Obstetrical cases are often thought of as the most challenging type of medical malpractice case. Injuries suffered by a baby due to such things as oxygen deprivation during labour and delivery can cause lifelong catastrophic injuries. The damage awards for such injuries vary based on the extent of the injuries, but can be as high as $10,000,000 or more. Most obstetrical claims are against obstetricians, but claims against family physicians doing obstetrics and midwives are becoming more and more common.
Types of obstetrical malpractice cases include:
Brain Injury Caused by Oxygen Deprivation During labour and Delivery
Contractions during labour result in diminished blood flow through the umbilical cord to the fetus. This results in decreased oxygen delivery to the fetus. In most cases, the fetus has the ability to tolerate this reduction in oxygen supply. In others, the reduction in oxygen or the contractions may be coming too quickly for the fetus to recover. In those situations, there will be tell-tale changes to the fetal heart rate. It is the responsibility of the obstetrical healthcare providers to monitor the fetal heart rate and, if there are signs the fetus is not tolerating labour, to intervene and deliver the fetus — often by emergency caesarean section. The changes to the fetal heart rate occur before neurological injury occurs and that gives healthcare providers the opportunity to intervene before injury occurs.
Brain injuries caused by oxygen deprivation include hypoxic ischemic encephalopathy and cerebral palsy. Further information can be found here.
Stroke Suffered During Labour and Delivery
There is an ongoing debate amongst obstetricians and paediatric neurologists about the cause of strokes suffered by fetuses during labour. Many experts believe that fetal strokes can be caused by oxygen deprivation, as described above. In a situation where a stroke occurs in the context of oxygen deprivation during labour and delivery, a strong argument can be made that earlier intervention and delivery would have prevented the stroke.
Injury Caused by Delivery Instruments
A newborn can be injured by the use of forceps or vacuum extractors.
When a baby is born prematurely, there are significant risks to the baby. In some situations, it may be possible to advance a claim based on the failure to take all appropriate steps to prolong the pregnancy.
During delivery, an infant may become stuck on their mother’s pubic bone. This is an obstetrical emergency. If the obstetrician applies excessive traction to the baby’s head trying to dislodge the stuck shoulder, nerves in the baby’s surgical spine can be stretched or torn. An injury to the nerves may result in the baby having significantly reduced functioning and movement of one of their arms. This is called a brachial plexus injury or Erb’s palsy.
Failure to Properly Resuscitate
In the minutes following birth, some babies require suctioning for meconium or resuscitation. The failure to properly resuscitate the newborn baby can result in neurological injury.
Failing to Properly Assess the Neonate
In the days following birth, the healthcare providers need to assess the child’s blood sugar and bilirubin levels and check for signs of infection. The failure to properly monitor for these conditions can result in the baby suffering a brain injury.
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