Cerebral palsy is the most common form of childhood physical disability.
If your child has been diagnosed with cerebral palsy, you have the right to know if their condition was preventable during or just following childbirth. You have the right to know if the negligence of doctors and nurses was a cause or contributing cause of your child’s cerebral palsy. The experienced cerebral palsy attorneys at Miller Weisbrod Olesky can help answer these questions.
Yet, the condition is still challenging for most of us to understand. In fact, many people think everyone with Cerebral Palsy (CP) is the same. But symptoms actually vary significantly from person to person.
The causes of cerebral palsy can be even more difficult to grasp, especially if medical errors are involved. Cerebral palsy may be caused by doctors or nurses failing to respond to fetal distress, failing to perform a timely C-section or other errors during the labor and delivery process or care shortly after birth of a child. These errors can constitute medical malpractice. When medical malpractice causes CP, children and their parents can seek compensation from medical providers to cover medical treatments, therapies, and adaptive equipment as well as for their child’s lifelong impairment and disability.
The future for children with cerebral palsy depends on the type, classification, and severity of their symptoms. However, children with CP need early interventions like treatment, surgery, and therapies to realize their full potential. Cerebral palsy can be treated, but it cannot be cured. In many cases, the cost of lifelong care and therapies will be in the millions of dollars in order to provide your child with a fair quality of life.
Our national cerebral palsy attorneys have been helping children diagnosed with cerebral palsy and their families for 40 years. Our team of birth injury lawyers stands ready to help you and your child find answers to questions you may have and help recover compensation for the lifelong expenses your child will need from negligent hospitals, nurses and doctors that may have caused or contributed to their cerebral palsy. We are here to help with no fees ever unless we make a financial recovery.
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Recent Birth Injury Settlement:
Birth Injury settlement against a hospital in which nurses and physicians failed to properly monitor the mother's blood pressure during delivery causing an HIE event resulting in neonatal seizures and cerebral palsy at birth. Our national birth injury lawyers recovered $13,750,000 for the family to help with future medical expenses and developmental therapy.
With the recovery that Miller Weisbrod made for our son, I feel like our voice was heard in a sense of what can possibly go wrong in a delivery and finding us answers. I feel with our settlement, we are now in a comfortable position to provide for our son. Things are different because he's able to be in his own space. He's developing well. He is starting to speak a little bit more and live a bit more independently. He is also in school full-time and he gets help from his nurse aid that helps him with all his appointments, all his therapy. Pretty much, I feel like it kind of helped us in a good way. I feel like they care about your personal needs and how to make you comfortable in any situation.
Lyric, C.
Mother of Miller Weisbrod Olesky Client
What Is Cerebral Palsy?
Cerebral palsy is not just one condition. It’s a group of physical disorders that permanently affect:
posture
balance
movement
ability to control movement
communication
eating
sleeping
learning
The symptoms of cerebral palsy are primarily physical. However, injuries to an infant’s brain, including hypoxic-ischemic encephalopathy (HIE), are the primary cause of CP. Cerebral actually means brain, while palsy means muscle weakness.
Specifically, cerebral palsy affects the outer layer of the brain. Also called the cerebral cortex, this area directs our muscle movement and motor skills. Injuries to the cerebral cortex can cause irreversible brain damage and cerebral palsy.
Just because cerebral palsy is permanent does not mean symptoms will become progressively worse. A child’s symptoms may change slightly as they mature, but their condition will not progress.
Signs of cerebral palsy usually occur within a few months of a baby’s birth. However, doctors might not diagnose the condition right away, especially in mild cases. Generally, parents learn of their child’s CP by age two.
There is no known cure for cerebral palsy. However, there are treatments, surgeries, medications, therapies, and adaptive equipment that can help. Children typically are more likely to reach their full potential when doctors diagnose their condition as early as possible.
Birth injuries are a leading cause of cerebral palsy. Often, they are caused by medical errors including:
When a child’s cerebral palsy results from medical errors (also called medical malpractice), parents can seek compensation to pay for their child’s future needs.
Symptoms vary widely among children with cerebral palsy. Some signs may show up soon after delivery, while milder cases may not be diagnosed until later, usually by two to five years of age. The two general classifications of symptoms are:
Decreased muscle tone (hypotonia) – Infants with hypotonia may seem floppy. Brain damage can cause hypotonia
Increased muscle tone (hypertonia) – Muscles become stiff and challenging to move. Hypertonia also can be caused by brain damage
As infants mature, development milestones gain importance. Symptoms of cerebral palsy often become evident when children begin missing those milestones. As adults, people with cerebral palsy exhibit hypotonia and hypertonia in diverse ways.
Symptoms in Infants
Parents and caregivers often notice the following problems in babies up to six months of age:
Floppy, head lags
Overextension of back and neck
Scissoring gait, where knees and thighs press together or cross
Between ages 6 months and 12 months, an infant with cerebral palsy might exhibit the following symptoms:
Keeping one hand fisted while reaching with the other
Lopsided crawling
Not crawling on all fours
Symptoms in Adults
Adults with cerebral palsy might exhibit additional symptoms, including:
Lack of muscle coordination
Difficult performing precise movements
Difficulty walking
Stiff muscles
Exaggerated reflexes
Shaking, twitching, or other involuntary movements
Drooling or having trouble swallowing
Difficulty speaking
Early intervention is crucial to the child’s future. Doctors and specialists must closely monitor children who suffer birth trauma to watch for signs of brain injury and cerebral palsy. Failing to do so could delay the child’s diagnosis and access to much-needed medical treatments.
A missed diagnosis also could prevent parents from seeking compensation before the statute of limitations runs out. Contact our office today if you suspect medical mistakes caused your child’s cerebral palsy.
Cerebral palsy is a complex disorder where brain damage causes physical disabilities. The wide range of symptoms and degrees of severity complicate diagnosis and treatment, as well as perception.
Within the cerebral palsy diagnosis, there are four basic types of CP:
Parents and doctors observe and test children who show signs of cerebral palsy to determine the type. Pinpointing the type of CP a child has gives doctors and therapists the information they need to provide the right kinds of treatment, therapies, and medication. However, some children experience more than one type of cerebral palsy, further complicating treatment plan development.
Spastic cerebral palsy
Spastic cerebral palsy is the most common type of cerebral palsy. In fact, roughly 80% of people with Cerebral Palsy are diagnosed with a form of spastic Cerebral Palsy. People with spastic cerebral palsy exhibit uncontrollable, involuntary limb movements and tight muscles that inhibit movements, causing bone and joint deformities.
Doctors split spastic cerebral palsy into several subtypes based on the individual’s symptoms:
Spastic Diplegia or Diparesis: This type of Cerebral Palsy indicates that an individual has severe muscle stiffness, particularly in their legs. Their arms might be affected very little or not at all.
Spastic Hemiplegia or Hemiparesis: Here, disability affects only one side of an individual’s body. Typically, this type of Cerebral Palsy affects a person’s arms more than their legs.
Spastic Quadriplegia or Quadriparesis: This is the most severe form of spastic cerebral palsy because it affects a person’s arms, legs, trunk, and face. Also, people with this form of Cerebral Palsy usually have intellectual disabilities and suffer from seizures and speech, hearing, and vision problems.
Dyskinetic Cerebral Palsy
Dyskinetic cerebral palsy is the second most common form of cerebral palsy. Research indicates dyskinetic cerebral palsy is caused by “non-progressive lesions to the basal ganglia or thalamus or both.” Frequently, birth trauma due to medical errors during labor and delivery or immediately following birth (called “neonatal negligence”) causes these injuries.
Dyskinetic cerebral palsy causes uncontrollable body movements, including jerking, writhing, and overly rapid or slow movements. Some children find it challenging to sit and walk.
Since dyskinetic cerebral palsy may affect the face and tongue, it may be difficult to talk, suck, and swallow. However, the muscle tone of children with dyskinetic CP often varies from day to day and even from hour to hour. Doctors recognize three forms of dyskinetic CP based on an individual’s symptoms:
Dystonic: Dystonic symptoms include twisting, repetitive movements that are more prominent when a child is tired or emotional. For some children, pain levels increase with increased movement. These symptoms affect activities of daily life, quality of life, and participation in social activities.
Athetoid: Characterized by slow, writhing movements, athetoid’s primary symptoms include abnormal posture, impaired coordination, and minimal control over movement. A child with athetoid symptoms might be unable to maintain posture. Other limitations include trouble with standing, sitting, and hand movements. Athetoid dyskinetic cerebral palsy can be caused by bilirubin encephalopathy or hypoxic-ischemic encephalopathy (HIE).
Choreoathetosis: Someone with chorea symptoms will have movements that are clumsy, abrupt, and unpredictable. Wild, violent movements are possible with more severe forms of choreoathetosis cerebral palsy. Chorea can interfere with movements, speech, and swallowing.
Dystonia and choreoathetosis are often found together.
Ataxic Cerebral Palsy
Issues with balance and coordination characterize ataxic cerebral palsy. Children with this form of CP might appear unsteady and shaky. Their movements might seem disorganized and jerky to other people.
It’s believed that ataxic cerebral palsy is the result of damage to the cerebellum. This part of the brain is responsible for controlling movement and plays a part in “cognition, emotional processing, and social behavior.”
Mixed Cerebral Palsy
Mixed cerebral palsy is the diagnosis when children have a combination of cerebral palsy symptoms. Typically, this means that brain injury has occurred in several parts of the brain. Currently, spastic-dyskinetic CP is the most common type of mixed cerebral palsy.
Conditions and Complications Associated with Cerebral Palsy
Children with cerebral palsy often experience related conditions and complications, including:
Delayed physical development: Babies and children with cerebral palsy might lag behind others in their age group. Their shortened muscles and limbs may cause them to appear shorter than average.
Intellectual and learning disabilities: An estimated 30 to 50 percent of people with cerebral palsy have at least one form of intellectual impairment like: • Mental retardation • Limited cognitive functioning • Limited adaptive behavior • Attention-deficit hyperactivity disorder (ADHD) • Autism spectrum disorder
Spinal deformities. CP is often associated with spinal deformities like scoliosis (curvature), kyphosis (humpback), and lordosis (saddle back). Because the spine and joints are misaligned, the resulting pressure can cause osteoarthritis to form.
Osteoporosis. Inactivity, malnutrition, and medications can cause low bone density in children with cerebral palsy. This, in turn, often leads to bone fractures.
Contractures. Spasticity can cause muscles to tighten and shorten. Someone with cerebral palsy might experience bone deformities and inhibited bone growth, as well as full and partial dislocation caused by contractures.
Vision problems. Some children have a condition called strabismus, or “cross eyes.” Left untreated, strabismus can cause poor vision. Defective vision and blindness can make it challenging to understand visual information.
Hearing loss. Partial or complete hearing loss can occur when someone has cerebral palsy. Sometimes jaundice or loss of oxygen damages a baby’s hearing, especially if doctors and other medical providers fail to diagnose and treat the conditions.
Speech and language restrictions. Cerebral Palsy often causes children to slurred or slow speech. A condition called dysarthria makes it very difficult for them to control and coordinate the muscles they need to speak. Other people may assume the child also has intellectual disabilities, which is not always true.
Dental issues. Some medications prescribed to alleviate symptoms of cerebral palsy cause or contribute to gum disease and cavities.
Drooling. Poor muscle control of the throat, tongue, and mouth can make it difficult to stop saliva from unintentionally dripping from someone’s mouth.
Incontinence. Some forms of cerebral palsy involve extensive muscle weakness that can lead to incontinence.
Infections and long-term medical conditions. People with cerebral palsy often are susceptible to infections, heart disease, lung disease, and pneumonia.
Malnutrition. It’s often challenging for children and even adults to swallow or suck. This leads to feeding problems, which then can cause malnutrition.
Mental health conditions. Depression is one of the most common mental health conditions related to cerebral palsy. However, children also might exhibit behavioral issues with cerebral palsy that become more pronounced after the age of two.
Chronic pain. Some studies show that up to 75% of people with Cerebral Palsy suffer from chronic pain. Spasticity and dystonia can contribute to increased pain levels.
Seizure disorders. Up to 50 percent of children with cerebral palsy also experience seizures. Some may only have seizures as infants, while others continue treatment for seizures throughout their lives.
The presence of other medical conditions can complicate the diagnosis and treatment of cerebral palsy. However, medical professionals should be well aware of the risks that can cause brain damage and the early signs of Cerebral Palsy.
Some children exhibit signs of cerebral palsy as newborns. However, doctors might not diagnose mild cases cerebral palsy until children are between two and five years old.
The actual diagnosis of cerebral palsy, especially the type and levels of disability, requires time, testing, and scrutiny from experts. The child’s primary doctor or pediatrician typically will:
Examine the child for signs of cerebral palsy including floppy or stiff muscle tone
Review child’s medical history, especially when birth trauma occurred
Monitor the child’s growth and development over time to watch for delays in developmental milestones like standing or walking
Evaluate signs and symptoms of cerebral palsy to identify what type of cerebral palsy the child has
Review parents’ observations of the child’s difficulties with movement
Consult with specialists, including: • Developmental pediatricians • Neurodevelopment pediatricians • Child neurologists • Pediatric rehabilitation doctors or physiatrists
Order tests that might include CT scans, MRIs, EEGs, ultrasounds, evoked potential tests, and blood tests
A child’s doctor typically uses three distinct stages of evaluation to diagnose cerebral palsy.
Stage 1 – Developmental Monitoring or Surveillance Parents are often the first to notice signs of physical or developmental issues in their children. The child’s pediatrician or family doctor may also notice irregularities during well-child visits. In fact, doctors should be especially watchful if the baby potentially was injured before, during, or after being born.
For example, some children might be considered “at-risk” due to:
When children are at risk or parents have voiced concerns, doctors tend to monitor growth and development more closely. They may move to the next level of diagnosis if they observe anomalies.
Stage 2 – Developmental Screening At this stage, doctors begin looking for evidence of specific developmental delays. Parents continue their close observation but also complete questionnaires and participate in interviews with doctors and specialists. Screening often follows the recommendations made by the American Academy of Pediatrics:
9 months: Physical signs of developmental delays at age 9 months may identify a child’s severe movement issues. Doctors may note that the baby is too stiff or too floppy. When picking up the baby, doctors may notice the baby:
is too floppy (hypotonic) or too stiff (hypertonic)
pulls away with an overextension of the neck and back
crosses, scissors, or stiffens their legs
is unable to hold up their head
bends their thumbs consistently in toward the child’s palm (called cortical thumbs)
doesn’t roll over
reaches out with only one hand and holds the other in a fist
18 months: During a child’s 18-month checkup, doctors may screen for mild movement and developmental problems. Signs of mild Cerebral Palsy overlooked at 9 months become more noticeable at 18 months. Missed developmental milestones pile up and doctors will notice the child:
cannot walk or walks with an uneven gait
is unable to speak
has trouble eating and drinking
fails to react to surrounding stimuli, including caregiver or parent walking away
30 months: By this age, most of the child’s movement and developmental delays are apparent during screening. If doctors have not already identified the type and classification of the child’s cerebral palsy, they will do so now. At any point during the screening process, doctors may proceed to the next level.
Stage 3 – Developmental and Medical Evaluations
At this stage, doctors rely on medical tests and evaluations as well as a thorough medical history provided by the parents. The goal at this stage is to identify specific disorders that might affect the child. Specifically, doctors look closely at the child’s:
Posture: A child with cerebral palsy might show postural or positional deformities including scoliosis. Sitting and standing straight may be difficult or impossible due to spinal curvature, hip rotation, and pelvic misalignment
Muscle tone: Specialists like neurodevelopmental pediatricians and pediatric physiatrists will evaluate muscle tone to see if the child is too floppy or too stiff
Motor control: Children with Cerebral Palsy exhibit poor control of muscles cause by injuries to the brain and spinal cord. Signs of cerebral palsy can present as: • stiff, jerky movements • uncontrollable movements • difficulty eating, drinking, and speaking
Other disabilities: Specialists usually test children with cerebral palsy for hearing and vision deficits
Doctors use everything from simple blood tests to innovative technology during the difficult task of diagnosing a child with cerebral palsy.
Common Tests and Diagnostic Tools
Cerebral palsy results from a brain injury. The type and degree of Cerebral Palsy depend upon where the injury occurred. Doctors might use some or all of the following tests to arrive at the correct diagnosis for a CP patient:
Brain imaging evaluations: Doctors may use CT scan, MRI, cranial ultrasound, electroencephalogram (EEG), electromyography (EMG), and evoked potential tests to evaluate a child for brain damage
Lab tests: Doctors might screen a child’s blood, urine, and skin for metabolic or genetic issues. The results might point to cerebral palsy or give another explanation for the child’s symptoms
Medical evaluations are extensive and require a team of medical providers.
People Involved in the Cerebral Palsy Diagnosis
As a child’s evaluation for cerebral palsy proceeds, parents and the child’s doctor may call in specialists, including:
Pediatric neurologists
Pediatric physiatrists
Developmental or neurodevelopmental pediatrician
The analysis provided by specialists can help discover the child’s exact diagnosis. This, in turn, helps parents and medical providers discover the best types of therapy and treatments for the child’s unique situation.
Diverse symptoms make cerebral palsy challenging to diagnose and classify. Once doctors determine the diagnosis and type of CP, they can develop a treatment plan. Categorizing a child with CP can be done based on which of the child’s limbs are affected:
Before development of the following classification systems, doctors routinely miscommunicated their patient’s condition by using standard yet imprecise terminology.
Doctors consider the following primary movement disorders when determining the cerebral palsy type:
Stiff muscles (spasticity)
Uncontrollable movements (dyskinesia)
Poor balance and coordination (ataxia)
Now, children with cerebral palsy are assessed and classified by functional capacity. Using standardized tests eliminates or minimizes miscommunication between the medical team. The four major ordinal classification systems are:
These systems identify the patient’s abilities at the time the test is conducted. Each system includes levels of functionality. For example, the GMFCS describes children at Levels 1 through 5 based on their ability to do specific tasks.
The results do not assess the patient’s underlying etiology or describe any potential improvements. However, they do provide the information that doctors and therapists need to form treatment plans that fit a person’s individual abilities.
Gross Motor Function Classification System (GMFCS)
The GMFCS, which is the most established and most recognized system, assesses “self-initiated movement” with and without assistive devices. Consisting of Levels 1 through 5, the GMFCS describes a child’s mobility while engaging in normal daily activities.
Level 1: The child can walk, climb stairs, run, and jump. However, speed, balance, and coordination are limited
Level 2: At this stage, a child can walk on most terrains and climb stairs while holding the handrail. Other limitations for gross motor skills like jumping and running are apparent. Walking long distances is possible with assistance or mobility devices
Level 3: Children can walk indoors using hand-held mobility devices like canes and walkers. Limitations on other gross motor skills exist, although the child can climb stairs with assistance and a handrail. Wheeled mobility is necessary for longer distances
Level 4: The child’s mobility is dependent on powered devices or personal assistance. Manual wheelchairs or powered devices are needed when ambulating away from home. Other gross motor skills are pretty limited
Level 5: The child must use wheelchairs in all settings. The child's ability “to maintain antigravity head and trunk postures and control leg and arm movements” is severely limited
This list contains the general activities for each level. However, evaluations are tailored to the child’s age-based developmental milestones.
Manual Ability Classification System (MACS)
Doctors use this assessment primarily for children aged 4 through 18. While the GMFCS deals with gross motor skills, the MACS assesses fine motor skills. Specifically, doctors use MACS to classify the child’s ability to use their arms and hands.
Level I: The child can handle objects easily but with limited speed and accuracy. However, those limitations do not restrict the child’s independence in performing daily activities
Level II: At this level, individuals can physically handle most objects but with a reduction in speed. Although they might need alternative ways to handle certain tasks, their limitations usually don’t overly restrict their independence
Level III: Children at Level III do experience some difficulty handling objects. Their efforts may be successful in limited ways. Independent daily activities are possible if adapted to their needs
Level IV: Children can handle a limited selection of items at this stage but with great effort and limited success
Level V: Doctors assign this level to children who cannot handle objects independently. They require complete assistance for even simple tasks that involve grasping items
In 2016, researchers developed the Mini-MACS system to measure the manual abilities of children aged 4 and younger.
Communication Function Classification System (CFCS)
Many children with cerebral palsy also have communication disorders. The CFCS classification system assesses everyday communication. This includes all forms of communication since some people with cerebral palsy are non-verbal. CFCS also recognizes that a child’s comfort level may vary when communicating with familiar people and strangers.
As with GMFCS and MACS, patients are assessed using a five-point system.
Level 1: The child can effectively send and receive messages with both familiar and unfamiliar people
Level 2: At this level, communication is effective but at a slower pace than someone at Level 1
Level 3: Children at level 3 effectively send and receive communication with familiar partners
Level 4: Children at this level inconsistently communicate with familiar people
Level 5: At Level 5, children rarely send or receive communications, even with familiar partners
CFCS assessments enhance communication between doctors, therapists, and specialists treating a child with CP.
Eating and Drinking Ability Classification System (EDACS)
Motor control problems can affect every aspect of a child’s life. However, walking, fine motor skills, and communication are only part of the story. Issues with eating and drinking are prevalent for children with cerebral. The risk here is that such issues could cause choking or aspiration of food or beverages, which could be life-threatening.
Researchers designed the EDACS system to assess how safely and efficiently children with CP can eat or drink. Aspiration and choking risks are significant concerns. But the system also assesses the amount of food lost during eating and how long it takes to eat a meal.
As with other classification systems, EDACS uses a five-level list based on a patient’s abilities. However, assessments also consider an additional three-point system regarding the patient’s level of assistance: independent, requiring assistance, totally dependent.
Level 1: The child can eat and drink safely
Level 2: Although eating and drinking are still safely completed, more food is lost. Meals also take longer to accomplish
Level 3: Here, there are limitations on both safety and efficiency
Level 4: The child finds it hard to coordinate breathing and swallowing, increasing their risk of aspiration
Level 5: Children at level 5 require tube feeding for safety reasons. Their aspiration risk is high
Understanding the amount of assistance someone with cerebral palsy needs can help prevent serious and life-threatening complications.
Cerebral palsy consists of a number of physical disabilities caused by injuries to specific areas of a baby’s brain.
But what causes the brain injuries?
The list of reasons birth-related brain injury occurs is long. Generally, issues that arise before, during, and after a child’s birth cause the severe damage that leads to cerebral palsy.
For parents of children with cerebral palsy, understanding what happened and why is crucial. Parents sometimes learn that the medical professionals they trusted contributed to or caused their child’s condition.
Mothers and babies may suffer serious injuries before, during, or after childbirth because doctors, nurses, laboratory staff, or hospital staff failed. Common medical errors that can cause cerebral palsy include:
Failing to identify situations that are dangerous to the mother or child
Inadequate monitoring of an at-risk baby after birth
Medical professionals have a duty to provide their patients with a certain level of care. This is called the “standard of care”. When doctors or nurses fail to meet the standard of care during pregnancy and childbirth or in the period shortly following childbirth and this causes a birth injury the child and parents of the child may be entitled to compensation.
Determining what constitutes a “breach of the standard of care” (also known as “medical malpractice” or “medical negligence”) can be a difficult question for the parents of a child diagnosed with or suspected of suffering from cerebral palsy.
Problems During The Mother’s Pregnancy Can Cause Cerebral Palsy
Pregnancy complications occur in approximately 196 women per every 1,000 expectant moms. Of course, an expectant mother’s health condition can harm or slow fetal development. When the baby’s brain development is affected, cerebral palsy can be the result.
The risk of cerebral palsy can increase for the following reasons:
Maternal infections that could contribute to brain damage and cerebral palsy include:
bacterial vaginosis (BV)
chickenpox
chorioamnionitis
cytomegalovirus
Group B Strep (GBS)
herpes simplex virus (HSV)
intrauterine infections, including placental or fetal membranes
rubella
syphilis
toxoplasmosis
urinary tract infections (UTIs)
Zika virus infection
When certain infections are present, proteins called cytokines can circulate through the mother’s body to the baby’s brain and blood. Cytokines cause inflammation, which in turn can cause fetal brain damage.
Infections in the mother can transfer to the baby through vertical transmission, which means the disease passes through the mother to the baby shortly before or after the child’s birth. The damage from infections can increase the risk for premature birth and oxygen deprivation that, in turn, causes hypoxic-ischemic encephalopathy (HIE). HIE is a leading cause of cerebral palsy.
It’s important to note that doctors can test for these infections and watch for HIE during a woman’s pregnancy. With property identification and treatments, doctors can minimize, eliminate, or at least anticipate potential risks to the baby’s brain.
Existing Medical Conditions. The babies of women who have the following medical conditions while pregnant may be at greater risk for cerebral palsy:
autoimmune disorders
Crohn disease
intellectual disabilities
lupus erythematosus
seizure disorders
thyroid conditions
Type I and II diabetes
Disorders to decrease blood flow to the placenta, which can deprive the fetus of oxygen causing hypoxic-ischemic encephalopathy
Medical professionals need to monitor women with existing medical conditions closely. Failing to do so could be considered medical malpractice, especially if the infant develops cerebral palsy.
Maternal Pregnancy-Related Medical Conditions
Some women develop pregnancy-related conditions that can adversely affect fetal development:
Oligohydramnios, which is low amniotic fluid that could cause umbilical cord compression
Preeclampsia, which involves dangerously high blood pressure and protein in the mother’s urine
It’s crucial to both mother and child that doctors identify these conditions as early as possible. Close monitoring or treatments could prevent damage to the fetus. Failing to identify and treat these conditions can cause serious conditions like brain injury and life-threatening complications.
When medical professionals fail, their injured patients – including babies with birth injuries – can receive compensation for their injuries and future medical care.
Other Circumstances That Can Increase the Risk of Cerebral Palsy
The following situations can be potential causes of cerebral palsy:
Assisted reproductive technology, which can cause premature births and multiple births
Cerebral dysgenesis
Exposure to toxic chemicals, including methyl mercury that can be contained in some seafood
A woman with a normal pregnancy could also suffer birth trauma beyond her control that injures her baby’s brain. Doctors, nurses, midwives, and other healthcare providers could overlook conditions that endanger both mother and baby during delivery. They may also fail to react quickly and appropriately to safeguard patients under their care.
Medical negligence before and during labor and delivery also can result in brain damage
Medical staff presented with life-threatening situations during labor and delivery. They must act quickly to minimize or eliminate the risk of birth trauma if the following conditions arise:
Failing to monitor the use of Pitocin or Cytotec, which can cause stronger, faster contractions, endangering the baby and allowing mild issues to become life-changing problems
Doctors and other medical staff must thoroughly assess mothers and babies after delivery. A baby’s low APGAR scores and breathing difficulties could indicate serious conditions that need immediate treatment, including damage to organs and the brain due to HIE. Risk factors for cerebral palsy do not end at birth.
Medical errors after birth can cause cerebral palsy
Babies sometimes make it through the stress of childbirth only to sustain brain damage because of negligent care from doctors, nurses, lab technicians, and hospital staff. Severe brain injury, cerebral palsy, and death can occur when medical professionals fail to:
During and after childbirth, a team of medical professionals monitor both mother and baby, providing medical intervention when needed. The team could include:
Neonatologists
Pediatricians, including pediatric neurologists
Labor and delivery nurses
Neonatal intensive care nurse and aids
Respiratory therapists
Doctors and nurses can make mistakes. Medical errors can change lives forever, especially if those mistakes cause brain injury or cerebral palsy.
There’s no cure for cerebral palsy. But that doesn’t mean there’s no way to alleviate symptoms and improve abilities. In fact, treatments and therapies that are currently available can help someone with cerebral palsy live as fully as possible.
However, children with cerebral palsy benefit from early intervention. Early diagnosis of CP symptoms helps doctors develop effective treatment plans.
Typical goals for a child with CP include:
Preventing or reducing physical symptoms
Improving the child’s mobility
Optimizing the child’s overall health
Maximizing success and independence
But treating cerebral palsy is not a one-size-fits-all proposition. CP affects children differently. Such a wide range of symptoms and capabilities requires a broad range of treatments. Often, doctors consider the following factors when treating a child with CP:
Age
Overall health and medical history
Type of cerebral palsy
Level of disabilities
Tolerance for procedures and medications
How doctors expect their cerebral palsy to proceed
Medications Medical professionals might administer medications orally, in IVs, or through muscle injections. The drugs prescribed for people with cerebral palsy fall into the following categories:
Anti-spasmodic: These drugs help reduce muscle spasms, spasticity, and tight muscles. Examples: Baclofen, benzodiazepines like diazepam, lorazepam. Dantrolene sodium (Dantrium and Revonto). Diazepam (Valium). Tizanidine or Flexeril (muscle spasms). Botulinum toxin (injected). Intrathecal baclofen (implantable pump)
Anticonvulsant: Medical professionals sometimes prescribe anticonvulsants for children who experience seizures. Examples of anticonvulsants medications include Clonazepam/Klonopin (benzodiazepines), Dilantin (phenytoin), Tegretol (carba-mazepine)
Anticholinergic: Doctors sometimes prescribe anticholinergics to patients with involuntary muscle movements and excessive drooling. Examples are benztropine mesylate, Robinul, and Sinemet
Anti-inflammatory: These medications might be administered for pain relief. Reducing inflammation also helps control the chronic pain that people with Cerebral Palsy often face. Examples: Nonsteroidal anti-inflammatory drugs, steroids
Doctors also often prescribe anti-depressants for people suffering from depression. In addition, recent studies indicate that medications containing cannabidiol (CBD) may have a positive effect on children with cerebral palsy. However, research is ongoing.
Surgeries Sometimes surgery is the best option to treat a child’s cerebral palsy symptoms, particularly those associated with motor skill deficits.
Intrathecal baclofen pump: Baclofen is used to treat muscle spasms, which is a common symptom of cerebral palsy. Some patients benefit from having an intrathecal baclofen pump surgically inserted into their abdominal wall. The pump then sends baclofen directly to the patient’s spine
Orthopedic surgeries: Some children and adults with cerebral palsy benefit from surgery used to ease tight muscles and correct problems with bones and joints
Surgeries to Address Other Conditions: Cochlear implants can improve or restore a patient’s hearing. Many people with cerebral palsy suffer from gastrointestinal problems that can be eased with surgery. Finally, nasogastric tubes and gastronomy tubes help when feeding issues arise
Therapies Therapies like the following can help people with cerebral palsy improve and retain capabilities.
Physical Therapy: Typically, children learn how to sit, walk, and use orthotics with the help of a physical therapist. Other benefits include stretching muscles, improving mobility, and preventing or reducing muscle contractures
Occupational Therapy: This type of therapy teaches children how to handle activities of daily living. For example, children may learn how to get dressed, bathe, and eat. Therapists help the children make the most of their abilities, which can improve the child’s self-confidence. Occupational therapists tend to focus more on fine motor skills and hand-eye coordination
Speech and Language Therapy: Many people with cerebral palsy experience speech and communication issues. This type of therapy helps people improve their ability to speak and addresses muscle control problems with the tongue and mouth. Some children learn new ways to communicate, like sign language or computer software
Recreational Therapy: Engaging in recreational activities can help a child with cerebral palsy improve their physical and intellectual skills. Also, parents often see improvement in self-esteem and emotional well-being
Alternative Therapies: Children may also benefit from other, complementary forms of therapy, including: • Hippotherapy: Riding and interacting with specially-trained horses sometimes improves a child’s balance, especially children with pelvic bone disorders. This therapy also helps with other activities involving balance and postural alignment, including walking, jumping, and using stairs
• Hyperbaric oxygen therapy (HBOT): This therapy exposes children to pressurized air or oxygen while in a special chamber. With higher air pressure, lungs can take in extra oxygen that is then used throughout the body to promote healing. HBOT is often used for people with traumatic brain injuries.
Therapists are an integral part of a child’s medical team. As with other treatments, though, early diagnosis and intervention are more likely to help a child reach their full potential.
Assistive Equipment and Technology
Medical equipment designed specifically for children with cerebral palsy can improve their quality of life. The type and severity of symptoms dictate the assistive devices used.
Children with cerebral palsy have trouble walking, sitting, and standing. Many are able to improve their mobility by using assistive equipment, including:
braces or orthosis
Velcro-fastened shoes
custom shoes and inserts
crutches
strollers and medical strollers
headrests and assistive seating options for neck support, trunk support, and chest straps
custom car seats
rolling walkers
gait trainers
wheelchairs
powered scooters
standers (devices that help children stand)
ankle-foot orthoses (AFOs) to support ankles
Communication can be difficult for children with cerebral palsy. They often cannot control the muscles needed to speak, and some children have hearing problems. The following communication aids can help them improve their communication skills:
Children who have cerebral palsy have other disabilities related to posture, personal hygiene, and eating and drinking. They may reach their full potential using:
ergonometric chairs
feeding chairs
special eating utensils, plates, and bowls
long-handled bath brushes
adaptive dressing aids
safety grab bars
adjustable tables
mechanical lifts
wheelchair-accessible showers
non-slip mats
Children with cerebral palsy and their parents often need help from other trained caregivers.
Homecare and Caregivers for Children with Cerebral Palsy
Parents are a child’s first caregivers. However, in-home aides and other caregivers give children and parents extra, much-needed support to cover a broad range of needs.
The level of support needed depends on the child’s individual needs. For example, some children can feed themselves independently while others require assistance. Feeding tubes and other special equipment may be needed to help children with more severe levels of disability.
In-home therapists, registered nurses, aides, and other home caregivers can assist with:
Using and maintaining feeding tubes
Organizing and administering medications
Handling physical and occupational therapy exercises
Personal hygiene, including bathing, dressing, and toileting
Lifting and physically transferring children (from bed to wheelchair, in and out of the bathtub)
Transporting the child to and from appointments
Assisting parents with household tasks, including cleaning, caring for other children, and preparing meals
A cerebral palsy diagnosis is just the start. Children with cerebral palsy need medication, surgeries, therapies, and caregivers that cost far more than most parents can afford. When medical errors cause a child’s cerebral palsy, parents may hold the responsible parties accountable through a birth injury lawsuit. These lawsuits can provide the money resources needed to pay for the necessary aid to help children and parents of children suffering from cerebral palsy live the highest quality of life.
Cerebral palsy is not curable, but it may be preventable.
Medical professionals are responsible for a woman’s care at every stage of her pregnancy. Special attention should be paid when risk factors exist. Unfortunately, birth injury can occur when doctors, nurses, and other healthcare workers neglect care for the mother and baby or make outright mistakes. And medical neglect and error can cause the types of brain damage that lead to cerebral palsy.
Prenatal Care: Identifying Risks for Cerebral Palsy. From the initial stages of her pregnancy, a woman’s doctor should be watching for risks like:
Complications associated with a mother’s existing medical conditions including hypertension, hypotension and diabetes (including diabetes caused pregnancy “gestational diabetes”)
Tandem mass spectrometry tests a mother’s blood for free thyroxine levels
Premature birth is a leading cause of cerebral palsy. That’s because babies need as much time as possible to grow and develop in utero. Doctors can delay or attempt to delay pre-term labor by giving the mother the following drugs:
Corticosteroids: A pre-term baby’s lungs are underdeveloped, which can cause oxygen deprivation during delivery. Babies can develop hypoxic-ischemic encephalopathy (HIE), a leading cause of cerebral palsy
Magnesium sulfate and other tocolytics: Doctors give mothers these drugs to slow labor. Delaying the birth of the baby gives corticosteroids time to work, potentially reducing the risk the baby will sustain brain injuries
When doctors fail to perform the proper tests or misinterpret the result, women and their babies can suffer life-long, debilitating injuries.
Mistakes During Labor and Delivery
Some medical errors and medical negligence happen during an expectant mother’s labor and delivery.
Medical staff may fail to properly monitor the baby for signs of fetal distress
Doctors and nurses may ignore maternal distress that puts both mother and baby at risk
Poor communication between doctors, nurses, and patients can lead to misdiagnosis or underdiagnosis of serious conditions like placental abruption, perinatal asphyxia, fetal malpresentation and malposition, cephalopelvic disproportion, uterine rupture, and strokes
Misuse of certain drugs during the labor process including Pitocin or Cytotec causing prolonged or overly strong contractions during the labor process that can cause a lack of oxygen to the baby leading to HIE or excessive pressure on the baby’s head leading to a brain injury
Meconium Aspiration Syndrome(MAS). Babies that suffer fetal distress may release meconium from their intestines. This meconium can be sucked into the lungs (“aspirated”) during or shortly after the delivery process. Babies born with signs of meconium aspiration must be quickly treated with suction and meconium aspiration therapies to prevent inflammation of the lungs or primary pulmonary hypertension (PPHN) that can lead to lack of oxygen to the baby’s brain causing hypoxic ischemic encephalopathy (HIE)
Medical negligence can occur when doctors and nurses fail to identify and treat these serious conditions. When birth injury and medical errors cause cerebral palsy, families may seek compensation from the responsible parties. This could include doctors, nurses, midwives, laboratories, and medical facilities.
We diligently investigate the facts and hold responsible parties accountable by pursuing medical malpractice claims against them. The compensation our clients receive helps them pay for their child’s current and future medical treatment, assistive technology and equipment, and the other expenses associated with caring for a child with cerebral palsy.
Sometimes families are afraid to talk to lawyers about their child’s case. Others may simply feel overwhelmed by their circumstances and unable to participate in a birth injury lawsuit involving their child’s birth injury.
Why Should You Talk with the Knowledgeable Attorneys at Miller Weisbrod?
The only way to find out if you have a birth injury case is to talk to an attorney who understands birth injury.
At Miller Weisbrod Olesky, a team of committed professionals use our detailed case review process to assess your potential claim. They start by learning more about you and your child. Then we gather medical records to determine what happened before, during, and after your delivery. We call in skilled medical experts who review your records and let us know if they think medical errors could have caused your child’s injuries.
If we feel medical malpractice was present, we meet with you to discuss how you can receive compensation from the medical professionals who made the errors. At no point in our legal intake process will we you to pay anything. The medical review of your case and the consultation are free. We only receive payment when you do when, and only when, a money settlement is reached for your child.
Contact Miller Weisbrod Olesky
Meet our Legal Nursing Team
Linda Chalk
As a registered nurse, Linda practiced ICU nursing for 44 years while caring for a wide range of patient conditions. She has worked closely with founding partner Les Weisbrod for over 30 years, investigating and pursuing birth injury cases.
Along with DJ Weisbrod, Linda heads up the firm’s birth injury intake, screening, and medical literature research team. She personally screens all potential cases to ensure that medical issues have been addressed before we file lawsuits on behalf of birth-injured children and their families.
DJ Weisbrod
Before joining Miller Weisbrod, DJ practiced as a surgical nurse in various hospital and operative settings. She has been with the firm over 30 years.
DJ directs Miller Weisbrod’s birth injury intake and medical screening team. She has also served as firm founder Les Weisbrod’s trial nurse for all cases involving medical negligence and birth injury.
Linda Cuaderes
Linda Cuaderes is both a registered nurse and a licensed lawyer. Linda works exclusively in Miller Weisbrod’s Birth Injury and Medical Malpractice section. Linda acts as the firm’s patient advocate and liaison with our young clients and their parents.
Linda combines her legal and nursing experience along with her exceptional organizational talent and attention to detail to make sure each child we represent is provided the highest level of medical care and attendant care during the pendency of their case. Linda communicates with our parent clients regularly to monitor their birth injured child’s treatment, provide guidance as to additional care and therapies and when necessary assist them in obtaining specialized medical providers.
Linda was raised in Bartlesville, Oklahoma and completed her Bachelor of Science in Nursing with Honors at the University of Oklahoma. She started as an Oncology Nurse at Presbyterian Hospital in Oklahoma City, quickly becoming the Assistant Head Nurse of the Outpatient Endoscopy Unit. Linda then entered the University of Oklahoma College of Law.
She is admitted to practice before the Texas Supreme Court and routinely works on cases pending throughout the United States. Linda has worked with child victims of birth injury, their parents and other victims of medical malpractice in Texas, New Mexico, Oklahoma, Arkansas, Louisiana, Iowa, Ohio, New York, Alabama, Georgia, Arizona, Utah and Missouri.
Education
University of Oklahoma - School of Law, 1990, J.D. - Norman, Oklahoma
University of Oklahoma - School of Nursing, 1985 - Norman, Oklahoma
Bar Admissions
Texas - 1990
Areas of Practice
Birth Injury/Birth Trauma
Medical Malpractice
Associations & Memberships
Texas Bar Association
American Association of Justice
Texas Trial Lawyers Association
Dallas Trial Lawyers Association
Kristin Jones
Kristin combines her medical and legal training to provide invaluable, passionate service to parents struggling to care for their birth-injured children.
Families often have questions as they go through the birth injury lawsuit process. Kristin diligently identifies and investigates all medical issues so the birth injury attorneys at Miller Weisbrod can answer those questions Kristin ensures that our birth injured children’s medical records are thoroughly reviewed and organized. Miller Weisbrod’s birth trauma litigation attorneys and medical experts retained by the firm need her services while pursuing justice for our clients.
Kelly Kunkel
Kelly Kunkel was born and raised in Dallas, Texas. She has 15 years’ experience in hospital based High Risk Obstetrics and Labor and Delivery bedside nursing care. Kelly graduated with an Associate’s Degree in Nursing from El Centro College in December of 1990 and received her Bachelor’s Degree in Nursing from West Texas A & M University in 2008; graduating with honors.
In addition, Kelly has over 25 years’ experience in medical malpractice case management and litigation and has worked with David Olesky for over 22 years. After many years of assisting in defending healthcare providers and hospital systems in medical malpractice cases involving complex litigation matters related to birth injury, catastrophic injury and death, Kelly has proudly joined David Olesky in the national birth injury and medical negligence practice at Miller Weisbrod Olesky.
