Quality prenatal care (health care during pregnancy) is critically important to the eventual health of babies. Many birth injuries are the result of emergency events that arising during the labor and delivery stage such as shoulder dystocia and oxygen deprivation. However, a significant percentage of birth injuries are actually the direct result of improper or negligent medical care during the prenatal phase.About Prenatal Care
Medical care during pregnancy is much different than other types of medical care and treatment. In most contexts, the primary goal of medical care is accurate diagnosis and effective treatment. Aside from periodic physical exams, most people do not see their doctor every 4-6 weeks to make sure everything is going well. The primary goal of prenatal medical care is prevention. OB/GYNs providing prenatal care regularly examine the mother to ensure normal progression of the pregnancy and prevent any issues from arising. Pregnant women visit their prenatal doctors for exams and diagnostic testing multiple times during pregnancy. During a normal pregnancy, a woman might be in her OB/GYNs office anywhere from 4-8 times. At each appointment doctors and nurses track and record things such as weight, blood pressure and other general indicator of fetal and maternal health. Prenatal care providers will also utilize a host of diagnostic imaging tools (e.g., ultrasounds, sonograms, etc.) to get an internal view of the fetal development. There are also a number of lab tests that check for common problems or conditions. The underlying purpose behind these frequent checkups and diagnostic tests is to identify complications and problems early on and hopefully prevent them from harming mother or the baby. Advance identification of these problems is very important. Most potentially harmful issues or conditions occurring during pregnancy can be effectively managed by doctors, but only if they are diagnosed in advance.Birth Injuries from Prenatal Diagnosis Errors
When birth injuries are related to prenatal care it is usually the result of negligent care which caused a harmful condition or complication to go undiagnosed for too long. The preventative nature of prenatal care combined with the limited window of time (9 months), makes diagnostic errors or delays in diagnosis very harmful. When a prenatal problem is not promptly diagnosed and left untreated it usually does not take very long for it to disrupt the normal development of the baby. Failure to identify complications can also result in unforeseen emergencies during labor and delivery. Described below are some of the most common types of prenatal problems and complications that can and often do cause birth injuries when not timely diagnosed:
- Fetal Macrosomia: macrosomia is a prenatal complication which arises when the baby is oversized. When babies are too big vaginal delivery can be very risky because large babies will have a difficult time fitting through the birth canal. The general definition of fetal macrosomia is when the baby is 9 lbs. or more. Fetal macrosomia occurs in about 1 out of every 10 pregnancies which makes it a comparatively common prenatal complication. So long as macrosomia is timely diagnosed during pregnancy, the risk of harm to mother and baby can be totally prevented simply by scheduling a c-section delivery in advance. Diagnosing fetal macrosomia might seem simple at first, but estimating the size and weight of a fetus during pregnancy is actually very difficult. For obvious reasons, doctors are not able to simply weigh the baby on a scale during a prenatal visit. There is also no instrument or imaging tool that can accurately estimate the weight of fetus. Instead, doctors must make an educated guess of fetal weight based on measurements of: (1) amniotic fluid level, and (2) fundal height. For a summary of birth injury malpractice case based on failure to monitor fetal macrosomia see Taylor v. Southern Maryland Women's Healthcare.
- Maternal Infection: When women are pregnant they are often at risk for various infections due to a somewhat compromised immune system. In the modern world of antibiotics we tend not to worry too much about common infections. However, there are actually a number of ordinary types of infections that can be potentially dangerous for babies during pregnancy. If undiagnosed and not treated, these infections disrupt the exchange of oxygen and nutrients from mother to baby and result in serious development brain injuries. These potentially harmful infections include: Group B Strep; Rubella (German Measles); Chickenpox (varicella); and Toxoplasmosis. Another especially dangerous type of maternal infection during pregnancy is Chorioamnionitis. Chorioamnionitis occurs when a bacterial infection invades the fetal membranes and amniotic fluid around the baby. This is a very serious condition that can result in major brain injuries.
- Gestational Diabetes: Gestational diabetes is a particular type of diabetes that commonly occurs during pregnancy. Pregnant women generate higher levels of certain hormones that make the insulin in their bodies less efficient in maintaining blood sugar levels. As a result of this hormonal insulin disruption, many expecting mothers eventually become diabetic at the end of their pregnancy. Gestational diabetes can increase the risk a host of complications all of which create a greater risk of birth injury. Screening for gestational diabetes is a very important aspect of prenatal care.
Negligent prenatal care frequently result in birth injury malpractice litigation. Below are examples of recently reported settlements & verdicts from malpractice cases based on prenatal care.
- Sperling v. Pecos Valley (New Mexico 2018) $73 million: Mother had diabetes which significantly increases the risk of fetal macrosomia. Despite this increase risk of macrosomia, her doctors failed to render appropriate prenatal care for pregnant patients with diabetes that called for ultrasounds every four weeks after 20 weeks' gestation to monitor fetal growth. Fundal height measurements clearly indicated that the baby might be abnormally large. Despite all of these warnings that the baby was macrosomic and vaginal delivery would be risky, doctors did not recommend a C-section. The baby ended up weighing over 11 lbs. During the vaginal delivery the baby proved too large to pass easily through the birth canal and shoulder dystocia was encountered. The baby remained stuck in the birth canal without oxygen for almost 10 minutes which caused him to suffer a severe brain injury known as HIE. He also suffered injury to his brachial plexus nerves. The jury in Albuquerque found the doctors were grossly negligent and awarded $33 million in compensatory damages plus $40 million in punitive damages.
- Plaintiff v. OB/GYN (Virginia 2017) $950,000: Plaintiff alleged that doctor negligently failed to diagnose fetal macrosomia during prenatal care and order a preemptive C-section in response. During vaginal delivery shoulder dystocia occurred due to size of the baby and damage to the brachial plexus nerve eventually resulted in Erb's palsy. There was some debate as to how permanent the injury was and defendants insisted that the shoulder dystocia was an unpredictable event. The case settled prior to trial for $950,000.
- Lorenzo v. United States (Florida 2017) $2.5 million: Prenatal doctors miscalculated the gestational age and projected due date by 3 weeks. As a result of this miscalculation doctors induced labor and the baby was delivered 4 weeks before the baby reached full gestational age. As a result of the premature delivery the baby suffered a hypoxic ischemic encephalopathy (HIE) brain injury resulting in mental delays, seizures, and hearing loss. The defendants mostly admitted negligence but contested the extent of the alleged injuries. The case eventually settled for $2.5 million.
- Plaintiff v. Prenatal Clinic (Michigan 2016) $2.75 million: Baby was delivered prematurely and diagnosed with brain damage resulting in various developmental and cognitive impairments. Mother sued her prenatal clinic and doctors alleging numerous specific failures in her prenatal care including: failing to treat her pregnancy as high risk; failing to perform adequate fundal height measurements and ultrasounds; and failing to do a non-stress test at her 33-week appointment which would have led to hospital admission and earlier delivery. Defendants countered that the mother repeatedly missed prenatal appointments, did not follow instructions, and continued to smoke marijuana during pregnancy. The case was settled for $2.75 million.
If your child suffered a birth injury in can sometimes be difficult to determine whether it was the result of negligent prenatal care. The birth injury lawyers at Miller & Zois have the knowledge and experience you need to investigate your case and find out what really happened. Contact our team today and we can collect your medical records and consult with an expert witness to find out if you have a potential malpractice claim. The consultation and investigation are completely free. Get your online case review or call us at 800-553-8082.