the lives of the children and families Les has represented tell only part of the story.
Les has worked with his law partner Clay Miller for years to build a one-of-a-kind law firm.
Miller Weisbrod Olesky provides unique and unparalleled services to families of birth-injured and brain-injured children from the moment the firm decides to take the case.
The registered nurses and registered nurse-attorneys on staff are valuable team members who assist Miller Weisbrod birth-injury clients. Les has designed a system where each birth injured child is assigned a nurse-attorney liaison to guide them through the process of medical treatment/evaluation, therapies, home assistance, and quality of life improvement.
Miller Weisbrod’s unmatched service allows families to better cope with the immediate challenges facing our young clients.
Birth-injured children and their families are Les and Miller Weisbrod’s priority.
Les and the attorneys at Miller Weisbrod fight for the justice their clients are entitled to under our nation’s system of justice.
This fighting spirit has taken Les across the United States to represent clients in birth injury and medical negligence cases. In fact, he has personally handled cases not only in Texas but also in Arkansas, Arizona, Colorado, Oklahoma, Louisiana, Utah, Iowa, Ohio, Oregon, Montana, Alabama, Georgia, Florida, and New York.
Les and Miller Weisbrod continue to expand their reach of helping brain-injured children to new states each year as we strive to bring a sense of justice to each affected family. And Les is not the only one who notices he fights for his clients.
Michael Rustad, a Professor of Law at Suffolk University Law School in Boston who has done extensive research on punitive damage awards, says,
“Les Weisbrod has obtained more medical malpractice punitive damage jury verdicts for his clients than any other attorney in the United States.”
Also, a well-known defense medical malpractice attorney dubbed Les Weisbrod the “pitbull” of the Texas medical malpractice bar in a media profile of Les published by a major newspaper.
Les shares his experience and knowledge to improve the representation of all birth-injured children and their families.
In the early 1990s, Les recognized that a more focused effort needed to be made to educate attorneys who handle birth injury cases. As a result, Les was the founding Co-Chair of the American Association for Justice (AAJ) Birth Trauma Litigation Group in 1991. He also was a founding Co-Chair of AAJ’s Medical Negligence Litigation Group in 1999 and served as Chair of AAJ’s Professional Negligence Section in 1996.
Combined, these groups have put on more than a hundred continuing education seminars across the United States. helping to educate other attorneys by bringing in world-renowned experts in the fields of:
- labor and delivery
- neonatal care
- the care and treatment of birth-injured children, including those suffering from cerebral palsy and hypoxic-ischemic encephalopathy (HIE)
Education and professional experiences back up his dedication to helping children and families harmed by medical malpractice.
Les received his B.A. magna cum laude in 1975 from Claremont Men’s College and his J.D. in 1978 from Southern Methodist University Law School.
He is Board Certified by the Texas Board of Legal Specialization in Personal Injury Trial Law and Civil Trial Law.
Les was a past president of the Dallas Trial Lawyers Association in 1993. He has been a member of the Texas Trial Lawyers Association Board of Directors since 1990.
His work with the American Association for Justice (AAJ) (formerly ATLA) includes serving as President, President-Elect, Vice President, Secretary, Treasurer, and Parliamentarian. Mr. Weisbrod has also served on the AAJ Board of Governors since 1998 and the 17-member Executive Committee of AAJ since 2001. In 1990, he was chosen as a Rising Star of the ATLA and presented a paper entitled “Dirt and Greed: A New Look at Medical Malpractice Cases.”
Les has written and lectured extensively on birth injury litigation, medical malpractice, and medical product topics.
Les is a contributing author to the 1996 text Operative Obstetrics published by Williams & Wilkins. He also co-authored the “Drugs & Medical Devices” chapter in AAJ’s Litigating Tort Cases.
He also has lectured to lawyer groups across the U.S., Canada, England, and Australia.
Education
- Southern Methodist University - School of Law, J.D. - Dallas, Texas, 1978
- Claremont Men's College - B.A. - Claremont, California, 1975
Areas of Practice
- Medical Malpractice
- Birth Injury/Birth Trauma
- Products Liability
- Personal Injury
Associations & Memberships
- State Bar of Texas
- National Association Of Distinguished Counsel
- Million Dollar Advocates Forum
- Multi-Million Dollar Advocates Forum
- American Association for Justice
- Texas Trial Lawyers Association
- Dallas Trial Lawyers Association
- Pan-European Organization of Personal Injury Lawyers
- American Society of Law and Medicine
- Consumer Attorneys of California
- Arkansas Trial Lawyers Association
- Louisiana Trial Lawyers Association
- Dallas and American Bar Associations
- ABOTA (American Board of Trial Advocates)
Clay Miller
Clay is Board Certified in Personal Injury Trial Law by the Texas Board of Legal Specialization. Clay has practiced solely in the field of catastrophic injury and wrongful death since graduating from law school. His practice has been limited to the representation of victims. Over the past twenty-four years, Clay has successfully settled or tried to verdict cases in the areas of vehicular negligence, medical malpractice, construction site accidents, workplace injury, premises liability, and commercial trucking and a nationwide business loss case (suits filed in a dozen different states) involving defective truck engines sold to trucking companies.
Clay represented dozens of trucking companies in lost profit and diminished value claims against Caterpillar in 2010 through 2012. These cases were filed in over a dozen states with the bellwether trial set in Federal Court in Davenport, Iowa. After intense litigation and trial preparation, a global confidential settlement was reached for all the clients.
Clay's most recent 2017 victories are a $30,800,000 jury verdict in Tennessee arising from fraud claims in the sale of heavy-duty truck engines and a $26,500,000 jury verdict in a construction accident, obtained within 60 days of each other.
Clay was raised in Lewisville, Texas and completed his undergraduate degree in Finance at
Texas A & M University. Following graduation from Southern Methodist University School of law, Clay worked for two Dallas firms representing victims. In 1998, Clay began his own practice before forming his current partnership. In addition to his law practice, Clay has lectured at seminars and published in the areas of construction accidents, jury selection techniques, medical negligence, trucking accidents and settlement tactics.
He is active in local and statewide trial lawyers' associations including serving as the Chair of the Advocates for the Texas Trial Lawyers' Association in 2002 and remains on the Board of Directors. Clay served as President of the Dallas Trial Lawyers Association from 2008-2009. He has also been a member of the American Board of Trial Advocates (ABOTA) since 2014.
Education
- Southern Methodist University School of Law - Dallas, Texas
- Texas A&M University - Finance - College Station, Texas
Areas of Practice
Associations & Memberships
- State Bar of Texas
- State Bar of New Mexico
- State Bar of Colorado
- American Board of Trial Advocates (ABOTA)
- Texas Trial Lawyers Association
- Dallas Trial Lawyers’ Association
- American Association of Justice
David Olesky
David Olesky is Vice Chair of the Health Care Professional Liability practice. David is a trial lawyer focusing his practice on complex litigation matters that involve defending and protecting clients in all types of cases related to catastrophic injuries or death, but with a special focus on birth injury cases. David regularly advises his health care clients on the issues and challenges that they face on a daily basis. Clients repeatedly look to him for guidance to handle such high stakes cases and matters in Texas and jurisdictions outside of Texas.
David has earned the trust and reliance of clients he has worked with by consistently getting the results that matter most to them, whether that is a win at trial or a favorable outcome through alternative dispute resolution outside the courthouse. Through his representation, David demonstrates a true loyalty and hardworking commitment to the clients that he serves.
David believes the foundation of any client relationship is to act as a trusted advisor instead of simply as a litigator. Clients value his earnest representation of their business interests, accompanied by a devotion to understanding their businesses, prompt attention to their immediate needs and the challenges they face in their individual roles.
Education
- Southern Methodist University Dedman School of Law, J.D., 1992 - Dallas, Texas
- University of Texas, B.B.A, 1989 - Austin, Texas
Areas of Practice
Associations & Memberships
- American Bar Association
- Dallas Bar Association
- Dallas Bar Foundation Fellow
- Texas Bar Association
Alexandra V. Boone
Alexandra Boone is a partner in Miller Weisbrod. She concentrates her legal practice in the area of birth injury, medical malpractice and mass tort products liability. Alex currently works directly with firm partner Les Weisbrod in managing the birth injury docket and working with the firm’s highly qualified expert witnesses in the review of potential cases. Alex also litigates her own docket of medical negligence cases.
Over the course of her 17 years with the firm, Alex has focused on the administration and prosecution of mass tort litigation, originally focusing on occupational toxins, but more recently in the area of pharmaceuticals and medical devices. In the past, she has actively pursed cases involving hormone therapy, Vioxx, Fosamax, and Reglan. Alex was also instrumental in our firm successfully resolving thousands of cases transvaginal mesh, hip prosthetics, and the blood thinner Xarelto. She is actively prosecuting over 1,000 cases.
In addition to being a member of the Texas bar, she is also licensed in Oklahoma and is a member of the American Association of Justice, Texas Trial Lawyers Association, Oklahoma Association of Justice and the Dallas Trial Lawyers Association.
Education
- Baylor University - School of Law, 1996, J.D. - Waco, Texas
Areas of Practice
- Products Liability
- Mass Tort
Associations & Memberships
- State Bar of Texas
- American Association of Justice
- Texas Trial Lawyers Association
- Oklahoma Association of Justice
- Dallas Trial Lawyers Association
Pro Bono Activities
- East Texas Legal Services/Nix Law Firm Pro Bono Project, 1996 - 1997
Robert Wolf
Robert E. Wolf was born in Dallas, Texas and graduated Magna Cum Laude as a proud horned frog from Texas Christian University in 1997, with Bachelor of Science degree in Political Science and was inducted into Phi Beta Kappa and Mortar Board. He obtained his law degree from Southern Methodist University in 2000 while serving as an Articles Editor for the International Law Review and winning awards at Mock Trial and Appellate competitions.
Robert has been named a Thomson Reuters | Texas Super Lawyers Rising Star (less than 2.5% of attorneys in Texas receive this distinction) in 2011, 2012, 2013, 2014, and 2015. Further, Robert was recognized as a National Trial Lawyers Top 40 Under 40 attorney for Texas in 2012 (no more than 40 attorneys in Texas are eligible for this award annually).
Robert brought his passion for and over 14 years of experience of representing seriously injured individuals and their families to Miller Weisbrod in January 2015, and has concentrated his legal practice in the area of medical malpractice, products liability, and pharmaceutical/mass tort litigation. He is a member of the State Bar of Texas, American Association for Justice, Texas Trial Lawyers Association, and Dallas Trial Lawyers Association.
In addition to many successful jury verdicts and settlements across Texas, Oklahoma, Iowa, Wisconsin, and Idaho, Robert’s role as an attorney representing victims and their families has led to numerous changes to key safety practices and policies and procedures at corporations and medical facilities.
Robert and his wife Suzy also get plenty of exercise trying to keep up with their precious and very active daughter.
Education
- Southern Methodist University - Dedman School of Law, J.D. - 2000 - Dallas, Texas
- Texas Christian University - B.S. Political Science - 1997 - Fort Worth, Texas
Areas of Practice
- Medical Malpractice
- Personal Injury
- Products Liability
Associations & Memberships
- State Bar of Texas
- American Association of Justice
- Texas Trial Lawyers Association
- Dallas Trial Lawyers Association
Carrie Vine
Carrie Lynn Vine has over 15 years of experience in medical malpractice litigation, with a particular focus in representing children and families who have suffered birth injuries as a result of the negligence of either doctors, nurses or hospitals.
She is a passionate advocate for her clients and has handled hundreds of birth injury and birth trauma cases throughout the United States. As part of Carrie’s national birth injury legal practice, she has handled cases in Texas, Arkansas, California, Nevada, Kentucky, Georgia, Illinois, Wisconsin, Ohio, Pennsylvania, North Carolina, South Carolina, Florida, and North Dakota. She is determined to seek justice and works to obtain fair compensation for the children and families she represents.
Carrie earned her law degree from Northern Illinois University where she tutored other law students. Prior to law school, she received her undergraduate degree from the University of Notre Dame in Biomedical and Biological Science, and earned both a Master’s Degree and a Ph.D. from The Pennsylvania State University in Anthropological Genetics. She then conducted post-doctoral research at the University of Michigan Medical School before deciding to attend law school. She applies an academic mindset and love of science and medicine to mastering the medical principles and literature relevant to the cases she pursues.
Carrie is an active member of the American Association of Justice as well as the Birth Trauma Litigation Group (BLTG).
Education
- Northern Illinois University:
Law School
- University of Notre Dame:
Biomedical Science
- Pennsylvania State University:
Anthropological Genetics
Areas of Practice
- Birth Injury/Birth Trauma
- Medical Malpractice
Associations & Memberships
- American Association of Justice:
Member
- Birth Trauma Litigation Group:
Member
Larry Lassiter
Lawrence R. Lassiter is an AV-rated attorney with more than twenty years of experience in appellate and trial advocacy. He has been consulted by attorneys across the country to conduct research, evaluate cases, prepare appellate and trial briefs, and formulate litigation strategy. He has prepared hundreds of appellate briefs in federal and state appellate courts, including the highest courts of Texas, West Virginia, Georgia, Oklahoma, Ohio, Nebraska and Tennessee, and he is member of the Bar of the United States Supreme Court. Larry has a national appellate and legal briefing practice. Larry has filed extensive briefs and/or argued before either state or federal courts in 30 out of 50 states in his career.
Larry assists the Birth Injury team in all aspects of legal briefing. Unlike many other birth injury firms across the United States, Miller Weisbrod has an attorney dedicated to handling legal briefing on behalf of our clients across the country. Larry has handled extensive briefing in birth injury and other medical malpractice cases in Texas, New Mexico, Arkansas, Oklahoma, Iowa, Ohio, Alabama, Georgia, New York, Utah, Arizona, Louisiana and West Virginia.
Since joining Miller Weisbrod in 2010, Larry has won a number of important victories vindicating the rights of our clients in both state and federal appellate courts, including Vitacost.com, Inc. v. McCants, 210 So.3d 761 (Fla. Ct. App. 2017); TTHR Ltd. Partnership v. Moreno, 401 S.W.3d 41 (Tex. 2013); In re E.B., 729 S.E.2d 271 (W. Va. 2012); Mid-Continent Cas. Co. v. Davis, 683 F.3d 651 (5th Cir. 2012); Rouhani v. Morgan, 2017 WL 3526719 (Tex. App. – Houston [1st Dist.] 2017, no pet.); Mid-Continent Cas. Co. v. Andregg Contracting, Inc., 391 S.W.3d 573 (Tex. App. – Dallas 2012).
He was as a judicial clerk for the Honorable Harlington Wood Jr., Circuit Judge, United States Court of Appeals for the Seventh Circuit. Larry was a University of Iowa Presidential Scholar and served as Editor in Chief of the Iowa Law Review.
Larry is an active member of the American Association for Justice. He is a member of AAJ’s Birth Injury Litigation Group and Medical Negligence Sections.
Education
- University of Iowa - Political Science & History - B.A. - Iowa City, Iowa
- University of Iowa - School of Law - J.D. - Iowa City, Iowa
Areas of Practice
- Appellate Advocacy
- Medical Malpractice
- Pharmaceuticals & Medical Devices
- Products Liability
- Personal Injury
Associations & Memberships
- State Bar of Texas
- American Association of Justice
- Texas Trial Lawyers Association
- Dallas Trial Lawyers Association
Laurie Pierce
Laurie draws upon extensive experience in state and federal courts with a focus on complex claims involving medical malpractice cases. After many years of defending health care providers and hospital systems in medical malpractice cases, Laurie joined David Olesky in the national birth injury and medical negligence practice at Miller Weisbrod Olesky.
Laurie’s focus is to understand not only the facts and circumstances of the matter at hand, but to understand the specific needs and goals of the client and their unique business considerations. Her extensive background in commercial litigation provides a foundation that enhances her health care litigation practice. She works with clients that require more than a strong trial lawyer; they expect an attorney who understands the relationship between law and their specific business and who will work tirelessly to protect their rights, interests and bottom line.
Education
- Southern Methodist University:
Dedman School of Law - 1992
- Order of the Coif:
Journal of Air Law and Commerce, J.D. - 1992
- Miami University-Oxford, Ohio
B.S. Education - 1982
Areas of Practice
- Birth Injury/Birth Trauma
- Health Care Industry
- Health Care Litigation
- Litigation and Dispute Resolution
- Medical Malpractice
Associations & Memberships
- American Association for Justice
- American Bar Association
- Dallas Bar Association
- Dallas Bar Foundation Fellow
- Texas Bar Association
Distinctions
- Admitted to Pro Bono College of State Bar of Texas in 2019 for outstanding delivery of legal services to low-income Texans
Court Admissions
- United States Supreme Court
- U.S. District Court, Eastern District of Texas
- U.S. District Court, Northern District of Texas
- U.S. District Court, Southern District of Texas
- U.S. District Court, Western District of Texas
Linda Cuaderes
Linda Cuaderes is both a registered nurse and a licensed lawyer. Linda works exclusively in Miller Weisbrod’s Birth Injury and Medical Malpractice section. Linda acts as the firm’s patient advocate and liaison with our young clients and their parents.
Linda combines her legal and nursing experience along with her exceptional organizational talent and attention to detail to make sure each child we represent is provided the highest level of medical care and attendant care during the pendency of their case. Linda communicates with our parent clients regularly to monitor their birth injured child’s treatment, provide guidance as to additional care and therapies and when necessary assist them in obtaining specialized medical providers.
Linda was raised in Bartlesville, Oklahoma and completed her Bachelor of Science in Nursing with Honors at the University of Oklahoma. She started as an Oncology Nurse at Presbyterian Hospital in Oklahoma City, quickly becoming the Assistant Head Nurse of the Outpatient Endoscopy Unit. Linda then entered the University of Oklahoma College of Law.
Following graduation, Linda joined Les Weisbrod in the Medical Malpractice Section. After taking time off to raise her three lovely children, Linda returned to Miller Weisbrod and her passion of holding healthcare providers accountable for preventable errors. Linda is active in the American Association for Justice, Texas Trial Lawyers Association, Dallas Trial Lawyers Association, and the Texas Bar Association. Linda is an active member of the Birth Trauma Litigation Group and Medical Negligence Section of the American Association for Justice.
She is admitted to practice before the Texas Supreme Court and routinely works on cases pending throughout the United States. Linda has worked with child victims of birth injury, their parents and other victims of medical malpractice in Texas, New Mexico, Oklahoma, Arkansas, Louisiana, Iowa, Ohio, New York, Alabama, Georgia, Arizona, Utah and Missouri.
Education
- University of Oklahoma - School of Law, 1990, J.D. - Norman, Oklahoma
- University of Oklahoma - School of Nursing, 1985 - Norman, Oklahoma
Areas of Practice
- Medical Malpractice
- Birth Injury/Birth Trauma
Associations & Memberships
- Texas Bar Association
- American Association of Justice
- Texas Trial Lawyers Association
- Dallas Trial Lawyers Association
Kristin Jones
Kristin combines her medical and legal training to provide invaluable, passionate service to parents struggling to care for their birth-injured children. Families often have questions as they go through the birth injury lawsuit process. Kristin diligently identifies and investigates all medical issues so the birth injury attorneys at Miller Weisbrod can answer those questions. Kristin ensures that our birth injured children’s medical records are thoroughly reviewed and organized. Miller Weisbrod’s birth trauma litigation attorneys and medical experts retained by the firm need her services while pursuing justice for our clients.
Education
- SMU Dedman School of Law - Dallas, Texas
- University of Texas at Arlington - Arlington, Texas
Areas of Practice
- Medical Malpractice
- Birth Injury/Birth Trauma
Associations & Memberships
- State Bar of Texas
- American Association of Justice
- Texas Trial Lawyers Association
Matt Adair
Matt Adair is an attorney specializing in medical malpractice, products liability, and pharmaceutical litigation. He received his bachelor’s degree in Philosophy from the University of Notre Dame. During his time there, he studied abroad at the New College at Oxford University in Oxford, England.
Matt is a member of the State Bar of Texas, American Association for Justice, Texas Trial Lawyers Association, and Dallas Trial Lawyers Association.
Education
- University of Notre Dame - Philosophy, B.A. 2012 - Notre Dame, Indiana
- Baylor University - School of Law J.D. 2015 - Waco, Texas
Areas of Practice
- Medical Malpractice
- Products Liability
- Pharmaceutical Litigation
Associations & Memberships
- State Bar of Texas
- American Association of Justice
- Texas Trial Lawyers Association
- Dallas Trial Lawyers Association
Garrett Stanford
Garrett Stanford was born in Dallas, Texas and graduated from Southern Methodist University in 2017 with a B.A. in Political Science. After graduation, he attended Baylor University School of Law. During his time at Baylor, he was a member of the Order of the Barristers and he won the Judge W.C. Davis Endowed Criminal Practice Professional Track Award. He obtained his law degree and license to practice law in 2020.
Garrett joined Miller Weisbrod in August 2021. His legal practice is concentrated in the area of birth injury and medical malpractice. Garret is actively involved in handling birth injury and medical malpractice cases in Texas, Ohio, Utah, Arkansas and Oklahoma.
Education
- Southern Methodist University - Political Science, B.S. - Dallas, Texas
- University of Baylor - School of Law, J.D. - Waco, Texas
Areas of Practice
- Medical Malpractice
- Birth Injury/Birth Trauma
Associations & Memberships
- State Bar of Texas