Birth Injuries: What Causes Cerebral Palsy?

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Birth Injuries: What Causes Cerebral Palsy?

Birth injuries are oft-litigated medical malpractice cases.  There is much at stake when a newborn is injured because the costs of caring for a severely injured infant over the course his/her life can exceed $5-10 Million, depending on the severity of the injury and specific needs of the child. In addition, the personal costs of this injury on the injured child, the parents and other family members are huge and last a lifetime.  How do medical negligence lawyers prove whether a child’s cerebral palsy (CP) was caused by an obstetrician’s negligence?

CP can occur as a result of asphyxia that occurs during labor and delivery.  The American Congress of Obstetricians and Gynecologists (ACOG) estimates that approximately 25% of CP results from intrapartum asphyxia, while the remainder results from other problems like infection or genetics.

ACOG is forever trying to narrow the circumstances in which an OB can be found liable for birth injuries that result in CP.  One such effort is the so-called “Green Book.”  The Green Book sets forth criteria for establishing whether CP was due to intrapartum asphyxia or another cause.  If met, the criteria almost always results in death.  In other words, ACOG set the bar so high that CP rarely can be attributed to OB negligence when using the Green Book criteria.

The Green Book was prepared by ACOG for purposes of litigation and has not been endorsed by United Cerebral Palsy.  The Green Book also fails to include contradictory data and fails to establish criteria for establishing other causes to CP.  The Green Book criteria has spawned a cottage industry of defense experts who will readily attribute a child’s CP to some cause other than mismanagement of labor and delivery.

Defense experts will also question the usefulness of electronic fetal monitoring (EFM) in predicting when a baby is in trouble in utero, even though this monitoring has been the standard of care for over 30 years.  Recently, a detailed EFM survey published by Cahill, et al. proved that repetitive late, prolonged and variable decelerations, more severe decelerations, and tachycardia were all associated with an increased risk of CP.

In Ohio, plaintiff’s experts are not bound by the Green Book criteria.  They can offer expert opinions about the cause of CP based on the patient’s clinical history, EFM strips, lab studies and imaging studies like MRI.  A skilled and experienced medical malpractice attorney can teach the jury about the limitations of the Green Book and expose faulty defense expert testimony.  In birth injury litigation, the ability to prove causation is key to a successful lawsuit.

People interested in learning more about our firm’s legal services, including medical malpractice in Ohio, may ask questions or send us information about a particular case by phone or email. There is no charge for contacting us regarding your inquiry. A member of our medical-legal team will respond within 24 hours.

By David Kulwicki|2019-04-24T18:00:02+00:00February 11th, 2013|Birth Injury|Comments Off on Birth Injuries: What Causes Cerebral Palsy?

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