Category: Medical Lawyer

Cerebral palsy is a disability commonly caused by medical negligence during childbirth. This page will examine how medical mistakes during labor and delivery can cause cerebral palsy. We will also explain how parents and children can get compensation by filing a cerebral palsy malpractice lawsuit.

What is Cerebral Palsy?

Cerebral palsy (CP) is a permanent neurological condition in which the brain cannot direct normal muscle movement and coordination of the body. CP is caused by a defect in the brain that impairs its ability to direct motor and muscle function through electrical impulse signals. This “glitch” in the brain occurs when cells in the brain are damaged during fetal gestation, childbirth, or early infancy.

Once damaged, brain cells do not regenerate, so injury to the brain during this early developmental stage causes permanent disability. Although developmental abnormalities can cause cerebral palsy, they are not genetically inherited. Instead, cerebral palsy is considered a “birth injury” because it results from injury to a fetus or baby commonly occurring during gestation or labor and delivery.

The nature and severity of physical impairments caused by cerebral palsy can vary significantly for each individual. A child with mild cerebral palsy may only have a slight limp or somewhat awkward movements or speech. There are four separate and distinct types or classifications of cerebral palsy. Each type of cerebral palsy is defined by the specific type of movement impairment and the affected area of the body. The four types of cerebral palsy are Spastic, Dyskinetic, Ataxic, and Mixed.

Spastic CP: Spastic cerebral palsy is the predominant type of CP. More than 75{c024931d10daf6b71b41321fa9ba9cd89123fb34a4039ac9f079a256e3c1e6e8} of all cerebral palsy cases are classified as spastic CP. The hallmark of spastic CP is excessive muscle stiffness in a specific group of muscles in the body. The brain sends conflicting signals to the muscles causing them to stiffen and lock up instead of moving together.

Dyskinetic CP: This type of cerebral palsy causes muscles to suffer from excessive stiffness (spasticity) and excessive lack of muscle tone (hypotonia). The result is a disabling lack of muscle coordination and control that causes slow, writhing, twisting, and other involuntary muscle movements in the arms and legs.

Ataxic CP: Ataxic cerebral palsy is characterized by an extreme lack of balance and overall coordination, particularly when attempting fine motor activities like buttoning a shirt, using scissors, or writing. Most children with this type of CP also have difficulty walking independently because they lack the necessary coordination.

Mixed CP: Some cases of cerebral palsy involve a blend of 2 of the three primary types. These cases are classified as mixed CP. Spastic-dyskinetic is the most common type of mixed CP combination.

What Causes Cerebral Palsy?

CP results from a specific type of brain damage occurring while the brain is still forming during fetal gestation, birth, or infancy. When cells in the brain are injured during this early formative phase, it creates a permanent “glitch” or flaw in the hardware of the individual’s brain. This brain glitch is what ultimately causes movement disabilities in people with cerebral palsy.

The particular cause of the damage to the developing brain can vary. Any trauma, health condition, or event that kills or damages cells in the brain during this time can be the trigger. During childbirth, oxygen deprivation and head trauma are the primary causes. Pregnancy complications or infection are the most likely reasons the brain is damaged during gestation.

Oxygen Deprivation During Labor and Delivery

Loss of oxygen to the baby during labor and delivery is the most common cause of cerebral palsy. The human brain requires a continuous supply of oxygen to survive. If oxygen to the brain is stopped or restricted for an extended period, brain cells will rapidly die from oxygen starvation.

Until they start breathing independently, babies rely on maternal oxygen through the placenta and umbilical cord. However, this fetal oxygen delivery system is particularly vulnerable to interruption during labor and childbirth. Almost any delivery complication or prolonged delay during childbirth can potentially deprive the baby of oxygen and damage the brain. Delivery complications involving the placenta (e.g., placental abruption) or umbilical cord (e.g., umbilical prolapse or cord knots) threaten the fetal oxygen supply.

Head Trauma During Childbirth

Traumatic physical injury to the baby’s head during a difficult vaginal delivery can lead to internal damage or conditions affecting the baby’s brain. This can destroy cells in the baby’s brain and result in cerebral palsy. External trauma to the baby’s head can because caused by the mother’s pelvic bone.

However, the far more common source of head injuries during delivery are birth assistance tools such as obstetric forceps and vacuum extractors. Doctors use these devices to grip the baby’s head and manually maneuver it through the birth canal. However, these tools frequently damage the baby’s head when not used with extreme care. In some cases, this type of external head trauma can cause complications that injure the brain.

Cerebral Palsy Diagnosis

The diagnosis of cerebral palsy typically occurs between the ages of 18 months and five years. While parents and caregivers may first notice signs of cerebral palsy in infants, doctors may delay diagnosis until additional symptoms become apparent as the child ages. Diagnosing cerebral palsy is often a lengthy process requiring a medical professional team. While parents and caregivers may be the first to notice signs of cerebral palsy in infants, doctors often hesitate to make an immediate diagnosis because so many changes can occur with not only infants but toddlers.

To diagnose cerebral palsy, doctors typically use a combination of physical exams, medical history, and imaging tests. During a physical exam, doctors will observe the child’s movements and check for any signs of muscle weakness, spasticity, or other neurological symptoms.

Doctors will also review the child’s medical history and ask about developmental delays or other concerns. They may also ask about the mother’s pregnancy and delivery, as complications during childbirth can increase the risk of cerebral palsy.

Imaging Tests and Their Limitations

Imaging tests are used to look for brain damage, the underlying cause of cerebral palsy. These tests may include computed tomography (CT) scans, cranial ultrasounds, electroencephalograms (EEG), and magnetic resonance imaging (MRI) scans.

CT scans use X-rays to create detailed brain images, while cranial ultrasounds use sound waves to create images. EEGs measure electrical activity in the brain and can help identify abnormal patterns, and MRI scans use powerful magnets and radio waves to create detailed images of the brain.

While imaging tests can help diagnose cerebral palsy, they are not always conclusive. In some cases, brain damage may not be visible on imaging tests, or the damage may be too subtle to detect. Sometimes parents are left with a “we think” diagnosis.

Other Testing

In addition to imaging tests, doctors may also use other diagnostic tools, such as developmental assessments, speech and language evaluations, and genetic testing. Developmental assessments evaluate a child’s cognitive, motor, and communication skills and can help identify developmental delays or other issues.

Speech and language evaluations can help identify any difficulties with communication, such as speech delays or language disorders. Genetic testing may identify genetic mutations or other factors that could increase the risk of cerebral palsy.

Cerebral Palsy and Medical Malpractice

Cerebral palsy is closely linked to medical malpractice because most CP cases directly result from medical negligence by doctors and/or hospital staff during labor and delivery. Cerebral palsy is not a genetically inherited disorder; it is an injury caused by something that happens to the brain during pregnancy or childbirth. The primary responsibility of doctors and nurses is to prevent this type of injury from happening, and modern medicine gives them the tools to do that very effectively. When cerebral palsy occurs, it means that these tools were not effectively used.

This does not mean that every case of cerebral palsy results from medical negligence. The reality, however, is that most CP cases result from errors or negligence by the healthcare providers. When CP is caused by negligence, our civil legal system gives the parents and the child the right to bring a cerebral palsy malpractice lawsuit and get compensation.

Proof Required for a Cerebral Palsy Malpractice Case

To bring a successful cerebral palsy medical malpractice lawsuit, a plaintiff just needs to prove two key things:

1. The healthcare providers breached the applicable standard of medical care by doing something wrong or making a mistake during the labor and delivery process.
2. The mistake or medical negligence during the labor and delivery was the direct cause of the child’s cerebral palsy.

The primary focus in most cerebral palsy malpractice cases is proving the first element (i.e., the delivery team did something wrong). Cerebral palsy is caused by injury to the baby’s brain from loss of oxygen during gestation or delivery. This oxygen deprivation is caused by complications or adverse events during pregnancy or labor and delivery. In a cerebral palsy malpractice case, the critical question is whether the doctor and hospital staff could have prevented that oxygen deprivation.

Types of Medical Mistakes that Can Lead to Cerebral Palsy

Certain types or categories of medical negligence or mistakes during labor and delivery are repeatedly involved in cerebral palsy medical malpractice cases. Below is a brief description of these.

• C-Section Delays: Virtually all cerebral palsy cases can theoretically be prevented with a timely emergency C-section. An emergency C-section can be performed in a matter of minutes. This means that if the baby’s oxygen supply is disrupted, an immediate emergency C-section can prevent injury to the brain and cerebral palsy. Almost all cerebral palsy malpractice cases involve an allegation that the doctors were negligent in waiting too long to order a C-section.
• Fetal Monitoring Errors: Electronic fetal monitoring (EFM) strips monitor the baby’s heart rate during labor, providing doctors with critical early warning signs of a baby not getting enough oxygen during labor. The delivery team is supposed to monitor the EFMs to identify when a baby may be suffering from oxygen deprivation and respond accordingly. The problem is that doctors often ignore EFMs because they give a lot of false alarms. Failure to monitor or respond to EFM warnings is one of the most common liability theories in CP malpractice cases.
• Forceps / Vacuum Errors: Obstetrical forceps and vacuum extractors are tools that doctors can use to assist with a problematic vaginal delivery by gripping the baby’s head and pulling them out of the birth canal. Using these tools requires an extremely high level of skill by the doctor. When used improperly or without the requisite skill level, they can easily damage the baby’s head. External head trauma can potentially cause neurologic damage and trigger cerebral palsy.
• Maternal Infection: Some infections in pregnant women can impact the placenta and threaten the oxygen supply when left untreated. Failure to diagnose and treat maternal infections can cause cerebral palsy. Maternal infections are quickly and effectively treated with antibiotics but diagnosing them promptly can sometimes be tricky.

Cerebral Palsy Malpractice Settlement Amounts and Jury Payouts

Below are summaries of publicly reported settlements and jury verdicts in birth injury malpractice cases involving cerebral palsy.

• $98 Million Verdict (Iowa 2022):  A 39-year-old woman was admitted with painful contractions. The baby experienced fetal distress, but the doctors did not order a C-section. resulting in a hypoxic brain injury. Making matters worse, the doctor tried to deliver using both forceps and a vacuum. Every OB knows you do not use both of these during a delivery. You pick one or the other. The baby, now three years old, has cerebral palsy, a learning disability, requires assistance to stand and take steps, needs 24-hour care for the rest of his life, and is unlikely to be able to work.
• $35 Million Settlement (Illinois 2022): Twins were born prematurely at Evanston Hospital. The family accused obstetrician Fabio Ortega and Northshore University Health System of medical malpractice during the delivery of their twins. Ortega was accused of leaving the hospital during his 24-hour on-call shift and being late for the surgery the next day. He also used a transverse incision instead of a vertical incision and took 14 minutes to deliver the second twin, who was later diagnosed with severe disabilities and cerebral palsy.  The case proceeded to trial but ended in a deadlocked jury. Dr. Ortega pleaded guilty to aggravated criminal sexual abuse involving two female patients. This drove the hospital to want to get the lawsuit settlement.
• $25,400,00 Verdict (Missouri 2023): An obstetrician delegated the responsibility of administering and monitoring Pitocin (a medication used to speed up labor) to a student doctor. The fetal heart monitor warned of complications, but the doctor continued administering more Pitocin. As a result,  the baby experienced a significant loss of oxygen, which resulted in the child’s cerebral palsy. After a two-week trial, the jury granted the child and her family over $25 million (reduced to $19 million by the pain and suffering damage cap in Missouri).
• $1,000,000 Settlement (Indiana 2022): A woman, 37 weeks pregnant, allegedly went to a hospital with ruptured membranes, was placed on a monitor to track contractions and the fetal heart rate, was removed from the monitor and instructed to walk in the hallway to hasten labor. She suffered a prolapsed umbilical cord while the baby suffered oxygen deprivation. The child was diagnosed with spastic quadriplegic cerebral palsy.
• $2,500,472 Settlement (New York 2022): This cerebral palsy malpractice case involved failure to diagnose and treat a maternal infection (chlamydia). The failure to treat the infection caused the mother to go into labor prematurely, and the child suffered a brain injury and was diagnosed with spastic cerebral palsy.
• $2,200,000 Settlement (New York 2022): Infacnt reportedly suffered hypoxic brain damage, resulting in cerebral palsy and hemiparesis, during her premature birth at defendant NYU Langone Hospital. The infant plaintiff’s parents alleged that the hospital staff deviated from accepted medical standards of care in failing to properly treat the pregnancy as high risk in light of a diagnosis of trisomy 16 and failing to recognize dangers posed by a possible diagnosis of Intrauterine Growth Restriction (IUGR), among other failures.
• $23,374,555 Verdict (Missouri 2022): The lawsuit alleged that the defendants negligently failed to decrease or discontinue Pitocin despite warning signs that the mother was reacting with overly strong contractions and the fetus was under stress. The child suffered a hypoxic brain injury and was diagnosed with spastic cerebral palsy. The verdict included $18 million in future medical expenses.

How Cerebral Palsy Settlement Amounts Are Calculated

Cerebral palsy lawsuits can be challenging to calculate because many factors can influence the settlement amount. Some factors are difficult to quantify, and others may be subject to interpretation or dispute. Additionally, the costs associated with cerebral palsy can vary widely depending on the severity of the condition, the child’s age, and other factors. Yet cerebral palsy lawyers need to be able to estimate what a jury payout might be because this is how settlement amounts for birth injury lawsuits are calculated.

Several factors are considered when determining the settlement amount for a cerebral palsy lawsuit. These may include:

1. The Severity of the Child’s Condition: The severity of the child’s cerebral palsy is an essential factor affecting the settlement amount. For example, a child with severe cerebral palsy may require around-the-clock care, have significant mobility limitations, and require expensive equipment and medication. As a result, the settlement amount may be higher than that for a child with a milder form of cerebral palsy.
2. Impact on Quality of Life: The impact of cerebral palsy on the child’s quality of life is also a crucial consideration. This includes factors such as the child’s ability to interact with others, participate in recreational activities, and perform daily tasks independently. The more severe the impact on the child’s quality of life, the higher the settlement amount may be, particularly in jurisdictions without a malpractice pain and suffering cap.
3. Medical Care and Assistance Required:  Economic damages drive cerebral palsy settlement amount. The cost of medical care and assistance required for the child is another important factor in determining the settlement amount. The fact that insurance may cover some of these expenses does not matter in most states. These damages include the cost of surgery, medication, therapy, other medical interventions, specialized equipment, and accessibility modifications to the home. This number can quickly get deep into the tens of millions in some cases when you consider both past and future expected costs.
4. Jurisdiction: The jurisdiction where the case is heard will impact the settlement amount in a cerebral palsy case. Not only do different states have different laws and guidelines for determining damages in medical malpractice birth injury cases, but juries are also different in the same state. You can walk across a county line and see how much your case is worth triple (or decrease by two-thirds, as the case might be).

In summary, the settlement amount for a cerebral palsy lawsuit is influenced by several factors, including the severity of the child’s condition, the impact on their quality of life, the amount of medical care and assistance required, the estimated future costs of care, the circumstances leading to the injury, the strength of the evidence, and the jurisdiction where the case is heard. An experienced attorney can help a family navigate these factors and work to secure a settlement that provides adequate compensation for their child’s injuries and future care needs.

Getting a Lawyer for Your Cerebral Palsy Malpractice Claim

If your child has suffered from cerebral palsy or another birth injury due to mistakes during childbirth our law firm has the experience and resources to help you get the compensation you deserve. We handle birth injury lawsuits across the country. Do not look for a lawyer near you with a case so important. Talk to the best cerebral palsy lawyers that you can. If you decide that it is us, call Miller & Zois today and speak to a birth injury medical malpractice attorney at 800-553-8082 or get an online case evaluation.