Good medical care matters most when we are born and during the first hours of our lives. When a doctor, hospital or nurse fails to provide good medical care during the delivery of a child, some things can go wrong that can last a lifetime. Among the worst injuries is cerebral palsy, a brain injury that can lead to substantial medical expenses and make it difficult, and sometimes, impossible for the child to live a normal life. In a significant number of cases, cerebral palsy is caused by medical malpractice.
- The Settlement or Trial Value of a CP Case
- The Settlement Value of Birth Injury Cases (with sample verdicts, many of which are CP cases)
- Process of a Maryland Birth Injury Lawsuit (an overview)
- Birth Injury Cases Generally
- An Overview of malpractice cases in Maryland
- Example Lawsuit: 2016 case
Cerebral palsy is not a disease, but rather, a term that refers to a group of non-progressive conditions arising from an injury to the developing brain. CP affects approximately 2 in 1000 live births accordingly a commonly cited statistic. But this is misleading. The cerebral palsy that causes lifelong injury and leads to medical malpractice lawsuits - cases of hypoxic ischemic encephalopathy are much less common, affecting 1 out of approximately 12,000 live births.
Children with CP experience movement and posture disturbances including muscle weakness, reduced coordination, epilepsy, disturbances of sensation, cognition, perception, behavior, communication, and secondary musculoskeletal problems. It is important to recognize that cerebral palsy does not always result in profound handicap, but often has significant demands on the family, the risk of depression, and high costs associated with each case of negligent care.
Reduction in activity levels and participation restrictions resulting from impairments related to cerebral palsy often have a negative impact on the quality of life of the affected child. The quality of life is defined by the World Health Organization as "an individual's perception of their position in life in the context of the culture and value systems in which they live, and about their goals, expectations, standards, and concerns." It is also defined as feelings of well-being including social, physical, emotional and spiritual aspects.
Many children with cerebral palsy have a congenital malformation of the brain, meaning that the abnormality existed at birth and was not caused by factors occurring during the birthing process. Cerebral palsy may also occur due to brain damage sustained during labor and delivery, often resulting from lack of oxygen to the brain or trauma experienced. This type of damage may be, but not always, due to medical malpractice of those involved in delivering the baby. Recently, an infection has been shown to cause cerebral palsy, especially in cases where there are no other causes of cerebral palsy in term babies.
In a study published in 2010 in the American Journal of Obstetrics and Gynecology, researchers reviewed adverse birth events and possible associations with the development of cerebral palsy. The researchers identified six labor and delivery process events which could lead to cerebral palsy, these include:
- placental abruption
- uterine rupture during labor
- fetal distress (nonreassuring heart rate)
- birth trauma
- cord prolapse
Determining the cause of cerebral palsy often takes years. However, many signs and symptoms are present and prominent following birth and in early childhood. In cases where cerebral palsy is a result of intrapartum damage, neonatal encephalopathy is present. Neonatal encephalopathy is defined as abnormal neurological findings presenting within 12–24 hours after birth in conjunction with signs of cortical dysfunction, including lethargy, stupor and in severe cases, seizures. Signs of CP that may be present in early life include difficulties breathing, low APGAR score, significantly missing developmental milestones, abnormal bone growth, difficulty or inability to walk, spasticity, and lack of muscle tone.
There is currently no cure for cerebral palsy. But many affected CP victims can lead more productive and satisfying lives due to advances made in modern therapy and technology. Physical therapy is used in children with cerebral palsy to improve overall functional outcomes by reducing neurologic impairments, increasing physical strength and preventing the development of secondary impairments. Many intervention strategies focus on the reduction of spasticity, which is one of the most notable impairments associated with cerebral palsy.Malpractice and Cerebral Palsy
The exact cause(s) and pathogenesis of cerebral palsy are poorly understood, and several factors may lead to cerebral palsy. There is a large dispute in the medical community as to the percentage of cerebral palsy cases that are the result of medical malpractice. Every time you turn your head, there is a new study that suggests that CP is caused by some other factor than malpractice. But so many of these are researchers with an anti-malpractice bias. Often, the study has complaints about malpractice lawsuits in the text of the study's results. It is ridiculous. Still, we can agree that not every case of spastic paralysis is medical malpractice.
In figuring out whether medical malpractice could be the cause of the child's CP, the key is what was the condition of the child when the doctor began treating the mother. On this issue, the fetal heart rate is critical. Certainly, the first warning sign for a doctor is the absence of fetal heart rate accelerations. Acceleration is an abrupt increase in fetal heart rate accelerations above baseline with onset to peak of the acceleration less than 30 seconds and less than 2 minutes in duration.
Besides the absence of accelerations, the fetal admission test is also critical. A fetal admission test may include monitoring the fetal heart using a Doppler ultrasound transducer, uterine contractions, sound-provoked fetal movement, fetal breathing and amniotic fluid volume. Doctors have to see the signs and correctly interpret these tests. But doctors have to treat both patients and look for other warning signs, even when these tests appear to indicate that the child is neurologically intact.Do You and Your Child Need a Lawyer?
If you believe your child has cerebral palsy as the result of medical malpractice, we will do everything we can to help you and to get to the truth. Call to talk directly to an attorney at 800-553-8082 or get a free online consultation.Cerebral Palsy Lawsuits