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Articles Posted in Birth Injuries

Most of us have probably heard of Zika and know it is most often transmitted through mosquito bites and unprotected sex with infected people.  Zika is also linked to birth defects.

This is not a blog post about Maryland law or medical malpractice.  But we are interested in the health of babies. This is something that people need to understand.

Zika Virus

The recent decision by the New York Supreme Court Appellate Division in J.H. v. New York City Health and Hospitals Corporation, 169 A.D.3d 880 (NY App. Div. 2019) answers the question of whether a plaintiff can serve late notice of a claim upon a hospital operator. At issue, specifically in J.H., is whether a plaintiff, when there are actual knowledge and an absence of prejudice on part of the defendant, can be granted leave to serve a late notice of a claim despite lacking a reasonable excuse.

New York Law

baby-300x169Under New York’s General Municipal Law § 50–e[1][a], service of a notice of claim is a condition precedent to bringing suit against a public corporation and requires that the notice is served within 90 days after the claim accrues. Unless leave of court is made, late service of the original notice of claim is a nullity. Additionally, after the statute of limitations has run courts lack the authority to deem that late notice of claim timely served nunc pro tunc. The statute of limitations under General Municipal Law § 50–e[1][a] provides that the limitation period for commencing a tort action against a municipal corporation is one year and 90 days, however, in cases such as J.H., the statute of limitations does not expire after one year and 90 days because a plaintiffs infancy tolls the statute of limitations for 10 years.

The U.S. has long had the highest rate of maternal fatalities during childbirth of any country in the developed world. STOP.  Read that again.  We are inundated with so many statistics these days that we lose sight of the ones that matter.  This one matters. This is insane. The rate of maternal injuries and deaths during childbirth in U.S. hospitals has been steadily increasing over the decade. For their part, hospitals have insisted that this increase was largely out of their control and not a reflection of any declining quality of care. Hospital advocates suggest that poverty rates and an increase in pre-existing maternal health conditions are to blame for these morbidity rates.

USA Today Investigation

This attempt to shift blame away from doctors, nurses, and hospitals fails.  USA Today recently did an investigation of just this.  You don’t think USA Today is the New England Journal of Medicine?  Fair enough.  But this is not rocket science.  It is just a look at the numbers and, yes, the anecdotal stories. USA Today showed that demographics alone cannot explain maternal death rates in the U.S. The investigation looked at medical records and lawsuits from across the country, suggesting that delayed care, misdiagnosis, and poor safety measures contributed to maternal death and injury rates.

A recent study identified several specific conditions during pregnancy that appear to increase a baby’s chances of suffering hypoxic-ischemic encephalopathy (HIE) which is a very serious type of childbirth brain injury. This research helps advance our understanding of HIE’s causes, which will allow improvements in prevention and treatment. This is what we have to work towards — getting the science and the medicine better so we have less oxygen-deprived children during the birthing process.

What is hypoxic-ischemic encephalopathy?

Hypoxic-ischemic encephalopathy (HIE), is a brain injury resulting from a lack of oxygen and blood flow to the baby’s brain. It can lead to seizures, difficulty feeding, low muscle tone, organ dysfunction, and breathing difficulties. HIE may cause long-term neurologic disabilities such as cerebral palsy, intraventricular hemorrhages, and learning disabilities.

What risk factors did the new study link to HIE?

There are many additional pregnancy conditions or issues that are associated with HIE. All of them involve disruption of the delivery of oxygen to the fetus.

They include, but not are limited to:

  • Nuchal cordA nuchal cord occurs when the umbilical cord wraps around in a knot or loop around the baby’s neck. When this occurs, the cord can become obstructed, limiting the flow of oxygen-rich blood from the mother to the baby. Sometimes, it can get wound so tightly that it affects the blood vessels on the neck, depriving the baby’s brain of oxygen.

Do midwives have the midwives — basically nurses — have the medical knowledge and insight to provide consultation for mothers or help them make decisions that are a matter of life and death?

My feeling is that some do and some don’t.  But I think, on balance, why not have an OB/GYN?  If you are having a child, you want to mitigate risk.  The best way to mitigate risk is to find the best doctor you possibly can to guide you through pregnancy and deliver your child.

  • Why midwives are both easier and harder to sue

Since cerebral palsy (CP) is associated with children, much of the data comprises infants and young children. There is little information on difficulties that adults with cerebral palsy face as they get older. However, a recent study fills in this lack of data. Published in JAMA Neurology, it concluded that adults with cerebral palsy are more likely to be diagnosed with depression and anxiety.

The study                               

baby-in-womb-300x160Conducted by British, American, and Irish researchers, they used data from the United Kingdom’s Clinic Practice Research Datalink primary care database. Their data spans the years 1987 to 2015. The researchers examined 1,705 adults, ages 18 to 99, with cerebral palsy who also received depression and anxiety diagnoses. They compared each adult with CP to three adults without CP. The researchers chose these individuals based on the same age, gender, and primary care practice as adults with CP. The data covers about 7% of the country’s population. It comprises clinical events, prescriptions, referrals, and hospital admissions.

A team of researchers at University College London has developed a device known as a broadband near-infrared spectroscopy (NIRS) that uses light to detect brain damage in infants. They are now planning a clinical trial of the NIRS.

What is near-infrared spectroscopy?

Operating-room-pic-3-300x211Near-infrared spectroscopy (NIRS) is a spectroscopic method that uses the near-infrared region of the electromagnetic spectrum. There are many different applications of NIRS which include astronomical spectroscopy, agricultural, pharmaceutical, and neonatal research.

The potentially dramatic impact of a stroke on your health and wellness cannot be understated. What many people don’t know is that strokes arise from several possible conditions, including brain ischemia (commonly referred to as cerebral or cerebrovascular ischemia).

What is Brain Ischemia?

Brain ischemia occurs when there is insufficient blood flow to the brain. This happens when arteries within the brain become blocked or there is bleeding. The resulting lack of oxygen can cause brain tissue death, cerebral infarction, or ischemic stroke. The longer your brain goes without oxygen, the more serious the damage.

med-mal-300x200Ischemia is divided into two categories: focal (specific to one portion of the brain) and global (impacting a large general area of the brain). While focal ischemia is often caused by a blood clot, global ischemia is most often linked to heart attacks.

As a parent, you don’t want to hear that there’s a problem with your soon to be son or daughter.  Or that a life-changing complication was discovered in the hours after their birth. An infection during pregnancy can have devastating consequences for you and your child.  If untreated, maternal infection can result in a permanent birth injury or even death.

What Are Maternal Infections?

Operating-room-pic-3-300x211These are illnesses that affect both mother and fetus during pregnancy. While some common maternal infections, (such as flu or a cold) will very little impact on a pregnancy, there are a few that can result in serious health complications.

This is a guest post from Jonathan Rosenfeld, a medical malpractice attorney in Chicago, IL. Jonathan is the founder of Rosenfeld Injury Lawyers. I appreciate his contribution to this blog. The topic Jonathan attacks today is an important one: how to help cerebral palsy patients get the best possible outcomes.

There is no doubt that many cerebral palsy (CP) patients face many obstacles. But there is some relatively low hanging fruit to improve patients outcomes: good nutrition. Because of their condition, patients can be malnourished even when though they are fed regularly with what may seem like a healthy diet for the average person.

Causes of Malnutrition in CP Patients