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WHAT IS BIRTH INJURY?
Birth injury refers to any damage suffered by an infant during the process of birth. Birth injury can encompass a wide array of problems ranging from minor to major. Birth injury can be used to describe a minor problem such as a superficial laceration or a major problem like severe hypoxic brain injury that could leave a baby brain dead. The actual injury can occur before, during, or immediately after birth. Babies can suffer serious medical problems as a result of negligent prenatal care, delivery, or post-delivery care. Birth injuries commonly occur as the infant travels through the birth canal. Childbirth places a significant amount of pressure and stress on the baby. Birth injury is a tragic but common event that can have long term impact on the mother and child. In a birth injury case one has to show that the injury was avoidable and that the healthcare provider’s care was inadequate. Babies injured at birth may become permanently disabled and require life-long care. Some babies even die from birth injury.
Medical malpractice claims involving birth injuries are some of the most emotionally charged cases that our law firm handles. There are two main types of injuries that can occur during the birth/delivery process - injuries from trauma , and injuries from lack of oxygen and blood to the brain. Medical errors at the time of delivery can also lead to birth injury. Improper application of forceps or vacuum extractors can cause brain injuries or death. Medical professionals have a responsibility to properly diagnose conditions that could lead to birth injury and provide treatments that eliminate the chance of birth injury will occur.
CAUSES OF BIRTH INJURY
There are many causes for birth injury. Some causes of birth injury are natural or genetic, meaning that they are not the result of any human error. While other causes of birth injury result from human error and negligence. Anything that disrupts the blood or oxygen delivery to the developing fetus could lead to birth injury. Twisting of the umbilical cord, compression of the umbilical cord, placental disruption or separation, or excessive uterine compression of the fetus can result in suboptimal oxygen and blood delivery to the fetus. Any trauma in the mother’s womb could lead to birth injury. This trauma could result from an accidental fall. The impact from the fall could directly injure the fetus and the supporting tissue like the amniotic sac and uterus. It could create internal bleeding inside the uterus putting pressure on the fetus compromising blood flow and oxygen delivery to the fetus.
Birth Trauma can cause birth injury. Birth trauma is a term used to describe traumatic injury that is directly related to the normal course of child birth. Excessive uterine contractions can create so much force that the uterus itself ruptures. When this happens it is a serious emergency that can peril the life of the baby and mother. Birth trauma can also result from the excessive and inappropriate traction put on the baby as it travels through the birth canal. Excessive traction on the arm of a baby can result in nerve damage in that arm leading to a brachial plexus injury.
Birth injury can also result from infection. There are some serious bacterial and viral infections that can infect a mother’s body which can damage fetal organs including the brain.
Birth injuries can be caused by blood incompatibility between the mother and fetus. If maternal and fetal blood mixes proteins in the mother’s blood may attack the baby’s blood creating what is called an ABO RH transfusion reaction. As a result of this transfusion reaction chemicals like bilirubin are released from the baby’s blood and can reach toxic levels leading to brain injury and birth injury. The doctors and nurses have a duty to minimize the chance of these blood incompatibilities.
Inappropriate administration of medication can lead to birth injury. If an inappropriate dosage of medication , such as pitocin, is given that causes excessive stimulation of the uterus, this can put excessive pressure on the umbilical cord compromising blood flow to the baby. Other inappropriate medications such as Demerol or other narcotics, may decrease the respiratory drive of the mother leading to inadequate oxygenation of the blood flowing to fetus. As a result the fetus could suffer brain injury.
Failure to provide adequate care that is within the accepted standards of practice during pregnancy, labor or delivery can result in significant birth injury, disability and even death. During the birthing process, failure to diagnose a situation, take appropriate preventive measures, or quickly respond to events such as fetal distress or a lack of oxygen to the baby, can produce devastating results. Birth injury can be caused by mistakes made by doctors, nurses, medical professionals, and hospitals. Failing to take necessary actions in a timely manner, for example failing to quickly perform a cesarean section, or misjudging the situation can lead to birth injury.
Birth injury can be caused by the use of forceps or a vacuum delivery. The use of forceps or vacuum delivery devices sometimes creates excessive pressure on the baby’s head and brain. This pressure can lead to scarring , cranial fractures, and even bleeding underneath the cranial bones called cephalohematoma. These injuries frequently result in birth injury and even brain injury.
Excessive traction or compression of the umbilical cord can lead to birth injury. Compression of the umbilical cord restricts blood and oxygen flow while a child is being born. Birth injury can occur if a mother labors too long, or if a mother is unable to deliver vaginally. Other factors that can lead to birth injury include a fetus being too large, positioned incorrectly during birth, or born prematurely. Babies with a birth weight over 4,000 grams (8 pounds, 13 ounces) are at higher risk, as are babies born before 37 weeks of pregnancy. Any interruption in the flow of oxygen to the brain while the fetus is still in utero can result in birth injuries.
Call now to speak with a birth injury attorney or birth injury lawyer at the Kane | Varghese Law Firm. Birth injury attorneys and birth injury lawyers are standing by to answer any questions you may have about a birth injury case. We offer free consultation.
Cerebral palsy is a type of birth injury resulting in permanent brain injury. Cerebral palsy results from injury to the cerebrum (the largest portion of the brain involved with higher mental functions, processing sensations, and initiating voluntary muscle movements). Cerebral palsy can be the result of an injury to a baby's brain in the womb, during delivery, or after birth. It can result from trauma during birth or the lack of oxygen flow to a baby's brain during delivery. Cerebral palsy describes a spectrum of permanent movement disorders affecting body and muscle coordination. Motor skills, senses, muscles, mental development, and many other areas are affected by this disease. Cerebral palsy affects an infant and child’s ability to control his or her own movement. There are three main categories of cerebral palsy which are classified on the specific type of disability of motor function exhibited. These three types are: ataxic cerebral palsy, athetoid cerebral palsy, and spastic cerebral palsy. A child with ataxic cerebral palsy has difficulty with balance and depth perception.
A child with athetoid cerebral palsy has movements he cannot control. A child with spastic cerebral palsy has stiff muscles with frequent muscle spasms which restricts movement. Some children have a mixed type of cerebral palsy exhibiting a combination of signs of all three. Often a diagnosis of cerebral palsy is not made until many months and even years after a child’s birth. Cerebral palsy and brain damage affect more than 10,000 babies each year. Cerebral palsy affects each child differently, but it is not curable. Cerebral palsy can differ in its severity from mild to very severe. Severe cerebral palsy will usually necessitate the use of a wheelchair and the parts of the brain that control speech and other functions may be effected. Cerebral palsy causes many different problems, including poor motor skills, breathing difficulties, seizures, poor sense perception, and poor bowel or bladder control. Some children with cerebral palsy have a hard time performing basic tasks such as eating, walking, speaking, and reaching for objects. Children with cerebral palsy and other types of brain damage may need special assistance to perform the daily tasks of life. They may need occupational therapy, physical therapy, medications, and possibly lifelong nursing care. In addition to dramatically affecting the child and his or her family for a lifetime, the treatment for cerebral palsy can also be a very expensive burden for an average family.
Parents who suspect their child may have cerebral palsy should look for some tell tale signs of cerebral palsy which include: excessive stiffness, excessive lack of muscle tone, delay in sitting, inability to sit up by one’s self, delay in crawling, delay in grabbing or reaching for objects, or unexplained seizures. If you feel your child suffers from cerebral palsy as a result of medical malpractice, call Kane | Varghese Law Firm for immediate help.
Shoulder dystocia—occurs when a baby’s shoulder gets stuck behind the mothers supra-pubic pelvic bone during a vaginal birth. This prevents the baby from being delivered easily. If shoulder dystocia occurs, different delivery maneuvers are attempted by the physician to dislodge the stuck shoulder. Sometimes a physician will need to electively break the baby’s collar bone to dislodge the shoulder to deliver the baby through the birth canal. If a health care provider does not manage shoulder dystocia appropriately it can lead to birth injury. Shoulder dystocia is a common birth complication that leads to birth injury in about 20 percent of the people it happens to. Many of these babies develop a brachial plexus injury.
BRACHIAL PLEXUS INJURIES
Brachial plexus injury, also called Erb’s palsy, Klumpke’s palsy, and brachial plexus palsy, are terms which describe paralysis of the arm or hand due to damage of the major nerve bundles that come from the neck down the shoulder region. Brachial plexus palsy can occur during a difficult childbirth and can be the result of medical malpractice. Brachial plexus palsy occurs in 0.4 to 5.1 infants per 1000 live birth. It occurs when there is difficulty delivering the baby's shoulder, called shoulder dystocia, or when the baby’s shoulder is stretched during passage in the birth canal.
The factors that could lead to shoulder dystocia include large newborn size, use of forceps or vacuum during delivery, a breech delivery and extended labor. If excessive force is used to pull the baby from the womb, nerve damage can result when the newborn’s head and neck are pulled to the side as its shoulders pass through the birthing canal. Brachial Plexus Palsy occurs when the brachial plexus (the group of nerves that supplies the arms and hands) is injured, which causes the baby to lose the ability to flex and rotate the arm. Children with brachial plexus injuries may require multiple surgeries and years of physical therapy. Special exercises are also used to help maintain the range of motion of the arm. Infants with brachial plexus palsy can benefit from surgical procedures to increase their arm function. Since most children with Erb's Palsy have damage to multiple nerves of the brachial plexus, more than one procedure, preformed by a pediatric neurosurgeon, may be necessary.
When bilirubin levels reach a toxic level in a newborn they can cause serious brain damage called kernicterus. Common causes leading to the buildup of these toxic bilirubin levels include neonatal or fetal infection, and maternal fetal blood reaction. The maternal fetal blood reaction can be the result of the mom and fetus having different blood types. Introduction of maternal blood into the fetal body leads to the mother’s immune system attacking the fetal blood cells causing a disruption of the fetal red blood cells. The break down product of the fetal blood cells leads to the elevated bilirubin level. Doctors and other health care providers need to be vigilant to look for signs of elevated bilirubin levels and treat the underlying causes aggressively to avoid kernicterus and brain injury.
Oxygen deprivation is a major cause of birth injuries. Oxygen deprivation to the fetus commonly occurs when the umbilical cord is compressed or twisted in the birth process. It can also occur from any significant disruption of the placenta or from excessive uterine contractions or uterine pressure. The brain is acutely sensitive to oxygen deprivation. If oxygen deprivation is serious enough it may cause permanent brain damage to the new born baby. The more severe the oxygen deprivation the more significant the brain injury that results. Oxygen deprivation can lead to mental retardation, hypoxic encephalopathy, anoxic encephalopathy, cerebral palsy, and other types of brain damage. Fifteen to twenty percent of all infants exhibiting hypoxic encephalopathy will die during the newborn period. Of those who survive, approximately 1 in 4 will have permanent problems, including mental retardation, epilepsy, learning disabilities and cerebral palsy.
Anoxic Encephalopathy and Hypoxic Encephalopathy are terms used to describe brain injury from oxygen deprivation.
Hypoxic Brain Injury (Hypoxic Encephalopathy also known as Hypoxic Ischemic Encephalopathy HIE) occurs when there is a decrease in the delivery of oxygenated blood flow to the brain resulting in brain injury. When the cells in the brain do not receive the proper oxygen they need to maintain cell function the brain cells die. As a result permanent brain injury may occur. The lower the concentration of oxygen that is delivered to the brain, and the longer the period of oxygen determines the extent of brain injury.
Anoxic Brain Injury (Anoxic Encephalopathy also knows as Hypoxic anoxic injury HAI) occurs when there is a complete absence of oxygen flow or blood flow to the brain. This typically results in more serious brain injury as compared to hypoxic brain injury. The duration of the anoxia will determine the severity of brain injury. Monitoring the degree to which an infant is adequately oxygenated is critical during the birth process: this is why electronic fetal monitoring is vitally important in the hours leading up to birth. An elevation in heart rate (tachycardia) may be an indication that an infant is experiencing a potentially life-threatening problem. The fetal heart monitor is a machine that is used to monitor fetal well being, and the signs of fetal distress. Specific patterns on the fetal heart monitor machine can notify physicians and nurses early when a fetus is not receiving the proper oxygen or nutrients the fetus needs. If the fetus is not receiving the proper oxygen or blood it needs the doctors and other healthcare providers need to take immediate action to correct the problem. Sometimes the appropriate treatment to protect the baby’s health requires an immediate cesarean section.
The consequence of having either Hypoxic Brain Injury (HIE) or Anoxic Brain Injury (HAI) is devastating on the baby. Children with these brain injuries typically have a significant decrease in brain function. They may have difficulty feeding, difficulty maintaining body temperature, difficulty moving their arms and legs, and developing appropriately as other babies do. Infants commonly will have either excessive muscle tone causing spasticity or a lack of muscle tone called hypotonicity. Either way they are not able to move their body appropriately. Many babies with hypoxic brain injury and anoxic brain injury have injury to the visual center of the brain resulting in blindness. They frequently have seizures and epilepsy as a result of their brain injury. The medical and social care that children require as a result of hypoxic brain injury and anoxic brain injury is enormous. The costs for medications, doctors visits, hospitalizations, necessary surgery, physical therapy, occupational therapy, and 24 hour care to help with the activities of daily living alone can cost millions. That is why it is important to call Kane | Varghese Law Firm, so we may start our investigation immediately into the cause of your baby’s hypoxic brain injury and or anoxic brain injury case. We will fight to get you the money you deserve to compensate you for your child’s brain injury and to help you to continue to pay for medical expenses to take care of your brain injured child.
Fetal distress is a term used to describe a fetus in stress. Fetal stress is often the result of a decrease in the flow of oxygen and blood to the fetus. Prolonged fetal distress leads to birth injuries. Medical staff can detect signs of fetal distress by using a fetal monitor to observe changes in a newborn's heart rate and rhythm. When distress is recognized, it is extremely important for healthcare providers to take immediate steps to prevent further oxygen deprivation by performing immediate maneuvers or procedures to decrease fetal distress. Often an immediate cesarean section is the best way to resolve the problem.
COURSE OF BIRTH INJURIES
Infant outcome is the product of multiple factors. Separating the effects of a hypoxic-ischemic insult from those of traumatic birth injury is difficult. Infants often survive these birth injuries but may require many years of rehabilitation.
Babies with birth injuries often require extended hospitalization, multiple surgeries, and many require special and expensive care throughout their lifetime. Our experienced birth injury attorneys work with families to secure the financial resources required for the long term care of birth injuries.
Birth injury cases are very complex, and require a great deal of investigative work, time, and attention. You can trust that your case will be handled by an experienced attorney who genuinely cares about the needs of you and your family. Birth injury cases usually result in very large financial settlements to offset a lifetime of medical bills.
PROSECUTING YOUR BIRTH INJURY CLAIM
The Kane | Varghese Law Firm is a premiere birth injury law firm. Dr. Kane, one of the founders of Kane | Varghese is not only a medical malpractice attorney, but also a practicing physician. He has delivered hundreds of babies in his career. He has managed difficult deliveries, and even assisted during emergency cesarean section surgeries. He knows how to interpret fetal heart monitor strips. He knows the importance of being vigilant during child birth and making the right decisions to protect the health of the mother and the baby.
At Kane | Varghese Law Firm, we work closely with medical experts to determine whether a birth injury is the result of medical negligence. Birth injury cases are handled by a team of professionals, including nurses, doctors, and other experts. State-of-the-art technology is utilized to effectively present claims.
Birth injury lawsuits are complex and time-consuming, because expert medical testimony is expensive and sometimes reluctant. Medical professionals aren’t always willing to testify against each other. Assessing damages is a complicated process. At Kane | Varghese, we work with a team of experts to calculate the dollar amount required for you or someone else to care for your disabled child, the cost for therapy, rehabilitative services, medications, doctor visits, future medical costs and equipment needed to raise your child. Babies with birth injuries often require extended hospitalization and many require special and expensive care throughout their lifetime. At Kane | Varghese our experienced birth injury attorneys work with families to secure the financial resources required for the long term care of birth injuries.
COMMON MISTAKES THAT LEAD TO BIRTH INJURY:
Failure to adequately monitor pregnancy, including mother and baby.
Failure to perform appropriate testing during pregnancy.
Failure to treat screen for and treat infections during pregnancy and the perinatal period.
Failure to adequately monitor fetal heart monitor strips.
Failure to adequately monitor vital signs, and oxygen saturation .
Inappropriate administration of medications including pitocin.
Failure to perform cesarean section in a timely and adequate manner.
Failure to treat maternal fetal blood transfusions and RH incompatibility
Failure to adequately staff labor and delivery floor, and or surgical cesarean section floor.
Failure to call specialist support, such as perinatologist or neonatologist to deal with difficulties during delivery.
Failure to follow hospital protocols.
Call now to speak with a birth injury attorney or birth injury lawyer at the Kane | Varghese Law Firm. Birth injury attorneys and birth injury lawyers are standing by to answer any questions you may have about a birth injury case. We offer free consultation. outcome complained of, would not have occurred but for the negligent medical treatment received. A patient must prove for example, that a reasonable doctor would not have treated the patient in the manner complained of. More specifically, there must be acts or omissions that a healthcare provider engaged in that resulted in the injury to the patient.
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