Cerebral palsy is a neurological disorder that affects approximately 500,000 people. Cerebral palsy is a complex disorder that presents itself in various forms as well as levels of severity.  It is a neurological disorder that affects motor coordination in one or more limbs.  Sometimes cerebral palsy is a term that includes a number of different movement-and-brain-related disabilities, but generally there are three kinds of cerebral palsy: spastic cerebral palsy, athetoid cerebral palsy, and ataxic cerebral palsy. Spastic cerebral palsy includes stiffness and a problem moving limbs. Athetoid cerebral palsy involves involuntary, uncontrolled, and sometimes abnormal movements. Ataxic cerebral palsy includes problems with a sense of balance, depth-perception, or walking.

While there are different theories concerning the onset of cerebral palsy, oxygen deprivation during childbirth has been linked to the neurological disease.  Cerebral palsy can also be caused by the improper use of surgical instruments during surgery such as forceps or vacuum-assisted delivery.  Cerebral palsy contracted during childbirth may also be caused by improper procedures of fetal extraction from the birth canal such as employing too much force to the fetus or twisting or turning the baby in such a way as to cause damage to the delicate fetal nerve system.

According to the Centers for Disease Control and Prevention (CDC), some of the clinical signs and symptoms of cerebral palsy include:

• Muscle Tone: As previously mentioned, a person with cerebral palsy has lack of muscle control. This in turn may make what seems like simple tasks extremely difficult. For example, sitting down, walking, tying shoes, and grasping objects may prove to be exhausting and hard for those with cerebral palsy.
• Reflexes: People with cerebral palsy may have abnormal reflex responses such as asymmetrical or symmetrical tonic reflex, palmer grasp reflex, and spinal gallant reflexes. Moro reflexes may be present in some infants, but generally clear up with 5 months of age.
• Coordination and Control: Both coordination and control is limited with those who have cerebral palsy, and it usually more pronounced when stressed or overwhelmed. Common issues with coordination and control include spastic movements, walking with a wide gait, walking with toes pointed inward or outward, dragging one leg while walking, and waddling when walking.
• Oral Motor Problems: Many people with cerebral palsy will experience difficulties with communication because of the spastic movements of face muscles. This also can affect breathing, eating, closing the mouth, and swallowing.

Abramson, Brown, and Dugan Cerebral Palsy Birth Injury Case-

This is a birth injury medical malpractice case arising out of the defendants’ negligent management of a 24-year old mother’s labor and delivery and the neonatal care of her newborn baby girl. The defendants failed to appropriately evaluate, monitor and manage mother and baby during labor and delivery, and failed to appropriately evaluate, monitor and manage the baby’s condition in the early newborn period, resulting in prolonged oxygen deprivation for the baby and causing permanent brain damage, developmental delays, and associated impairments.The defendants failed to anticipate and plan for a potentially compromised infant, failed to ensure that appropriate staff were present to care for the newborn infant, failed to properly monitor and evaluate the plaintiff, failed to properly manage the resuscitation of the infant plaintiff, failed to timely order necessary tests, failed to properly respond to alarming test results, failed to provide appropriate treatments, and failed to timely transfer the infant to an institution capable of providing appropriate treatments.

After seventeen hours of labor, the infant plaintiff was delivered vaginally. She emerged floppy, pale, and without respiratory effort and was brought to the radiant warmer where she was intubated. She received positive pressure ventilation for one minute then blow-by oxygen and was transferred to the nursery for further monitoring. An arterial cord blood gas was ordered at 2:18 am. Laboratory testing of the arterial cord blood gas produced critically abnormal results and showed that the infant plaintiff was extremely asphyxiated/acidotic at birth.  Hospital nurses were unaware that the hospital had been transferring newborns to another facility for whole body cooling for birth asphyxia. As a result, the infant plaintiff’s care was managed in the hospital nursery by a family practice resident.  Rather than being prepared for cooling and emergently transferred, she remained in the nursery and received only a normal saline bolus, antibiotics, and intermittent blow-by oxygen. A hospital lab technician telephoned these critical blood gas results to the maternity department secretary, at 2:40 am. The results were not communicated to any of the plaintiff’s providers, nor did any of the providers follow up on the status of the test. At approximately 7 hours of life, the plaintiff developed seizure activity and a transfer was arranged. It was during the course of the transfer that personnel located the cord ABG results for the first time. At this point, the window of opportunity to provide hyperthermia and other treatments for hypoxia / ischemia had expired.

Following the hospital transfer, the infant plaintiff’s seizure activity continued and the plaintiff had evidence of multi-system organ involvement. A brain MRI showed findings consistent with global hypoxic injury and an EEG was markedly abnormal. The plaintiff was diagnosed with hypoxic ischemic encephalopathy.

Liability:

Suit was brought against the hospital for the negligence of its obstetrical nursing staff and pediatric providers.

Injuries:

The infant plaintiff suffered severe brain damage and she has cerebral palsy, visual and auditory impairment, developmental delays, oral-motor impairment, hypertonia, microcephaly, and seizure disorder among other injuries and deficits. She is not expected to ever walk or talk independently, or to be able to care for herself or perform any activities of daily living.  She has suffered and will continue to suffer physical pain, emotional distress, and permanent disability. She will continue to incur extraordinary medical expenses and has suffered a complete loss of her earning capacity.

This case settled prior to trial, at mediation, for a confidential amount.