Representing families in birth injury cases is one of the most emotionally difficult things we do at Rice & Bloomfield. The birth of a child is usually a most joyful event for the parents and family. However, an estimated 29 births out of 1,000 in the United States results in injury to the baby from birth trauma, according to a study by the National Institutes of Health. That is almost 4,000 birth injuries per year in Los Angeles. Some injuries are minor and resolve quickly. However, for those babies who suffer the most serious trauma – from lack of oxygen during labor or delivery to those with permanent, disabling injuries to an arm caused by negligence of a doctor or nurse – life will never be easy or normal for them or their families.
While some serious birth injuries are not preventable – those with genetic causes, for example – many of the most serious can be traced to the inattention of the nursing staff or delay in responding to potential distress of the baby by the delivering doctor. Fetal monitoring should alert the doctor and hospital staff if a fetus is under stress so that timely treatment decisions can be made about how to address that situation before it causes serious and permanent harm.
If a hospital is under-staffed or the nurses don’t pay sufficient attention to alarming changes in the fetal heart rate, the oxygen the fetus needs to stay healthy during labor and delivery can be interrupted. Sometimes, the nurses are concerned about the health of the fetus, but the doctor cannot be located or delays responding to those concerns. The result can be a condition called “perinatal asphyxia” or “fetal hypoxic ischemic encephalopathy.”
“Perinatal asphyxia” is a medical condition in which the fetus or newborn is deprived of oxygen long enough to cause physical harm, usually to the brain. Before the baby is born, it gets its oxygen supply from the circulation of blood; if that circulation is inadequate to provide sufficient oxygen to the fetus, there are usually signs of distress seen on the fetal monitor strip. Prompt recognition of those signs is critical to preventing injury.
If fetal distress caused by inadequate oxygen reaching the fetus is not identified and treated promptly, it can result in the condition known as “fetal hypoxic ischemic encephalopathy” or HIE. That simply means that brain damage has occurred because of the lack of blood and oxygen necessary to keep the brain (and other organ) cells healthy. Depending on how severe the condition is, a child born with HIE may have cerebral palsy, may not meet developmental milestones, may have problems moving his arms and legs normally, may not be able to communicate using language, and may require a lifetime of expensive care.
Most parents of children who suffer birth injuries are so busy attending to the needs of their “special” child, t
hat they may not seek legal advice within the first year after birth, when they may have separate claims of their own against a negligent doctor or nurse relating to the delivery. The child’s claim usually can be timely filed before age six or eight, but the parents’ claim has a much shorter “statute of limitations.” In California, this is particularly significant because of caps on non-economic damages which severely limit how much anyone harmed by a preventable medical mistake can recover.