When is Cerebral Palsy Malpractice and What is the Case Value?

Not all cases of cerebral palsy are the result of medical malpractice. Cerebral palsy is a broad term for damage in the mid-brain affecting motor function. Because this damage could be caused by many things, determining if cerebral palsy is the result of malpractice can be difficult. 

The following flow chart lists common events associated with cerebral palsy. The events in bold are usually suspicious for medical malpractice. In general, the clearer the cause of the CP, the more viable the lawsuit.  Keep in mind this chart is merely a guide of potential malpractice. It does not mean that medical malpractice-induced cerebral palsy. 

Prenatal Period (Before Birth): 

1. Genetics: Are there mutated genes? Mutated genes, although rare, can cause cerebral palsy. 
2. Infection: Did the mother or the child have any one of the following infections before birth (toxoplasmosis, rubella, cytomegalovirus, herpes simplex 1 or 2, or other viral infections such as syphilis)? Any one of these organisms could cause cerebral palsy. 
3. Placental Insufficiency: Is there evidence the placenta did not form properly or was damaged? This could cause cerebral palsy. 
4. Prematurity (<37 weeks old): children born prematurely commonly have periventricular leukomalacia, which is a fancy way of saying an underdeveloped mid-brain that could cause cerebral palsy. 

Perinatal (During Birth) 

1. Infection: Did the mother or the child have any one of the following infections during birth (toxoplasmosis, rubella, cytomegalovirus, herpes simplex 1 or 2, or other viral infections such as syphilis)? Any one of these organisms could cause cerebral palsy. 
2. Oxygen Deprivation: Did the child suffer oxygen deprivation? This could be malpractice if it occurred during birth. Often evidence of oxygen deprivation shows up on Fetal Heart Rate (FHR) monitoring strips during delivery. As a result of the lack of oxygen to the brain, the baby's heart starts beating irregularly. When this occurs, an emergency c-section is usually necessary. This kind of injury could lead to cerebral palsy. 

Postnatal Period (After Birth): 

1. Head Trauma: This could be malpractice if the baby suffered head trauma while being delivered or later in the neonatal unit. Common red flags are if forceps or suction devices were used during the delivery. 
2. Oxygen Deprivation: This could be malpractice if oxygen deprivation occurred immediately after the delivery. 
3. Stroke: Strokes can cause cerebral palsy. 
4. Infection: The most common post-natal infection causing cerebral palsy is bacterial meningitis. 

As you can see from the above, cerebral palsy can be the product of many different things. The key to a successful malpractice case is identifying the cause and ruling out other causes.

Useful tests for identifying potential cause are as follows: 

1. Abnormal Fetal Heart Rate Monitoring Strips: Are there late heart decelerations or a prolonged loss of heart rate variability? These are indications of fetal distress and potential oxygen deprivation. 
2. Low APGAR Scores: APGAR scores are a way of predicting health within the first couple of minutes of birth. In general, the lower the scores the more likely that there might have been malpractice. 
3. Abnormal Cord Gases: Usually cord gases are measured at birth. Abnormal oxygen, carbon dioxide, or PH levels could indicate metabolic acidosis and oxygen deprivation. Normal cord gases are as follows: 
  • PH: Range is 7.35-7.45
  • PO2: Range is 75-100
  • PCO2: Range is 35 – 45
  • HCO3: Range is 18-23
  • Base Excess: Range is -8-0 (mmol/L)
4. Scans: Sometimes CT Scans, MRI, or Ultrasounds after birth identify damage to the areas of the brain involving motor function. These are good indicators for potential cerebral palsy. 


It has been cited that approximately 2-3 in every 1000 live births results in cerebral palsy. But about 1 in every 12,000 live births are caused by something being done wrong by a doctor, nurse, or hospital resulting in oxygen deprivation. These are the types of cases that lend themselves to medical malpractice lawsuits. If it can be proven that the baby appeared to be progressing normally during pregnancy, but  the child began showing signs of fetal distress and either someone did not act appropriately, or quickly enough, then there is a good chance that there is a basis for a lawsuit.  The most common culprits are doctors but nurses can also make mistakes that can lead to CP. 

Rarely do the victim's parents know one way or the other without hiring a lawyer and having them collect the medical records to see what actually happened. In general, the best cerebral palsy cases are the ones with a clearly defined cause of injury. 

Examples of Settlements and Verdict in Cerebral Palsy Cases

Statistics that show median and average cerebral palsy verdicts and settlements are not especially useful. Why? Because the amount of economic damages varies so wildly from case to case and does not correlate well with how severely injured the child is or how good the negligence case was against the doctor (which has a significant indirect impact on the amount of the verdict).

Below are some sample CP jury verdicts and settlement that might give some better indication as to the value of these cases. Again, as trite as it is to say, every case is different. It is impossible to figure out the value of your child's case by looking at statistics or even seeing the recovery in a case that sounds similar to yours.

  • 2012: $4,380,000 Massachusetts Settlement –Mother presents for labor and delivery and comes under the care of Defendant labor and delivery nurse and Defendant second-year resident. There are a lot of malpractice cases that come from giving residents too much responsibility.  Anyway, the child is born with a profound injury to its basal ganglia and is diagnosed with cerebral palsy as a result of the neurological damage that occurred before birth. Plaintiff files suit contending that the Defendants failed to properly monitor the infant by failing to employ intrauterine measures to monitor labor. Plaintiff further contents that they were unable to realize that there were signs of fetal distress through her second stage of labor that were there to be seen.  Usual defense: the child’s neurological injuries were unrelated to the care and treatment. The parties reached a confidential settlement of $4,380,000 before trial.
  • 2012: $36,737,660 Florida Verdict – Plaintiff presents to a women’s center and is advised that she is 22.3 weeks into a pregnancy. Due to the gestational age and complications involved with a prior delivery of another child, Plaintiff decides to terminate the pregnancy. She is given the first injection of Cytotec, as well as one injection of RU-486. The injections occur over an 11-hour period without an examination by a physician. After failing to have completed the abortion, the Plaintiff leaves the facility. Several hours later Plaintiff presents to a medical center where a child is delivered via C-section. The child suffers from severe cerebral palsy and cannot speak, walk or take care of herself. Plaintiff files suit on her child’s behalf and contends that if she’d been seen by a doctor and given a sonogram, there was a reasonable expectation that the doctor would have determined that her fetus was viable and that abortion was no longer an option. Plaintiff contends there was no medical personnel available at the facility. Defendants argue that if Plaintiff had stayed, the abortion would have been completed. The case was initially dismissed but later reversed and reinstated in 2009. The jury awarded $18,737,660.16 in compensatory damages to the Plaintiff including $432,305.16 for past medical damages and $18,275,355 for the child’s future life care. This jury was also pretty mad, awarding an additional $18,000,000 in punitive damages.
  • 2012: $21,000,000 Verdict in Maryland. A Glen Burnie, Maryland couple allege their son's doctors at Johns Hopkins should have delivered him by c-section instead of a prolonged vaginal birth that leads to oxygen deprivation and cerebral palsy. Doctors argued that ultrasounds showed no brain swelling after the birth, which is what you might expect a lack of oxygen to the brain. Thankfully, the child suffered no mental injuries but had a myriad of physical problems. Still, the jury awarded  $18 million for future medical expenditures, $2 million for future lost wages, and $1 million for non-economic pain and suffering. 
  • 2012: $5,000,000 Settlement in Washington. A baby girl is born, limp and pale, with no respiratory effort, and a heart rate of 30. She is resuscitated and taken to the nursery for observation. Spontaneous rupture of the membranes occurred over four hours before the delivery, and the fluid was clear at that time. At 25-27 hours of life, the infant develops seizures and is transferred to a children’s hospital. Months later, the infant is eventually diagnosed with cerebral palsy and dystonic quadriplegia. Doctors at the children’s center had difficulty determining the underlying etiology of the infant’s hypoxic ischemic injury, but medical records indicate that the fetal heart monitoring strips show “good beat-to-beat variability” indicating that the injuries may have occurred before labor and delivery. The treating neurologist indicates that her injuries may have occurred during a period of delayed fetal movement earlier in the pregnancy, while other treating physicians indicate that there are multiple causes of cerebral palsy including infection, genetic disorders, trauma, and others. Plaintiffs allege that Defendants failed to identify signs of fetal distress including uterine hyperstimulation and also that Defendants lost the fetal heart tracing for the last hour and a half of labor. Defendants testify that there was no violation of the standard of care and that she did not fit the strict criteria for having sustained an intrapartum hypox ischemic injury. They claim the injury occurred before labor and delivery. After an unsuccessful mediation, the parties eventually reached a settlement one week before trial.
  • 2012: $103,075,618 Verdict in New York. A woman in her 25th week of gestation presents to the hospital with complaints of a painful condition of her abdomen. Several hours later, it is determined that she was experiencing labor. Delivery is promptly performed and she gives birth to twins, concluding a difficult final state of pregnancy. Two weeks before this event, she experienced a premature rupture of her amniotic membrane, was admitted to the hospital, monitored, and prescribed rest. It is determined that one of the twins has cerebral palsy. Suit is filed.  Plaintiffs allege that the infant’s cerebral palsy is the result of a failure to prevent the child’s premature delivery. Plaintiffs sue multiple entities including the medical center and the OB/GYN. Plaintiffs further claim that the resulting injury was a product of a failure to recognize the onset of labor, that the contractions were not recognized by the hospital’s staff though confirmed on the monitor’s readings. Plaintiffs additionally contend that the injury was the result of trauma that occurred during the infant’s passage through her mother’s vagina, and that the injury could have been prevented by an episiotomy or Caesarean delivery. Defendants contend that they properly managed the delivery and the prenatal period. Plaintiffs are awarded $103,075,618 broken down several ways. $17,000,000 for past pain and suffering; $60,000,000 for future pain and suffering; $247,219 for future surgeries; $1,785,161 for rehabilitation (60 years); $8,240,175 for medical equipment and other medical expenses (for 60 years); $10,022,315 for assisted living (30 years); and $5,780,449 for future lost earnings (40 years).
  • More CP verdicts and settlements

As you can see by the above examples, there are so many different errors that can occur during the birth of a baby.  Sometimes, it is the mom can often pick up on mistakes the doctors are making.What parents tell us about the labor and delivery process can be key. It pays to be vigilant and aware of what is going on during the pregnancy, labor and delivery. Did the doctor let the labor go on too long? Did something not feel right inside your body, but no one would listen? The earlier you start talking about these things, the more clearly you and everyone involved will remember all the little details that could make a difference in your case.

If your child's condition could have been avoided if things had been done properly, it makes sense to try to get restitution for those mistakes. Can any amount of money can ever fix the mistakes? No. But at least you may be able to get the best care, the best equipment, and the best chance to make their life as normal and happy as possible. As the years go on, more and more innovations are being developed to make life as easy as possible for these precious children, but these things always come at a very hefty -understatement of the year - price. Lawsuit help pay that price.

Getting the Right Advocate

If you are concerned your child may have a birth injury, and you think a doctor could be responsible for the harm that was done, call 800-553-8082 or get a free no obligation Internet consultation.

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