What are Neonatal Seizures?
Neonatal convulsions or neonatal seizures are epileptic fits that may occur during the first four weeks after birth (which is called the neonatal period). The first week after birth is particularly the most vulnerable for developing seizures.
Seizures during this time are often an important indicator that fetal distress and oxygen deprivation during the labor and delivery process. Newborn babies that suffer neonatal seizures are at high risk of other brain injuries such as hypoxic-ischemic encephalopathy (HIE) and cerebral palsy.
Neonatal seizures are the result of abnormal electrical activity in the brain usually caused by damage or injury to one or more areas of the brain. Neonatal seizures may only last for a few minutes, hours or days, but these short-lived events usually indicate major damage to the newborn’s brain or another serious brain malfunction. This condition should be treated as a neurological emergency, and the medical team must act fast to correctly diagnose and manage the condition.
Neonatal seizures are often a sign that the baby suffered fetal distress or birth trauma during the labor and delivery process or shortly after birth. When newborn (“neonatal”) seizures occur while the baby is still in the hospital shortly after birth, the medical providers must act quickly not only to control the seizures which can cause further brain damage due to oxygen deprivation (hypoxia/anoxia), but also determine if the cause of the seizures was a birth injury.
What Causes of Neonatal Seizures?
- Birth Trauma—including injury from compressive injuries, trauma induced strokes or fractures
- Birth injury including from hypoxia or anoxia as a result of fetal distress
- Hypoxic Ischemic Encephalopathy
- Infection
- Genetic abnormalities
- Metabolic disorders including metabolic acidosis
- Medications given during labor and delivery or shortly after birth
- Fever
Noteworthy Definitions:
- Neonatal Period: The first 28 days from the date of birth of a full-term infant
- Full-term Infant: The infant that has completed the gestational age of 40 weeks
- Gestational Age: The total duration of the pregnancy
- Chronological Age: The infant’s legal age from the date of birth
- Conceptional Age: The total of gestational age and chronological age
It is important that doctors (including neonatologists and pediatricians) and newborn and neonatal ICU nurses understand the different types of seizures and the signs of each type of seizure.
What are Types Neonatal Seizures?
Just like any other seizures, neonatal seizures are stereotypical, repetitive, and paroxysmal events. Five primary types of neonatal seizures include:
- Subtle seizures (50%)
- Clonic seizures (25%)
- Myoclonic seizures (20%)
- Tonic seizures (5%)
- Repetitive non-paroxysmal behaviors
Subtle Seizures
This is the most commonly type of neonatal seizure. As the name suggests, the clinical manifestations of these seizures are subtle and often overlooked. They are similar to normal reactions and behaviors, and may include:
- Eye movements, ranging from roving and random ocular movements to sustained upward deviation of the eyes, with/without jerking
- Fluttering or blinking eyelid, eye opening, rolling up the eyes, nystagmus, or gaze fixation
- Lingual, buccal, oral movements, such as tongue protrusions, chewing, smacking, and sucking
- Progression movements, such as struggling, thrashing, bicycling, pedaling, swimming, or rowing movements
- Purposeless complex movements, such as sudden episodes of limb hyperactivity & crying
Clonic Seizures
These motor seizures are marked by rhythmic jerks, which might be localized to a specific area of the limbs or face, the diaphragm and axial muscles (mid-section), or be hemi-convulsive (one side of the body) or multifocal (coming from different parts of the injured brain).
Myoclonic Seizures
These motor seizures are single, rapid, or repetitive arrhythmic jerks, affecting a limb, finger, or the entire body. They are seen more often in pre-term infants, which usually indicate a poor prognosis and a severe brain injury.
Tonic Seizures
These seizures will manifest with continuous muscle contraction in the axial, limb, facial, or other muscles. They could be asymmetrical or symmetrical, generalized, focal, or multifocal.
Infantile Spasms
These muscle spasms marked by short jerking spells of extension or flexion are relatively rare. They are quicker than tonic seizures, but slower in comparison to myoclonic seizures.
Hypoxic-Ischemic Encephalopathy (HIE)
A Key Cause of Neonatal Seizures and Epilepsy
Hypoxic-ischemic encephalopathy or HIE is recognized as one of the leading causes of neurological disorders, such as seizures/epilepsy, mental delay and cerebral palsy. Neonatal seizures could be an acute HIE consequence, which could result in further damage to the newborn’s brain.
HIE is a serious brain disorder that may develop due to lack of blood flow or oxygen to the brain for a certain time period. “Hypoxic” means insufficient oxygen; “ischemic” indicates insufficient blood flow; and “encephalopathy” refers to brain dysfunction.
HIE may occur at any stage – pregnancy, labor or delivery, or during the postnatal phase. While some children may only experience moderate health effects from HIE, others may suffer far more serious effects, such as epilepsy, motor impairment (cerebral palsy), cognitive impairment, developmental delays, and such other permanent and severe disabilities.
When the supply of oxygenated blood to the brain is disrupted, it may result in oxygen starvation of the rest of the body as well. The consequences could be damage to the liver, heart, bowels, kidneys, or other organs. When the brain suffers damage or injury in this condition, a full recovery may not occur. The severity of brain damage is correlated to the time period for which the oxygen supply was interrupted.
How does HIE Cause Neonatal Seizures?
The occurrence of HIE triggers a cascade of events which reduce the energy generation activity in the brain due to oxygen deprivation. This can result in neonatal seizures and overstimulation of the brain impulses. The hypoxic-ischemic event can be caused by multiple events, but ultimately brain injury occurs because of impaired cerebral blood flow (CBF) and oxygen delivery to the brain.
Oxygen deprivation or asphyxia also causes cellular damage, but the exact mechanism of how this damage occurs is still a matter of research. What is clear is that a series of neurochemical (nerve tissue chemical process) and inflammatory changes occur with asphyxia, resulting in the death of nerve cells.
HIE accounts for nearly 50 percent of neonatal seizures in both premature and full-term babies. Newborns with HIE often have a high seizure burden, which may result in status epilepticus in up to 15% of cases. (Status epilepticus is a life-threatening brain disease causing impairment of the respiratory function and airway control. It is marked by rapid or continuous seizure activity lasting for over 30 minutes – without recovery between episodes.)
Types of Seizures Caused by HIE
About two-thirds of the cases reveal cerebral venous infarcts (infarcts of the cerebral vein). Newborns with diffuse or multiple lesions along with cerebral venous infarcts usually have migratory or multifocal (multi-location) seizures.
Clonic seizures are often observed in these cases. When the medical provider holds the limb with clonic rhythmic contractions, they can feel the limb movement. Clonic activity does not get suppressed with limb extension or flexion, as it would in jitteriness.
Diagnosing Neonatal Seizures
An electroencephalogram (EEG) test is the gold standard for diagnosing neonatal seizures. The EEG device records the brain’s electrical activity. If abnormalities in this activity are detected (measured between seizures), it could be indicative of neonatal seizures. Brain imaging tests, such as computed tomography (CT) scan and magnetic resonance imaging (MRI) are also used to diagnose seizures or to identify their cause. Cranial ultrasound may be performed to rule out intracranial hemorrhage (brain bleeds).
Differential Diagnosis
Differential diagnosis (differentiating between two similar-looking conditions) for neonatal seizures should include:
- Identifying any unusual stereotypical or repetitive movement during the neonatal phase as it could represent a seizure.
- Noting the changes in autonomic functions, such as the heart rate or blood pressure, which could be indicative of seizure activity.
- Finding any inconsistency in the relationship between EEG-detected abnormal electrical activity and a clinical seizure.
Seizure Assessment
Neonatal seizure assessment should involve a review of family history of epilepsy or seizures, gestational diabetes, infections or drug use during pregnancy, condition of the baby at birth (was there metabolic acidosis or low APGARS), birth trauma or birth injury history or fetal distress during labor. This assessment may give clues to the seizure etiology (manner of causation).
Pathology Tests
These may include full blood examination, blood glucose level, serum electrolytes, arterial blood gas, blood cultures, and lumbar puncture (if infection risk is indicated).
Treatment of Neonate Seizures
Following the early management and diagnosis of neonatal seizures and their possible underlying causes, the medical team should evaluate the seizure severity and duration to determine whether the baby must be treated with antiepileptic drugs (AED).
The FDA-approved Phenobarbital drug is usually the first treatment of choice for neonatal seizures. The drug has been in use for several decades as a therapy for seizures and is also used to treat status epilepticus.
Phenobarbital is a sleep-inducing barbiturate (based on barbituric acid) used as an anticonvulsant (drug to reduce the severity of convulsions or epileptic seizures) in sub-hypnotic doses. Babies with liver or kidney dysfunction may not be administered Phenobarbital in standard doses because it could prove toxic for these organs.
If this AED therapy fails to work, alternative treatments with Pyridoxine (vitamin B6) and/or folic acid (vitamin B9) should be considered. The medical team should ensure close monitoring of the baby in case of AED therapy, considering the toxicity risks. The baby’s blood work should be taken, and kidney and liver tests should be performed, apart from the standard monitoring procedures.
Needing Better Neonatal Seizure Treatments
Neonatal seizures can result in lifelong epilepsy, severe motor and cognitive impairment, and even death. The condition is often treatment resistant, in part because the treatments available for newborns are not very different from the treatments used for older children and adults with seizures. Therapies have not really changed for decades.
A prospective study at Boston Children’s Hospital found that out of 426 infants admitted consecutively, about 64% had neonatal seizures that did not respond to the early AED therapy, 16% were diagnosed with status epilepticus, and 17% died in the neonatal ICU.
Epilepsy Treatments for Young Children
Phenobarbital
As one of the oldest anticonvulsant medications, it is most commonly prescribed for infants and toddlers with epilepsy. It may initially cause drowsiness, but over time children may develop tolerance to it.
Valproic Acid
It is used to treat epilepsy in children and various types of childhood seizure disorders. Weight gain is a common side effect, but in some cases liver damage may occur with this medication.
Phenytoin
It is used both as a daily anticonvulsant and as an IV treatment in the ER to stop an ongoing seizure. Side effects may include weakened bones, involuntary eye movements, and hirsutism, among others.
Carbamazepine
This drug is used most effectively as a therapy for partial seizure disorders. It works well for students because it rarely interferes with learning ability and does not cause drowsiness in most cases.
Topiramate
This medication is used as an adjunct therapy with other drugs to treat epilepsy in children. Side effects may include dizziness, appetite loss, fatigue, and a tingling sensation in the hands and feet.
Epilepsy Surgery for Young Children
In certain cases, surgery may be recommended for young children who are diagnosed with intractable (hard to control) epilepsy. Very young children experiencing frequent and severe seizures that hamper their development and quality of life could be candidates for surgery. Children with focal seizures usually respond better to surgery compared to those with multifocal seizures.
Surgical procedures used currently may include temporal lobe resection (removing a circumscribed part of the temporal lobe) or hemispherectomy (removing almost half portion of the brain). The risks of intractable epilepsy must be weight against the risks of surgery. Infants may have higher likelihood of improved development outcomes post-surgery, but they also have a higher mortality rate compared to older children.
Implanted Electrical Devices
One of the commonly used electrical devices (battery operated) for young children with epilepsy is the vagal nerve stimulator. It is designed to deliver electrical signals intermittently to the vagus nerve in a cyclical manner. The signals get transmitted to the brain and help in inhibiting seizures. The device is implanted under the collarbone, and is known to reduce the frequency of seizures for some patients. Implanted electrical devices are not meant to replace drug therapy, but should only be used an adjunct treatment.
Medical Negligence that Contribute to Infant Seizures
Some of the common errors made by doctors and nurses that can cause a birth injury leading to seizures include:
- Failure to diagnose and treat the mother’s condition like preeclampsia, gestational diabetes, or maternal infection
- Failure to provide proper prenatal care and treatments for labor and delivery
- Delayed diagnosis and treatment of preterm labor
- Failure to diagnose fetal macrosomia (an abnormally large sized baby)
- Failing to react to umbilical cord complications
- Placental abruption, placental previa
- Failure to react to prolonged labor
- Failure to perform a timely c-section or vaginal delivery when the baby is in distress
- Failure to intervene in a timely manner to abnormal readings on the fetal heart rate monitor
- Inappropriate use of obstetrical forceps or vacuum extractors during delivery, causing injuries to the brain
- Failure to appropriately and timely provide neonatal resuscitation to the baby
- Failure to recognize and timely treat neonatal hypoglycemia
Are Your Child’s Seizure’s the Result of Medical Malpractice?
Parents whose children suffer from neonatal seizures or epilepsy deserve an answer to how their child developed this condition and whether it was preventable. Our dedicated birth injury lawyers want to help you find those answers.
If your child has been diagnosed with neonatal seizures or epilepsy, 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, equipment needed to help cope with disabilities, and the other expenses associated with caring for a child with brain injuries, seizure disorders, and cerebral palsy.
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.
Why Should You 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.
At Miller Weisbrod Olesky, a team of committed attorneys, nurses and paraprofessionals uses our detailed medical negligence case review process to assess your potential claim. 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.
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 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 bellwhether 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
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 Olesky can answer those questions Kristin ensures that our birth injured children’s medical records are thoroughly reviewed and organized. Miller Weisbrod Olesky’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.