Content on this page:
- When Medical Malpractice Leads to CP
- Known Risk Factors
- Is CP Preventable?
- Diagnosis, Tests and Missed Milestones
First, let's define cerebral palsy.
Cerebral palsy is a disorder that affects body movement and posture. It is caused by brain damage that occurs either before, during or immediately after birth. CP can be caused by genetic, environmental factors as well as prematurity. However, because hypoxia (lack of oxygen) to the baby’s brain during labor and delivery is a known cause of cerebral palsy it is important for the doctors and nurses to identify the signs on the fetal monitor and timely intervene to help the baby.
The type and timing of the injury to the brain determines the severity of cerebral palsy. Some children are mildly affected while others may be completely unable to move and require assistance to eat and even breathe.
Cerebral palsy can cause the following movement disorders:
- Spasticity (stiff muscles), which is referred to as spastic cerebral palsy
- Dyskinesia (uncontrollable movements), referred to as dyskinetic cerebral palsy
- Ataxia (poor balance and coordination), referred to as ataxic cerebral palsy
- A combination of movement disorders, referred to as mixed cerebral palsy
Signs and symptoms of cerebral palsy may take months or even years to become apparent. If your child has been diagnosed with cerebral palsy, it is important to answer the question: could this have been prevented? Cerebral palsy attorney Michael H. Bereston can talk to you about the circumstances surrounding your pregnancy, labor and your child’s birth and review medical records to determine whether malpractice may have been involved. Working with top-notch medical experts, he and our team can work to expose wrongdoing and help you pursue much-needed financial compensation.
To learn more, call (410) 220-6581. Your consultation is free! We serve clients across Maryland and throughout the country from our offices in Annapolis.
What Causes Cerebral Palsy?
In the broadest terms, cerebral palsy is caused by asphyxia-related brain damage. When a developing baby or newborn child does not receive adequate oxygen and blood to the brain, he or she can suffer serious and permanent brain damage as brain cells begin to die. In some cases, this leads to cerebral palsy.
There are many ways in which an unborn or just-born baby could suffer oxygen deprivation. For example, if labor is not progressing quickly enough and the delivery room doctor fails to order an emergency cesarean section (C-section), causing the baby to experience hypoxemia (low oxygen levels in the blood) which, in turn, can lead to hypoxia (low oxygen levels in tissues, including brain tissue). Additionally, problems with the umbilical cord, such as umbilical prolapse or an umbilical cord that is wrapped around the baby in the womb, could result in asphyxia.
These are just some examples of how oxygen deprivation before, during, or immediately after birth can occur; any time a baby suffers dangerous oxygen deprivation, they are at risk of developing a number of birth defects and related conditions, including cerebral palsy.
When Medical Malpractice Leads to Cerebral Palsy
While it is possible for a child to develop cerebral palsy as a result of completely unforeseeable complications or unpreventable conditions, many cerebral palsy diagnoses are the result of medical malpractice. When a child suffers a birth injury due to the negligent or careless actions of an obstetrician, delivery room nurse doctor, midwife, or any other medical professional, and that birth injury leads to permanent brain damage and cerebral palsy, the child’s parent/guardian may take legal action. While nothing can undo what has happened to your child, a birth injury claim can allow you to recover financial compensation, allowing you to get the critical treatment for your child that he or she needs.
So, when is medical malpractice responsible for a child’s cerebral palsy diagnosis? Some common examples include instances in which medical professionals:
- Fail to recognize/diagnose a high-risk pregnancy
- Fail to monitor or respond to signs of fetal distress
- Do not detect or treat maternal infections
- Allow labor to continue for a prolonged amount of time
- Do not order a timely C-section
- Misuse assistive birth devices, such as forceps or vacuum extractors
- Extend labor/delivery unnecessarily
In short, any time a medical professional does not uphold the standard duty of care—both to the mother and the baby—that doctor may be liable for any injuries either the mother or child suffers.
There are some known risk factors for cerebral palsy.
Birth weight less than 2,500 grams at birth and there is an additional risk if birth weight is less than 1,500 grams
Prematurity especially if born prior to 32 weeks gestation
Twins, triplets or multiple births
Infections—viral infections such as chickenpox, rubella, cytomegalovirus as well as bacterial infections of the placenta, uterus or other maternal organs
Medical conditions of mother that are undiagnosed or not treated may affect the blood and oxygen flow to the baby
Is Cerebral Palsy preventable?
Cerebral palsy that is due to genetics is not preventable. However, during the process of birthing the lack of oxygen may cause Cerebral Palsy. This can most times be prevented by the labor and delivery staff at the hospital.
Congenital CP vs. Acquired CP
Congenital CP makes up the vast majority of CP (85%-90%). This kind of CP is affiliated with brain damage that occurred prior to or during childbirth. Oftentimes, the distinct source is unknown.
Acquired CP makes up a very low percentage of CP patients. It is attributed to brain damage occurring over 28 days after the baby is born. This type of CP is widely attributed to infection (like meningitis) or head injury.
Lowering the Risks
In order to lower the risk factors for cerebral palsy, keep yourself healthy before and during your pregnancy.
- Before becoming pregnant, make sure you are as healthy as possible. Be sure to treat any infections before getting pregnant.
- Attain vaccines for diseases that could harm the baby before you become pregnant.
- If assistive reproductive technology (ART) infertility treatments are utilized in order to become pregnant, do what is possible to decrease your chance of a multiple pregnancy (twins, triplets, etc.).
During your pregnancy, have open discussions with your healthcare providers regarding any risk factors you may have and follow the advice of your healthcare providers to promote a healthy environment for the baby.
As labor and delivery approaches, make sure that healthcare providers and the hospital you select for labor and delivery are equipped with staff educated in the signs and symptoms your baby may show if hypoxia occurs in order to prevent injury from hypoxia and/or ischemia. If you have questions, before, during or after the labor and delivery, ASK QUESTIONS of the staff and your healthcare provider.
When is Cerebral Palsy Diagnosed?
During the hospitalization at the time of birth, the healthcare providers for the baby will monitor closely for signs of injury if risk factors were present or if there were signs the baby was lacking oxygen or blood supply during the labor and/or birth. The term hypoxic-ischemic encephalopathy or HIE is a term that is used when an injury to the brain of the baby from lack of oxygen and/or blood flow causes brain injury. Other terms used to describe this includes perinatal asphyxia, intrapartum asphyxia, and neonatal encephalopathy.
HIE can cause cerebral palsy, seizures, vision and hearing loss, cognitive and motor difficulties.
As children age from infants to toddlers, they begin to hit certain milestones in their development. One of the most notable is when they are able to smile and push themselves up while laying on their stomachs. Once a child is several months old, they begin to stand and even walk shortly thereafter. If babies are unable to reach expected developmental milestones, doctors can then investigate to determine why this is happening.
Cerebral palsy affects individuals depending on what area of the brain has been injured which means doctors can’t simply look at symptoms and automatically diagnose a child with the condition. It’s necessary to closely examine each child and their development or lack thereof. This includes motor skills, speech, autonomy, and independence.
In some cases, a doctor may tell parents they have a concern about cerebral palsy after childbirth due to certain factors. If there are complications during labor or delivery, the baby might be at a higher risk of developing the condition. Babies who are born prematurely are particularly at risk, especially if they develop jaundice that is left untreated. Other problems that can lead to cerebral palsy include infections like meningitis or trauma during delivery.
Cerebral Palsy and Missing Milestones
However, if there are no risk factors involved, the doctor must closely examine the child’s development. It’s common for parents to note certain issues with their children, such as not learning to crawl during the normal age or a lack of muscle tone. Parents who notice anything unusual must report their observations to their pediatrician immediately. These are known as missed milestones in the child's development.
On average, babies should begin to walk between 12 and 18 months and begin to speak in basic sentences or phrases by two years old. In some cases, cerebral palsy may affect only one side of the body or only the arms or only the legs.
Diagnosis in Children
A definitive cerebral palsy diagnosis generally depends on the child’s age. However, certain factors may determine a diagnosis, including the following:
•Severity: If severe symptoms are present in a child, notably their inability to control their movements, it may be possible for a doctor to diagnose cerebral palsy earlier in the child’s life.
•Parental involvement: In many cases, the doctor will rely on parents to tell them about the symptoms they have witnessed their babies experiencing.
•Type: Certain types of cerebral palsy are easier to diagnose.
Generally speaking, babies with severe cerebral palsy can be diagnosed within only a few months, but some babies are not diagnosed until their first birthday. If the condition is mild, the child may not be diagnosed until around three or four years old.
Tests for Cerebral Palsy
There are certain tests doctors can use to diagnose cerebral palsy in children. Overall, most of these are imaging tests that allow for a view into the brain. Doctors typically see the area in the brain that has suffered trauma and then make a definitive diagnosis. These are a few tests used:
•MRI: An MRI is noninvasive and can produce 3D images of the brain. This is the most common imaging used for this purpose and may be used in combination with an MRA or MRV (spectroscopy) that looks at blood flow in the brain)
•CT scan: A CT scan takes X-rays from many angles and shows images of the brain.
Recovering Fair Compensation After a Cerebral Palsy Diagnosis
A cerebral palsy diagnosis means that your child will lead a far different life than the one you had envisioned. This does not mean, however, that all of his or her opportunities should be limited. With the right care, therapy, and assistance, your child can lead a more fulfilling and stable life. The financial compensation awarded in a birth injury lawsuit can help ensure you can provide for all of your child’s needs.
As an experienced cerebral palsy lawyer, Michael Bereston knows what it takes to seek justice in birth injury cases involving this serious condition. For more than 30 years Mr. Bereston has been practicing law and using his trial experience to help disabled children and families recover the complete compensation they need – and deserve.
Find out more about recovering fair financial compensation to help your child face a brighter future. Call (410) 220-6581 for your free case evaluation. Our cerebral palsy attorney practices in Maryland and across the U.S.