Rice & Bloomfield Jan. 15, 2010

This is part two in a series of three relating to birth injuries in Los Angeles County.

Cerebral palsy, or CP, is a term that is used to describe a group of chronic conditions that result from injury to the brain, usually occurring before, during or shortly after birth. It generally affects motor function – how the body moves. Children with cerebral palsy may have mild symptoms affecting coordination or may be completely unable to control motor function, making it impossible to sit or stand independently.

Cerebral palsy can occur when oxygen to the fetus is interrupted during labor or delivery. Monitoring of the baby during labor is done to detect changes in the baby’s heart rate which may signal a problem. If the amount of oxygen the baby is getting is reduced or cut off during labor, the baby’s heart rate will change and its ability to recover from the stress caused by contractions will diminish, signaling a potentially catastrophic injury if appropriate medical intervention is not taken in a timely fashion.

It is the job of the obstetrical nurse to monitor the fetus during labor and communicate any significant changes in the fetal heart rate and tone to the obstetrician in a timely fashion. It is the doctor’s duty to respond promptly if conservative measures (changing the mother’s position, administering oxygen to her, for example) do not improve the fetal heart rate.

If the nurse is unskilled or inattentive, she may not appreciate the fact that the baby is in distress, putting the baby at risk of injury. A doctor who does not respond to a nurse’s concern in a timely fashion also puts the baby at risk. Over time, the lack of oxygen can cause the brain damage that results in cerebral palsy.

Review of the medical records and fetal monitor strip often will reveal whether the doctors and nurses did not respond in an appropriate and timely fashion to evidence that the baby was in distress. Low APGAR scores (less than 3) that persist for more than five minutes; abnormal laboratory results (arterial blood gases with a pH of less than 7.0); neonatal seizures; and multi-organ dysfunction are signs that the injury to the baby more likely than not occurred during labor or delivery.

If the injury to the baby was caused by medical malpractice of doctors or nurses, a lawyer can help the family obtain the resources necessary to provide appropriate care for the child so that she can maximize her full potential. The negligent health care providers should be held accountable; if they are not, it is the taxpayer who will end up paying for the lifetime of services child will need.