Helping Families With Babies Suffering From Cerebral Palsy

Hixson & Brown, P.C., has represented babies that suffer from cerebral palsy as a result of medical negligence occurring during the process of labor and delivery. The claims occur for a number of reasons, but the primary result is usually the same: an anoxic (lack of oxygen) injury to the baby.

Sometimes the medical malpractice involves the failure of the nursing staff or obstetrician to diagnose a problem with the labor. Other times, the medical negligence involves the failure to diagnose a poor fetal response to labor. In our experience, if a baby is born with a low APGAR score, a low blood pH or a low Base Excess with a resultant brain injury to the baby, the parents should have the complete medical record reviewed by a lawyer who handles medical malpractice claims involving birth injuries.

Types Of Cerebral Palsy

The Centers for Disease Control and Prevention notes that there are four main classifications for cerebral palsy. While it is true that every case is unique, many cases will fit into these main categories.

Spastic Cerebral Palsy

Roughly 80% of people who have cerebral palsy will have spastic cerebral palsy, making it the most common type in the United States. This disorder can make muscles stiff, changing the muscle tone itself and leading to awkward or difficult movements. In some cases, cerebral palsy will only affect one side or one portion of a person’s body. Often, the legs are affected, making it difficult to move. For instance, spastic hemiplegia/hemiparesis means the condition is on only one side, while spastic diplegia/diparesis means it mostly impairs a person’s leg movement.

Dyskinetic Cerebral Palsy

This type of cerebral palsy also creates movement issues, and people sometimes have trouble walking or even sitting because of the way it affects their legs, feet, arms and hands. They may have uncontrollable movements or jerky and rapid movements. The face and tongue can also be impacted, which can make it difficult to eat or drink.

Ataxic Cerebral Palsy

Those with ataxic cerebral palsy typically have coordination issues or balance issues. Fine motor control may be difficult, so they could struggle to write or play instruments. They may have difficulty walking because of their balance issues, so they will have to walk very carefully and may need assistance. This can also make injuries more likely. Parents will often notice when their child misses milestones, like not crawling or walking at the expected times.

Mixed cerebral palsy

Finally, the fourth category just applies to all those who have a variety of symptoms. Cerebral palsy is often caused by a lack of blood flow to the brain, which can lead to brain damage during birth. Because of this, the portion of the brain that was damaged and the severity of that injury can impact the type of cerebral palsy a person has and how serious it is.

Causes of Cerebral Palsy

Cerebral palsy results from damage to certain parts of the developing brain. This damage can occur early in pregnancy when the brain is just starting to develop, during the birth process as the child passes through the birth canal, or after birth in the first few days of life. However, in some cases, the exact cause of the brain damage is never known.

From a legal perspective, problems during birth, usually inadequate oxygen, have been blamed for cerebral palsy. Inadequate oxygen delivery to the baby can be caused by a number of factors including compression on the umbilical cord, a nuchal cord (cord wrapped around baby’s neck), hyperstimulation of the uterus (too many contractions) and hypertonicity of the uterus (contractions too strong). Hyperstimulation and hypertonicity of the uterus can be caused during induction or augmentation of labor with medications such as Pitocin.

In some cases the oxygen deprivation and corresponding brain injury can occur after birth. In cases that we see, this is often cause by inadequate resuscitative measure by medical personnel.

Risk Factors for Cerebral Palsy

There are a number of risk factors linked with cerebral palsy, many of which are not associated with medical negligence or medical malpractice. Risk factors for Cerebral Palsy include the following:

1. Infection, seizure disorder, thyroid disorder, and/or other medical problems in the mother.
2. Birth defects, especially those affecting the brain, spinal cord, head, face, lungs, or metabolism.
3. Certain hereditary conditions.
4. Complications during labor and delivery.
5. Premature birth.
6. Low birth weight (especially if less than 2 pounds at birth).
7. Multiple births (twins, triplets).
8. Lack of oxygen (hypoxia) reaching the brain before, during, or after birth.
9. Brain damage early in life, due to infection, head injury, lack of oxygen, or bleeding.

The risk factors that are underlined and in bold reflect risk factors that are potentially avoidable and represent areas of potential medical negligence.

When to Seek Legal Counsel and Guidance

If your baby is transferred to the Pediatric Intensive Care Unit (PICU), the Intensive Care Unit (ICU) or the Critical Care Unit (CCU) after birth then you should be asking physicians and medical care providers why. Key things to listen for that may give rise to medical / legal issues include the following:

1. Hypoxic injury.
2. Hypoxic Ischemic Encephalopathy (HIE).
3. Periventricular Leukomalacia (PVL).
4. Intraventricular Hemorrhage (IVH).
5. Brain injury (hemorrhage, bleeding) being reflected on MRI, Brain CT or Ultrasound of the brain.
6. Respiratory Distress Syndrome.
7. Seizures

If any of the above is diagnosed or suspected, then the brain injury may be the result of negligent care provided by nursing staff, midwives, obstetricians or other physicians during the labor and delivery process.

Treatment for Cerebral Palsy

There is no cure for cerebral palsy. With early and ongoing treatment, however, the disabilities associated with cerebral palsy can be lessened or reduced. Many different therapies are available, most under the supervision of a medical specialist or other allied professional. The therapy regimen for a specific individual with cerebral palsy should be tailored to meet the needs of that individual. A treatment may work for one child but not for another. The parents and the child’s care team work together to choose only those treatments that offer some benefit to the child.