Napoli Bern Ripka, LLP Birth Injuries Injuries suffered by newborns during the delivery process can be serious and life threatening. Such damage can affect your child not only through their development, but throughout their entire life, especially if they have experienced traumatic brain injuries. There are many types of injuries that newborns can suffer from their delivery, although keep in mind that many birth injuries are not the consequence of medical malpractice. Our lawyers can help you determine if your baby's injury is the result of medical malpractice. A list of the most common injuries during the birthing process is as follows: * Cerebral Palsy * Brachial Plexus Palsy (Erb's Palsy and Klumpke's Palsy) * Facial Paralysis * Horner's Syndrome * Shoulder Dystocia * Spinal Cord Trauma * Cranial Nerve Trauma * Intracranial Hemorrhage * Cephalohematoma * Caput Succedaneum * Fractures Cerebral Palsy There are three common types of Cerebral Palsy (CP): athetoid (uncontrolled movements), ataxic (perception and balance difficulties), and spastic (muscles that are permanently stiff/contracted). Sometimes a newborn or infant may show signs of a combination of the conditions, which is called a mixed type. Spasticity is the most frequent form of CP, which occurs in just under two-thirds of newborns that have CP. CP, as a whole, is a form of congenital paralysis (with the discoordination of muscles) that is the result of a brain injury or trauma during birth, a deficiency of oxygen to the brain, or a viral infection. This neuromuscular disorder causes a distortion and impediment of motor skills (i.e., an inability to walk straight or difficulty in swallowing and/or speaking), which may or may not include involuntary movements. Other residuals from CP may include a limited range in motion, poor control of the head, arms, or legs, underdeveloped muscles, seizures, and overall slow development. Brachial Plexus Palsy (Erb's Palsy and Klumpke's Palsy) Brachial Plexus Palsy is the result of damage to the brachial plexus, which is the network of nerves that conducts signals from the spine to the arms and hands and controls sensation and movement to said appendages. This type of damage occurs during the actual moving through the birth canal, when the newborn's shoulders and/or neck are stretched too far apart. The four types of nerve injuries are avulsion (the nerve is torn form the spine itself), praxis (the nerve is damaged but not torn), neuroma (after the nerve was torn, it attempted to heal itself but scar tissue had formed, putting pressure onto the injured nerve, which blocks the signals from the nerve to muscles), and rupture (the nerve is torn, but not at the point where it attaches to the spine). Erb's Palsy is a brachial plexus injury to the newborn's upper portion of the plexus. Klumpke's Palsy is a brachial plexus injury to the newborn's lower portion of the plexus. Facial Paralysis Isolated facial paralysis usually stems from pressure to the facial nerves during labor or birth and can cause complications with the shutting of the newborn's eyes, which can then lead to corneal ulcerations. Usually, you can determine this condition when the newborn is crying, because there will be no movement on the injured side of the face (i.e., the eye not being able to close). If the nerve was damaged to the extent that it was torn, surgery may be needed. Although not inherently common, it can be related to (or in connection with) other birth injuries (i.e., brachial plexus). Horner's Syndrome Oculosympathetic deficiency (or Horner's Syndrome) can be a result from Klumpke's Palsy, trauma to the thoracic or cervical sections of the spinal cord, or a neck trauma during the birthing process that causes damage to the sympathetic nerve to the eye. Usually, if the syndrome was onset at birth, you can notice the condition around the age of two by the existence of a color variation to the iris and a drooping eye (and/or slight elevation of the lower eye lid). Shoulder Dystocia Shoulder dystocia is an obstetrical complication that occurs during the delivery of the newborn's head, when the shoulders are stuck behind the mother's pelvis (pubic bone), or in really rare cases, the sacrum; damage has occurred due to special maneuvering in order for the shoulders (and eventually the baby) to twist free. In most occurrences, shoulder dystocia takes place due to the newborn's shoulder size being almost equivalent to their head size. Fractures to the shoulder, clavicle, or nerves can result from the movements needed to birth the child; also, brachial plexus injuries can stem from shoulder dystocia. Spinal Cord Trauma Two of the most common injuries to the newborn's spine are in the upper thoracic and lower cervical sections during feet first deliveries (breech presentation). Spinal cord trauma is sometimes the result of incorrect maneuvering and can affect the nerves or actual vertebrae of the newborn's spine. Cranial Nerve Trauma Some cranial nerve traumas result from the natural passing of the head by the sacrum or from pressure on said nerve within the uterus (fetal positioning). Very rarely does this injury occur because of the compression of the forceps blades, but it does happen. The outcome for this injury is usually isolated to the forehead, mouth, or eyes. Oftentimes, injuries to the vagus and facial nerves result in a temporary or occasionally permanent paralysis and/or facial asymmetry. Intracranial Hemorrhage Typically, premature newborns are the most susceptible for intracranial hemorrhaging. The most common type is the subarachnoid hemorrhage, which may result in seizures, apnea, or lethargy. Others include subdural hemorrhaging and intraventricular (and/or intraparenchymal) hemorrhaging, which in severe cases may including bleeding into the parenchyma. Examinations, such as a head CT or an ultrasound, can identify such hemorrhaging. Cephalohematoma This condition is referred to for an area of bleeding to a specific bone (underneath one of the cranial bones), or more specifically, a hemorrhage beneath the periosteum. Some of the effects of cephalohematoma could be hyperbilirubinemia or anemia and can be detected by an elevated lump on the newborn's head. If there happens to be a large area of bleeding, the newborn may develop jaundice (a slightly yellow discoloration of the eyes and skin). Caput Succedaneum The caput succedaneum is caused by the maneuvering and traveling through the birth canal (from the pressures of the vaginal wall, cervix, or uterus during vertex, or head-first, delivery); it is a distributed swelling (and sometimes bruising) of the soft tissues within the scalp. Oftentimes, newborns delivered by vacuum extraction are most susceptible to this circumstance. Fractures Collarbone and midclavicular fractures are of the most common breaks of the newborn's bone. They can occur with such events as dystocia or breech presentation, or with standard, non-traumatic deliveries. One thing to look for is the immobility of an arm, as the newborn will obviously not want to move the arm with the fractured clavicle. In rare cases, the femur and/or humerus may be fractured in very difficult deliveries. Birth Injury FAQ Q. What steps should I take if I feel that medical malpractice originated my child's birth injury? A. If you feel that your child's birth injury (and/or damage) was the consequence of a doctor's negligence, you must act quickly. Time is of the essence in any injury case, so please call us at 1-888-LAW-INNY without delay, in order for us to advise and inform you with the investigation process. Q. How do I decide that my child's birth injury is the result from my doctor's negligence? A. Our attorneys at Napoli Bern Ripka, LLP that specialize in birth injuries can determine whether or not your child's injuries were due to a doctor's mistake or of natural birthing causes. As soon as you call us and have one of our attorneys on your side, they can commence the investigation that will examine every single medical, newborn, and delivery record to see if all of the standard procedures have occurred. Please give us a call at 1-888-LAW-INNY to allow us to start your investigation. Q. What should I look for when assessing my child's birth injury? A. Especially with the condition of Cerebral Palsy (CP) or Brachial Plexus Palsy, look for abnormalities such as underdeveloped motor skills (lack of head control or awkward crawling and/or walking), underdeveloped (or overdeveloped) muscles (as in your child's body acts and feels limp or rigid), or lying in unconventional positions. Of course, if there are any visible bruises, bumps, or discolorations that last longer than a day or so, this is a sign that a more serious injury may have occurred. If your child does not have the use of all of their extremities, this could be an indication of some sort of dislocation or fracture within their bone or some sort of tear in the nerves, ligaments, or muscles. After you communicate with your doctor, please call us at 1-888-LAW-INNY so that we may assist you on your next step. Contact Napoli Bern Ripka, LLP Toll-Free Phone: 1-888-LAW-INNY (529-4669) Local Phone: 212-267-3700 E-mail: Pnapoli@nbrlawfirm.com
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