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Judges Hammer

Medical Negligence & Personal Injury Law

What is Medical Malpractice?

Medical malpractice occurs when a health care provider fails to follow the standard of care when treating a patient. Standard of care is defined as what a reasonably prudent health care provider would or would not have done under the same or similar circumstances in caring for a patient. When health care providers deviate from standards of care, it is negligence. When negligence causes a patient to be injured, it constitutes medical malpractice. Babies who are victims of medical malpractice often have birth injuries such as hypoxic ischemic encephalopathy (HIE), developmental delays and cerebral palsy.

How do Medical Malpractice Attorneys Determine if Malpractice Occurred?

Medical malpractice attorneys carefully analyze the medical records of their clients to determine if negligence caused a client’s injury. The attorneys assess the nature and extent of the client’s injury, review all aspects of the medical records – including ultrasounds, MRIs, and lab results – and take depositions of the physicians and other health care members suspected of causing the client’s injury. Experts help attorneys review the records and they are also used to help support claims that specific incidents of negligence caused the patient’s injury. Sometimes forensics experts are used to help determine if medical personnel tried to cover up evidence of negligence in the medical records. Indeed, medical malpractice attorneys closely scrutinize all medical records to find any negligence that may have caused the client’s injury. Medical records don’t just include records from the client’s hospital stay; they also typically include visits to the physician’s office and any rehabilitation / therapy visits that are required due to the injury. For example, if a baby has a birth injury, medical malpractice attorneys for babies will review all prenatal care records as well as the child’s post-hospital brain scans and rehabilitation records.

What You Should Do If You Think Negligence Caused You Or Your Child’s Injury

If you think negligence played a role in you or your child’s injury, you should contact an attorney who has experience handling cases that involve the specific injury with which you need help. The attorney should be contacted as soon as possible because there is a statute of limitations (which varies from state to state). This means that certain cases have only a limited time in which a case can be filed.
If your child has an injury that you suspect occurred during or near the time of birth, you should contact a medical malpractice attorney who focuses on birth injury cases, called a birth injury attorney. It is best to obtain the help from a birth injury attorney who focuses only on birth injury cases and who has handled cases that involve the type of injury your child has, such as cerebral palsy.

Medical Malpractice & Birth Injuries

In a recent study that compared 13 industrialized countries, the U.S. had the highest infant mortality rate and the 3rd highest postneonatal mortaliy rate. Birth injuries affect an estimated 28,000 babies each year. The most common birth injuries include the following:
•    Birth asphyxia
•    Brain bleeds (cephalohematoma, intracranial hemorrhages, etc.)
•    Spinal cord injuries
•    Erb’s palsy
•    Cerebral palsy
Other common birth injuries include:
•    Hypoxic ischemic encephalopathy (HIE). HIE usually involves damage to the basal ganglia and watershed regions of the brain, but sometimes also includes periventricular leukomalacia (PVL)
•    Neonatal encephalopathy
•    Permanent brain damage
•    Seizure disorders
•    Intellectual disabilities
•    Developmental delays
•    Motor disorders and low muscle tone
•    Microcephaly
•    Periventricular leukomalacia (PVL)
Birth injuries can be the result of negligent prenatal care, negligent care during labor and delivery, or negligent management of a baby after birth, including the baby’s care in the neonatal ICU and any resuscitation of the baby that took place. Often, a baby’s birth injury is caused by failure to quickly perform an emergency C-section as soon as the baby starts to experience oxygen deprivation (birth asphyxia), which is called fetal distress. Impending fetal distress should also be recognized as soon as possible. For example, if a baby’s shoulder gets stuck on the mother’s pelvic bone during delivery, labor can be prolonged and the baby is at risk of experiencing an umbilical cord prolapse, which can cause severe birth asphyxia.
A prompt C-section delivery when a baby is in distress is very important because the longer a baby is left in oxygen-depriving conditions in the womb, the more severe the brain damage will likely be. Getting the baby out of the womb is the only way to directly help her. Sometimes physicians try to force a vaginal delivery, often using risky delivery drugs (Pitocin and Cytotec) and delivery instruments (forceps and vacuum extractors). This often just prolongs labor and delivery when what the baby really needs is an emergency C-section. In addition, Pitocin and Cytotec can cause the baby to experience oxygen deprivation and forceps and vacuum extractors can cause brain bleeds and hemorrhages.

How Can You Tell If Your Child Has a Birth Injury?

Some babies are diagnosed with birth injuries, such as hypoxic ischemic encephalopathy, shortly after birth. Other times, a baby’s birth injury may not be noticed until the child is 5 or 6 years old and certain developmental milestones are missed. If your baby is missing developmental milestones or you have been told she has a speech delay or low muscle tone, it is crucial that you make sure she has been examined by a neurologist and that a brain scan such as an MRI has been performed to determine if she has a brain injury. Brain injury is an evolving process; the injury can continue for days and weeks after the initial insult to the brain.

How Can You Help Ensure The Health & Safety Of Your Baby During Pregnancy & Delivery?

A very important question to ask a potential obstetrician is how competent the staff is at interpreting fetal heart rate tracings. It is crucial to make sure that staff is present to review the tracings, and that the staff members – especially the obstetrician – have experience and skill in interpreting the tracings. Close monitoring of a baby’s heart rate is always important during labor and delivery. This is because the fetal heart rate is often the only indication of how well the baby is doing.
There are many conditions that can occur during labor and delivery that can cause a baby to be oxygen deprived and in distress. Thus, it also is crucial to make sure the labor and delivery unit and obstetrician have the capacity to perform an emergency C-section if needed. Of course, it is the duty of the obstetrician to get informed consent from the mother for any procedure performed. This means that the obstetrician must explain the risks, benefits and alternatives of all procedures and potential delivery methods. But when a baby is in distress, a C-section is often the best (and sometimes only) way to quickly deliver her to prevent brain damage when she is experiencing birth asphyxia. Certain conditions, such as cephalopelvic disproportion (CPD) and total placenta previa, require a C-section delivery.
Important questions to ask the obstetrician include the following:
•    Will my baby have continuous electronic fetal heart rate monitoring as soon as I’m admitted to the labor and delivery unit?
•    Are you skilled in fetal heart rate tracing interpretation, and how many years of experience do you have?
•    Is there at least one other person involved in my labor and delivery that is skilled at fetal heart rate tracing interpretation?
•    If my baby gets in trouble, do you have the ability to deliver my baby very quickly by emergency C-section?
•    How many years of experience do you have in performing emergency C-sections?
•    Is there an additional physician immediately available in the event that multiple dangerous conditions occur simultaneously, such as my baby and I having difficulty at the same time?
•    Is there proper resuscitation equipment immediately available in case my baby needs to be resuscitated at birth? Will there be a skilled neonatal resuscitation team immediately available that can put a breathing tube in my baby (intubate) if needed?
In addition to proper fetal monitoring, the mother must also be properly monitored. A mother’s blood pressure, heart rate, and physical signs (such as abdominal and back pain and lack of fetal movement) can give important information regarding impending or current fetal distress.

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