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Birth Injury/Labor and Delivery

Birth Injury/Labor and Delivery

Perhaps the greatest tragedy we see is injury to an infant. The most fragile time in human life is the period surrounding labor and delivery. Emergencies can arise that can threaten the life and well-being of both mother and baby, and hospitals should be set up to monitor, detect, and treat these conditions to protect their two patients – mother and baby. Typically these situations begin with a perfectly normal and healthy pregnancy and a perfectly normal and healthy fetus that is subsequently injured due to the negligence of doctors and nurses. Sadly, these injuries seem to occur with the same fact patterns repeating themselves (and frequently the same doctors over and over again).

One situation that arises often is ongoing fetal distress. The standard of care requires continuous electronic fetal monitoring during labor. This monitoring tracks the mother’s contraction pattern and the baby’s heart beat. There are certain patterns that arise that alert doctors and nurses to situations where the baby is not tolerating labor and needs to be delivered immediately by cesarean section. If ignored, this situation can lead to a baby not receiving enough oxygen and blood flow to his or her brain.  This is one of the leading causes of cerebral palsy (CP).

Another frequent cause of birth injuries is an inadequate response to an obstetric emergency. Placenta previa (when the placenta is over the cervix), placental abruption (when the placenta separates from the wall of the uterus), and certain infections can all be emergencies that can result in injury or death.

Brachial Plexus injury (Erb’s Palsy) is another preventable injury. The Brachial Plexus is a bundle of nerves that goes from the spinal cord to the hand and arm. When a baby is too large to be delivered vaginally, their head is delivered but one or both of their shoulders gets “stuck” – this is known as shoulder dystocia. Excessive traction and pulling by a doctor can injure those nerves and result in a paralysis of the arm and/or hand. It can be avoided in two ways. First, if the doctor knows in advance that the baby is going to be very large (“macrosomic”) a c-section can be scheduled. Second, once a shoulder dystocia is encountered, there are numerous maneuvers that can be performed to overcome it, and avoid injuring the brachial plexus nerves.

An example of a birth injury case handled by the lawyers at Kelley/Uustal is the case of a young mother who went to the hospital because she thought she might be in labor. The nurses started electronic fetal monitoring and concluded that the fetal monitoring strip was non-reassuring and that the baby needed help. The nurse testified that she called the doctor and the doctor said not to bother him. However, the doctor testified that the nurse was lying and he never received a call. They all agreed that the baby was in fetal distress and needed help, but they all blamed each other for the baby not receiving medical attention. It was hours later before a doctor came in and delivered the baby. A $4 million recovery was made.