Medical Mistakes That Cause Cerebral Palsy

The most common cause of Cerebral Palsy is hypoxic-ischemic encephalopathy or HIE. Doctors, nurses, and other medical professionals are responsible for preventing and treating dangerous pregnancy issues before, during, and after delivery. If they fail to provide the appropriate standard of care, they may be held liable for medical malpractice or negligence.

The majority of birth injuries that result in cerebral palsy are caused by medical personnel such as obstetricians and labor and delivery nurses failing to:

• Treat expectant mothers' previous or current health conditions
• Identify and respond to signs of fetal distress during labor
• Safely deliver the baby, causing injury to the newborn
• Provide proper treatment to the baby after birth

If your child's birth injury occurred due to a preventable medical error, consult with Miller Weisbrod Olesky's cerebral palsy lawyers, who will examine the facts of your case and file a birth injury lawsuit against the hospital or medical professional responsible for your child's birth injury.

Cerebral palsy is typically caused by damage to the developing brain that occurs most often before birth. In most cases, brain damage is caused by a lack of oxygen in the baby's brain. A baby's oxygen supply is like an air tank, and the baby uses its oxygen reserves to survive labor without injury.

Even a small change in the fetal oxygen supply can result in a severe birth injury that leads to cerebral palsy. When the fetus is deprived of an adequate supply of oxygen, this is called "hypoxia." If there is reduced blood flow to the baby, this is known as "ischemia." There are many reasons oxygen deprivation at birth may occur. Infants with that suffer from a lack of oxygen are at high risk for the development of hypoxic-ischemic encephalopathy (HIE). HIE can cause developmental delays, cognitive impairment, and is one of the most common causes of cerebral palsy.

Oxygen deprivation and birth asphyxia cause the development of lactic acid in the blood, and when lactate builds up in a baby's blood, it can lead to acidosis. Fetal acidosis is dangerous and potentially life-threatening condition that can also cause hypoxic-ischemic encephalopathy. HIE is a disorder that results in brain damage and may cause the baby to experience seizures, have delays in growth or development, and CP. Although some cases of cerebral palsy are not related to birth issues, an estimated 20% of all cases are the result of complications encountered during labor and delivery, many of which of are preventable.

Some of the causes of decreased oxygen before or during the birth process may include:

During Labor & Delivery

• Fetal heart rate monitoring often becomes critical when labor and delivery begin. During labor, the fetal heart rate can signal that the baby is in fetal distress and trying to compensate for a reduction in oxygen or blood flow. When fetal monitoring strips show signs of fetal distress, doctors, nurses, and midwives must immediately intervene to prevent oxygen deprivation and address reduced blood flow to the baby’s brain.
  
  Physicians and midwives sometimes failing to properly observe a mother’s progress through labor. It’s especially critical for them to pay attention to the fetal rate heart monitoring strips and other signs that a baby is in fetal distress. In addition, they must consider the baby and mother’s overall medical condition. When they fail to do so, babies can be born with preventable brain damage, hypoxic-ischemic encephalopathy, and cerebral palsy.

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• Umbilical Cord Prolapse and Compression: Umbilical cord prolapse happens when the umbilical cord exits the cervix before the baby. The umbilical cord is responsible for carrying oxygen, blood, and nutrients from the placenta to the baby. Any disruption to its placement or function can reduce or cut off the oxygen supply to the baby and lead to serious injuries such as birth asphyxia, hypoxic-ischemic encephalopathy (HIE), or cerebral palsy (CP). Umbilical cord compression occurs when the placenta, vaginal walls, or baby's weight puts pressure on the cord and restricts the flow of blood, oxygen, and nutrients to the baby. Because umbilical cord compression restricts oxygen to the fetus, it can lead to brain damage and organ failure and result in cerebral palsy due to lack of oxygen. · Uterine rupture, including during a VBAC pregnancy: This happens when the forces and stresses of pregnancy cause a tear in the wall of the uterus.

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• Uterine Rupture: occurs most often during active labor and along the scar tissue from a previous C-section. Without any connection between the placenta and the uterus, the fetus is more likely to suffer from inadequate blood (oxygen) supply, which results in hypoxia, which can lead to brain damage and the development of CP.

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• Uterine Tachysystole: This refers to excessive uterine activity (contractions) during labor and delivery and most often occurs when a laboring mother has been provided with the improper dosage of labor-inducing drugs like Pitocin or Cytotec. When contractions last too long or happen too frequently, the placenta has insufficient time to recharge, and it can cause a decrease in the flow of oxygen from the mother to the baby. A baby who experiences oxygen deprivation for a prolonged period may suffer birth injuries that result in cerebral palsy.

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• Fetal Distress: Signs before and during childbirth indicating that the fetus is experiencing fetal distress may include changes in heart rate or signs of oxygen deprivation. When the fetus shows signs of distress during late pregnancy or labor, a doctor, midwife, or other medical professional has a responsibility to respond promptly and try and treat any underlying causes. If the fetal distress is not corrected or responded to appropriately, oxygen deprivation or birth asphyxia can result in permanent brain damage, HIE, and CP.

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• Failure to Perform a Timely Cesarean Section (C-section): When a C-section is not performed in a timely manner, it can lead to severe and life-threatening injuries to both the mother and her infant. Some examples of pregnancy complications that may warrant an emergency C-section include fetal distress, placental abruption, or prolonged labor. If a doctor fails to or delays in performing a necessary C-section, the fetus may struggle to get the oxygen it needs to feed vital organs. As a result, the baby may suffer from brain damage, cerebral palsy, and other neurological injuries.

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• Prolonged Labor or Arrested Labor: Prolonged labor happens when any of the stages of labor take longer than expected (typically over 20 hours for first-time mothers and over 14 hours for women who have previously given birth). Arrested labor occurs when the labor process has ceased completely. The risk of prolonged or arrested labor includes oxygen deprivation during labor (fetal distress), intracranial hemorrhage, and increased possibility of the need for an emergency C-section or the use of forceps or vacuum extractors. Prolonged or arrested labor can lead to complications that increase the risk of CP and hypoxic-ischemic encephalopathy.

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• Significant Trauma to the Head: Trauma to the head that occurs during labor and delivery can cause irreparable damage to the baby's undeveloped brain. For example, a doctor who improperly uses birth-aiding tools, such as forceps or a vacuum extractor, or uses too much force when pulling the baby out of the birth canal can cause severe damage to a newborn's sensitive head. Head injuries to an infant are one of the leading causes of an infant developing cerebral palsy.

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• Premature Birth: Babies born earlier than 32 weeks of pregnancy are at an increased risk of having serious health complications that affect the brain, resulting in CP. When a child is born prematurely, they are often born with underdeveloped brains, lungs, kidneys, and other organs, making them more vulnerable to an injury that can cause cerebral palsy.

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• Placenta Abruption: Placental abruption occurs when the placenta detaches from the uterine wall prior to delivery (after 20 weeks of pregnancy). Placenta previa is a condition during pregnancy that happens when the placenta lies very low in the uterus and completely or partially covers the opening to the cervix. Placental complications can disrupt the oxygen supply to the fetus and contribute to or cause CP if a doctor or other medical professionals fail to detect or adequately manage this rare complication of pregnancy.

Shortly after birth

• Hypoxic Ischemic Encephalopathy (HIE): This is a dangerous brain injury caused by a lack of oxygen in the baby's blood and/or decreased or restricted blood flow to the newborn's brain. This damage to the brain tissue is one of the leading causes of mental and physical disabilities in the child, including cerebral palsy.

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• Neonatal Resuscitation: Resuscitation errors at birth can lead to severe birth complications and injuries, such as the baby being deprived of oxygen and diminished blood flow. If not done correctly, infant resuscitation can cause permanent brain injuries such as HIE, cerebral palsy, and periventricular leukomalacia (PVL).

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• Neonatal Hypoglycemia: This refers to a common but potentially dangerous metabolic disturbance that happens in the neonatal period. Hypoglycemia is when the level of glucose (the source of fuel for the brain and the body) is too low in the first few days of the baby's life before regular feeding is established. Untreated hypoglycemia can cause long-term injury, including permanent brain damage, hypoxic-ischemic encephalopathy, CP, and epilepsy.

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• Meconium Aspiration Syndrome (MAS): This is a serious medical issue that happens when an infant has trouble breathing because a sticky substance called meconium gets into their lungs. In severe cases, when the baby is left without oxygen for too long, it can cause the baby to experience respiratory distress and lead to permanent conditions like cerebral palsy, seizures, and HIE.

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• Failure to Perform Hypothermia Therapy (newborn cooling): Lack of oxygen during the neonatal period can result in long-term issues such as CP and hypoxic-ischemic encephalopathy. Doctors and other healthcare professionals should begin to intentionally induce hypothermia in babies after childbirth to mitigate the consequences of lack of oxygen and potentially limit the extent of brain damage.

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• Jaundice and Kernicterus: Newborn jaundice is caused by the build-up of bilirubin (a yellow substance in the blood that the body creates when it replaces old red blood cells). While all babies are born with jaundice to some extent, if left untreated, babies are in danger of developing a rare form of brain damage called kernicterus. Untreated jaundice or kernicterus can permanently damage the brain and result in cerebral palsy, seizure disorders, speech, sight, and hearing difficulties.

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• Infant Brain Ischemia: This is a severe clinical condition that presents in the form of constricted or complete cessation of oxygenated blood flow to a prenatal or neonatal brain. When the brain is starved for oxygen due to inadequate blood, the brain will suffer from hypoxia, resulting in cell death and brain damage. Neonatal ischemia is a leading cause of cognitive, sensory, and motor impairment in children, including cerebral palsy.

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• Caput Succedaneum: Swelling of the scalp in a newborn is most often brought on by pressure on the baby's head as they move through the birth canal during a difficult or prolonged vaginal delivery. If left untreated, caput succedaneum can lead to more severe birth complications, such as newborn jaundice, which in turn can result in a baby developing cerebral palsy or other lifelong disabilities.

Other conditions of childbirth that can cause Cerebral Palsy

• Gestational Diabetes: Also known as maternal diabetes, gestational diabetes is a type of diabetes that can develop during pregnancy in a woman who did not have diabetes before she was pregnant. Some babies may grow too large to safely pass through the birth canal as a result of gestational diabetes, which puts them at risk for a complicated delivery. Gestational diabetes increases the risk of a birth injury that causes damage to a baby's brain and results in CP.

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• Group B Streptococcus (GBS): Pregnant women who carry GBS can pass the bacteria to the baby during childbirth. In newborns, GBS bacteria is the leading cause of meningitis and bloodstream infections. Bacterial meningitis can cause the lining around the brain to become inflamed and, if left untreated, can cause permanent brain damage, seizures, and cerebral palsy.

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• RH Incompatibility: Incompatibility in blood types and RH factor between mother and baby can cause jaundice and kernicterus. Without proper diagnosis and treatment, RH incompatibility can lead to oxygen deprivation, called HIE, and result in lifelong problems, including cerebral palsy. If kernicterus is left untreated, it can also cause a baby to develop CP.

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• Cephalopelvic Disproportion (CPD): This happens when the baby's head or body is too large to clear the opening of the mother's pelvis during childbirth. When a medical professional fails to identify CPD before delivery and perform a timely C-section, the baby may become stuck in the birth canal and suffer from asphyxia, leading to hypoxia and permanent brain damage. Additionally, when a doctor improperly uses forceps or a vacuum extractor to facilitate a problematic delivery, it may have a detrimental effect on the baby's brain and lead to serious consequences such as hypoxic-ischemic encephalopathy and cerebral palsy.

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• Perinatal Stroke: One of the leading causes of brain damage that leads to cerebral palsy is a perinatal stroke that occurs in the womb within the first month after birth. Blood clotting disorders and placental disorders are common risk factors that may contribute to perinatal stroke. When the signs of a stroke are obvious, doctors may administer anticonvulsant medicines to limit or stop seizures.

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• Fetal Bradycardia: Changes in an unborn baby's heart rate are critical indicators of their health, and anything below what is considered normal (120-160 beats per minute(bpm)) should be recognized as a slow heart rate (bradycardia). A slow and irregular heart rhythm can cause the baby to suffer from fetal distress and put the baby at higher risk of a birth injury like HIE that causes CP and other developmental delays.

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• Premature Rupture of Membranes (PROM): This is a medical condition that occurs when the amniotic sac holding the amniotic fluid and the baby ruptures before the onset of labor. Without proper medical intervention, loss of the protective amniotic sac lawyer puts the baby at increased risk of birth complications like umbilical cord complications and Group B strep, which can cause the baby to suffer a brain injury that leads to cerebral palsy.

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• Cholestasis of Pregnancy (ICP): Also known as cholestasis of pregnancy, this prenatal disease typically develops late in the second or third trimester and creates a temporary impairment of the liver function and raised serum bile acids. If improperly managed, the build-up of bile acids can be released into the bloodstream and cause serious problems for a developing baby. ICP can increase a baby's chances of developing HIE and MAS. Babies who suffer a birth injury related to MAS or HIE may experience long-term health issues like cerebral palsy.

Doctors, nurses, hospitals and other healthcare providers sometimes stray from standard practices used in the medical field. They may fail to provide adequate care for patients in several ways, including:

• Diagnostic errors: Medical providers involved in a baby’s birth and newborn care may misdiagnose or fail to diagnose serious conditions. This includes fetal distress that occurs during birth or conditions that develop shortly after birth, like hypoglycemia. When diagnoses are incorrect, treatment can be delayed until it is too late or the wrong treatment is given
• Surgical errors: Many medical malpractice lawsuits involve errors that occur during surgery. Outside of birth trauma, surgeons and their teams sometimes operate on the wrong patient, remove the wrong body part, perform the wrong surgery, and leave surgical tools in patients. Teams may also fail to provide proper post-surgical care, leaving the patient vulnerable to infection. Some of these mistakes are easily overcome or do not constitute a breach of patient care, but most of them do.
  

  

• Laboratory mistakes: Laboratories and their employees sometimes fail to follow standard protocols when conducting tests for patients. Using the wrong tests, providing incorrect results, and failing to follow proper cleaning guidelines can cause incorrect results that lead to incorrect diagnosis and treatment. These can lead to many complications for babies including rh incompatibility, infection or kernicterus
• Failing to provide correct treatments: Some medical workers may choose an incorrect treatment or fail to provide any treatment at all. Doctors, nurses, and other medical providers are expected to follow standards of care. When they fail to do so, patients can be injured. During labor and delivery, this includes failing to perform a timely cesarean section and failing to provide interventions for fetal distress. For newborns, medical staff must provide timely treatment for jaundice, hypoglycemia, and hypoxic-ischemic encephalopathy (HIE).
• Birth injuries: Labor and delivery is stressful for both baby and mother. Medical providers must monitor both closely, especially if they are considered at risk. For example, medical staff must watch for signs of fetal distress during fetal heart monitoring to prevent brain damage and death
• Medication errors: Patients are sometimes harmed because of incorrect prescriptions, dispensing errors, and failing to follow proper standards of care. The most often medication misuse during labor and delivery involves the use and monitoring of Pitocin or Cytotec.
  

  

• Anesthesia errors: Anesthesiologists must understand a patient’s medical history, prior problems during anesthesia, and allergies before administering anesthesia. During surgical procedures, it’s crucial that they monitor the patients and take immediate action if something is wrong.
  

  

  
  One of the major mistakes we see in the birth process is failure to take into account all of the mother’s underlying conditions that can lead not only to serious injuries to the mother but also a lack of oxygen to the baby
• Failure to prevent or treat infections: Hospitals and other medical providers should have protocols for reducing the threat of infection to their patients. But they must also stringently enforce those rules. Otherwise, patients can develop serious infections, including sepsis. During the birth and newborn process, the highest risks to babies include failure to recognize and treat Group B infection
• Equipment: Patients can be injured when equipment is defective, obsolete, or operated by untrained or poorly trained staff. For example, obstetricians may use forceps or vacuum extractors to deliver a baby. When misused, babies can be born with severe head injuries.

Hospitals can be held liable for malpractice

• Failing to develop and enforce proper policies, procedures and protocols to protect patients
• Poorly training employees or failing to train them at all
• Improper cleaning and disinfecting
• Understaffing the hospital including the labor and delivery suite and neonatal ICU so patients cannot get the care they need in a safe environment

The first person that comes to mind when a birth injury happens is the attending physician. However, depending on the facts of your situation, your doctor may not be the only party held responsible for your child's birth party.

Some of the parties that can be sued for your child's birth injury include:

• Obstetricians (OB-GYN)
• Maternal-fetal medicine physicians/specialists (MFM)
• Other obstetric professionals
• Pediatricians (including pediatric neurologists)
• Anesthesiologists
• Labor and delivery nurses
• Midwives
• Nurses
• Physician assistants
• Hospitals and healthcare facilities (including birth centers)
• Hospital administrators
• Other hospital staff
• Neonatal nurses and aids
• Neonatologists or pediatricians providing neonatal care
• Respiratory therapists
• Laboratory staff

A successful birth injury claim requires the plaintiff's lawyer to establish medical negligence legally by proving that a healthcare provider's substandard care caused harm. The plaintiff's lawyer will need to provide evidence of the following four legal elements of medical malpractice.

• Duty: When a physician-patient relationship is established, the physician owes the patient a duty of care.
• Breach: The healthcare provider breaches that duty when they deviate from the standard of care that would be expected of another reasonably competent physician in the same field and under the same or similar circumstances.
• Causation: The patient suffered injuries due to the healthcare professional's breach of duty.
• Damage: As a result of the healthcare professional's breach of duty, the patient suffered physician, emotional, or financial harm.

Clinics and hospitals may also be vicariously liable for the actions of their employees. The hospital may be held vicariously liable if it fails to make reasonable inquiries into the education, training, or licensing of an applicant or does not confirm the credentials of an attending physician.

In the event that hospitals fail to maintain adequate medical records, implement proper policies, or ensure that there are always enough nurses or support personnel on hand, they can face direct liability for any harm caused to a patient.

Birth injuries, like cerebral palsy, have a life-long impact. If your child's cerebral palsy was caused by medical malpractice, you consider filing a birth injury lawsuit and seeking compensation to help you cover costs associated with your child's birth injury. Our birth injury malpractice attorneys can help you obtain the maximum compensation available in your case and build a strong case against those at fault.

Compensatory damages are subdivided into two categories: economic and non-economic damages. Economic damages refer to verifiable monetary losses. Non-economic damages are more subjective than economic damages and represent intangible losses and suffering. Punitive damages may be awarded in cases where a healthcare professional’s actions are intentional or especially reckless. These damages are designed to punish the at-fault party and deter others from engaging in similar behavior.

Economic Damages

• Medical expenses, including the cost of ongoing treatment
• Expenses for physical, speech, or occupational therapy
• The cost of prescription medication
• Emergency treatment costs
• The cost of medical equipment or assistive devices
• Cost of special education and behavioral services
• Nursing or home care costs
• Any other injury-related out-of-pocket costs
• Home or vehicle alteration expenses

Non-economic Damages

• Pain and suffering
• Emotional distress and mental anguish
• Loss of enjoyment of life
• Lost wages for parents
• Loss of companionship and support
• Permanent disabilities, disfigurement, or impairment
• Future loss of income if the child will never be able to work
• Lost future earning capacity for parents who must leave work to care for their child

Statute of limitations specifies the maximum amount of time a person has to bring a lawsuit against a negligent doctor or hospital. This time frame can vary depending on your state and the type of claim you're filing. Your right to pursue legal action and recover compensation for your losses may be lost if you fail to file a claim before the deadline. This law varies by state and the type of claim being filed.

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The discovery rule is an exception to this rule and extends the time frame within which the injured party can file a suit. Under the discovery rule, the clock doesn't start running until the injury is discovered or reasonably should have been discovered. Consult a birth injury attorney for more information about the time limits that may apply to your case.

Mistakes made by negligent medical professionals and hospitals can change a baby's future and drastically affect a family for a lifetime. If your baby experienced trauma and was diagnosed with cerebral palsy, HIE, a brain bleed, or any other condition you believe may have been caused by medical negligence, our skilled and compassionate birth injury lawyers at Miller Weisbrod Olesky are here to help you.

Our nationally-recognized team of birth injury lawyers, registered nurses, and nurse-attorneys have assisted countless children and their families in receiving the financial compensation they need to cover the cost of their child's treatment and care. During your free consultation, we’ll investigate the facts of your case to determine how and why your child sustained a birth injury. Call us today at 888-987-0005 or use our online form to schedule your free consultation.