Common Labor and Delivery Errors

mattcaseydeskLegal Blog post by Partner Matt Casey

Common Labor and Delivery Errors

Most births in the United States are complication-free.  However, approximately 5 to 7 out of every 1,000 births results in some sort of birth trauma.  Many of these are a result of errors by physicians, nurses, or other healthcare providers.  The following is a list of the most common labor and delivery errors and the possible resulting birth injury:

    1. Failure to diagnose potential birth complications.  A simple ultrasound can detect potential complications such as breech position or cephalo-pelvic disproportion – when a mother’s pelvis is too small or a baby’s head is too large.  Allowing a vaginal delivery under these conditions can lead to erb’s palsy or shoulder dystocia.
    2. Failure to monitor or detect problems with fetal heart rate, oxygen levels or other fetal vital signs.   Too many fetal heart rate decelerations during labor and poor oxygenation during labor and birth can lead to birth injuries such as, cerebral palsy, brain damage from hypoxic ischemic encephalopathy (HIE) or birth asphyxia, or seizures.
    3. Failure to order a timely C-section.  Laboring too long and delaying a C-section can lead to cerebral palsy, erb’s palsy, shoulder dystocia or brain damage.
    4. Incorrect or inappropriate use of a delivery tool.  A parent should be consulted of the risks prior to the use of a delivery tool, such as forceps or a vacuum.  A parent’s decision for a C-section should be respected.  If a delivery tool is used there is a risk for cerebral or intracranial hemorrhage, hematomas, seizures, brain damage or facial paralysis.
    5. Incorrect medication or incorrect dose.  Any medications given before, during or after labor (such as Pitocin or Morphine) must be appropriately prescribed and monitored.   An incorrect dose can lead to seizures, uterine rupture, hemorrhages or retinal hemorrhages.
    6. Failure to identify or treat infections.  A woman with an infection such as Group B strep, e-coli, herpes simplex virus (HSV), or any sexually transmitted disease (STD) must be appropriately treated during pregnancy, labor and delivery.  Otherwise, these infections can be transmitted to the baby or cause meningitis and encephalitis.
    7. Incorrect or inappropriate delivery techniques. Any prolonged pulling or pushing during the delivery has the potential to cause brain damage, erb’s palsy or shoulder dystocia.

Oftentimes parents who sensed that something went wrong during their labor and delivery are usually right. The following conditions or circumstances may indicate a medical mistake was made:

  • Mother had undiagnosed or untreated infection
  • Babies heart rate dropped or decelerated during labor and delivery
  • Medical records have been change, altered or are missing
  • A C-section was preformed, but only have many hours of attempted natural delivery
  • Umbilical cords wrapped around baby’s neck
  • Delivery tools like forceps or vacuum were used to quickly deliver the baby
  • Low APGAR scores
  • Baby is taken to NICU
  • Baby experiences lethargy, fuzziness, seizures or other medical conditions shortly after birth
  • Medical staff indicates something went wrong or should have been done differently
  • Medical records show events that are not true or accurate
  • Baby is diagnosed with a permanent injury – such as cerebral palsy or mental retardation

If a child is diagnosed with any of the conditions mentioned in this article, it merits further investigation to be sure Standards of Medical Practice were followed to ensure patient safety. A personal injury attorney well-versed in medical malpractice should review the circumstances of the labor and delivery to determine if there was negligence.

This article originally appeared in July 2015 on the Casey & Devoti website.

Matt Casey is a partner with Casey Devoti & Brockland, a St. Louis-based personal injury law firm.  Matt handles a variety of personal injury cases with a special emphasis on medical malpractice and birth injuries.

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