Why Checking a Baby’s Heart Rate During Delivery is So Important
Doctors monitor and test expectant mothers during their prenatal visits. They also check on the baby’s well-being using ultrasounds and devices that check their heartbeat.
Fetal heart rate monitoring often becomes critical when labor and delivery begin. During labor, the fetal heart rate can signal that the baby is in fetal distress and trying to compensate for a reduction in oxygen or blood flow. When fetal monitoring strips show signs of fetal distress, doctors, nurses, and midwives must immediately intervene to prevent oxygen deprivation and address reduced blood flow to the baby’s brain.
Parents of a baby showing symptoms of birth injury, including cerebral palsy, may not realize that healthcare providers could have prevented or reduced their child’s injury through proper fetal heart monitoring.
Let’s start by understanding the baby’s heart rate.
The Significance of Fetal Heart Rates
The fetal heart rate does not just tell us how the baby’s heart is doing. It’s also a sign of the baby’s overall health status.
Most of the time, an abnormal fetal heart rate indicates a condition like oxygen deprivation, shock, or infection that could affect the fetal brain. Unless doctors and other medical staff intervene, the baby could suffer from a complete lack of oxygen (“asphyxia”) or a dangerously decreased oxygen (“hypoxia”). When either asphyxia or prolonged hypoxia occurs, a baby can suffer a severe birth injury, including hypoxic-ischemic encephalopathy (HIE), metabolic acidosis, or cerebral palsy.
The average fetal heart rate ranges between 110 and 160 beats per minute. The heart rate can vary from five to 25 beats per minute, which is a sign of a healthy baby.
Why Monitor Fetal Heart Rates During Labor?
The baby’s heart rate fluctuates during labor. Some changes are normal and not cause for alarm. However, certain patterns of decelerations, changes in the heart rate, or variability during labor signal medical providers that something’s wrong.
Common issues that can affect the baby’s heart rate include:
Regardless of the situation, fetal heart monitoring is an essential tool during childbirth. When done correctly, the results of monitoring alert obstetricians, maternal-fetal medicine specialists, nurses, midwives, and other healthcare professionals that the baby could be in fetal distress.
Three Kinds of Fetal Heart Monitoring
Some mothers enter labor with few signs that they might have complications. Still, even women with low-risk pregnancies will be monitored during labor. In fact, fetal heart monitoring is the most common obstetric procedure performed in the United States. But the methods her physicians use might differ based on a mother’s medical condition.
In years past, her medical team would use only intermittent auscultation unless there were signs the baby was not doing well. “Auscultation” means listening to someone’s body sounds, including those made by their lungs and heart. Doctors, nurses, and midwives typically used special stethoscopes to check the baby’s heartbeat.
Now, the standard of care has changed due to the development of new technology. Healthcare providers use an electronic Doppler transducer attached to the mother’s abdomen to monitor the baby’s heart rate. Sometimes another transducer is attached to the baby’s scalp for closer monitoring. The transducer sends and receives sound waves, then amplifies the sounds created by the baby’s heartbeats.
This type of electronic fetal heart rate monitoring is divided into two parts:
External monitoring: When a mother arrives at the hospital, staff members place two belts around the mother’s abdomen. Transducers on the belts electronically monitor the fetal heart rate and maternal uterine contractions
Internal monitoring: This method can only be done when the mother’s water has broken. The doctor or nurse will insert a wire through the cervix and into the mother’s uterus. They then attach an electrode to the fetus, usually on the scalp. Data transmitted by the electrode helps doctors monitor the baby more closely.
Doctors may also insert a catheter into the mother’s uterus that checks uterine pressure during contractions.
A new, wireless fetal heart monitor is available at some hospitals or for at-home use. As technology develops, these wireless monitors might be useful in telemedicine during online doctor’s appointments and in hospital settings during childbirth.
Only trained staff members should use fetal and maternal monitoring equipment. When monitoring is performed incorrectly, or medical staff misinterprets or ignores the results – the result can be severe brain damage, hypoxic-ischemic encephalopathy (HIE), cerebral palsy, or, in severe cases, death.
What Fetal Heart Monitoring Results Mean
Physicians and other medical providers caring for an expectant mother know the importance of fetal heart monitors. But medical negligence or poor training can cause warning signs to be overlooked.
When analyzing a fetal heart tracing in conjunction with uterine contractions, staff members start with the baby's baseline rate. This number ranges from 110 to 160 beats per minute (bpm). Medical staff may mention two types of abnormal heart rate: tachycardia and bradycardia.
Tachycardia means the baby’s heart rate is over 160. This increase is potentially dangerous for the baby. Tachycardia can mean that the baby’s heart is working harder than normal to pump blood and oxygen to the rest of the body to compensate for low oxygen levels. A sustained fast heart rate puts babies at risk for cardiovascular failure.
Bradycardia means the baby has a potentially dangerous slow heart rate. This condition can be caused by fetal oxygen deprivation, which can be caused by complications like uterine tachysystole or hyperstimulation, placental abruption, or uterine rupture. Maternal health issues like hypotension or seizures can contribute to bradycardia.
Then medical professionals look for the following patterns:
Accelerations
Decelerations
Variability
Accelerations show up on the fetal heart tracing as an abrupt increase from the baby’s baseline rate. Most accelerations are normal and indicate that the baby has enough oxygen. When accelerations are absent and other abnormal signs exist, the baby is suffering or has suffered a birth injury caused by oxygen deprivation.
Decelerations (also called decels) are decreases in the baby’s heart rate, but there are several types:
Early decelerations occur as the mother’s contraction peaks. These can often happen as the baby passes through the birth canal because of pressure on the baby’s head. Early decelerations are usually not a sign of fetal distress.
Late decelerations begin after the contraction peaks or after the contraction is finished. Recurrent decelerations that cannot be corrected with interventions are glaring signs that the baby is in trouble, and an emergency C-section is necessary.
Variable decelerations show as jagged, exaggerated dips in the fetal heart rate. This usually means the baby’s umbilical cord is being compressed, cutting off oxygen to the fetal brain. These can be dangerous signs, especially when coupled with decreased variability. A C-section might be needed to prevent brain damage and asphyxia when this happens during labor.
Variability refers to differences in the fetal heart rate over several minutes. A baby’s heart might accelerate or decelerate but should return to or near its baseline rate. When fetal tracings are flat—showing minimal or absent variability (less than 5 beats per minute), it can mean the baby has or is suffering from a lack of oxygen.
Medical professionals should watch for several types of variability:
Absent Variability
Minimal Variability – below 6 bpm and absent when nonvisible (increased risk of fetal acidemia)
Moderate Variability – presence of accelerations and no decelerations (6-25 bpm) Healthy baby
Marked Variability – may represent an increased response due to a stressful event
Normal fetal heart rate (baseline): approximately 110 bpm - 160 bpm Slow fetal heart rate (bradycardia): under 110 bpm Fast fetal heart rate (tachycardia): more than 160 bpm
Acceleration and deceleration fetal heart rate patterns in response to contractions are signs of the baby’s overall well-being. Doctors and nurses can tell if the baby is not getting enough oxygen or blood to their brain.
Classifying Fetal Heart Rates
Medical professionals must communicate clearly and efficiently about a patient’s status. This is particularly true in the type of emergency situations obstetricians, midwives, and nurses encounter during labor and delivery.
The following method of classifying fetal heart rates should assist them in quickly identifying and addressing problems.
Category I: The baby’s baseline heart rate is normal, between 110 and 160 beats per minute, with good variability and no variable or late decelerations. This reading usually means the fetus has a normal acid-base status which means they have not or are not suffering from a lack of oxygen. Unless there are signs of complications, medical staff usually do not need to intervene.
Category II: The fetal heart rate monitoring strips show any one of the following:
moderate variability with recurrent late or variable decelerations
minimal variability with recurrent variable decelerations
absent variability without recurrent decelerations
bradycardia with moderate variability
prolonged decelerations
tachycardia
A Category II Fetal Heart Rate Strip is a worrisome sign that the medical staff must closely evaluate. Category II readings that persist – especially when delivery is not near – could indicate that the doctor should perform a C-section to avoid subjecting the baby to prolonged potential hypoxia.
Category III Fetal Heart Rate Strip: When the fetal heart rate falls into this category, the baby needs immediate attention. The fetal heart tracings will show:
Minimal or absent fetal heart rate variability and
• Recurrent late decelerations
• Recurrent variable decelerations
• Bradycardia (slow heartbeat)
Sinusoidal patterns indicate conditions like intra-uterine bleeding, severe fetal anemia, Rh disease, severe oxygen deprivation
Babies in Category III often need to be delivered as quickly as possible using assistive delivery methods. Under almost all circumstances, this means performing an emergency C-section.
With Category I or Category III readings, the baby’s status is easier to determine. A heart rate classified as Category I probably requires no intervention. On the other hand, Category III requires immediate attention to prevent or minimize birth injury.
Category II is more difficult to understand – the baby might or might not be in distress. But a baby’s healthcare providers should be concerned when the baby’s heart rate is Category II. Doctors, labor and delivery nurses, and other medical professionals must conduct further monitoring and testing to determine if the Category II strip does indicate fetal distress.
Medical staff can try interventions with a Category II baby. However, they must deliver the baby when interventions do not work and the heart rate falls into Category III. If obstetricians and delivery nurses fail to act, the baby can suffer a lifelong birth injury, including hypoxic-ischemic encephalopathy or cerebral palsy.
Where Medical Providers Can Go Wrong
An expectant mother usually has a team of medical professionals guiding her and her baby through labor and delivery. And childbirth usually occurs in hospitals and other facilities that should have trained staff and adequate equipment.
Even so, the doctors, nurses, midwives, medical staff, and hospitals make mistakes that harm mothers and babies.
Physicians and midwives sometimes fail to observe a mother’s progress through labor. It’s especially critical for them to pay attention to the fetal rate heart monitoring strips and other signs that a baby is in fetal distress. In addition, they must consider the baby and mother’s overall medical condition. When they fail to do so, babies can be born with preventable brain damage, hypoxic-ischemic encephalopathy, and cerebral palsy.
Nurses typically watch the fetal heart tracings and report back to the doctors. Overlooking troublesome test results and failing to report them to a mother’s physician or midwife can contribute to any birth trauma the baby suffers.
Hospitals have a responsibility to provide safe, effective care to their patients. But sometimes they fail to train staff properly. Fetal heart monitoring is too important to be performed by untrained or undertrained personnel. Also, many hospitals are understaffed. When there are not enough adequately trained nurses and other providers in Labor and
Delivery, will patients get the care they need?
When hospitals fail to have a properly trained staff, signs of fetal distress on fetal monitoring strips can be missed. In such cases, state medical malpractice laws allow for a recovery not only against the nurses and doctors but also the hospital where the malpractice took place.
Is Your Child’s Birth Injury the Result of Medical Malpractice?
The parents of children who suffered birth injuries often want answers. They want to know what happened to harm their child’s brain. Were there signs on the fetal monitoring strips that were missed or that were seen but not properly responded to by the doctors and nurses?
We diligently investigate the facts and hold responsible parties accountable by pursuing medical malpractice claims against them. We are trained to review the fetal monitoring strips with a fine-tooth comb—just like the medical providers should have been doing during your delivery. We have a team of nurses experienced in birth injury that assists us in not only reviewing the fetal monitor strips but the entire labor and delivery and newborn medical record chart.
When we find the necessary evidence, we pursue every means possible to obtain you and your child appropriate compensation. 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 brain injuries, seizure disorders, and cerebral palsy.
Sometimes families are nervous to talk to lawyers about their child’s case. Others may simply feel consumed by their circumstances and unable to participate in a lawsuit involving their child’s birth injury. We are here to take a large part of that burden off of you and your family.
Why Should You 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 an attorney who understands birth injury.
At Miller Weisbrod Olesky, a team of committed professionals uses 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 ask you to pay anything. The medical review of your case and the consultation are free. We only receive payment when you do.
Contact Miller Weisbrod Olesky
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 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
Bar Admissions
Texas
Arkansas
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 $26,500,000jury 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.
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
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 medications. Alex was also instrumental in our firm successfully resolving thousands of cases transvaginal mesh, hip prosthetics, and the blood thinner medications. 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
Bar Admissions
Texas - 1996
Oklahoma - 2006
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
Bar Admissions
Texas - 2000
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
Bar Admissions
Texas
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
Bar Admissions
Texas - 1996
Kansas
Missouri
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.
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
Bar Admissions
Texas - 1996
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
Bar Admissions
Texas - 1996
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
Bar Admissions
Texas - 2015
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
Bar Admissions
Texas - 2020
Areas of Practice
Medical Malpractice
Birth Injury/Birth Trauma
Associations & Memberships
State Bar of Texas
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.
