Archive for the ‘Birth Injury Law’ Category

Birth Injury Malpractice and Forceps Deliveries

Monday, July 11th, 2011

Forceps are metal tongs used in childbirth. They are used to apply traction to the baby’s head, in an attempt to move the infant out of the birth canal and into the world. Forceps deliveries, once common, have been on the decline in the United States in the past few years. This is largely due to the increase in the rate of cesarean section in the U.S. – deliveries which once would have been done using forceps (or vacuum extraction) are now routed to c-section, instead.

The choice of c-section over forceps-assisted delivery is often a difficult one for mothers, many of whom fear surgery, and have been dreaming of a traditional childbirth since they learned they were expecting, or before.

But, from a medical perspective, the choice is easy. In fact, the use of forceps, rather than a c-section, can often result in birth injury medical malpractice.

The high risk of severe injury or death to infants delivered using forceps is now well-documented. One roughly one of every three malpractice cases based upon birth injury involves the use of forceps in delivery – a figure hugely disproportionate to the percentage of births in which forceps are used, which is currently around 5 percent. And in those cases, in around one-half of cases forceps were found to have been used in delivery in spite of the presence of warning factors or contraindications. Indeed, a high forceps delivery (use of forceps when the infant’s head is not yet deeply engaged) is extremely risky, and often causes both death of the infant and injury to the mother. This procedure is now always outside the standard of care.

Yet obstetricians continue to insist that the choice to use forceps should be entirely left to the physician, in his or her own experience and preference. This assertion is startling, in light of the evidence that forceps are often used when they should not be, and used negligently. This negligent use can lead to severe complications for both infant and mother.  For the mother, complications can include:

  • Vaginal lacerations
  • Cervical lacerations
  • Perineal lacerations
  • Blood loss and/or hemorrhage
  • Hematoma
  • Bladder or urinary tract injury
  • Anal sphincter injury and/or fecal incontinence
  • Death

For the infant, complications can include:

  • Facial bruising
  • Facial lacerations
  • Cephalohematoma
  • Facial palsy
  • Brain injury
  • Shoulder dystocia
  • Skull fractures
  • Intracranial hemorrhage
  • Tentorial lacerations
  • Cerebral palsy

Delivery with forceps should only be attempted when the factors calling for this delivery method are present. It is almost certainly medically negligent to use forceps in delivery if any of the following conditions is not met:

  • The head of the fetus is engaged, ideally deeply (so that a low forceps delivery can be performed).
  • The fetus is positioned properly – head down (not breech) and not transverse.
  • The physician knows precisely where the head is located.
  • The mother’s cervix is completely dilated (10 centimeters or more).
  • The membranes have been ruptured (the water is broken).
  • The fetal head is small enough to pass through the mother’s pelvis.

The use of forceps when all of these conditions are not met is may constitute medical malpractice. In addition, certain problems in forceps deliveries are almost always the result of medical negligence. For example, physicians now agree that the forceps slipping off the infant’s head (often, but not always the result of unruptured membranes) is almost always the result of medical negligence.

If you are expecting, you should talk to your obstetrician about his position on the use of forceps in delivery. If your doctor favors the practice, you may wish to consider changing obstetricians. Whatever you decide, you should be prepared to insist that only safe practices be used if your physician attempts to use forceps in the delivery-room.

If forceps were used in your delivery, and you or your child suffered serious birth injury or disability, you should talk to an attorney. An experienced birth injury attorney can help you to determine if you have a legal claim.

For a free consultation with an experienced Chicago birth injury lawyer at Passen Law Group, call us at (312) 527-4500.

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Pitocin and Medical Malpractice

Thursday, June 30th, 2011

Many women in recent years have been helped by Pitocin or oxytocin, drugs used to induce labor or speed it up once it has begun. But the use of Pitocin has now skyrocketed, to the point where in many labor and delivery units, the administration of Pitocin has become standard in nearly every birth, simply to shorten an otherwise natural and safe labor.  The expression “pit her” (short for the directive to administer Pitocin) is now heard more often than “it’s a boy!” in many hospitals.

Oxytocin is a naturally occurring hormone used by a woman’s body during the labor and delivery process to cause contractions and expel the baby. Pitocin is simply a synthetic (man-made) version of Oxytocin. But while Pitocin is very similar to natural Oxytocin in structure and effect, there are a few key differences.

First and foremost, Pitocin causes sharper contractions than natural Oxytocin. Additionally, Oxytocin is released in a woman’s body irregularly, in short bursts. Pitocin, by contrast, is administered using an intravenous pump, and enters a woman’s body in a continuous stream.  Women administered Pitocin thus experience fast, hard, painful labors.

This increase in the speed of labor can be extremely useful. If for medical reasons labor must be completed quickly to avoid fetal distress, Pitocin can be a good choice.

But the use, and the overuse, of Pitocin can be extremely dangerous. In fact, the overuse of Pitocin, or the failure to properly manage and monitor a patient who has been administered Pitocin can cause severe injury or death. These practices can even amount to Pitocin-related medical malpractice.

The primary, general rule for the use of Pitocin is that it should only be used by a competent, experienced labor and delivery physician, and in a careful, professional manner.  If Pitocin is used in excessive quantities, serious injury can result, which threatens the life of both mother and infant. Among the risks of excessive Pitocin are:

•    Stillbirth
•    Paralysis
•    Rupture of the uterus
•    Premature separation of the placenta (which in turn can lead to brain injury or death of the infant)
•    Post-birth hemorrhage
•    Fetal asphyxia
•    Neonatal hypoxia
•    Brain injury
•    Cerebral palsy

To avoid fetal distress and the attendant dangers during Pitocin use, an electronic fetal monitor should be used continuously and watched carefully. And at the first sign of fetal distress, such as a change in fetal heartrate or fetal movement, Pitocin should be halted. The failure to do so may amount to medical malpractice.

If your doctor administers Pitocin, you should demand fetal monitoring, and be proactive – speak up if you believe that the continued use of Pitocin could be harming you or your child. If you were given Pitocin, and then experienced birth injury to yourself or your child, an experienced birth injury attorney can help you to determine if legal action is warranted.

For a free consultation with a top Chicago birth injury lawyer at Passen Law Group, call us at (312) 527-4500.

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Fetal Distress: A Primer

Monday, June 27th, 2011

Today, our top Chicago birth injury lawyers discuss a common precursor to injuries at birth: fetal distress.

What Is Fetal Distress?

Fetal distress occurs when an infant – either in utero or during the childbirth process – suffers from a compromised oxygen supply. While fetal distress is a single condition, it can in turn be caused by any number of things. These potential causes include:
•    maternal illness
•    placental abruption
•    umbilical cord compression
•    fetal infection
•    maternal position (putting pressure on major blood vessels and thereby limiting the infant’s oxygen).

If fetal distress is not corrected promptly and correctly, the consequences can be tragic. Many infants who suffer fetal distress are left with a serious, often permanent, neurologic or intellectual disability. Others do not survive childbirth. Physicians and other medical professionals who fail to promptly respond to fetal distress can be guilty of medical malpractice.

What Is My Risk?

Estimates of how common fetal distress is vary. But, in general, experts estimate that fetal distress occurs anywhere from once in every 25 births to once in every 100 births. There are also a number of risk factors for fetal distress. When these risk factors are present, both mother and baby should be carefully monitored. The failure to properly monitor when these conditions are present can constitute actionable medical negligence. These risk factors include:
•    intrauterine growth restriction
•    hydramnios or oligohydramnios
•    preeclampsia or eclampsia
•    gestational diabetes
•    multiple pregnancy.

At times, high-risk pregnancies are easily identifiable based upon a mother’s medical history. At other times, a high-risk pregnancy can be identified based on simple laboratory tests (such as the test for gestational diabetes). Physicians who fail to identify these high-risk pregnancies, and properly monitor the fetus for signs of distress, may be committing medical malpractice.

Symptoms of Fetal Distress

The primary symptom of fetal distress is decreased heartrate. In high-risk cases, as well as during the childbirth process, fetal heartrate can be easily monitored using a fetal monitor. The failure to properly monitor fetal heartrate can lead to fetal distress and to serious or even deadly birth injury.

Another strong indicator of fetal distress is a changed pattern in fetal movement, particularly a decrease or cessation of fetal movements. Some infants in distress also have their first bowel movement (a substance called meconium) while still in their mother’s uterus.

What Can Be Done?

Fetal Distress is an extremely serious condition that must be addressed promptly.  Generally, an infant in distress must be delivered as soon as possible. Sometimes, if a natural birth is close to complete, a vaginal birth can proceed. But almost always, fetal distress calls for an immediate or emergency C-section.

A Mother’s Role

Hopefully, your practitioner will notice fetal distress and respond appropriately — especially if distress occurs during labor and delivery.  You can also watch for fetal distress yourself by keeping track of your baby’s movements or performing the “kick test” –counting the number of kicks from your baby during a one to two-hour period.

Any time you believe your baby may be in distress, you should see your doctor as soon as possible. Your doctor should hook you up to a fetal monitor to ensure that your baby is not in distress.

For a free consultation with an experienced Chicago birth injury attorney at Passen Law Group, call us at (312) 527-4500.

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