What Is An Umbilical Cord Gas?
After birth, babies receive oxygen into their system through breathing in and carbon dioxide out of their system by breathing out. But during pregnancy, babies are surrounded by amniotic fluid so they cannot “breath” using their lungs.
Instead prior to birth, the baby receives all of its oxygen from blood flowing from through the vein of umbilical cord. The carbon dioxide is eliminated by the baby when it is returned through the umbilical arteries of the cord to the placenta. An analysis of an umbilical arterial cord blood sample immediately after birth can determine if the baby suffered fetal hypoxia, birth asphyxia or hypoxic-ischemic encephalopathy (HIE), which can lead to cerebral palsy. This testing is called “Blood Gas” testing.
Medical providers should draw this arterial blood gas sample immediately after the baby is born because it can help them objectively determine the metabolic condition (whether they are “acidotic” due to lack of oxygen) of the baby at the time of delivery.
In simple terms, blood gas can help establish whether the baby experienced significant oxygen deprivation around the time of birth, which can cause a birth injury such as birth asphyxia or HIE.
Research studies have shown that umbilical cord blood analysis in conjunction with other measurements, such as non-reassuring fetal heart rate readings, low APGAR scores and MRI imaging can be used to determine if the baby has suffered brain damage (HIE). This information is critical to determine when medical treatment (such as hypothermia/cooling) needs to be started to prevent or lessen brain damage.
What does Blood Gas Testing actually Test?
pH Testing
pH is an indicator of the acidity level in the baby’s blood. An abnormally low pH value means the baby’s blood is more acidic. This indicates that the concentration of carbon dioxide in the baby’s blood (pCO2) was high at the time of birth. When the arterial cord pH value is found to be low, it has a strong correlation with the occurrence of fetal hypoxia during the birthing process, which may have resulted in hypoxic-ischemic encephalopathy (HIE).
Base Excess/Base Deficit
When the base excess (BE) in the arterial cord blood is negative, it is termed as base deficit (BD). BD indicates the amount of base that should be added to restore a normal pH value. The higher the base deficit, the higher is the metabolic concentration which caused a low pH value. A higher BD (lower base excess) is an indicator of more severe fetal acidosis. Severe fetal acidosis causes acute oxygen deprivation, which increases the risk of hypoxic-ischemic encephalopathy (HIE) and consequently cerebral palsy.
PO2 and PCO2
PO2 or partial pressure of oxygen is a measure of oxygen within arterial cord blood. An abnormally low level of PO2 indicates that the baby is not receiving sufficient oxygen. PCO2 or partial pressure of carbon dioxide is a measure of the saturation level of carbon dioxide within arterial cord blood. A higher level of PCO2 is a marker of increased hydrogen ion concentration and a progression to fetal acidosis along with an accumulation of lactic acid.
What are Abnormal Arterial Cord Blood Gas Results?
Normal pH results on blood gas testing are 7.18-7.38. Anything lower shows the baby likely suffered fetal distress that caused the blood to become more acidic.
- PCO2: A Normal result is typically around 3. Results in excess of 30 are considered high
- P02: A Normal result on blood gas testing is between 5.6 and 30. An abnormal result is lower than 5.6
- Base Excess: A Normal result is anywhere -8 to 0. Anything lower than -8 shows that the baby was acidic prior to birth
Fetal Hypoxia and Metabolic Acidosis
Cord blood gas test results are valuable in birth injury cases because they provide measurable objective evidence of birth asphyxia. Researchers have shown that correctly drawn and interpreted blood gas tests are usually more reliable compared to the APGAR score and other routine clinical assessments. This is because APGAR scores are dependent upon the doctors and nurses who may not assess the baby correctly or “over call” the APGAR in an effort to excuse their malpractice.
Birth asphyxia occurs when the baby is severely deprived of oxygen for a prolonged time period, which leads to fetal acidosis. When the baby’s tissue cells are significantly depleted of oxygen, the accumulation of metabolic acids in the bloodstream (primarily lactic acid) causes the pH levels to fall.
Therefore, cord blood metabolic acidosis indicated by abnormally low pH level and reduced base excess shows that at some point during labor or delivery the fetal tissue oxygenation was significantly compromised. Medical providers should also note the difference between cord blood respiratory acidosis and cord blood metabolic acidosis.
Respiratory acidosis is characterized by a lower pH level but a normal level of base excess. When respiratory acidosis alone is detected at birth (not accompanied by metabolic acidosis), it also indicates impairment of gas exchange and the resulting oxygen deprivation for the baby. But the duration and severity is relatively low and may not lead to metabolic acidosis.
Cord Blood Metabolic Acidosis and HIE
Researchers commonly define severe fetal acidosis as cord arterial blood pH below 7.0 and base excess below -12.0 mmol/L. This degree of metabolic acidosis is associated with a heightened risk of hypoxic-ischemic encephalopathy (HIE), which can lead to cerebral palsy. HIE reflects neurological dysfunction with symptoms in babies including poor feeding, hypotonia (low level of muscle tone), seizures, respiratory problems, and developmental delays.
Babies with moderate or severe HIE often have permanent and severe neurological disabilities, such as cerebral palsy. At present, hypothermia (controlled brain cooling therapy of the baby) is the only effective treatment for HIE. Efficacy of this treatment will depend on initiating hypothermia within six hours of birth.
The presence of significant metabolic acidosis (pH <7.0 and or base excess <-12.0 mmol/L) are two of key indicators for medical providers to initiate hypothermic treatment. Research has shown that hypothermia can either prevent the occurrence of cerebral palsy, or at least reduce the severity of cerebral palsy in many cases.
Why Would a Follow-up Blood Gas Result Get Worse?
Many babies are born with a need for neonatal resuscitation due to inadequate breathing, meconium aspiration or as a respiratory birth complication caused by fetal distress. When this occurs it immediate neonatal resuscitation is the standard of care. If the doctors delay in providing neonatal resuscitation or fail to have a neonatology team present, a baby’s hypoxia and acidosis may worsen.
A powerful indicator that medical malpractice occurring after birth caused a birth injury like HIE is when a follow up blood gas tests results in worsening values like the pH or Base Excess.
Worsening blood gas results may also be seen if doctors and nurses fail to respond to common birth complications like jaundice, kernicterus and neonatal hypoglycemia.
Collecting an Umbilical Cord Blood Gas Sample
To draw the umbilical cord blood for gas and acid-base status after birth, the following three steps are generally performed:
- 1. Clamp a segment of the umbilical cord
- 2. Remove the cord segment which is clamped
- 3. Use needle aspiration to draw two blood specimens (one arterial and one venous) from the removed clamped segment into syringes
The timing of obtaining the sample for analysis is critically important. Right after birth, ideally before the first breath of the baby, a cord segment (about 20 cm) should be isolated using two clamps. A clamping delay of as little as 45 seconds can materially change the acid-base status, rendering the results unreliable. The greater the delay, the more unreliable will be the measurements.
According to the Clinical and Laboratory Standards Institute (CLSI) recommendations, the arterial cord blood samples should be analyzed in less than 30 minutes after collection. Since the veins and arteries in the umbilical cord are closely located, the medical team can sometimes mistakenly sample venous blood while assuming it to be arterial blood.
For this reason, experts recommend that blood specimens should be obtained from both the cord vein and artery for analysis to ensure that arterial blood test results can be conclusively validated as arterial.
Well-founded studies have found that errors in collecting the cord blood gas sample can cause invalid results in 20% of blood gas results. Therefore, in a birth injury lawsuit the blood gas results must be carefully evaluated by an experienced birth injury attorney. We have seen many cases with “normal” blood gas results, but clear evidence that fetal distress and hypoxia occurred during the labor and delivery period.
Factors Interfering with Cord Blood Gas Values
Delay in Sampling
A delay in drawing blood gas samples (over 20 minutes from an unclamped umbilical cord segment and over 60 minutes from a clamped segment) will result in unreliable test results and distorted values of pH, pO2 and pCO2. Similarly, a delay in the interpretation of test results also makes the readings of pH, pO2 and pCO2 unreliable.
Delay in Cord Clamping
If the clamping of the umbilical cord is delayed, it can alter the entire blood gas analysis. Samples should be obtained from the unclamped cord soon after birth in order to determine the most accurate measurements. But a delay in cord clamping after delivery will also lower the reliability of test results.
Additional Factors
Factors such as fetal presentation and the mode of delivery may also impact the cord blood gas values. In a vaginal delivery, the metabolic stress is higher because of uterine contractions, so the cord pH values may be slightly lower. In a planned cesarean section without labor, the cord pH values will be relatively higher. Similarly, a baby born with a breech (feet-first) presentation will have lower umbilical cord pH value compared to a baby with cephalic (head-first) presentation.
The differences between arterial and venous cord gas values may also be indicative of the nature or timing of birth asphyxia. But cord compression, as seen with prolapsed umbilical cord and nuchal cord, may lead to significant arteriovenous (AV) differences. Similarly, small clots in the cord blood may also interfere with blood gas sample analysis.
American Obstetricians Guidelines For Blood Gas Testing
According to the American College of Obstetricians and Gynecologists (ACOG) guidelines, umbilical cord blood gas testing should be performed only in selective cases, and not for all births. ACOG recommends testing in the following cases:
- Cesarean section due to fetal complications
- Low APGAR score
- Non-reassuring fetal heart rate readings
- Severe IUGR (intrauterine growth restriction)
- Intrapartum fever
- Maternal thyroid disease
- Multiple pregnancy
In contrast to the ACOG guidelines, the Society of Obstetricians and Gynecologists of Canada (SOGC) recommends that umbilical cord blood analysis should be performed for all births. Researchers have also indicated that there is merit in performing cord blood analysis as a routine/standard procedure for all births.
The issue becomes if the doctors and nurses miss critical signs of fetal distress or birth complications, not running the Blood Gas testing eliminates critical information needed to help in providing immediate treatment of birth injuries including hypothermia or cooling therapy.
Benefits of Umbilical Cord Blood Gas Testing on all Babies
- All babies with birth injury will have a record of cord blood pH value
- Results can be helpful in planning newborn care in case of unforeseen post-birth complications
- When the cord-blood sampling process becomes routine, the risk of forgetting or delaying the sample collection in emergencies gets reduced
- Medical teams acquire higher accuracy and precision in sample collection
- The collected data provides the medical teams with educative value and useful insights into the interpretation of fetal heart rate monitoring for more strategic medical interventions
Is Your Child’s Birth Injury the Result of Medical Malpractice?
Parents whose children suffer from birth injuries or birth complications want and deserve answers as to cause of their child’s injury and whether mistakes by the doctors and nurses contributed to the injury.
- Were there signs of a birth injury during the pregnancy, labor, and delivery process, or presence of risk factors, which were either not recognized or properly treated?
- Did the medical team fail to order important blood gas tests to diagnose a suspected birth injury such as fetal hypoxia in a timely manner?
- During the labor and delivery, were there clear indications that their baby was suffering from fetal distress, but appropriate actions were not taken by the obstetrician or nurses?
- Did the neonatal resuscitation team delay in providing important breathing support after birth?
- Were serious neonatal conditions like hypoglycemia or jaundice missed or treated incorrectly?
- Should brain cooling (also called “hypothermia therapy”) have been offered to your baby, but the doctors and nurses failed to perform the appropriate tests or ignored the results of the tests?
The seasoned and rigorous birth injury lawyers at Miller Weisbrod Olesky, who have been through the legal battlefields before, 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 polished and dependable birth injury attorneys have represented families all over the United States in their time of need after a birth injury. We use our experience and expertise to obtain you and your child a medical malpractice settlement that will help provide specialized medical therapy like speech 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.
Registered Nurses and Nurse-Attorneys Are a Vital Part of Our Birth Injury Team…and Yours
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.
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.
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 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, 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. 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.
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