What is Fetal Acidosis?
In the first one to two weeks after conception, an organ called placenta will begin to form in the uterus and will continue to develop throughout the pregnancy. The placenta facilitates fetal respiratory gas exchange (transfer of oxygen and vital nutrients from the mother to the fetus and the removal of waste products and carbon dioxide from the fetus to the maternal circulation.)
This exchange of gases for the fetus is dependent on the following factors:
- Placental transfer
- Uterine blood supply
- Maternal blood gas concentration levels
- Fetal gas transport.
When a disruption occurs in any of these mechanisms, the baby may experience hypoxia and/or anoxia (oxygen deprivation). When this hypoxia (inadequate oxygen to the fetus) is prolonged or anoxia (complete lack of oxygen to the fetus) or the fetus is unable to clear carbon monoxide back to the mother fetal acidosis can occur.
When fetal hypoxia, and therefore, fetal acidosis lasts for extended periods of time, it is associated with severe long-term consequences, such as hypoxic-ischemic encephalopathy (HIE), cerebral palsy, or even in the most severe cases fetal death. Research remains unclear about whether the damage to the brain tissue occurs primarily because of lack of cell energy (caused by hypoxia) or as a secondary effect of cell poisoning (caused by acidosis).
It is in fact possible that fetal acidosis may simply be a marker of the underlying cause and severity of fetal hypoxia. But for parents to understand how “fetal acidosis” can or did harm their baby, they must first understand what it is and how it can cause harm.
Fetal acidosis refers to abnormally high concentration of acid and hydrogen ions in the unborn baby’s blood. This makes the blood more “acid” like and is usually the result of the lack of oxygen.
In the simplest terms “acidosis” means there are toxic levels of chemicals in the blood that can cause cell damage to the brain and other organs and be the result of cell damage that has already occurred to the cells in the brain and other organs. When a baby suffers a birth injury to the brain like hypoxic-ischemic encephalopathy (HIE) including cerebral palsy they typically have evidence of “fetal acidosis”.
There is bloodwork that is routinely drawn just after birth to determine if a baby is suffering from acidosis.
This bloodwork is typically referred to as “blood gas” results. The blood gas tests several things in the blood including:
- The pH levels of the blood
- The base excess of the blood
- PO2 which is the oxygen in the cord gas
- PCO2 which is the carbon dioxide in the cord gas
The most important results that are viewed to determine if the baby suffered a lack of oxygen and a resulting fetal acidosis are the pH levels and base excess results
The unit to measure the acid levels in the baby’s cord blood is called pH. Umbilical cord blood samples taken just after delivery are used to determine the pH levels in the baby’s blood and tissue. When a baby’s blood is more acidic the levels of pH are lower than normal findings. These results are important evidence in determining whether or not a baby has suffered from hypoxia during the delivery process and has likely suffered a birth injury.
The base excess results when considered along with the pH levels are important evidence to determine if fetal hypoxia has occurred and the severity of the fetal acidosis. When the baby’s blood is acidic there will be negative base excess results (normal base excess is 0 to 8). As the severity of the acidity grows, the base excess becomes larger negative number.
Babies from pregnancies with antepartum or intrapartum complications are more likely to have fetal acidosis at birth. A key distinction medical providers should make is whether the fetal acidosis resulted from acute hypoxia or from chronic hypoxia (present before labor). The difference in umbilical vein and artery gases can provide insights into this.
When hypoxia occurs because of placental dysfunction, the umbilical vein and artery values will be similar and abnormal. On the other hand, when the underlying cause is fetal bradycardia or acute umbilical cord compression, the fetal hypoxia and acidosis will primarily occur in the umbilical artery, resulting in a significant difference between the vein and artery values.
An analysis of the umbilical cord gas is, therefore, an important measure of the metabolic acidosis condition of the baby at the time of delivery. Once the acid-base status is determined, it can help identify babies that are at a risk of hypoxic-ischemic encephalopathy (HIE), which can cause cerebral palsy.
Stemming from this, blood gas lab results should not be used as an isolated measure to predict HIE injury. The medical team should combine the clinical results with other potential abnormal findings, such as low APGAR scores, non-reassuring fetal heart patterns, or the need for fetal resuscitation as well as the findings from MRI imaging. A comprehensive evaluation may serve as a strong indicator for neonatal seizures, cerebral palsy, and other neurological consequences in the baby.
Causes of Fetal Acidosis
The causes of fetal hypoxia/anoxia and the resultant fetal acidosis can be categorized into fetal, placental, and maternal. The consequences of fetal acidosis vary according to its duration and severity as well as the fetal condition prior to the insult. Severity can be classified as acute (a short number of minutes) or chronic (minutes that are approaching an hour or even hours).
When fetal acidosis occurs primarily due to a lack of oxygen, it is called respiratory acidosis. When the predominant cause is an increase in the levels of lactic acid, it is called metabolic acidosis. Acute fetal acidosis is usually respiratory in the initial stages. If oxygenation does not improve soon, it will be rapidly followed by metabolic acidosis
Etiology (set of causes or the manner of causation) of fetal acidosis may be described as follows:
Acute Fetal Acidosis
This occurs when hypoxia or anoxia occurs over minutes or more often hours. The common causes can be divided into three categories:
- Maternal: Epidural anesthesia (anesthetic injected in the spinal cord), vasovagal shock (sudden drop in blood pressure or heart rate due to a highly stressful event or improper placement of the mother (e.g. failing to wedge), and hemorrhage are some of the reasons that may cut down maternal blood supply, resulting in low delivery of oxygen to the uterus. Prolonged uterine contractions may also interrupt the blood flow to the uterus, causing hypoxia and fetal acidosis.
- Placental: The utero-placental circulation may get disrupted if placental abruption occurs. This condition may develop when the placenta separates partially or completely from the intra-uterine wall prior to delivery. This can block or reduce the baby’s oxygen supply and cause heavy maternal bleeding. Additionally, if a uterine rupture occurs there will be a profound anoxia due to the inability to exchange oxygen and carbon dioxide with the fetus.
- Fetal: Blood flow to the fetus from the placenta may get interrupted due to umbilical cord complications. A number of cord complications can occur during labor and delivery because of the baby’s position in relation to the umbilical cord or due to manipulation of the cord. When cord complications occur this an compromise the cord’s ability to deliver oxygen and nutrients to the baby, resulting in fetal hypoxia, and consequent fetal acidosis. Any causes of fetal distress or fetal hypoxia that appear on the electronic fetal monitoring equipment can also cause acute fetal acidosis.
Chronic Fetal Acidosis
- Maternal: Chronic fetal acidosis may occur due to a number of maternal causes, such as: (a) Severe cardiac or respiratory illness may contribute to low maternal blood oxygenation; (b) Maternal connective tissue diseases, such as SLE (systemic lupus erythematosus) may cause reduction in blood flow to the placenta; and (c) Pre-eclampsia (hypertension or high blood pressure disorder that may usually begin after 20 weeks of pregnancy).
- Placental: When the placental oxygen transfer to the fetus is impaired, it may lead to fetal hypoxia and chronic fetal acidosis. Pregnancies that are complicated by Intra-uterine growth restriction (IUGR) (the fetus is abnormally small for its gestational age) should be particularly monitored for the risk of chronic fetal acidosis due to reduced placental transfer.
- Fetal: Conditions related to the fetus may sometimes cause chronic fetal acidosis, even when then the placental function is normal. Fetal bradycardia or other types of arrhythmias, major structural cardiac abnormalities, anemia from rhesus disease (fetal blood cells are destroyed by the antibodies in the maternal blood), and alpha thalassemia (blood disorder that lowers hemoglobin production) can lead to chronic acidosis in unborn babies.
Signs of Fetal Acidosis
Medical providers should look for the indicators of fetal acidosis during labor and delivery in order to make a timely intervention. Some of the common signs may include:
- Prolonged or arrested labor
- Fetal Bradycardia, Decelerations, absent or minimal variability on fetal monitoring strips
- Cramping by the mother
- Vaginal bleeding
- Pre-eclampsia or maternal hypertension (high blood pressure)
- Abnormal maternal weight gain
- Fetal distress revealed by abnormal heart rhythms appearing on the fetal heart rate monitor
- Abnormal results seen on contraction stress testing (CST) or non-stress testing (NST)
- Abnormal biophysical profile (BPP) readings (ultrasound and NST performed in the third trimester)
- Abnormal amniotic fluid index or AFI (quantitative estimate of amniotic fluid)
- Respiratory distress indicated by rapid breathing, grunting sound with each breath, chest retractions, and/or change in the color of toes, fingers, and lips
- Impairment in oral motor functions, such as difficulty in swallowing, sucking, or latching onto the mother’s breast
- Weakness or fatigue indicated by minimal or lethargic body movements
- Feeble crying or no crying
- Difficulty in waking up from sleep
- Meconium aspiration syndrome (breathing a mixture of amniotic fluid and meconium into the baby’s lungs)
- Low pH levels in the cord blood
- Low APGAR score
Preventing Fetal Acidosis
Prior to delivery, if there are signs on the electronic fetal monitoring strips or other diagnostic tests of severe chronic or acute fetal acidosis or hypoxia intervention is necessary. If supplemental oxygen, turning the mother and/or fluid replacement do not improve the signs of hypoxia or acidosis then the nurses must recommend and the doctors must perform an emergency c-section in order to stop the fetal distress that is causing the hypoxia and acidosis.
When a baby is born and the blood gas tests reveal acidosis, the neonatal nurses and neonatology physicians must immediately evaluate the baby to see if they need hypothermia therapy or cooling. Babies with certain blood gas levels of acidosis must receive cooling therapy unless there are certain concurrent conditions that cause the risks of the therapy to outweigh the well-documented benefits.
Consequences of Fetal Acidosis
Fetal acidosis may be associated with one or more of the following complications in babies:
- Hypoxic-ischemic encephalopathy (HIE)
- Cerebral palsy
- Seizure disorders or epilepsy
- Mental retardation
- Developmental delays
- Paralysis
- Periventricular leukomalacia (white matter brain tissue injury in babies)
Research is ongoing about whether the adverse consequences in babies occur primarily due to fetal hypoxia or fetal acidosis. In relation to this, what is now medically established is that the consequences of hypoxia and acidosis will vary according to whether the condition is acute or chronic. Babies exposed to chronic fetal hypoxia and acidosis will have a significantly higher risk of long term disabilities.
Significant fetal acidosis indicates severe intrapartum hypoxia, which is associated with an increased risk of hypoxic-ischemic encephalopathy (HIE). Babies with moderate to severe HIE may either not survive or may have to live with cerebral palsy or other permanent and severe neurological and/or psychological deficits. HIE is considered a major cause of birth related long-term disability and perinatal death.
Is Your Child’s Fetal Acidosis the Result of Medical Malpractice?
Parents whose children suffer from fetal acidosis related complications as well as parents who have suffered the loss of their baby due to fetal acidosis deserve an answer to how their child developed this condition and whether the complications resulting from it were preventable. Were there signs during the labor and delivery process that fetal acidosis was occurring, but an emergency c-section was either delayed or not performed at all. Did their baby qualify for hypothermia therapy, but the doctors and nurses failed to perform the appropriate analysis or ignored the results of the analysis? Our dedicated birth injury lawyers want to help you find those answers and obtain monies necessary to purchase devices that can help improve the quality of your child’s life.
If your child has been diagnosed with fetal acidosis related injury (including Hypoxic-Ischemic Encephalopathy (HIE) or cerebral palsy), and you suspect this may have been caused in part by medical mistakes, Miller Weisbrod Olesky will thoroughly investigate the facts and hold responsible medical providers 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 and devices to help the child adjust to living with a permanent disability, and to be able to pay for these cutting-edge devices.
Sometimes families are hesitant to reach out to a medical malpractice attorney or law firm. Other parents feel overwhelmed by their circumstances and worried that they will not be able to help out in a lawsuit involving their child’s birth injury.
Miller Weisbrod Olesky is different from most law firms.
We provide help NOW.
Many attorneys focus only on pursuing their client’s legal case. At Miller Weisbrod Olesky, we know your child needs help today – not just when your birth injury lawsuit is settled. We have a team focused on helping our clients NOW when they need it most.
We know that children with birth injuries like hypoxic-ischemic encephalopathy (HIE) and cerebral palsy often require intense therapy, specialized medical treatment, and assistive care. The stress of providing for a birth injured child’s needs can be both emotionally and financially draining.
But just ‘knowing’ this is not enough. We act on this knowledge by providing exceptional services to birth-injured children and their families.
While Miller Weisbrod Olesky’s birth injury attorneys aggressively prepare each legal case, another department goes into action to help the families of children we represent. Led by a nurse-attorney, this department acts as a medical case manager for our birth injury clients by:
- Regularly monitoring the child’s medical treatment status,
- Helping facilitate medical treatment and therapy, and
- Arranging transportation and services.
Where necessary, we also help families locate local medical providers specializing in the care and treatment of children who have suffered a birth injury. With Miller Weisbrod Olesky, you’re not just a ‘case’. And that’s important when you’re looking for a lawyer who can help you cope with your child’s needs today.
Please call or email us today to get started.
Registered Nurses and Nurse-Attorneys Are a Vital Part of Our Birth Injury Team … and Yours
Most national birth injury law firms will employ one or two nurses to assist the review of cases and medical research. But Miller Weisbrod Olesky offers an unmatched number of nurses and nurse-attorney employees support to both the birth injury attorneys and our clients.
Our team of registered nursing staff and nurse-attorneys bring a deep level of medical and personal insight to every client’s case. Our nursing team includes both an experienced labor and delivery nurse as well as an ICU nurse. Working closely with the rest of the team, they investigate the reasons behind a birth injury and how medical professionals breached their standard of care.
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.
Following graduation, Linda joined Les Weisbrod in the Medical Malpractice Section. After taking time off to raise her three lovely children, Linda returned to Miller Weisbrod and her passion of holding healthcare providers accountable for preventable errors. Linda is active in the American Association for Justice, Texas Trial Lawyers Association, Dallas Trial Lawyers Association, and the Texas Bar Association. Linda is an active member of the Birth Trauma Litigation Group and Medical Negligence Section of the American Association for Justice.
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
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.
Talk with the Knowledgeable Attorneys at Miller Weisbrod Olesky
The only way to find out if you have a birth injury case is to talk to a birth injury malpractice attorney who understands birth injuries leading to a delay or failure in developmental milestones including birth injuries that cause cerebral palsy. Many times fetal acidosis is a preventable birth injury, but it takes a detailed expert review of the facts and circumstances of your child’s birth to determine the birth injury was the result of medical malpractice.
At Miller Weisbrod Olesky, a team of committed attorneys, nurses and paraprofessionals uses our detailed medical negligence case review process to assess your potential birth injury case. We start by learning more about you and your child and the status of meeting/missing developmental milestones. 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 negligence caused or contributed to your child’s injuries, 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 ask you to pay anything. The medical review of your case and the consultation are free. We only receive payment when you do.
Contact Our National Birth Injury Lawyers
Our Birth Injury Attorneys
Les Weisbrod
Les Weisbrod has been on the cutting edge of the national birth injury litigation scene for almost 40 years.
As a national birth injury attorney, Les has settled over 204 medical negligence cases for more than $1,000,000. He also obtained settlements in 75 birth injury cases for over $1,000,000 each.
His $31 million verdict against Baylor University Medical Center in Dallas was one of the top 100 verdicts in the United States that given year.
Les is recognized nationally and internationally as one of the top plaintiff’s medical malpractice trial lawyers in the United States. But the recoveries for the clients and the differences made in the lives of the children and families Les has represented tell only part of the story.
Les has worked with his law partner Clay Miller for years to build a one-of-a-kind law firm.
Miller Weisbrod Olesky provides unique and unparalleled services to families of birth-injured and brain-injured children from the moment the firm decides to take the case.
The registered nurses and registered nurse-attorneys on staff are valuable team members who assist Miller Weisbrod birth-injury clients. Les has designed a system where each birth injured child is assigned a nurse-attorney liaison to guide them through the process of medical treatment/evaluation, therapies, home assistance, and quality of life improvement.
Miller Weisbrod’s unmatched service allows families to better cope with the immediate challenges facing our young clients.
Birth-injured children and their families are Les and Miller Weisbrod’s priority.
Les and the attorneys at Miller Weisbrod fight for the justice their clients are entitled to under our nation’s system of justice.
This fighting spirit has taken Les across the United States to represent clients in birth injury and medical negligence cases. In fact, he has personally handled cases not only in Texas but also in Arkansas, Arizona, Colorado, Oklahoma, Louisiana, Utah, Iowa, Ohio, Oregon, Montana, Alabama, Georgia, Florida, and New York.
Les and Miller Weisbrod continue to expand their reach of helping brain-injured children to new states each year as we strive to bring a sense of justice to each affected family. And Les is not the only one who notices he fights for his clients.
Michael Rustad, a Professor of Law at Suffolk University Law School in Boston who has done extensive research on punitive damage awards, says,
“Les Weisbrod has obtained more medical malpractice punitive damage jury verdicts for his clients than any other attorney in the United States.”
Also, a well-known defense medical malpractice attorney dubbed Les Weisbrod the “pitbull” of the Texas medical malpractice bar in a media profile of Les published by a major newspaper.
Les shares his experience and knowledge to improve the representation of all birth-injured children and their families.
In the early 1990s, Les recognized that a more focused effort needed to be made to educate attorneys who handle birth injury cases. As a result, Les was the founding Co-Chair of the American Association for Justice (AAJ) Birth Trauma Litigation Group in 1991. He also was a founding Co-Chair of AAJ’s Medical Negligence Litigation Group in 1999 and served as Chair of AAJ’s Professional Negligence Section in 1996.
Combined, these groups have put on more than a hundred continuing education seminars across the United States. helping to educate other attorneys by bringing in world-renowned experts in the fields of:
- labor and delivery
- neonatal care
- the care and treatment of birth-injured children, including those suffering from cerebral palsy and hypoxic-ischemic encephalopathy (HIE)
Education and professional experiences back up his dedication to helping children and families harmed by medical malpractice.
Les received his B.A. magna cum laude in 1975 from Claremont Men’s College and his J.D. in 1978 from Southern Methodist University Law School.
He is Board Certified by the Texas Board of Legal Specialization in Personal Injury Trial Law and Civil Trial Law.
Les was a past president of the Dallas Trial Lawyers Association in 1993. He has been a member of the Texas Trial Lawyers Association Board of Directors since 1990.
His work with the American Association for Justice (AAJ) (formerly ATLA) includes serving as President, President-Elect, Vice President, Secretary, Treasurer, and Parliamentarian. Mr. Weisbrod has also served on the AAJ Board of Governors since 1998 and the 17-member Executive Committee of AAJ since 2001. In 1990, he was chosen as a Rising Star of the ATLA and presented a paper entitled “Dirt and Greed: A New Look at Medical Malpractice Cases.”
Les has written and lectured extensively on birth injury litigation, medical malpractice, and medical product topics.
Les is a contributing author to the 1996 text Operative Obstetrics published by Williams & Wilkins. He also co-authored the “Drugs & Medical Devices” chapter in AAJ’s Litigating Tort Cases.
He also has lectured to lawyer groups across the U.S., Canada, England, and Australia.
Education
- Southern Methodist University - School of Law, J.D. - Dallas, Texas, 1978
- Claremont Men's College - B.A. - Claremont, California, 1975
Areas of Practice
- Medical Malpractice
- Birth Injury/Birth Trauma
- Products Liability
- Personal Injury
Associations & Memberships
- State Bar of Texas
- National Association Of Distinguished Counsel
- Million Dollar Advocates Forum
- Multi-Million Dollar Advocates Forum
- American Association for Justice
- Texas Trial Lawyers Association
- Dallas Trial Lawyers Association
- Pan-European Organization of Personal Injury Lawyers
- American Society of Law and Medicine
- Consumer Attorneys of California
- Arkansas Trial Lawyers Association
- Louisiana Trial Lawyers Association
- Dallas and American Bar Associations
- ABOTA (American Board of Trial Advocates)
Clay Miller
Clay is Board Certified in Personal Injury Trial Law by the Texas Board of Legal Specialization. Clay has practiced solely in the field of catastrophic injury and wrongful death since graduating from law school. His practice has been limited to the representation of victims. Over the past twenty-four years, Clay has successfully settled or tried to verdict cases in the areas of vehicular negligence, medical malpractice, construction site accidents, workplace injury, premises liability, and commercial trucking and a nationwide business loss case (suits filed in a dozen different states) involving defective truck engines sold to trucking companies.
Clay represented dozens of trucking companies in lost profit and diminished value claims against Caterpillar in 2010 through 2012. These cases were filed in over a dozen states with the bellwhether trial set in Federal Court in Davenport, Iowa. After intense litigation and trial preparation, a global confidential settlement was reached for all the clients.
Clay's most recent 2017 victories are a $30,800,000 jury verdict in Tennessee arising from fraud claims in the sale of heavy-duty truck engines and a $26,500,000 jury verdict in a construction accident, obtained within 60 days of each other.
Clay was raised in Lewisville, Texas and completed his undergraduate degree in Finance at
Texas A & M University. Following graduation from Southern Methodist University School of law, Clay worked for two Dallas firms representing victims. In 1998, Clay began his own practice before forming his current partnership. In addition to his law practice, Clay has lectured at seminars and published in the areas of construction accidents, jury selection techniques, medical negligence, trucking accidents and settlement tactics.
He is active in local and statewide trial lawyers' associations including serving as the Chair of the Advocates for the Texas Trial Lawyers' Association in 2002 and remains on the Board of Directors. Clay served as President of the Dallas Trial Lawyers Association from 2008-2009. He has also been a member of the American Board of Trial Advocates (ABOTA) since 2014.
Education
- Southern Methodist University School of Law - Dallas, Texas
- Texas A&M University - Finance - College Station, Texas
Areas of Practice
Associations & Memberships
- State Bar of Texas
- State Bar of New Mexico
- State Bar of Colorado
- American Board of Trial Advocates (ABOTA)
- Texas Trial Lawyers Association
- Dallas Trial Lawyers’ Association
- American Association of Justice
David Olesky
David Olesky is Vice Chair of the Health Care Professional Liability practice. David is a trial lawyer focusing his practice on complex litigation matters that involve defending and protecting clients in all types of cases related to catastrophic injuries or death, but with a special focus on birth injury cases. David regularly advises his health care clients on the issues and challenges that they face on a daily basis. Clients repeatedly look to him for guidance to handle such high stakes cases and matters in Texas and jurisdictions outside of Texas.
David has earned the trust and reliance of clients he has worked with by consistently getting the results that matter most to them, whether that is a win at trial or a favorable outcome through alternative dispute resolution outside the courthouse. Through his representation, David demonstrates a true loyalty and hardworking commitment to the clients that he serves.
David believes the foundation of any client relationship is to act as a trusted advisor instead of simply as a litigator. Clients value his earnest representation of their business interests, accompanied by a devotion to understanding their businesses, prompt attention to their immediate needs and the challenges they face in their individual roles.
Education
- Southern Methodist University Dedman School of Law, J.D., 1992 - Dallas, Texas
- University of Texas, B.B.A, 1989 - Austin, Texas
Areas of Practice
Associations & Memberships
- American Bar Association
- Dallas Bar Association
- Dallas Bar Foundation Fellow
- Texas Bar Association
Alexandra V. Boone
Alexandra Boone is a partner in Miller Weisbrod. She concentrates her legal practice in the area of birth injury, medical malpractice and mass tort products liability. Alex currently works directly with firm partner Les Weisbrod in managing the birth injury docket and working with the firm’s highly qualified expert witnesses in the review of potential cases. Alex also litigates her own docket of medical negligence cases.
Over the course of her 17 years with the firm, Alex has focused on the administration and prosecution of mass tort litigation, originally focusing on occupational toxins, but more recently in the area of pharmaceuticals and medical devices. In the past, she has actively pursed cases involving hormone therapy, Vioxx, Fosamax, and Reglan. Alex was also instrumental in our firm successfully resolving thousands of cases transvaginal mesh, hip prosthetics, and the blood thinner Xarelto. She is actively prosecuting over 1,000 cases.
In addition to being a member of the Texas bar, she is also licensed in Oklahoma and is a member of the American Association of Justice, Texas Trial Lawyers Association, Oklahoma Association of Justice and the Dallas Trial Lawyers Association.
Education
- Baylor University - School of Law, 1996, J.D. - Waco, Texas
Areas of Practice
- Products Liability
- Mass Tort
Associations & Memberships
- State Bar of Texas
- American Association of Justice
- Texas Trial Lawyers Association
- Oklahoma Association of Justice
- Dallas Trial Lawyers Association
Pro Bono Activities
- East Texas Legal Services/Nix Law Firm Pro Bono Project, 1996 - 1997
Robert Wolf
Robert E. Wolf was born in Dallas, Texas and graduated Magna Cum Laude as a proud horned frog from Texas Christian University in 1997, with Bachelor of Science degree in Political Science and was inducted into Phi Beta Kappa and Mortar Board. He obtained his law degree from Southern Methodist University in 2000 while serving as an Articles Editor for the International Law Review and winning awards at Mock Trial and Appellate competitions.
Robert has been named a Thomson Reuters | Texas Super Lawyers Rising Star (less than 2.5% of attorneys in Texas receive this distinction) in 2011, 2012, 2013, 2014, and 2015. Further, Robert was recognized as a National Trial Lawyers Top 40 Under 40 attorney for Texas in 2012 (no more than 40 attorneys in Texas are eligible for this award annually).
Robert brought his passion for and over 14 years of experience of representing seriously injured individuals and their families to Miller Weisbrod in January 2015, and has concentrated his legal practice in the area of medical malpractice, products liability, and pharmaceutical/mass tort litigation. He is a member of the State Bar of Texas, American Association for Justice, Texas Trial Lawyers Association, and Dallas Trial Lawyers Association.
In addition to many successful jury verdicts and settlements across Texas, Oklahoma, Iowa, Wisconsin, and Idaho, Robert’s role as an attorney representing victims and their families has led to numerous changes to key safety practices and policies and procedures at corporations and medical facilities.
Robert and his wife Suzy also get plenty of exercise trying to keep up with their precious and very active daughter.
Education
- Southern Methodist University - Dedman School of Law, J.D. - 2000 - Dallas, Texas
- Texas Christian University - B.S. Political Science - 1997 - Fort Worth, Texas
Areas of Practice
- Medical Malpractice
- Personal Injury
- Products Liability
Associations & Memberships
- State Bar of Texas
- American Association of Justice
- Texas Trial Lawyers Association
- Dallas Trial Lawyers Association
Carrie Vine
Carrie Lynn Vine has over 15 years of experience in medical malpractice litigation, with a particular focus in representing children and families who have suffered birth injuries as a result of the negligence of either doctors, nurses or hospitals.
She is a passionate advocate for her clients and has handled hundreds of birth injury and birth trauma cases throughout the United States. As part of Carrie’s national birth injury legal practice, she has handled cases in Texas, Arkansas, California, Nevada, Kentucky, Georgia, Illinois, Wisconsin, Ohio, Pennsylvania, North Carolina, South Carolina, Florida, and North Dakota. She is determined to seek justice and works to obtain fair compensation for the children and families she represents.
Carrie earned her law degree from Northern Illinois University where she tutored other law students. Prior to law school, she received her undergraduate degree from the University of Notre Dame in Biomedical and Biological Science, and earned both a Master’s Degree and a Ph.D. from The Pennsylvania State University in Anthropological Genetics. She then conducted post-doctoral research at the University of Michigan Medical School before deciding to attend law school. She applies an academic mindset and love of science and medicine to mastering the medical principles and literature relevant to the cases she pursues.
Carrie is an active member of the American Association of Justice as well as the Birth Trauma Litigation Group (BLTG).
Education
- Northern Illinois University:
Law School
- University of Notre Dame:
Biomedical Science
- Pennsylvania State University:
Anthropological Genetics
Areas of Practice
- Birth Injury/Birth Trauma
- Medical Malpractice
Associations & Memberships
- American Association of Justice:
Member
- Birth Trauma Litigation Group:
Member
Larry Lassiter
Lawrence R. Lassiter is an AV-rated attorney with more than twenty years of experience in appellate and trial advocacy. He has been consulted by attorneys across the country to conduct research, evaluate cases, prepare appellate and trial briefs, and formulate litigation strategy. He has prepared hundreds of appellate briefs in federal and state appellate courts, including the highest courts of Texas, West Virginia, Georgia, Oklahoma, Ohio, Nebraska and Tennessee, and he is member of the Bar of the United States Supreme Court. Larry has a national appellate and legal briefing practice. Larry has filed extensive briefs and/or argued before either state or federal courts in 30 out of 50 states in his career.
Larry assists the Birth Injury team in all aspects of legal briefing. Unlike many other birth injury firms across the United States, Miller Weisbrod has an attorney dedicated to handling legal briefing on behalf of our clients across the country. Larry has handled extensive briefing in birth injury and other medical malpractice cases in Texas, New Mexico, Arkansas, Oklahoma, Iowa, Ohio, Alabama, Georgia, New York, Utah, Arizona, Louisiana and West Virginia.
Since joining Miller Weisbrod in 2010, Larry has won a number of important victories vindicating the rights of our clients in both state and federal appellate courts, including Vitacost.com, Inc. v. McCants, 210 So.3d 761 (Fla. Ct. App. 2017); TTHR Ltd. Partnership v. Moreno, 401 S.W.3d 41 (Tex. 2013); In re E.B., 729 S.E.2d 271 (W. Va. 2012); Mid-Continent Cas. Co. v. Davis, 683 F.3d 651 (5th Cir. 2012); Rouhani v. Morgan, 2017 WL 3526719 (Tex. App. – Houston [1st Dist.] 2017, no pet.); Mid-Continent Cas. Co. v. Andregg Contracting, Inc., 391 S.W.3d 573 (Tex. App. – Dallas 2012).
He was as a judicial clerk for the Honorable Harlington Wood Jr., Circuit Judge, United States Court of Appeals for the Seventh Circuit. Larry was a University of Iowa Presidential Scholar and served as Editor in Chief of the Iowa Law Review.
Larry is an active member of the American Association for Justice. He is a member of AAJ’s Birth Injury Litigation Group and Medical Negligence Sections.
Education
- University of Iowa - Political Science & History - B.A. - Iowa City, Iowa
- University of Iowa - School of Law - J.D. - Iowa City, Iowa
Areas of Practice
- Appellate Advocacy
- Medical Malpractice
- Pharmaceuticals & Medical Devices
- Products Liability
- Personal Injury
Associations & Memberships
- State Bar of Texas
- American Association of Justice
- Texas Trial Lawyers Association
- Dallas Trial Lawyers Association
Laurie Pierce
Laurie draws upon extensive experience in state and federal courts with a focus on complex claims involving medical malpractice cases. After many years of defending health care providers and hospital systems in medical malpractice cases, Laurie joined David Olesky in the national birth injury and medical negligence practice at Miller Weisbrod Olesky.
Laurie’s focus is to understand not only the facts and circumstances of the matter at hand, but to understand the specific needs and goals of the client and their unique business considerations. Her extensive background in commercial litigation provides a foundation that enhances her health care litigation practice. She works with clients that require more than a strong trial lawyer; they expect an attorney who understands the relationship between law and their specific business and who will work tirelessly to protect their rights, interests and bottom line.
Education
- Southern Methodist University:
Dedman School of Law - 1992
- Order of the Coif:
Journal of Air Law and Commerce, J.D. - 1992
- Miami University-Oxford, Ohio
B.S. Education - 1982
Areas of Practice
- Birth Injury/Birth Trauma
- Health Care Industry
- Health Care Litigation
- Litigation and Dispute Resolution
- Medical Malpractice
Associations & Memberships
- American Association for Justice
- American Bar Association
- Dallas Bar Association
- Dallas Bar Foundation Fellow
- Texas Bar Association
Distinctions
- Admitted to Pro Bono College of State Bar of Texas in 2019 for outstanding delivery of legal services to low-income Texans
Court Admissions
- United States Supreme Court
- U.S. District Court, Eastern District of Texas
- U.S. District Court, Northern District of Texas
- U.S. District Court, Southern District of Texas
- U.S. District Court, Western District of Texas
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.
Following graduation, Linda joined Les Weisbrod in the Medical Malpractice Section. After taking time off to raise her three lovely children, Linda returned to Miller Weisbrod and her passion of holding healthcare providers accountable for preventable errors. Linda is active in the American Association for Justice, Texas Trial Lawyers Association, Dallas Trial Lawyers Association, and the Texas Bar Association. Linda is an active member of the Birth Trauma Litigation Group and Medical Negligence Section of the American Association for Justice.
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
Areas of Practice
- Medical Malpractice
- Birth Injury/Birth Trauma
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.
Education
- SMU Dedman School of Law - Dallas, Texas
- University of Texas at Arlington - Arlington, Texas
Areas of Practice
- Medical Malpractice
- Birth Injury/Birth Trauma
Associations & Memberships
- State Bar of Texas
- American Association of Justice
- Texas Trial Lawyers Association
Matt Adair
Matt Adair is an attorney specializing in medical malpractice, products liability, and pharmaceutical litigation. He received his bachelor’s degree in Philosophy from the University of Notre Dame. During his time there, he studied abroad at the New College at Oxford University in Oxford, England.
Matt is a member of the State Bar of Texas, American Association for Justice, Texas Trial Lawyers Association, and Dallas Trial Lawyers Association.
Education
- University of Notre Dame - Philosophy, B.A. 2012 - Notre Dame, Indiana
- Baylor University - School of Law J.D. 2015 - Waco, Texas
Areas of Practice
- Medical Malpractice
- Products Liability
- Pharmaceutical Litigation
Associations & Memberships
- State Bar of Texas
- American Association of Justice
- Texas Trial Lawyers Association
- Dallas Trial Lawyers Association
Garrett Stanford
Garrett Stanford was born in Dallas, Texas and graduated from Southern Methodist University in 2017 with a B.A. in Political Science. After graduation, he attended Baylor University School of Law. During his time at Baylor, he was a member of the Order of the Barristers and he won the Judge W.C. Davis Endowed Criminal Practice Professional Track Award. He obtained his law degree and license to practice law in 2020.
Garrett joined Miller Weisbrod in August 2021. His legal practice is concentrated in the area of birth injury and medical malpractice. Garret is actively involved in handling birth injury and medical malpractice cases in Texas, Ohio, Utah, Arkansas and Oklahoma.
Education
- Southern Methodist University - Political Science, B.S. - Dallas, Texas
- University of Baylor - School of Law, J.D. - Waco, Texas
Areas of Practice
- Medical Malpractice
- Birth Injury/Birth Trauma
Associations & Memberships
- State Bar of Texas