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Pregnancy culminating in birth is a complex process, and physicians and their obstetrical teams need to be vigilant throughout. While most pregnancies end with a happy and healthy mother and baby, numerous complications can intrude and cause catastrophic injuries for infants and mothers. 

Birth Injury Claims

Healthcare professionals are trained to anticipate, recognize, and react to any condition that may alter the outcome of a pregnancy negatively. Unfortunately, that is not always the case and in those circumstances, an evaluation of the actions and omissions of the providers is warranted. Examples of potential problems with the medical care provided in this obstetrical setting include; 

  • The occurrence of a brachial plexus injury, impairing the function of the child’s arm
  • Hypoxic Ischemic Encephalopathy which can lead to cerebral palsy

Types of Birth Injuries

Shoulder dystocia / brachial plexus. 

A network of interconnected nerves exits from the side of the spinal cord in the neck and extends toward the shoulder/arm. This “plexus” (Latin for braid) branches off and forms other nerves in the arm and down to the fingers. Uninterrupted communication between the brain and the nerves is essential to the arm working correctly. Unfortunately, in certain circumstances, these nerves are susceptible to injury. They can be disrupted on the inside, torn somewhere along their path or completely disconnected from their base at the spinal cord. Depending on the extent of that damage, the arm may have temporary problems or be permanently left with little or no useful function. 

A severe subset of these injuries can occur during the birth process, related to a condition known as shoulder dystocia.

Shoulder dystocia is a complication of the delivery process where a baby’s shoulder gets stuck behind a bone in the mother’s pelvis and requires an extra maneuver (or more) to release the shoulder. The occurrence of shoulder dystocia generally is not the legal issue, as this event is largely unpredictable and unpreventable. However, when it does happen, it is considered an “obstetrical emergency,” and a misstep in dealing with it may be devastating to the health and well-being of the infant.

The brachial plexus sits between the neck and shoulder and if the obstetrician or midwife does not correctly respond in executing the maneuvers intended to release the shoulder dystocia, the obstetrician or midwife can cause an injury to these critical nerves; If the nerves are damaged badly enough, the error will result in permanent and severe impairment of the use the arm. 

This is a complex area of obstetrical medicine, and fervent opinions have long been voiced on both sides in the medical-legal arena. It requires very knowledgeable counsel well-versed in anatomy, obstetrics and neurology to carefully analyze all aspects of an obstetrical brachial plexus injury, from the conduct of the physician or healthcare provider to the exact extent of the harm to the infant. Pat has been involved in these cases since the early 90’s and has the expertise and knowledge to assist a child and family through this ordeal.

Cerebral Palsy 

This group of disorders is caused by damage to or abnormal development of the brain and disrupts the ability to control muscles. CP may also damage such vital areas as vision, hearing and speech, and can cause intellectual impairments and learning disabilities as well. It is a life-long physical disability. The spectrum of CP can range from mild weakness in a limb to profound loss of movement control. 

The critical time of brain development related to CP is during pregnancy and up through the first years of life. It is true that the causes of many cases of CP are thought to be events, many unknown, that took place before birth and disrupted brain development. In the obstetrical setting, a number of things have been found to have an association with an increased risk of CP, including low birth weight, premature birth, and infections. However, a percentage of infants who suffer from CP do so because of a disruption of their oxygen supply to the brain during the birthing process, at a time when the healthcare team is in control and presumably monitoring the mother and child. 

Among the things obstetrical providers need to keep a watchful eye on during pregnancy are signs and symptoms of infection. Timely and appropriate interventions are essential. In addition, Labor and Delivery is a crucial period, where the obstetricians and healthcare team need to be extremely attentive and prepared to take appropriate measures to resolve any indication that an infant is not receiving adequate oxygen. A prolonged delivery process, failure to timely appreciate abnormalities demonstrated on monitoring equipment, improper use of assistive devices such as vacuum extractors, failure to recognize uterine, placental or umbilical cord issues, failure to timely proceed to a c-section, all can adversely impact the oxygenation to an infant’s brain.

CP may not reveal itself for months following birth. To determine whether it is a consequence of physician acts or omissions during Labor and Delivery, issues that may need to be evaluated include whether the documentation of the baby’s heart rate reveals evidence of distress, how the physician accomplished the delivery, the Apgar scores, what resuscitative measures if any were provided, and whether any brain imaging has shown abnormalities associated with fetal distress at birth.

Hypoxic Ischemic Encephalopathy (HIE) 

HIE is the term applied to describe brain damage sustained by an infant, at/near birth, from insufficient oxygen (“hypoxia”) and inadequate blood flow (ischemia”), causing brain damage or malfunction (“encephalopathy”). Related terms include neonatal encephalopathy, birth asphyxia and perinatal asphyxia. It can cause an infant to develop cerebral palsy. 

While treatment is essentially limited to cooling down the infant’s brain or whole body soon after birth, known as therapeutic hypothermia, prevention may be within the skill set of the obstetrician or healthcare team. Recognition of a problem with blood flow and/or oxygenation and an expeditious response can resolve the deficits before potential brain damage occurs. Failure of recognition or proper response will result in a catastrophic outcome for the child and his or her family.


This medical complication of pregnancy can have devastating consequences for the infant or the mother if not timely recognized and treated. It is defined as having high blood pressure after the 20th week of a pregnancy plus at least one of the following:

  • Protein in the urine (“proteinuria”)
  • Low platelet count
  • Liver dysfunction
  • Other kidney problems besides the protein
  • Pulmonary edema (excess fluid in the lungs)
  • Headaches or vision problems starting during the pregnancy

In addition to determining if anything on this list is occurring, fetal ultrasound may be performed to assess the baby’s growth along with additional testing to evaluate the health of the baby.

Preeclampsia causes increased risks of seizures, placental abruption, stroke and the potential for severe bleeding. The most effective treatment for preeclampsia for the mother is immediate delivery, if the pregnancy is far enough along, because the mother and child are at high risk of injury, or worse. Treatment with medications to lower the blood pressure, increase platelets and improve liver function may be possible as well. 

The failure to obtain the necessary tests, or to appreciate the results and take appropriate action can have dire results. Left unchecked preeclampsia will develop into eclampsia and severe complications for mother and child may ensue.

Analyzing the propriety of obstetrical care can be a very complex process and requires considerable knowledge and experience. Pat has been intimately involved in obstetrical cases for several decades and is well-versed in the issues that often arise in these cases.

Contact an Ohio Birth Injury Attorney

If your doctor or health care professional failed to anticipate, recognize or react to any condition that may have impacted the outcome of your pregnancy in a timely manner, contact Pat at 937-901-4394 to schedule a free, no-obligation consultation. Pat has the experience and skill needed to provide you with the legal representation you deserve.


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