Value of Cerebral Palsy Cases in Maryland
Cerebral palsy is permanent disability that is caused by injury to a baby’s brain from oxygen deprivation during childbirth or pregnancy. When oxygen deprivation occurs during labor and delivery it is often an indication that doctors or hospital staff were negligent. If you believe that a doctor's mistake may have caused your child's cerebral palsy, you may want to seek compensation for both you and your child.
You may not know whether your child's cerebral palsy was caused by a medical mistake or negligent care. While not all cases of cerebral palsy are caused by medical malpractice, many are. The results can be tragic.... and infuriating because so much harm is caused.
If you suspect that your child or a family member may have been injured during birth by a medical mistake that could have been prevented, our cerebral palsy lawyers can investigate your claim and help determine if you are entitled to financial compensation in a medical malpractice case. For more information, call 800-553-8082 or get a free online consultation here.What is Cerebral Palsy?
Cerebral palsy is an umbrella term that describes a group of related disorders in a child’s brain is damage during birth or earlier in the womb leaving them unable to coordinate and control certain parts of their bodies. Although cerebral palsy has probably afflicted us from the beginning of time, there is little in the "medical literature" (if you can call it that) before the mid-1800s.
The brain functions like the command and control center for the entire body. The brain transmits electrical signals or messages across nerve pathways to control and direct every movement of the body. In people with cerebral palsy, these messages between the brain and the rest of the body become scrambled. As a result the brain sends distorted and confusing movement signals to certain muscles causing them to react abnormally and causing impaired walking, speech, balance and coordination. Cerebral palsy is a permanent disorder but it is not progressive or communicable. Some children with cerebral palsy are also affected by other medical disorders, but cerebral palsy does not always result in a profound handicap.
Regrettably, there is no cure for cerebral palsy. However, with therapy and modern technology, people with cerebral palsy often lead productive and, more importantly, happy lives. There are a lot of great kids with cerebral palsy who are living great lives. But these children require special support and often need help to pay for their care and other services. This is where, when appropriate, malpractice lawsuits come into play.Causes of Cerebral Palsy – Malpractice and Otherwise
The causes of cerebral palsy vary. Some cases of cerebral palsy are the result of a congenital malformation of the brain related to genetic or developmental abnormalities and not caused by factors during pregnancy or childbirth. However, most cases of cerebral palsy are the direct result of brain damage that the child sustains before, during or immediately after childbirth.
The brain damage that causes cerebral palsy is generally the result of prolonged lack of oxygen or physical trauma to the head during gestation or the labor and delivery process. This sort of injury to a baby’s brain is commonly caused by medical malpractice or error by the physicians delivering the baby. Some of the most common types of medical malpractice resulting in cerebral palsy include:
- Delayed C-Section: many children end up with cerebral palsy because they were deprived of oxygen for a prolonged time period during labor and delivery. Doctors and hospital staff in a modern labor and delivery room have the ability to deliver any baby via emergency C-section in 10-15 minutes. This makes the emergency C-section the ultimate lifeline in the delivery room. If a baby’s supply of oxygen is disrupted during delivery, an immediate cesarean delivery can almost always prevent brain injury and cerebral palsy. Unfortunately this doesn’t always happen. Too often doctors and nurses tend to ignore fetal stress warnings and wait too long before resorting to a C-section. Almost all cerebral palsy malpractice lawsuits involve C-section delays.
- Fetal Monitoring Negligence: today all hospital labor and delivery units utilize electronic fetal monitoring (EFM) devices. These devices continuously track the baby’s fetal heart rate throughout labor and delivery. Patterns in the fetal heart rate tracings can tell doctors when the baby is under stress and possibly suffering from oxygen loss. The EFM tracings essentially warn doctors and nurses when something is going wrong so that they can decided whether to intervene with an emergency C-section lifeline. For these devices to be effective, however, requires careful monitoring and the appropriate response by the delivery team. Unfortunately, doctors and delivery room nurses often ignore EFM warnings until it is too late to prevent harm to the baby. Failure to take appropriate, timely action in response to EFM warnings is a common theme in many cerebral palsy cases.
- Forceps Negligence: when a baby is stuck in the birth canal doctors often use obstetric forceps to facility delivery. Forceps are like a big pair of tongs with curved cups on the ends. The cups are used the grip the baby’s head to enable the doctor to manually maneuver them through the birth canal. Forceps must be used very carefully and skillfully. Too much force or pressure can easily injure the baby’s head. Trauma to the baby’s head from forceps can sometimes lead to internal brain damage and cerebral palsy.
You have to remember that almost all babies are delivered without any mistakes. If a suit has been filed, you are dealing with a very rare delivery. And, yes, some doctors for varying reasons make awful mistakes that cause lifelong consequences. Looking back in hindsight, it is sometimes hard to imagine how the mistake, or the chain of errors, occurred.
A classic example is the failure to pay attention to the fetal heart monitor (EFM). We have been using these fetal monitors for 55 years. Their use is so widespread because they are a great tool in telling us if a fetus is in distress.
Here's the problem: many EFMs produce a lot of false-positive results. That's okay, you go back and perform the tests that need to be performed to rule out a complication that might require more aggressive action to deliver the infant safety. Some doctors roll their eyes and an abnormal heart rate.
The thinking, apparently, is that only inexperienced doctors freak out about such things. But ignoring potential signs of complication - even those that are usually insignificant - can lead to problems. When we are talking about the amount of oxygen a child has before birth, the problems can change the life of that child forever: fetal distress-asphyxia causes cerebral palsy and brain injuries that can't be fixed.
Having access to fetal monitoring strips generated by a fetal monitor does something else unrelated to the treatment of the mother and child. It gives plaintiffs' attorneys the opportunity to have real evidence to present to the jury as to what happened. Doctors control so much of "what happened?" information and, like most people, they have a proclivity to interpret facts in a way that gets them out of trouble. If a child later developed a birth injury, no amount of speculation about the baby's distress could overcome the trusted obstetrician's memory. Now, we have EFM strips don't lie because it does not just monitor the baby - it records what happened and is often the key proof in cerebral palsy cases.Defenses From Doctors in CP Injury Cases
The bedrock defense that is always raised in cerebral palsy malpractice cases is that a health care provider's mistake is only rarely a cause of cerebral palsy, mental retardation, and other birth injuries. This argument implies that there really is not much that can go wrong during childbirth.
Of course, this is silly. If you have any doubts, tell an obstetrician that you are considering a using a midwife instead of an OB. Virtually everyone will launch into a speech about all of the things that can go wrong during labor and delivery without good care. These doctors - after they have been sued - want it both ways: good delivery care is essential. Yet they end up arguing that there is nothing they can do to screw it up. Like lawyers sometimes do, admittedly, this is doctors talking out of both sides of their mouth. The reality is that there are many things that can and often do go wrong during childbirth. This is exactly why most babies are delivered in hospitals by doctors.
Still, extremely well-paid defense experts have continued to deny that cerebral palsy can be caused a mistake during delivery. There is has never been, to our knowledge, a CP case where the doctor did not offer a defense regardless of the facts and circumstances surrounding the care.Maryland Cerebral Palsy Settlements and Verdicts
Below are summaries of recent verdicts and reported settlements in cerebral palsy malpractice cases in Maryland. For cerebral palsy settlements and verdicts outside of Maryland see our page on Value of CP Cases.
- 2015, Baltimore County: $2,000,000 Verdict. A female is having her baby delivered at St. Joseph Medical Center via Cesarean section. The plaintiff claims that the doctors fail to recognize that the baby is premature before the birth, miscalculating the fetal age by three critical weeks. So instead of taking steps to delay and therefore proceed with the delivery, resulting in a premature baby. The baby suffers periventricular leukomalacia and cerebral palsy. The doctor and hospital deny liability for the injuries to the newborn. However, a jury agrees with the plaintiff and awards her $2,000,000.
- 2013, Prince George's County: $9,500,000 Verdict. A two-week-old infant arrives at the ER, and the nurse fails to report her abnormal blood culture results to the physician. This results in a delayed diagnosis of Group B streptococcus sepsis and meningitis, which leaves the infant suffering from hemiplegic cerebral palsy, moderate mental retardation, and a seizure disorder. The doctors and hospitals attempt to argue that the parents of the child were contributorily negligent. However, the jury does not buy this defense. They award the plaintiff $5,000,000 for future medical expenses, $1,500,000 for future lost earnings, and $3,000,000 for noneconomic damages such as pain and suffering.
- 2013, Allegany County: $7,006,719 Verdict. A female infant presents for her two-day routine checkup, at which time she has a heart rate significantly higher than normal. The doctors do not order tests or follow-up examinations to figure out why the infant's heart rate is so high. Two days after this checkup, the infant has another checkup, at which time her heart rate is even higher than it was two days prior. She is ordered to return for an outpatient metabolic screening, and the day after this, the infant's mother notices the child is experiencing labored breathing. She calls the nurse, who tells the mother not to be concerned unless she starts to turn blue. A few hours later, the mother observes the mouth area turning blue, and brings her to the ER. While at the ER, a chest x-ray reveals that she has an enlarged cardiac silhouette and congenital heart narrowing of the aorta. The ER does not have the medicines and surgeons needed to treat these serious issues, so the infant is transported to a different hospital. This all results in cerebral palsy, and she brings suit against the nurses, claiming they negligently failed to investigate the elevated heart rates and failed to order tests to determine the exact problem. The doctors deny any negligence, but after a mistrial, a second jury agrees with the plaintiff, awarding her $1,000,000 for pain and suffering, $269,909 in past medical expenses, $4,518,655 in future medical expenses, and $1,218,155 in future wages.
- 2012, $55,000,000 Maryland Verdict – A 30-year-old woman goes into labor at home, as planned for a homebirth, with a midwife and two others present. After 2:00 a.m. complications arise when the birth progression stops. An ambulance is called around 2:35 a.m. An urgent C-section is ordered soon after her arrival but is not performed for nearly two hours. The baby is born with permanent brain damage, multiple physical and mental disabilities, and cerebral palsy. Suit proceeds against Johns Hopkins Hospital. Plaintiffs claim that the hospital’s staff is negligent by taking an hour and 55 minutes to perform an urgent C-Section and that all of the infant’s injuries were inflicted in the last 18 minutes. Defendant claims that all of the infant’s injuries occurred while Plaintiff was laboring at home under the care of the midwife, that the fetus was showing signs of distress shortly after 1:00 a.m. Defendant contends that all good standards of medical practice were followed and that all times while Plaintiff labored at the hospital, her monitoring strips were reassuring indicating that the fetus was not suffering an acute injury at that time. The child, now three, requires 24-hour aid and attendant care, in addition to intense physical and occupational therapies for the rest of his life. It is noted that he will never walk or talk. The jury returns a verdict of $55 million. The non-economic damages are reduced according to Maryland statute from $26 million to $680,000. Damages for future lost wages are reduced from $4 million to $2,621,825. Plaintiffs stood to recover $28,301,825 in total, but the case was reversed on appeal.
- 2012, $21,000,000 Maryland Verdict – Plaintiff presents at 31 weeks to the hospital with symptoms of high blood pressure and hypertension. She is connected to a fetal heart rate monitor and evaluated by a maternal-fetal medicine specialist who instructs that a vaginal delivery is reasonable as long as the mother and fetus remain clinically stable. She cautions that if the patient’s clinical status worsens, or upon standard fetal indication, delivery should be performed via C-Section. Plaintiff was kept overnight and started on labor-inducing medication the next morning. Plaintiff contends that before noon, the fetal heart rate was reassuring with minimal to moderate variability, but that afternoon, the heart rate became non-reassuring with late and prolonged variable decelerations. Plaintiff further contends that per the maternal-fetal medicine specialist’s recommendation and the applicable standard of care, a timely C-section was to be performed. The infant was born at approximately 5:13 p.m. with the umbilical cord wrapped around his neck. He was pale and lifeless. He was diagnosed with cerebral palsy. Plaintiffs contend that the labor was allowed to continue for an additional three hours, unnecessarily and wrongly. Defendants contend that the infant’s Apgar scores, taken five minutes post-birth, was normal and so were the blood gasses taken shortly after birth. Defendants further contend that the ultrasound taken of the head three days post-birth was normal and that if there had been any brain damage from asphyxia at birth, it would have shown up on the ultrasound, since the brain swells, but the scan was normal. Defendants allege that problems did not show until 10 to 14 days after the infant's birth, thereby demonstrating that the injury occurred post-birth and was due to prematurity, not anything to do with the delivery. The jury sided with the Plaintiffs and awarded $18,000,000 in future medical costs; $2,000,000 in future lost earnings capability; and $1,000,000 in noneconomic damages.
- 2009: $3,991,000 Maryland Verdict – Plaintiff, 36 weeks pregnant, presents to the hospital with complaints of diarrhea, pain, and vomiting. Approximately three hours after she is admitted, it is determined that the fetal heart rate is 30, and an emergency C-section is performed. The infant had to be revived Immediately upon birth, but suffers brain damage and is diagnosed with cerebral palsy. Plaintiff files suit against the emergency room doctor and the treating OB/GYN alleging that the doctors were negligent in failing to properly monitor the fetal heartbeat. Plaintiffs allege that the ER doctor did not evaluate the mother’s condition, even though he had been informed of her arrival 45 minutes after she got to the hospital, and further allege that the OB/GYN was informed of Plaintiff’s condition two hours after she arrived at the hospital, but failed to evaluate her. Plaintiffs further allege that a placental abruption occurred long before a C-Section delivery was decided and that an earlier delivery would have prevented the child’s brain damage. Defendants deny Plaintiffs' allegations and contend that the placental abruption occurred 15 to 20 minutes before the C-section. The jury agrees with the Plaintiffs and award $300,000 for noneconomic damages; $71,000 for past medicals, $2,870,000 in future medicals; and $750,000 for future lost income.
- Get more cerebral palsy case results
If you believe your child has cerebral palsy as the result of medical malpractice and want to speak with a Maryland cerebral palsy lawyer, call 800-553-8082 or get a free online consultation.More on Cerebral Palsy Lawsuits
- Cerebral Palsy Lawsuits (how do you know if your child's cerebral palsy is from medical malpractice?)
- Finding Experts: experts who testify in these cases
- The process of a Maryland Birth Injury Lawsuit (an overview)