Our lawyers handle gestational diabetes misdiagnosis and treatment lawsuits. A failure to diagnose gestational diabetes can lead to a host of injuries that can have a lasting effect on the child.
What Is Gestational Diabetes?
Gestational diabetes mellitus (GDM) is an intolerance of carbohydrates that appears during pregnancy. In simpler terms, it is diabetes while being pregnant.
This can complicate childbirth. The most common concern is the size of the child. Delivering large children can lead to more difficult labor and delivery, resulting in shoulder dystocia or a brachial plexus injury.
A recent study using new diagnostic criteria found that 18% of pregnancies are affected by gestational diabetes, much higher than previous estimates of 1-14%. Think about that—almost one in five pregnant women. Doctors should be on the lookout.
Still, misdiagnosis of gestational diabetes is all too common, carrying risks to both mother and fetus. Children born to mothers with GDM may have excessive birth weights, resulting in high rates of cesarean delivery, which carries the risk of trauma to both mother and child. Babies also have a risk of hypoglycemia (low blood sugar) and hyperinsulinemia (high blood insulin). They are also at risk for glucose intolerance and long-term obesity.
Following pregnancy, women who have gestational diabetes have a 40 to 60% chance of developing diabetes in the next 10 to 20 years, and an estimated 5 to 10% of women who have had GDM develop diabetes immediately following pregnancy. Current practice has been under recent review to correctly diagnose GDM, with a goal of increasing the proportion of women diagnosed.
Gestational Diabetes Guidelines and Testing
Gestation diabetes is identified using an oral glucose tolerance test (oGTT) or elevated fasting glucose levels (≥ 92 mg/dl). This is usually done at 24 weeks gestation, although the best time to test for gestational diabetes is still being studied.
A two-step approach (glucose challenge test + oral glucose tolerance test) is recommended by the American Diabetes Association to help prevent missed opportunities for diagnosis. It is reported to increase diagnosis rates from 80% to 90% although at least many doctors defending other doctors in medical malpractice cases sometimes disagree.
Others have suggested that glucose testing at 16 weeks of pregnancy has a high predictive rate (up to 96%) to detect those women at risk of developing GDM during the third trimester.
Although there are additional costs associated with glucose challenge, due to the high rate of missed diagnoses of GDM, it may be best practice to test all women during pregnancy and not select those that should undergo a glucose challenge and OGTT based on risk factors.
This is further supported by a study in Belgium that found that over half of the cases of GDM were missed when only subjects with risk factors were tested. Furthermore, testing during each trimester may be indicated to prevent a missed diagnosis.
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Who Is at Risk for Gestational Diabetes?
Any woman can get gestational diabetes. Doctors should not stereotype who may have it based on anything other than proper assessment, evaluation, and testing.
One study found that in a group of 532 patients tested for gestational diabetes without consideration of risk factors found that 47% of the women with GDM would have been missed if screened only based on risk factors.
That said, women of Native American/Aboriginal, Hispanic, South Asian, Asian, and African descent are at increased risk.
Other risk factors include age, obesity, use of corticosteroids, and polycystic ovary syndrome.
Is It Medical Malpractice Not to Get a C-Section If You Have Gestational Diabetes?
The risk of a difficult delivery with a large baby leads many obstetricians to recommend that many women with gestational diabetes should have a C-section instead of vaginal birth.
The allegation that the OB should have performed a C-section is at the core of many birth injury lawsuits. Whether the failure to perform a C-section is medical malpractice depends on the unique facts of a given lawsuit.
Treating Gestational Diabetes
Doctors must monitor a woman with gestational diabetes to ensure the child is growing at the appropriate rate and that the woman’s glucose levels are under control.
Gestational diabetes can usually be controlled by making diet and lifestyle changes. But 30% of women with gestational diabetes cannot achieve glucose target levels without pharmacotherapy.
So insulin shots are sometimes necessary to keep diabetes under control so that it does not interfere with the pregnancy.
Gestational Diabetes Medical Literature
In gestational diabetes malpractice cases, there is a body of medical literature frequently relied upon by experts. Here is some of that literature:
- 2023: Simmons, D., et al.; TOBOGM Research Group (2023). Treatment of Gestational Diabetes Mellitus Diagnosed Early in Pregnancy. N Engl J Med, 388(23), 2132-2144. DOI: 10.1056/NEJMoa2214956 (This study aimed to determine the benefits of treating gestational diabetes diagnosed before 20 weeks’ gestation on maternal and infant health. Eight hundred two women, between four and 19 weeks six days’ gestation, were diagnosed with gestational diabetes. They were split into two groups: immediate treatment and deferred/no treatment. The primary outcomes focused on neonatal adverse events, pregnancy-related hypertension, and neonatal lean body mass. The results showed that immediate treatment before 20 weeks reduced the incidence of adverse neonatal outcomes by 5.6%. But there was no significant difference between the two groups in pregnancy-related hypertension or neonatal lean body mass. Overall, early treatment had a modest benefit in reducing specific neonatal complications.
- 2020: Artzi, N, et al.: Prediction of gestational diabetes based on nationwide electronic health records. Nat Med 2020; 26(1):71-76 (2020) (Israeli study that shows that gestational diabetes can be diagnosed with a high degree of accuracy by asking nine questions).
- 2019: Scholtens, D, et al.: Hyperglycemia and Adverse Pregnancy Outcome Follow-up Study (HAPO FUS): Maternal Glycemia and Childhood Glucose Metabolism, Diabetes Care 2019 Mar; 42(3): 381-392 (on the maternal glucose spectrum, exposure to higher levels in utero is linked with childhood glucose and insulin resistance, regardless of maternal and childhood BMI and family history of diabetes).
- 2018: Lowe, W. et al.: Association of gestational diabetes with maternal disorders of glucose metabolism and childhood adiposity. JAMA 320, 1005–1016 (2018).
- 2015: Peterson C, et al. Preventable health and cost burden of adverse birth outcomes associated with pregestational diabetes in the United States. Am J Obstet Gynecol 2015;212:74.e1–74.e9.
How to Calculate a Gestational Diabetes Settlement Amount
Determining a settlement amount for a gestational diabetes birth injury lawsuit, like any personal injury or medical malpractice lawsuit, requires a multifaceted analysis. A gestational diabetes settlement amount in a birth injury lawsuit will depend on the case’s specifics, the injuries’ severity, the strength of the evidence, and numerous other factors. We give you the same settlement amounts and jury payouts below. But they cannot tell you the value of your case.
But here are the key factors to determine appropriate settlement compensation:
- Strength of the Case: A gestational diabetes birth injury case is almost sure to be a serious claim. So everything begins with the question of whether you can win the case. The strength of evidence linking the medical professional’s negligence to the birth injury plays a vital role. Do you have strong experts who can show negligence and that the negligence caused the injury? That is the key.
- Nature and Extent of the Injury: The more severe and permanent the injury, the higher the potential settlement. It’s essential to understand the nature of the injury, its long-term implications, and whether the child will need lifelong care.
- Medical Expenses and Other Economic Cost: Pain and suffering drives the value of any case like this. But juries use the economic damages as a benchmark for pain and suffering. And the economic damages in a birth injury lawsuit can quickly get into the tens of millions of dollars over a lifetime. So your lawyer needs to put the right experts in place -doctors, life care planners, and economists – to weigh in on crucial damage elements like future care costs and lost earning potential.
- Pain and Suffering: This non-economic damage is more subjective and can vary significantly from one case to the next. It’s compensation for the physical and emotional pain and suffering from the injury.
- Jurisdiction: Some states have more favorable laws for birth injury claims than others. And how juries view how much damages to award – and how much they think doctors can do no wrong – varies from county to county and city to city.
- Your Lawyer: The best birth injury lawyers get the best settlement amounts and jury awards. Picking the right lawyer is the most significant decision you will make.
Gestational Diabetes Settlements and Verdicts
There are two types of gestational diabetes malpractice cases:
- Failing to realize the woman has gestational diabetes
- Failing to properly treat the patient who has it
Below are gestational diabetes stories of complications and how the legal system handled the case, either by settlement or verdict.
- 2023, Georgia: $30,000,000 Verdict. A 35-year-old expectant mother, diagnosed with gestational diabetes and preeclampsia, was admitted to the hospital for labor induction. During the administration of an epidural, complications ensued when the fetal heart monitor was displaced, leaving the unborn child’s heartbeat undetectable. So if the child is in trouble, no one would know. The critical delay in medical intervention resulted in the mother experiencing a sudden amniotic fluid embolism that could not be immediately diagnosed. She required urgent resuscitation and a subsequent hysterectomy. Tragically, the child was born with an acute brain injury due to a lack of oxygen. The family pursued legal action against the hospital and medical staff involved. Their lawsuit alleged significant negligence and oversight during labor. The malpractice suit emphasized overlooked warning signs, including the mother’s prolonged contractions and the delay in medical responses as contributing to the adverse outcomes.
- 2023, Connecticut $6,500,000 Verdict. The mother was admitted to Yale-New Haven at 37 weeks due to abdominal ascites in the unborn baby. She also exhibited gestational diabetes, which influenced the baby’s growth, leading to broader shoulders and an enlarged stomach, increasing risks of complications like shoulder dystocia. Instead of a C-section, the doctors attempted a vaginal delivery. She suffocated and suffered a fractured neck while being stuck in the birth canal and tragically died.
- 2023, Pennsylvania: $16,000,000 Verdict. A western Pennsylvania jury awarded $16 million to a couple who claimed the stillbirth of their child was due to the negligence of the wife’s obstetricians. The plaintiffs contended that a severe undiagnosed case of gestational diabetes and preeclampsia led to the stillbirth, the defendants refuted this and maintained they provided appropriate care. This verdict included $10 million for wrongful death, $5 million for pain and suffering, and over $1 million for loss of income.
- 2021, Virginia: $900,000 Settlement. The plaintiff was admitted to a hospital at 39 weeks for induction due to gestational diabetes and the anticipated weight of the fetus. Given that four of her previous eight children weighed over 9 lbs. at birth, a vaginal delivery was planned. When the baby’s head appeared during delivery, complications arose, suggesting shoulder dystocia. The delivering obstetrician, suspecting this, applied downward traction before attempting other maneuvers. Despite the obstetrician’s claim of using only gentle traction, the baby’s shoulder remained impacted against the mother’s pubic bone. After the application of various techniques, including a rotational maneuver, the baby was delivered with an immediately apparent injury to its left arm. The child suffered permanent damage to the C5-C8 nerve levels, with a significant neuroma between C5-C6 and complete avulsion at C7. An MRI indicated the likely avulsion of the C8 nerve root as well. So the injury would have lifelong impacts on the child.
- 2019, New York: $850,000 Settlement. A mother alleged that the physician’s negligent delivery of her son caused Erb’s palsy, brain injury, and developmental delays. Her birth injury lawsuit claimed that he failed to treat her gestational diabetes, failed to consider macrosomia, failed to order a C-section, applied excessive force during a vacuum-assisted delivery, and failed to treat fetal distress. The physician denied liability. This case settled for $850,000.
- 2018, Minnesota: $8,986,957 Verdict. A mother alleged that the nurse-midwife’s negligently delivered her son, causing a brachial plexus injury involving significant paralysis. She alleged that the nurse-midwife failed to consider gestational diabetes, despite having tested positive in two out of three tests. The mother argued that her gestational diabetes necessitated a C-section because of the macrosomia risk. Instead, the nurse-midwife performed a vaginal delivery, where she encountered shoulder dystocia. The mother claimed the physician used excessive force and failed to timely summon an available OB/GYN. She also alleged the nurse-midwife should have called for assistance rather than perform the delivery herself jury awarded an $8,986,957 verdict.
- 2016, California: $950,000 Settlement. A newborn’s parents alleged that the physician’s negligent delivery of their daughter caused arm paralysis. The physician had delivered one of their prior children. During that delivery, he encountered shoulder dystocia but failed to inform the parents. Thankfully, the child was born uninjured. During this pregnancy, the physician diagnosed gestational diabetes but failed to inform the parents. The parents hired a gestational diabetes lawyer who filed a lawsuit alleging that the physician’s failure to inform them of these two birth complications prevented them from considering a C-section. They argued that the physician should have informed them about the prior shoulder dystocia because this increased the risk of another one. The parents also claimed that the physician and nurses performed inappropriate maneuvers when they encountered shoulder dystocia. Even after surgery, their daughter continued to suffer from a brachial plexus injury that left her arm paralyzed. The mother also suffered vaginal injuries, while the father suffered emotional distress. The defense argued they provided appropriate treatments and did not cause either the parent’s or daughter’s injuries. This case settled for $950,000.
- 2016, New York: $2,000,000 Settlement. A newborn girl’s parents alleged the physicians’ negligence caused their daughter’s brachial plexus injury. They claimed that the physicians failed to consider a C-section despite the mother’s gestational diabetes and the daughter’s macrosomia. The parents alleged that this resulted in a negligently performed vaginal delivery. They claimed that the physicians performed inappropriate maneuvers when they encountered shoulder dystocia. As a result, their daughter suffered Erb’s palsy, Horner syndrome, and a left humerus fracture. Despite undergoing surgery, she ultimately suffered permanent injuries. The case settled for $2,000,000.
- 2014, Massachusetts: $950,000 Settlement. A mother alleged that the physician’s failure to consider a C-section caused her child’s brachial plexus injury. She argued that her gestational diabetes and her daughter’s macrosomia necessitated a C-section. Instead, the physician attempted a vacuum-assisted delivery that failed to deliver her daughter. They then encouraged the mother to keep pushing, rather than order an emergency C-section. The physician made another attempt at a vacuum-assisted delivery, which delivered the head. However, they encountered shoulder dystocia, prompting them to attempt unsuccessful maneuvers. The physician ultimately performed a posterior arm delivery and applied suprapubic pressure. Two minutes later, the 10-pound baby was delivered. They suffered a permanent brachial plexus injury. The mother and child’s birth injury attorney filed a gestational diabetes misdiagnosis lawsuit alleging that the physician’s negligence in failing to timely perform a C-section caused her child’s injuries. She also claimed they failed to consider several risk factors for shoulder dystocia,cia including gestational diabetes and macrosomia. This case settled for $950,000.
Getting a Lawyer for Your Gestational Diabetes Birth Injury Lawsuit
Gestational diabetes is a challenge to pregnancy. But with good care and treatment, it can usually be managed so that mother and child emerge unharmed.
If you believe you had gestational diabetes but were not correctly diagnosed and treated, and there is an injury to you or your baby, you may have a medical malpractice case for which you and your child could receive compensation. If you believe this was the case with you, call 800-553-8082 or get a free online consultation.