Spinal Cord Injury At Birth

Neonatal spinal cord injury is a birth complication of birth trauma that may occur when the medical providers strain the baby’s neck by twisting, pulling, or using assistive devices to remove the baby from the birth canal. Spinal cord injury during delivery may also result from undiagnosed spinal damage that occurred before birth.

Spinal cord injury at birth disrupts the nerve connections between the baby’s brain and the rest of the body, typically resulting in catastrophic long-term consequences, such as limb weakness or paralysis, respiratory complications, or even the baby’s death.

Neonatal spinal cord injury sometimes occurs concurrently (at the same time) with hypoxic-ischemic encephalopathy (HIE), which may lead to cerebral palsy. Typical manifestations of this birth complication include loss of movement or decreased movement, slow or no reflexes, breathing difficulties or apnea, and absence of response to painful stimulation.

Poor medical judgment or negligence of the obstetrics team is often involved when a baby is diagnosed with spinal cord injury. The parents may have strong grounds for a medical malpractice case, if spinal cord injury occurring at the time of delivery was preventable, or further neural damage could have been avoided with early diagnosis and appropriate neuroprotective treatment, such as hypothermia therapy.

In cases of neonatal spinal cord injury, negligent use of forceps or vacuum extractors, excessive application of force while removing the baby from the birth canal, failure to react to fetal distress during labor or delivery, or the failure to recommend a cesarean delivery when it was the best course of action available particularly in a condition of fetal distress or prolonged/arrested labor often constitute medical malpractice.

The ligaments and vertebrae that protect the spinal cord are still developing in newborns. Therefore, prolonged or excessive pressure applied on the baby’s spine during the birth process can cause neonatal spinal cord injury. Here are some of the notable causes of this condition:

If the birth attendants (obstetricians, labor and delivery nurses or midwives) use excessive twisting or pulling (known as excessive extraction, hyperextension, or rotation of the baby’s spine or neck) during delivery, it can result in neonatal spinal cord injury. In a vertex (head-first) delivery, the upper and mid cervical spine may be injured, while in a breech (feet or buttocks first) delivery, the upper thoracic and lower cervical region are usually involved.

In a case of umbilical cord compression, the severity of blood loss in the mother or fetal hypoxia (oxygen deprivation of the baby) may prompt the medical team to rush the delivery. Failure to identify fetal distress, delayed diagnosis, lack of coordination among the medical team members leading to preventable delays, or poor judgment to avoid cesarean section may contribute to a rushed delivery and resulting spinal cord injury.

• Assisted vaginal delivery with the use of midcavity forceps or vacuum extraction
• Abnormal fetal presentation (in particular, breech presentation)
• Prolonged or arrested labor
• Labor is too rapid
• Premature birth
• Cephalopelvic Disproportion (baby’s head is too large for the maternal pelvis)
• Shoulder Dystocia (the baby’s head gets stuck in the maternal pelvis during delivery)
• Macrosomia (larger than average size of the baby)
• Spina Bifida undiagnosed (spinal bones are not fully formed, resulting in unprotected spinal cord. Lack of prenatal diagnosis increases the risk of spinal cord injury at birth.)
• Oligohydramnios (low amniotic fluid volume)
• Primigravida (first-time pregnancy of the mother)

An alert medical provider should be able to identify signs of spinal cord injury at birth immediately during the post-delivery physical examination. But in some cases, the signs of injury may appear after a few days. Signs and symptoms include:

• Abnormal reflexes or lack of reflexes
• Weakness in muscles or paralysis
• Muscle spasms
• Breathing difficulties
• Low APGAR scores
• Baby appears floppy (limp) when picked up
• Lack of movement in some areas of the body
• Lack of sensation in some areas of the body
• Changes in bladder or bowel function
• Curled feet or hands
• Excessive sleepiness
• Excessive drooling
• Feeding difficulties
• High-pitched cries or irritation
• Sensitivity to light
• Seizures
• Slow heart rate
• Low levels of oxygen

• Cervical Spinal Cord Injury: It affects the uppermost part of the spinal cord, located in the neck. It may cause loss of motor function and sensation in most areas of the body (paralysis in both legs and arms, known as quadriplegia).
• Thoracic Spinal Cord Injury: It affects the thoracic area of the spinal cord, which is located in the mid-back. It rarely affects the arms, but the legs and some parts of the torso can be severely affected with this injury.
• Lumbar/Sacral Spinal Cord Injury: It affects the lower part of the spinal cord, generally resulting in paralysis in the lower limbs. Based on this, the injury can disrupt the pathways controlling the bowels and bladder, causing poor control of these functions.

The prognosis of spinal cord injury at birth is poor (which means, the rate of death and long-term disability is high). Therefore, early diagnosis and proper treatment is critical to prevent further neural damage. The medical provider should be familiar and alert to the symptoms of spinal cord injury during delivery and should be able to differentiate the symptoms from neuromuscular diseases, hypoxic-ischemic encephalopathy (HIE), and brachial plexus injury.

When neonatal spinal cord injury is clinically suspected, a full medical evaluation should be conducted and the baby should receive prompt medical care. Apart from review the medical history and conducting a physical examination, the medical provider should order x-rays, CT scans and/or MRIs as well as blood work to confirm the diagnosis.

Although a severe spinal cord injury at birth may cause permanent damage, a range of medical interventions are available to reduce additional damage and optimize body function. These include:

• Immobilization of the spine using special devices
• Corticosteroids
• Surgery
• Physical therapy
• Supportive treatment
• Occupational therapy
• Mechanical ventilation
• Feeding tube insertion
• Bladder catheterization

Some babies with neonatal spinal cord injury may qualify the criteria for therapeutic hypothermia (body cooling therapy). There is growing medical evidence to show that the neuroprotective effects of hypothermia therapy may improve the secondary mechanisms of neonatal spinal cord injury.

According to researchers, considering the potentially dangerous consequences of spinal cord injury in newborns, and the extensive recorded evidence of safe use of therapeutic hypothermia in infants, it is useful to apply moderate whole-body hypothermia therapy as soon as possible after birth for babies with spinal cord injury.

This cooling therapy should be initiated within six hours after the baby’s birth to achieve beneficial effects. If the medical providers miss this crucial time window due to delayed diagnosis or delays in initiating the treatment, the baby may fail to receive the neuroprotective benefits of therapeutic hypothermia.

Parents whose children suffer from spinal cord injury related birth trauma or birth complications want and deserve answers as to the cause of their child’s birth injury and whether mistakes by the doctors and nurses contributed to the injury.

• Were there signs of birth injury or birth complications during the pregnancy, labor, and delivery process, or presence of risk factors, which were either not recognized or properly treated?
• During the labor and delivery, were there clear indications that the baby was suffering from fetal distress, but appropriate actions were not taken by the obstetrician or nurses?
• Was there a delay in diagnosis of the neonatal spinal cord injury that led to later complications, including brain injury?
• Did the medical team fail to order a series of tests to diagnose this birth complication in a timely manner?
• Was the decision to perform a cesarean delivery delayed leading to birth trauma during vaginal delivery or labor?
• Did the neonatal resuscitation team fail to quickly begin important breathing support?
• Should brain cooling (also called “hypothermia therapy”) have been provided to your baby, but the doctors and nurses failed to perform the appropriate tests or ignored the results of the tests?

Our national birth injury attorneys have extensive experience in this and all areas of birth injury medical malpractice. The lawyers and nurses at Miller Weisbrod Olesky will help you determine if mistakes of the medical providers caused a birth injury to your child, including Hypoxic-Ischemic Encephalopathy (HIE) or cerebral palsy.

Our award-winning birth injury attorneys represent families all over the United States in their time of need after a wrongful birth. We use our skills and expertise to obtain for you and your child a medical malpractice settlement that will help provide specialized medical therapy in order to maximize the quality of life and independence of your child throughout their life.

Sometimes families are reluctant to contact a medical malpractice lawyer. It’s also not uncommon for parents to feel overwhelmed by the responsibilities they encounter in caring for their injured child and worried that they will not be able to help out in a lawsuit involving their child’s birth injury. Our birth injury attorneys and nursing staff will address these hesitations and concerns, so you can focus on your child and maximizing their care.

Most 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.

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

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.

Why Should You Talk with the Highly Capable Attorneys at Miller Weisbrod Olesky?

The only way to find out if you have a birth injury case is to talk to a lawyer experienced in birth injury lawsuits. It’s not uncommon that a birth related complication results in a preventable birth injury, including cerebral palsy, but it takes a detailed expert review by a birth injury attorney of the medical records from your child’s birth to determine if the birth injury was the result of medical malpractice.

At Miller Weisbrod Olesky, a team of committed lawyers, nurses and paralegals uses our detailed medical negligence case review process to assess your child’s 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 pregnancy. We call in documented and proven 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 wrongful birth in your case, we meet with you to discuss how you can receive compensation from the medical professionals who made the errors. Our birth injury attorneys have recovered millions of dollars in settlements for families of children that have suffered a birth injury.

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 no matter how long or tough your case is.