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Just last month, Casey & Devoti started the Eastern Missouri Legal Examiner. I thought that I would take the opportunity presented by this blog to concentrate my posts on the various aspects of the type of case for which I have a passion – the birth injury case.

As a personal injury lawyer, I am lucky that the fruit of my work goes to helping other individuals. I don’t discriminate; my clients are all different ages.  But, if I had to choose, I get the most satisfaction representing children. The injuries suffered by babies at birth are typically traumatic, tragic and permanent. Although the cases are sad, I find it highly rewarding to know that my work can ameliorate the harm caused to the child throughout his or her life. So, I hope through a series of posts on this blog that I would attempt to highlight various aspects of the medicine underlying the birth of a baby and issues that might arise in a birth injury lawsuit.

If a child is born with a birth injury, why is it important to have a lawyer review the medical records of the birth?

To start, pregnancy and the birth of a child is complicated medical event. This complexity is illustrated in a child that suffers asphyxia, a common cause of brain damage. Asphyxia is the severe deficiency of oxygen to the brain. The oxygenation of a baby’s brain is an involved process. A fetus receives its oxygen from its mother. The mother’s blood is oxygenated in her lungs, flows to her placenta – the organ connecting her to the baby fetus. The placenta is able to transfer oxygen and nutrients from the mother’s blood to the baby’s blood. The oxygen is then transported by the baby’s circulatory system to the brain.  After birth, the baby’s lungs take over for the placenta and begin oxygenating the baby’s own blood.

It is possible for any part of this process to break down causing a restriction in the amount of blood reaching the baby’s brain (ischemia) or reducing the amount of oxygen in the blood (hypoxia) and ultimately causing asphyxia. Further, asphyxia can occur prior to labor beginning, during labor, or even after the baby is born. Damage to the baby’s brain caused by oxygen deficiency may be recognized immediately after birth and is regularly identified in medical records as Hypoxic Ischemic Encephalopathy (HIE). In some instances, the brain damage is not diagnosed until a parent realizes delays in the baby’s development.

Linking the birth injury to medical negligence.

Whether the brain damage is discovered early or late, one thing is for certain, the doctors will claim that the brain damage could not have been prevented. They will claim that it was caused prior to the mother arriving at the hospital or due to genetics, structural malformations in the brain, or metabolic conditions. Every doctor knows that serious neurologic injury can occur if hypoxia or ischemia progresses to asphyxia. The monitoring of labor and timing of the birth are extremely important. Doctors utilize Electronic Fetal Monitoring (EFM) to monitor the fetal heart rate. By carefully watching the EFM, a doctor can see signs of distress in a baby and make decisions concerning the timing and method of delivery.

Attorneys can help a parent review the EFM and the medical records to determine whether the doctors failed to recognize that the fetus was in distress, failed to properly monitor the mother’s labor, and whether they failed to take appropriate action to protect the safety of the baby. The determination of the cause and the timing of the brain injury requires a careful scrutiny of the medical records with an eye towards all of the medical conditions of both mother and fetus that could possibly cause the injury to the baby. Finally, most lawyers have the resources to consult with other independent doctors to have the medical records and consequently the quality of the medical care rendered properly reviewed.

Matt Casey is a Partner with Casey & Devoti, a St. Louis-based personal injury law firm.  Matt handles a wide variety of personal injury cases, with a special emphasis on birth injuries.



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