$11.8 Million for Child with Cerebral Palsy, Intellectual Disabilities & Developmental Delays Caused by Hypoxic Ischemic Encephalopathy (HIE)

This case was settled for $4.75 million (total annuity payout: $11.8 Million).

A young mother who did not speak English very well arrived at the hospital complaining of cramping, which she said she thought were
labor pains, and bleeding.  An ultrasound and a 45 minute fetal heart rate assessment were performed, and in a little over an hour after she arrived, the pregnant woman was discharged.  She was not seen by a physician or even a resident, and her tests were not properly evaluated.  In fact, the hospital discharged her with a high blood pressure and a baby who was past the due date and showing signs of fetal distress and oxygen deprivation.  When the mother returned to the hospital 5 days later, again complaining of labor pains and bleeding, her baby was experiencing a very slow heart rate and had to be delivered by emergency cesarean section. The mother was experiencing a dangerous pregnancy condition called preeclampsia (high blood pressure that starts during pregnancy).

The baby boy was born limp and lifeless, with very low Apgar scores (an indication of how much medical care a baby will need) and extremely acidic blood, another indication that he had suffered brain damage.  Sadly, the little boy’s brain had suffered from a lack of oxygen for far too long and he had hypoxic ischemic encephalopathy (HIE), which is a brain injury caused by oxygen deprivation.  He was soon diagnosed with cerebral palsy, an intellectual disability and development delays.  He requires around the clock care and was wearing diapers in elementary school.  The young boy has trouble getting his legs to work together and in school, his performance is that of a much younger child.  He has trouble with his large muscle groups as well as his smaller ones, and he drools and has a difficult time grabbing small pieces of food and toys.

POST TERM PREGNANCY & CEREBRAL PALSY

When a pregnancy goes beyond the due date, it can be very risky for the baby.  In general, the longer a pregnancy goes beyond 40 weeks, the more risks there are to the baby.  The major risk to the baby comes from the fact that the placenta reaches its maximum size and surface area around 37 weeks.  After 37 weeks, its surface area and function gradually deteriorate.  This can cause the placenta to be inadequate at supplying enough oxygen and nutrients to the baby, which is called uteroplacental insufficiency.

Postmaturity syndrome occurs in about 20% of pregnancies that continue beyond the due date.  This syndrome is caused by uteroplacental insufficiency that causes long-term oxygen and nutrient deprivation in the baby.  These babies often show signs of fetal distress in the womb, as the little boy in this case did.

The baby boy in this case was older than 42 weeks of gestation.  Had physicians looked at and properly interpreted the ultrasound on the day the mother was discharged early, they would have known that the baby was past his due date.  It is imperative for the medical team to know the precise age of the unborn baby so they can prevent post-term deliveries.  After 40 weeks of gestation – and sometimes sooner –  more frequent testing must be performed on the baby, such as non-stress tests and biophysical profiles.

FETAL DISTRESS & THE IMPORTANCE OF PROMPT DELIVERY

When a baby has a non-reassuring heart rate, it means he is being deprived of oxygen.  Physicians must take measures to decrease the fetal distress and get oxygen to the baby.  If a heart rate remains non-reassuring – or if an ominous heart tracing is present – the baby must be delivered immediately.

Often, the fastest and safest way to deliver a baby in distress is by an emergency C-section.  Birth injuries often occur when the medical team lacks skill in interpreting the fetal heart tracings and then the baby is not delivered, leaving him in oxygen depriving conditions.  Or, the staff recognizes fetal distress, but then the hospital lacks the proper staff and equipment to quickly deliver the baby by cesarean section.

SPASTIC CEREBRAL PALSY

The oxygen deprivation caused severe brain damage in this little boy and he now has spastic cerebral palsy, which is the most common type of CP.  Cerebral palsy is a group of disorders that cause a child to have problems with movement, balance, coordination and posture, and it is the most common cause of childhood motor disability.

In spastic cerebral palsy, the muscles do not coordinate in pairs the way they are supposed to.  Instead of opposing muscles working together to create smooth movement, muscle groups become active at the same time, which prevents coordinated movement.  The muscles in children with spastic cerebral palsy are constantly tight, and the child has stiff, jerky movements.

The major difference between spastic diplegia (spastic cerebral palsy that primarily affects the lower body) and a normal walking pattern is the “scissor gait,” which is when a child’s knees appear to cross like scissors.