Establishing the cause of a baby's brain injury
Since my practice focuses upon birth injury cases, most of my clients come to me with questions about what happened to their baby, and whether it could, or should, have been prevented.
The first step is always identifying the mechanism of injury? Was it distress during labor that resulted in hypoxic ischemic encephalopathy (HIE), which means brain damage due to inadequate oxygen, or was it one of a number of other unpreventable causes such as a genetic abnormality?
The next question is when did the injury occur? Did a hypoxic event occur silently, and without any telltale signs or other symptoms, days or weeks before labor began, under circumstances that no one could have prevented? Or, did it occur at the hospital, with an electronic fetal heart monitor in place producing a tracing that should have alerted the healthcare providers of impending harm?
The obstetrical and pediatric organizations have reached a consensus on the criteria that must be present in order for cerebral palsy to be blamed on hypoxia around the time of birth. Those criteria include such factors as the pH of the baby's blood at birth, the presence of certain neurological signs or symptoms, as well as the specific type of cerebral palsy involved.
Neuroimaging often can be used to establish the timing of a hypoxic event, based on factors such as the onset of swelling. This requires the services of a very skilled and experienced neuroradiologist who can also determine whether the injury resulted from total, or intermittent hypoxia. There are often issues that require the expertise of placental pathologists, neonatologists and pediatric neurologists as well.
The next step is to determine whether the injury could have been prevented. To investigate this issue, it is usually necessary to involve maternal-fetal specialists or obstetricians who can interpret fetal heart monitor tracings and address the issue of when intervention should have occurred.
Birth injury cases are complicated. If you retain an attorney to investigate the cause of your child's cerebral palsy, make sure to retain one with extensive expertise and an established track record in this area.