One of the most traumatic events new parents can experience is an injury to their newborn during birth. Birth injuries strike at a time when the new parents are most vulnerable and can be especially heartbreaking. Some birth injuries are caused by the negligence of a physician or other medical professional. When a medical professional is negligent, and their negligence results in an injury or death, this is defined as medical malpractice.

 

A birth injury can happen any time during the birthing process. A baby is vulnerable to physical injury during pregnancy, delivery, and immediately after birth. Injury to the infant can be the result of the physician's failure to recognize complications during pregnancy or from the mishandling of the infant during delivery.

 

An average of 546,510 infants were born in California each year between the years 1999 through 2003. During this period, a per year average of 16,561 babies were born with one or more major structural malformations. This is one in every 33 live births.

 

There are many types of birth injury. Some of the more common include the following:

There are many conditions that are associated with difficult births. A physician should be aware of these conditions. These conditions may call for particular procedures and should be identifiable to an obstetrician. If the obstetrician does not use reasonable care and fails to identify such a condition, he or she may be liable for damages if that failure leads to a birth injury. Some common conditions include the following: 

Another condition of which an obstetrician should be aware is Brachial Palsy or Erb's Palsy. Brachial Palsy occurs when the nerves running from the spinal cord through the arm (the brachial plexus nerves) are damaged. This damage causes varying degrees of paralysis to one or both of the arms, potentially limiting the newborn's ability to grasp objects, reach overhead, or straighten the arm. In severe cases, complete paralysis and disfiguration of one or both arms may result. Approximately three out of every 1000 babies are born with some sort of brachial plexus injury.

 

Shoulder dystocia is a type of brachial plexus injury where one or both of the baby’s shoulders becomes impacted on the mother’s pubic bone during delivery. If the condition is not caught, the baby's head can be stretched away from the baby’s shoulders, resulting in nerve damage. Although it may occur with smaller or average weight babies, it is most common during the delivery of large babies.

 

An obstetrician should be aware of certain risk factors that have been identified as contributing to shoulder dystocia injuries. These risk factors include the following:

The obstetrician must also monitor labor carefully. The presence of certain warning signs during labor should alert the doctor to the increased possibility of a brachial plexus injury, and the doctor should react accordingly. The doctor should be aware of a number of methods for releasing a trapped shoulder that can be used to avoid injury to the baby. In some cases, a cesarean section delivery may be advisable. These warning signs include:

The neurological disorder, Cerebral Palsy, affects body movement and coordination. It is caused by abnormalities in the parts of the brain that control muscle movement. These abnormalities can be the result of a cerebral motor cortex that has not developed normally or has been injured before, during, or after birth. Although the condition is irreversible and permanent, it is a non-progressive disorder that will not get worse. 

 

Medical disorders such as seizures, mental retardation, impaired vision or hearing, and strange physical sensations or perceptions are among the symptoms suffered by people with cerebral palsy. The severity and type of symptom varies with the individual.

 

Common symptoms may include the following:

Approximately 10,000 babies born in the U.S. each year will develop cerebral palsy, according to the federal government’s Center for Disease Control. About 800,000 children and adults living in the U.S. exhibit one or more symptoms of cerebral palsy.

 

Cranial Nerve Injury
Compression by forceps has been associated with cranial nerve injury. Damage to the facial nerve and vagus nerve (the long nerve that “wanders” from the brain stem through the neck, thorax and abdomen) can result in temporary or permanent paralysis. 

Spinal Cord Injury
Excessive rotation (torsion) or traction during delivery may cause a spinal cord injury. Traction causes the most problems in breech deliveries whereas torsion is the main issue in normal, head-first deliveries. The severity of injury ranges from stretching to laceration to a severing of the spinal cord. Injury to the upper cervical cord or brain stem can result in the infant's death.  

Laryngeal Nerve Injury
The laryngeal nerve can be damaged if the head is rotated and flexed laterally during delivery. This injury accounts for about 10% of birth-trauma-related vocal cord paralysis. An infant suffering from laryngeal nerve injury will often exhibit a high pitched or hoarse cry. 

Bone and Soft Tissue Injury
Fetal monitoring, especially using a fetal scalp blood sampling or a fetal scalp electrode can cause hemorrhage, infection, or abscess. Several other soft tissue injuries can affect a fetus or newborn. Some of the most problematic include the following: 

           -Subgaleal hematoma: bleeding in the potential space between the scalp and skull. Ninety percent of these cases are caused by a vacuum applied to the head during delivery. 

       -Abrasions and lacerations: these sometimes occur during a cesarean delivery or during delivery with a vacuum or forceps, sometimes causing infections.

       -Subcutaneous fat necrosis: pressure during delivery may cause the extremities, face, trunk or buttocks to form irregular, hard, subcutaneous plaque with overlying dusky red-purple discoloration. This condition may cause complications if it calcifies.  

Bone injury during birth is seen mostly with breech delivery, shoulder dystocia, or in infants with excessive birth weights. The clavicle (collar bone) is the most frequently fractured bone in these cases, although long bones in the arms and legs may also be affected. This sort of injury may not be life threatening, but it can lead to complications if not diagnosed.

 

Thon, Beck, Vanni, Callahan & Powell has successfully represented families of children who have suffered trauma during birth that has led to cerebral palsy, brain damage, brachial palsy, mental retardation, seizures and other injuries. In birth injury cases, it is important to act immediately, to take the necessary steps to preserve evidence, review the medical procedures in question, and to enable physicians or other expert witnesses to thoroughly evaluate the birth record and injuries. If your baby suffered injuries before, during, or after birth, contact us by e-mail or by telephone at (626) 795-8333 to schedule a confidential consultation.