Prenatal Testing

Prenatal testing involves screening and diagnostic tests that a medical provider must perform during pregnancy to obtain vital information about the developing baby’s health. No matter whether the pregnancy is high-risk or not, prenatal testing is an important preventative measure in every case.

The scope and frequency of prenatal tests should increase where the expectant mother’s health history, pre-existing medical conditions, or other risk factors and complications indicate that the baby has an increased risk of birth injury, such as hypoxic-ischemic encephalopathy (HIE), which may lead to cerebral palsy.

During prenatal testing, the obstetricians, maternal fetal medicine specialists and even midwives are required to adhere to the prevailing standards of care. Appropriate prenatal tests must be performed at regular intervals, particularly in high-risk pregnancies or when there are signs of birth complications. Accurate interpretation of the test results is equally important and timely medical interventions must be made when prenatal tests indicate a risk of birth complications or birth injury.

When risks to the baby’s health are identified through prenatal testing, the medical team must perform continuous fetal heart rate monitoring. If signs of fetal distress are present, it requires prompt and appropriate medical intervention because the baby may not be receiving sufficient oxygen.

The risks vs. benefits of an emergency cesarean section should be considered. If the medical providers are negligent in performing prenatal tests, interpreting the results or taking timely action, the resulting birth injury or birth complication may constitute medical malpractice.

In high-risk pregnancies or when the expectant mother has one or more of the following conditions, frequent and thorough prenatal testing is particularly important:

• Preeclampsia (maternal high blood pressure)
• Gestational diabetes or pre-existing diabetes
• Maternal infection or other medical conditions affecting pregnancy
• Expectant mother has previously had a miscarriage in the second trimester or stillbirth
• IUGR or intrauterine growth restriction (baby is small for their gestational age)
• Macrosomia (baby is larger than average for their gestational age)
• Baby’s movement in the womb has reduced
• Expectant mother received an external cephalic version (ECV), a medical maneuver to correct the baby’s position for birth
• Amniocentesis has been performed in the third trimester to check the baby’s infection status or lung maturity
• Birth defects or abnormalities in the baby are suspected

Ultrasound exams are performed at multiple stages during the pregnancy for the following purposes:

• First Trimester
  • To determine the due date
  • To identify the number of babies
  • To examine the uterus as well as other pelvic anatomy
  • To diagnose a miscarriage
  • To detect birth defects
• Second Trimester
  • To reconfirm the due date
  • To examine the baby for abnormalities
  • To assess blood flow patterns
  • To identify major dysfunction in the umbilical cord (which could potentially lead to hypoxic-ischemic encephalopathy)
  • The check the amniotic fluid volume
  • To measure the cervix length
  • To observe fetal activity
  • To monitor fetal growth
• Third Trimester
  • To check the amniotic fluid volume
  • To perform the biophysical profile (BPP) test
  • To monitor fetal growth
  • To determine the position of the baby
  • To examine the placenta for the risk of premature delivery, IUGR, neurodevelopmental problems, or brain damage

Fetal heart rate monitoring may be performed during late pregnancy and around labor and delivery to check the baby’s heart rate and rhythm. An abnormal fetal heart rate pattern could indicate oxygen deprivation, and the risk of HIE, which can eventually lead to cerebral palsy. The test can help the medical providers decide if an emergency cesarean section is necessary.

Glucose challenge is a prenatal test to screen for gestational diabetes. Expectant mothers with an average risk of gestational diabetes should be screened during the second trimester, while those at a high risk should be screened as early as their first prenatal visit. In absence of timely diagnosis and careful management, maternal diabetes increases the risk of preeclampsia, excessive birth weight of the baby, and may increase the risk of birth injuries.

Group B Strep is the most common cause of serious or life-threatening infections in babies, including meningitis and pneumonia. The CDC recommends that all expectant mothers should be screened for vaginal & rectal bacterial colonization of GBS around 35 to 37 weeks of pregnancy. Timely detection and treatment of this maternal infection is to lower the risk of transmission to the baby.

A non-stress test is usually performed around 38 to 42 weeks, or earlier in case of high-risk pregnancy. The test shows how well the baby’s heart rate responds to movement. In case the baby’s heart rate acceleration is low in response to the movement, it may indicate lack of oxygen supply from the mother to the baby. This should prompt the medical team to make appropriate interventions to reduce the risk of hypoxic-ischemic encephalopathy (which may lead to cerebral palsy) or plan for an emergency cesarean delivery.

Measurement of amniotic fluid volume helps determine if the amniotic fluid which protects the baby inside the uterus is too little (oligohydramnios) or too much (polyhydramnios). These conditions can restrict the flow of oxygen and nutrients to the baby via the umbilical cord, and increase the risk of premature birth, placental abruption, PROM (premature rupture of membranes), and hypoxic-ischemic encephalopathy, which can lead to cerebral palsy.

Biophysical profile prenatal testing is usually performed after 28 weeks of gestation. Thereafter, repeated BPPs may be scheduled every week or more frequently, depending on the baby’s condition. The test includes BPP ultrasound to observe the baby’s movements in the womb and measure the amniotic fluid volume. The other BPP component is a nonstress test, where a fetal heart rate monitoring device is used to measure the baby’s heartbeat while at rest and during movements. The test can predict the baby’s risks of fetal hypoxia, fetal acidosis, and hypoxic-ischemic encephalopathy.

An amniocentesis test is usually performed between 15 to 20 weeks of gestation when the expectant mother has a high risk of chromosomal abnormalities. If the maternal serum screening test shows abnormal findings, an amniocentesis test may be advised. The test involves drawing a specimen of the amniotic fluid to diagnose birth defects, such as spina bifida and some other genetic disorders.

All obstetrical doctors and medial providers must abide by certain principles known as the medical standard of care. If a doctor or midwife fails to perform prenatal testing, this can be found to be violation of the medical standard of care and deemed medical malpractice.

If a delivery team fails to use important prenatal testing in the monitoring and planning of delivery, fetal distress can occur. These medical errors are often below the standard of care and can form the basis of a medical negligence lawsuit if the baby suffers a serious birth injury or birth complication.

Parents whose children suffer from birth trauma or birth complications resulting from errors in prenatal testing or lack of testing want and deserve answers as to the cause of their child’s birth injury and whether mistakes by the doctors and nurses contributed to the injury.

• Were there signs of birth injury or birth complications during the pregnancy, labor, and delivery process, or presence of risk factors, which were either not recognized or properly treated?
• During the labor and delivery, were there clear indications that the baby was suffering from fetal distress, but appropriate actions were not taken by the obstetrician or nurses?
• Was there a delay in diagnosis because of mistakes in prenatal testing or missed prenatal testing that led to later complications, including brain injury?
• Did the medical team fail to order a series of tests to diagnose this birth complication in a timely manner?
• Was the decision to perform a cesarean delivery delayed leading to birth trauma during vaginal delivery or labor?
• Did the neonatal resuscitation team fail to quickly begin important breathing support?
• Should brain cooling (also called “hypothermia therapy”) have been provided to your baby, but the doctors and nurses failed to perform the appropriate tests or ignored the results of the tests?

Our national birth injury attorneys have extensive experience in this and all areas of birth injury medical malpractice. The lawyers and nurses at Miller Weisbrod Olesky will help you determine if mistakes of the medical providers caused a birth injury to your child, including Hypoxic-Ischemic Encephalopathy (HIE) or cerebral palsy.

Our award-winning birth injury attorneys represent families all over the United States in their time of need after a wrongful birth. We use our skills and expertise to obtain for you and your child a medical malpractice settlement that will help provide specialized medical therapy in order to maximize the quality of life and independence of your child throughout their life.

Sometimes families are reluctant to contact a medical malpractice lawyer. It’s also not uncommon for parents to feel overwhelmed by the responsibilities they encounter in caring for their injured child and worried that they will not be able to help out in a lawsuit involving their child’s birth injury. Our birth injury attorneys and nursing staff will address these hesitations and concerns, so you can focus on your child and maximizing their care.

Most 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.

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

Bar Admissions

• Texas - 1990

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.

Why Should You Talk with the Highly Capable Attorneys at Miller Weisbrod Olesky?

The only way to find out if you have a birth injury case is to talk to a lawyer experienced in birth injury lawsuits. It’s not uncommon that a birth related complication results in a preventable birth injury, including cerebral palsy, but it takes a detailed expert review by a birth injury attorney of the medical records from your child’s birth to determine if the birth injury was the result of medical malpractice.

At Miller Weisbrod Olesky, a team of committed lawyers, nurses and paralegals uses our detailed medical negligence case review process to assess your child’s 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 pregnancy. We call in documented and proven 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 wrongful birth in your case, 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 children 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 no matter how long or tough your case is.