Table of Contents
- 1 Overview
- 2 Birth Injury Types
- 3 Signs of Birth Injury
- 4 So, what causes a birth injury?
- 5 Medical Negligence & Birth Injuries
- 6 Misdiagnosis of Maternal Health Conditions
- 7 Mismanagement of obstetric emergencies
- 8 Mismanaged Obstetric Events
- 9 Improper NICU Care
- 10 Medical Negligence Claim for Birth Injuries
- 11 Steps in a Birth Injury Claim
- 12 Damages Covered in a Birth Injury Lawsuit
- 13 Final Thoughts
Becoming a mother…Bringing a new life into this world, the most exciting as well as terrifying experience a woman would have in her life. A moment when all her hardships prove to be worthwhile.
Approximately 90% of childbirths in the United States are made each year without any problems that necessitate special medical support. So, what about the other 10%? This constitutes childbirths that need some kind of medical assistance to keep both the mother and the child healthy.
Not every baby is born with good health. Some of them are born with birth defects, while others suffer birth injuries. I don’t want to confuse you with a birth defect and a birth injury.
Birth defects are the abnormalities that develop in a fetus during the period of gestation. Birth injuries are physical damages caused in the infant during or after birth.
A birth injury results from a traumatic event during birth. The injury may occur during or after labor. Studies report that 8 in every 1,000 children in the U.S. will suffer some type of birth injury.
Birth injuries can be minor and treatable or may be complicated and life-threatening. Serious birth injuries may result in permanent disabilities, affecting the child cognitively, emotionally, and/or physically. Unfortunately, some birth injuries can even lead death of the infant.
Birth Injury Types
The most common types of birth injuries are orthopedic injuries, nerve injuries, and brain injuries.
1. Facial Nerve Injury
The loss of voluntary muscle movement in an infant’s face due to pressure on the facial nerve just before or after birth is known as facial nerve palsy. Facial nerve injury may be either due to forceps negligence during childbirth or may be due to smaller pelvis of the mother impacting pressure on the newborn’s facial nerves.
2. Hypoxic Ischemic Encephalopathy (HIE)
Hypoxia is a brain injury caused by oxygen deprivation to the brain causing destruction of the brain cells. It may be caused due to pregnancy complications or due to medical negligence during the labor. HIE may lead to further health issues in infants like epilepsy, developmental delay, motor impairment, neurodevelopmental delay, and cognitive impairment.
3. Cerebral Palsy
Cerebral palsy is a category of disorders that affect the regulation of muscles and the nervous system by the brain. Cerebral palsy results from a brain injury that occurs shortly before or after birth.
4. Shoulder Dystocia
Shoulder dystocia is a birth injury that occurs when a baby’s shoulders get trapped within the mother’s pelvis during labor. This may cause further complications like clavicle fracture of Erb’s Palsy.
5. Spinal Cord Damage
Spinal cord injuries may occur when the obstetrician pulls or twists the infant with forceps or vacuum extractors. Severe spinal injuries can lead to paralysis or permanent disability of the child.
6. Trauma to the Neck Muscles
Trauma to the infant neck muscles is called torticollis. It is a disorder in which a newborn’s neck is abnormally twisted, causing the jaw to point upward and the head to tilt to one side. It is not a permanent injury and could be treated with passive stretching therapy or in some cases with surgical intervention.
7. Fractures of the Clavicle and Femur
It refers to the fractures of the collar bone and thigh bone occurring during birth. These fractures are the common orthopedic injuries in infants during childbirth and is often treatable. Clavicle fractures contribute to 1.5% of all birth injuries.
8. Erb’s Palsy
Erb’s Palsy is caused due to the injury of the brachial plexus which is the group of nerves that travel from the neck down the arm. During childbirth, the head of the infant may be pulled in one direction and the arm in the opposite. This may cause stretching of the brachial plexus leading to weakness of the arm.
Signs of Birth Injury
- Delay in achieving milestones of development
- Hypertonic or hypotonic muscles
- Difficulty in crawling or walking
- Difficulty in swallowing
- Abnormal postures
- Poor eye contact
- Poor gross motor and fine motor skills
- Delayed language development
So, what causes a birth injury?
The following are some of the most common causes of birth injuries reported in the United States.
- Maternal Risk Factors
During pregnancy, the mother’s health issues can affect the developing fetus and have a negative effect on the newborn’s health. These are called maternal risk factors of birth injury.
Below are the most important maternal risk factors that may lead to birth injuries in infants.
- High blood pressure or diabetes
- Thyroid problems
- Premature membrane rupture
- Prolonged labor
- Complications in cesarean delivery
- Cephalopelvic disproportion- where the size and shape of the mother’s pelvis does not support vaginal birth
- Infant Risk Factors
Infant risk factors refer to the complications associated with the fetus during the gestation period that results in birth injuries. The common infant risk factors causing birth injuries are as follows.
- Overweight of the baby
- Premature birth
- Abnormal fetal position
- Medical Negligence
When a doctor or nurse takes a decision that is contrary to ethical ethics and causes damage to the mother and/or infant, this is known as medical malpractice.
Medical Negligence & Birth Injuries
In legal terms, Med mal is associated with birth injuries when medical practitioners fail to provide the standard of care, which may lead to an injury in the infant.
When maternal and infant risk factors are unavoidable complications that may cause birth injuries, medical negligence is preventable. The harsh truth is that improper prenatal medical care by physicians or other medical professionals may lead to severe birth injuries in infants.
Well, Let’s take a gander at some instances of medical malpractice that may lead to birth injuries.
Medical malpractice leading to a birth injury can involve the following factors.
Misdiagnosis of Maternal Health Conditions
In some cases, maternal health conditions are not monitored properly during the gestation period which causes birth injury complications in the infant. Routine check-ups of the mother with imaging studies and blood investigations should be carried out periodically during pregnancy to avoid birth injuries related to maternal health issues. This is very important especially in high-risk pregnancies to ensure that both the mother and the baby are doing well during the pregnancy.
Mismanagement of obstetric emergencies
Childbirth could quickly deteriorate into situations that necessitate immediate or emergency action. Some common emergencies are fetal distress, placental ubruption, uterine rupture and umbilical cord prolapse. When doctors delay a C-section for too long, it can lead to oxygen deprivation thereby, leading to brain damage in the infant.
In such instances, the medical personnel involved in labor may not be able to handle such situations well that may lead to birth injuries. Well-trained and experienced medical professionals can deal with obstetric emergencies and prevent such birth injuries.
Mismanaged Obstetric Events
Inappropriate use of forceps, vacuum extractors and other birthing tools may cause superficial and temporary birth injuries to the baby. In rare cases, this can even lead to facial nerve injury and even brain damage. Another medical malpractice is exerting unnecessary physical force to the infant during childbirth. This may cause swelling and bruising of the head of the infant or even cause blood clots.
Improper NICU Care
An infant taken care in the Neonatal Intensive Care Unit (NICU) for any health issue may develop serious injuries. This is due to the negligence of the NICU nurses and physicians in providing timely treatment and care to the infants. Diseases like jaundice and neonatal hypoglycemia are some of the conditions that when not managed properly may cause permanent birth injuries in the infant.
Medical Negligence Claim for Birth Injuries
As per the birth injury law, if an infant suffers birth injury due to the medical negligence of the obstetrician or any medical staff, parents are entitled to compensation.
The plaintiff has the legal burden of proof when pursuing medical negligence claims for birth injuries. A birth injury attorney may guide the parents in pursuing a medical negligence lawsuit. For pursuing a birth injury claim, some states demand an affidavit signed by a medical practitioner.
In the US, under the doctrine of “respondeat superior,” the hospital or birthing centre is the primary defendant in such a lawsuit. Individual providers can also be sued depending upon the particular case. Other defendants in a birth injury lawsuit would be the obstetrician, other medical staff, or pharmaceutical companies
To prove the negligence, the plaintiff must prove that the defendant violated a legal obligation or standard of care and that this violation caused a birth injury. This demands expert testimony by a medical expert. He would carefully evaluate all medical and hospital records related to the baby’s gestation, birth, and neonatal care.
With medical records as evidence, the expert should testify that
- Malpractice or medical neglect occurred to a fair degree
- The negligence resulted in a birth injury in the infant
- The birth injury has affected the infant’s health and life
It is important to note that in every state of the US, the parents are provided with a limited window of time within which the claim has to be filed. It is called the statute of limitations which may differ from one state to the other. In Florida, the statute of limitation for a birth injury medical negligence claim is two years from the date when the child suffered the birth injury. However, in Chicago the statute of limitation is eight years from the date of the incident.
Steps in a Birth Injury Claim
A birth injury lawsuit proceeds through the following six steps.
- Sending demand letter to the defendant
- Building the case if the demand letter is rejected
- Filing the claim
- Discovery phase
- Trial & Appeal
The demand letter is sent by the birth injury lawyer to the defendant which accommodates the estimate of expenses and compensation to be given to the plaintiff. If the demand letter is not accepted by the defendant, the plaintiff’s attorney would build a case and file the lawsuit. In the next step, attorneys on both sides gather evidence to support their argument which is called the discovery phase.
Attorneys on both parties may attempt to negotiate and come to an agreement through a settlement outside the court. If a reasonable settlement is not reached, then it may proceed towards a trial. The trial and appeals process could drag out the case for months or years, causing a huge financial burden on the family of the child.
Damages Covered in a Birth Injury Lawsuit
The case value of a birth injury claim depends upon the severity of the injury and the impact it has on the infant’s health and future. There are birth injury lawsuits where the affected families have received millions of dollars as compensation.
During a birth injury lawsuit, the attorney projects the estimated expense of the infant as Lifecare plan. Through this, the following damages may be covered in a birth injury claim.
- Immediate and ongoing medical expenses
- Physical therapy, occupational therapy and other rehabilitation costs
- Special education costs
- Other healthcare-related expenses
- Current and future care costs
- Cost of adaptive equipment and home modification
- Future medical expenses of the infant
- Loss of income of the parents
- Pain and suffering of the parents
The good news is that technological advances have helped to minimize the number of birth injury incidents in the United States. However, birth injuries are unfortunately too common.
There is nothing more heartbreaking for parents than having a baby with a lifetime disability. That too when it’s because of someone’s negligence it can never be justified. Though seeking financial claims would never compensate for the loss, it may help to improve the child’s overall quality of life.
Proving negligence in a birth injury case depends on the argument of the medical malpractice attorney. It should be established that the defendant failed to give the standard of care what a reasonable doctor would have done under the circumstances. Medical reports of the infant, as well as the mother, would help the attorney to prove the medical negligence aspect.