Birth Injury - Cerebral Palsy Medical Claims

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Birth Injury – Cerebral Palsy

Complications in ante-natal care and the process of labour and delivery can result in a wide range of problems for a newborn baby

• About Cerebal Palsy
• The three forms of Cerebral palsy
• Cerebral Palsy Acquired during labour or delivery
• Other causes of Cerebral Palsy

About Cerebal Palsy

The incidence of cerebral palsy in the UK is approximately 2-4 for every 1,000 births. There are many causes of this permanent non-progressive condition. A significant number of those diagnosed with cerebral palsy have a congenital abnormality or may have suffered damage to areas of the brain during foetal development. In some cases no cause may be found. However, studies suggest that 10%-20% of those born with cerebral palsy developed the condition as a result of brain damage during delivery. Many of these cases could have been avoided if adequate care had been given during the labour and birth. Many of these cases could have been avoided if adequate care had been given during the labour and birth.

The three forms of Cerebral palsy

Spastic Cerebral Palsy (an estimated 70-80% of cases) resulting from damage to cerebral motor cortex affects the ability to relax muscles, causing stiffness and difficulty in moving; Spastic cerebral palsy can include hemiplegia in which the leg and arm and one side of the body are affected; diplegia affecting both legs but not the arms or only minor involvement of the arms; and quadriplegia where both arms are legs are affected.

Athetoid or Dyskinetic cerebral palsy (10-20%) characterised by uncontrolled involuntary movement in affected muscles;

Ataxic (5-10%) characterised by reduced muscle tone and uncoordinated movement which affects the sense of balance and depth perception and is accompanied by tremors and shaky movements.

Each form affects a child differently. Some children may have mixed cerebral palsy, most commonly demonstrating typical, spastic and athetoid forms. Children with cereal palsy may well have a normal intellect but may find it difficult to articulate this. If you are concerned about your baby/child’s development you should discuss this with your GP or health visitor.

Cerebral Palsy Acquired during labour or delivery

Factors suggesting that cerebral palsy occurred as a possible consequence of the management of labour and delivery include seizures occurring within 24-48 hours, a baby delivered in a “floppy” condition or requiring resuscitation shortly after delivery to aid breathing; poor sucking, difficulty maintaining temperature; and meconium fecal staining at the time of delivery.

A medico-legal investigation of a potential claim on behalf of a child with cerebral palsy will focus on the management of the mother’s pregnancy, labour and delivery in order to establish whether the baby’s brain has been damaged as a consequence of avoidable asphyxia (insufficient oxygen to the brain). Establishing negligence (liability) and a link between sub-standard care identified by experts and the child’s neurological damage (causation) can be extremely difficult. The investigation of these claims can therefore be lengthy and sometimes inconclusive. It is important to remember that sometimes even if the Cerebral Palsy occurred due to an incident during labour or delivery this in itself does not necessarily mean that it was caused as a result of negligence.

The needs of the child and his or her parents in terms of care, accommodation, therapy, aids and equipment may be considerable and damages in successful cases will be substantial. Therefore if you are concerned that an error might have been made you should seek legal advice.

Examples of avoidable errors on the part of the team responsible for the mother’s antenatal care, labour and delivery and neonatal care of the infant include the failure to:

• Carry out appropriate tests to identify and address foreseeable complications.
• Treat conditions which may retard the growth and development of the foetus.
• Identify or prevent lack of oxygen producing hypoxic ischemic encephalopathy.
• Detect and treat jaundice.
• Monitor foetal health and condition during the pregnancy and delivery.
• Ensure a safe and timely delivery.

Other causes of Cerebral Palsy

Congenital cerebral palsy may be the result of damage to the brain during pregnancy or at the time of the baby’s birth. Causes of congenital cerebral palsy include:

• Infection during pregnancy which damaged the nervous system of the developing foetus.
• Rhesus incompatibility
• Stroke
• Toxicity as a result of drug or alcohol use during pregnancy
• Prolonged bleeding in the baby’s brain following delivery