Charlotte, North Carolina Birth Injury Attorney
Law Offices of Terry Duncan

Birth Injuries are sometimes so severe they affect the baby for the rest of their life.  This is especially true if the doctor, nurse or hospital has caused the injury.  Examples of birth injuries are lack of oxygen causing cerebral palsy, forced delivery that causes paralysis to body parts, wrong medications, failure to perform a caesarian section when needed, failure to diagnose and treat a problem during pregnancy, and other brain injuries.

Regretfully, many children must live the rest of their lives in this poor condition.  They will need on going care and medications they may cost millions of dollars during their lifetime.  According to an article in the Montgomery County Sentinel, attorney Dov Apfel stated that "approximately 3,000 children are diagnosed with cerebral palsy every year in the United States. Cerebral palsy is a neurological condition appearing early in life that can affect gross and fine motor skills in both the legs and the arms (quadriparesis), either the legs or the arms (diplegia), or one side of the body (hemiparesis). Some children diagnosed with cerebral palsy also may develop seizures, have sensory deficits (such as hearing or vision loss), and/or suffer from mental retardation and learning disabilities.

Whatever its particular manifestation, children with cerebral palsy have special needs for costly medical and educational services which have the potential to dramatically improve the quality of their lives. Sometimes the clinical condition of the newborn immediately after birth will alert the physicians and parents to the fact that the baby has suffered a brain injury. In other cases, the parents may not realize that their child suffered a brain injury until the child fails to achieve developmental milestones during the first years of life.

Regardless of when the parents find out about their child's condition, when they ask physicians for an explanation as to why their child suffered an irreversible brain injury, they are often told that the outcome was unavoidable. However, some parents suspect that the facts and circumstances that led to the brain damage are not being fully disclosed. These parents may decide to retain an attorney to help them to investigate the etiology and timing of their child's brain injury to determine whether the cerebral palsy could have been prevented with proper obstetric or neonatal care or earlier delivery.

In courtrooms throughout the United States, lawyers and doctors often debate the causes of cerebral palsy and whether it is preventable. There are several possible explanations. Genetic abnormalities and certain types of metabolic diseases and viral infections are risk factors for cerebral palsy. Some physicians routinely blame unidentifiable, undocumented events occurring before labor and delivery for causing brain damage; others blame low birth weight and prematurity. Some infants sustain brain injuries due to trauma caused by the improper use of forceps and vacuum extractors, or as a result of undiagnosed and untreated bacterial infections. Yet another group of infants who are diagnosed with cerebral palsy suffered perinatal or birth asphyxia. (Asphyxia refers to a sequence of events that begins when blood flow to the brain is reduced (ischemia), or the oxygen content of the blood perfusing the brain falls below normal levels (hypoxia). As the hypoxia or ischemia persists, harmful acids capable of causing brain damage can accumulate in the blood leading to metabolic acidosis.)

The knowledge that potential neurologic injury can result from asphyxia must play an important role in shaping the standard of obstetric care and the timing of delivery. During pregnancy, the developing fetal brain depends on an uninterrupted supply of oxygen and glucose. Thus, every clinician must be on the lookout for signs that the fetus' oxygen or blood supply is being compromised and that the potential for asphyxial brain damage is present. Moreover, it is well-known that the potential for severe and diffuse brain injury increases with the severity and duration of the hypoxia or ischemia. Thus, cerebral palsy may occur in some children because the clinicians failed to recognize and properly manage the underlying maternal or fetal conditions that led to birth asphyxia. One example of a tool that is available to help clinicians avoid fetal asphyxia and death during the pregnancy is electronic fetal monitoring. The fetal heart rate in both premature and term fetuses manifests abnormalities, such as late decelerations and decreased variability, when the fetus becomes hypoxic or acidotic.

Abnormal fetal heart rate patterns can signal a developing crisis for the fetus that can be prevented by timely intervention and expedited delivery. Thus, for electronic fetal monitoring to help doctors and nurses determine whether the fetus is being compromised in utero, doctors and nurses must be properly trained to recognize "abnormal" or "nonreassuring" fetal heart rate patterns. More importantly, they must appreciate the potential dangers associated with specific patterns and expedite the delivery in those circumstances where fetal well-being cannot be confirmed. Obviously, obstetricians believe that they can take steps to try to improve the outcome of every pregnancy. Why else would they emphasize the importance of prenatal care, order ultrasounds and other prenatal tests of fetal well-being, utilize electronic fetal monitoring during labor and delivery, and expedite delivery -- often via cesarean section -- when there are indications of fetal distress?

Specialists in obstetrics, neurology, pediatrics, pathology, and radiology continue to acknowledge that asphyxia can cause cerebral palsy and other permanent neurological complications. Unfortunately, however, cases of cerebral palsy continue to occur because some clinicians fail to recognize and to respond to fetal heart rate patterns suggesting the presence of hypoxia and developing acidosis and to expedite the delivery before the onset of irreversible brain damage. Thus, it is reasonable for parents to ask lawyers to review the medical records of a newborn - whether full term, low birth weight (less than 2,500 grams at birth), or born prematurely (less than 37 completed gestational weeks)  to determine if there were signs of fetal distress during the pregnancy or if the child suffered asphyxia at, or close to, the time of delivery.

Some of the questions that may be answered during the evaluation of a potential claim of medical negligence are whether the physician:

(1) diagnosed all maternal and fetal conditions capable of interfering with normal oxygenation of the fetus,
(2) ordered appropriate tests to assess fetal well-being,
(3) recognized the clinical signs of fetal distress,
(4) attempted appropriate interventions to eliminate the abnormal fetal heart rate and to increase oxygen delivery to the fetus,
(5) recognized signs of progressive hypoxia and developing acidosis, and/or
(6) expedited the delivery before the condition causing the fetal distress resulted in irreversible brain injury or death.

To properly answer these questions, lawyers should understand the mechanism of birth asphyxia and how it can cause irreversible brain injury and cerebral palsy. It is also important for lawyers to be familiar with, and to have access to qualified medical experts who are knowledgeable in, a wide range of medical topics, including but not limited to: electronic fetal monitoring, placental pathology, pediatric neuroradiology, antepartum fetal testing, maternal and neonatal infection, and the assessment and management of respiratory distress and other newborn complications.

The economic burden of caring for a child with cerebral palsy is overwhelming. When the evidence establishes that the brain injury could have been prevented, it is reasonable for the parents to resort to the legal system to obtain financial assistance from the negligent parties to help the parents provide long term care for their child.  Who is going to pay for their future needs.  Remember that most hospitals, nurses, and doctors have insurance to pay for their mistakes.

In the event this type of injury has happened to your child, you must act quickly. Please give us a call at 704-563-1224 or 1-800- 281-6917 to set up a free consultation to discuss your case. We work on a contingency basis.  You will usually owe us no money unless we win money for you and your child. 

If you would like a free consultation to discuss how we can help you please give us a call.

Please contact Terry Duncan today or use our free evaluation form.

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