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What is Birth-Related Injury? – Birth-Related Medical Malpractice



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Video Transcript

0:00 Intro
0:03 What Is Birth-Related Injury
0:33 What Is Neonatal-Perinatal Medicine
1:34 What Is A Neonatal Birth Injury?
4:42 What Do These Issues Include?
5:31 The Apgar Score

0:03 What Is Birth-Related Injury

So people frequently ask me the question: what is birth-related injury and medical malpractice related to birth.

This of course is a complicated question, but this is something that I’m familiar with because of my experience in practicing, what’s known as newborn intensive care or neonatal-perinatal medicine.

0:33 What Is Neonatal-Perinatal Medicine

Let’s break that down a second, neonatal-perinatal medicine. This has anything to do with newborns. And newborns are of course from the moment of birth up until the age of 30 days. And perinatal is anytime around the birth, which relates to the time up to the birth frequently in days or even in months, that we study to determine what can happen to a baby during that period of time. 

So neonatal-perinatal medicine; this was my specialty and I’m still board-certified in that specialty. As we look more at the question, what is the injury that can occur, this relates to frequently neurologic problems, problems where babies are damaged in one way or another during the birth process or immediately after birth.

1:34 What Is A Neonatal Birth Injury?

So what is neonatal birth injury? Well let’s go back into the time when the baby is still in the mother’s uterus, and labor starts. Now we have a time that can be critical in terms of birth injury. It is important to know that the obstetrician of course is in charge at this time. And that is not my specialty. But since I have been around and have studied so many birth injuries, it’s important to know that I understand what are the standards of care that obstetricians have.

So let’s take for example a baby who is going along just fine in labor, and suddenly, the nurses know that the heart rate has slowed down. This can either be a normal thing in the labor, or it can be something that is critical and the baby must be taken at that point by cesarean section. A lot of times, babies don’t have any kind of measurement of that except intermittently by nurses.

Many times, the baby is monitored with a little monitor that is placed on the mother’s belly, and actually can detect the baby’s heart rate, whether it speeds up or whether it slows down. So let’s just say a nurse is watching for that, and the monitor alarm comes on and the baby is found to have a very very low heart rate. 

Well, the nurse has to know what is happened before this time. What stage of labor is the baby in? How far down did the heart rate go? And how long did it stay down? And how fast did it come back up? And exactly how did it come back up? Was it a quick rise or did it take a long time to come up?

This is very important and the nurse has to report that to the doctor. Sometimes the nurse immediately calls the doctor or needs to immediately call the doctor. And it doesn’t happen. So these can cause major problems for a baby and we can of course look at the records and tell what has gone on in this particular part of labor for a baby.

Also, sometimes babies get stuck. For example, the baby might be descending just fine in labor, and almost ready to be delivered, and the baby’s head will not come out. So the obstetrician has certain things that they are supposed to do during that time to get the baby out. And sometimes they do and sometimes they don’t.

4:42 What Do These Issues Include?

This can be a lack of placing an instrument. This can be a lack of doing a cesarean section. This can be using an instrument in the wrong way or doing the cesarean section the wrong way. All of these things have standard ways they’re supposed to be done, and that’s what we look at. So we can tell whether that injury occurred at that time. 

The interesting thing about neonatal injuries is a lot of times you don’t pick them up right at the time that the baby is born. Sometimes you do. Sometimes the baby’s have seizures. Sometimes they have other things going on and you can say ‘boy, something definitely happened to this baby’.

5:31 The Apgar Score

But sometimes that’s not the case. The baby does ok. The Apgar scores, which are scored immediately after the baby is born are ok, they’re not exactly the greatest, but they’re certainly not the worst. And the baby’s examination is pretty good. Maybe the baby is a little bit hypotonic, in other words, they don’t move their arms as much or as vigorously. And sometimes they seem like they’re ok but they’re not.

And one of the things that I did as a neonatologist is I followed these babies for many months after they were born to determine if things were truly ok or not ok. And in fact, sometimes they weren’t.

So when we get a case at LawMD, I can look at that sort of thing and say to the practicing attorneys who are our trial attorneys that this is an issue that we need to get into. We need to look at all the records of this particular case and then we can decide whether this is a case that we will take.

So people frequently ask me about this and that’s kind of a short discussion of exactly what I do and how LawMD approaches this.

So if you have any questions about birth injury or anything I’ve been talking about, please click the link below and we will be happy to talk to you further about this issue. Thank you.



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