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Birth Injury Cases and Resources

Cerebral Palsy in Twins: What Are My Rights?

Cerebral Palsy in Twins: What Are My Rights?

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Cerebral palsy is a debilitating condition that can happen at birth and is more common with twins or multiple births. Learn about compensation that may be available to your family under Florida law…

Having a child with cerebral palsy can be extremely challenging for any parent.

Having multiple children with cerebral palsy means even greater difficulties and demands.

While that might seem like a rare and extraordinary circumstance, cerebral palsy is actually more common in twins than in single-birth pregnancies. In fact, multiple gestation (giving birth to twins, triplets, quadruplets, etc.) is one of the leading risk factors for cerebral palsy.

As parents, it is important to understand what causes cerebral palsy in twins, the steps your doctors should take to avoid the development of cerebral palsy, and your rights under Florida law after this devastating diagnosis.

What Is Cerebral Palsy?

While most people (including doctors) tend to talk about cerebral palsy as if it were a singular condition, it is in fact an umbrella term that is used to describe a wide range of neurological deficits, injuries, or abnormalities affecting infants at birth. The CDC defines cerebral palsy as “a group of disorders that affect a person’s ability to move and maintain balance and posture.”

Cerebral palsy is the single most common motor disability in children, including singletons, twins, and multiples. 

Facts About Cerebral Palsy in Twins

In twins, the risk of developing cerebral palsy is more than four times greater than in singletons.

Cerebral palsy affects roughly 0.2% of singleton births, 0.85% of twin births, and up to 4% of triplet births. These percentages are significant and alarming because the number of twin births in the United States is currently on the rise, thanks in part to the increasing popularity of fertility treatments.

A 2002 study found that, “Among twins, if one twin suffers a fetal death or dies in infancy, the prevalence of cerebral palsy in the surviving co-twin is considerably increased, and those from like-sex pairs are particularly at high risk.”

Likewise, there is some evidence to suggest that if one twin weighs significantly more than the other (a weight difference of at least 20%), the risk of cerebral palsy is increased for both twins.

Boy twins are more likely than girls to suffer from cerebral palsy.

In about 90% of cases, only one twin develops cerebral palsy. If both (or multiple) infants are affected, they tend to exhibit the same type of disorder with similar symptoms and levels of severity.

Causes of Cerebral Palsy in Twins

The single greatest risk factor for cerebral palsy is premature birth, which happens to be much more common in twins and multiple pregnancies.

Some causes of cerebral palsy in twins are believed to develop during pregnancy, including:

• Maternal iodine deficiency

• Maternal epilepsy / seizures

• Maternal thyroid issues

• Methylmercury exposure during pregnancy

• Gestational diabetes

• Preeclampsia / eclampsia

• Fetal macrosomia

• Problems with maternal blood pressure or circulation

• Anything that poses a risk of hypoxia

Alternatively, cerebral palsy may be caused by complications during labor and delivery, many of which are more likely when giving birth to twins:

• Prolonged labor / difficult labor

• Shoulder dystocia

• Abnormal position of fetus

• Anything that interrupts the supply of oxygen-rich blood to the baby’s brain (see hypoxic-ischemic encephalopathy[1] )

In rare cases, a newborn can develop cerebral palsy after birth, within the first year of life. Causes include:

• Trauma to the head

• Dangerous infections such as meningitis or septicemia

• Other causes of infant brain damage

What Are My Rights After a Cerebral Palsy Diagnosis for My Twins?

Even in singleton births, doctors have a duty to monitor mother and child closely for any conditions that might make labor, pregnancy, or delivery more difficult or dangerous. This includes the duty to monitor for cerebral palsy risk factors and take appropriate action.

When a mother is pregnant with twins, triplets, quadruplets, or other multiples, doctors are expected to recognize the heightened risk of cerebral palsy and provide diligent medical care to reduce the risk as much as possible.

Many cases of cerebral palsy in twins are the result of medical malpractice. If one or more of your children has been diagnosed with cerebral palsy, you may be entitled to compensation for your family’s pain and suffering and the years of exorbitant medical expenses that are likely to follow. The Miami birth injury lawyers at Kaire & Heffernan, LLC can help.

You Don’t Pay Unless We Get You Money. Schedule a Free Consultation Today.

Kaire & Heffernan, LLC is a Miami personal injury and medical malpractice law firm with years of experience in helping Florida families claim the justice they deserve.

Our Miami birth injury lawyers are here to help you understand your rights and options under Florida law. While we are based in Miami, we provide our services to families throughout the state. If you can’t come to us, we can come to you.

Our law firm will not charge you an attorney’s fee unless and until we recover compensation in your case, and the initial no-obligation consultation is absolutely free.

To learn more, contact Kaire & Heffernan, LLC and ask about scheduling a free consultation today.

Add link to April 2019 blog article: “What is hypoxic-ischemic encephalopathy?”

What Is Hypoxic Ischemic Encephalopathy (HIE)?

What Is Hypoxic Ischemic Encephalopathy (HIE)?

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Understanding HIE, How it Happens, and Your Rights After an Infant Brain Injury

Hypoxic Ischemic Encephalopathy (HIE) is a serious brain injury that can occur in newborn babies during labor and delivery. It is caused by an interruption to the brain’s supply of oxygen and blood.

HIE is a medical emergency, and doctors must be prepared to perform life-saving intervention at a moment’s notice. HIE can cause lifelong disabilities for the newborn, including cerebral palsy. Some cases are fatal. 

Hypoxic ischemic encephalopathy is considered a birth injury. Many cases are preventable through diligent medical care. Doctors, hospitals, and other health care providers may be liable for failure to prevent, diagnose, or treat HIE during pregnancy, labor, and delivery.

What Is Hypoxic Ischemic Encephalopathy (HIE)? How Does It Affect the Brain?

Hypoxic ischemic encephalopathy develops in one of two ways:

• The brains loses its blood supply.

• There is adequate blood flow to the brain but not enough oxygen in the blood.

HIE typically happens during the perinatal period (just before, during, or just after delivery). Even a momentary interruption in the brain’s blood supply can cause injury to otherwise healthy cells, which begin to die off rapidly.

Even once oxygen-rich blood supply is restored, the baby’s brain may still be susceptible to further injury. As healthy blood enters damaged cells, they release dangerous toxins, a phenomenon known as ischemia-reperfusion injury (IRI) or reoxygenation injury.

The underlying causes of HIE can also lead to damage in other organs if they do not get enough oxygen-rich blood.  

HIE is the leading cause of infant fatality in the United States, as well as the leading cause of serious disability in newborns. It occurs in approximately 2% of all live births in the U.S., and in 60% of premature births. 

HIE Symptoms

Symptoms of hypoxic-ischemic encephalopathy in newborns include:

• Slow pulse (or, alternatively, no detectable heart rate)

• Acidosis (a buildup of acid in the blood)

• Slow or irregular breathing (or, alternatively, no detectable respiration)

• Meconium stain (infant fecal stain) in the mother’s amniotic fluid

• Poor muscle tone (a “floppy” or weak appearance)

• Blue or pale skin color

• Absent or depressed reflexes

• Seizures

• Reduced consciousness

• Feeding problems

• A low Apgar score (less than three, lasting longer than five minutes)

HIE Causes

The causes of hypoxic ischemic encephalopathy (HIE) depend on the stage of childbirth at which it develops.

Causes that develop at the very end of pregnancy but before delivery (antepartum causes of HIE) include:

• Preeclampsia / eclampsia

• Alcohol or drug abuse

• Gestational diabetes

• Infections

• Fetal deformities affecting vital organs

• Fetal macrosomia 

• Maternal blood clotting disorders

• Maternal vascular disease

• Cardiac problems, poor circulation to the placenta, or anything else that might keep the baby from receiving oxygenated blood while still in the womb

Causes that develop during delivery (intrapartum causes of HIE) include:

        • Placental abruption

• Placental blood clots

• Placental insufficiency

• Low maternal blood pressure

• Uterine rupture

• Umbilical cord compression

• Prolapsed umbilical cord

• Prolonged labor or other difficulties with delivery (e.g. abnormal positioning of fetus, shoulder dystocia, etc.)

Causes that develop soon after delivery (postpartum causes of HIE) include:

• Fetal heart disease

• Fetal pulmonary disease

• Low blood pressure in the newborn

• Trauma during delivery

• Dropped baby / other physical trauma

• Meningitis

• Any close call with SIDS

These are only some of the most common causes of hypoxic-ischemic encephalopathy. There are others. Every situation is different.

It is critical that doctors have an in-depth understanding of HIE beginning early in pregnancy so that they monitor the mother and baby and treat any emerging problems, such as preeclampsia or gestational diabetes, as soon as possible. With careful medical treatment, many cases of hypoxic-ischemic encephalopathy can be prevented.

You Don’t Pay Unless We Get You Money. Schedule a Free Consultation Today.

If your child has suffered injury or death as a result of hypoxic-ischemic encephalopathy, we encourage you to call our office and talk about your options.

The Miami birth injury attorneys at Kaire & Heffernan, LLC have extensive experience in helping families hold negligent health care providers accountable across the state of Florida.

We will not charge you for our services unless and until we recover compensation in your case, and the initial no-obligation consultation is absolutely free.

Schedule a free consultation with the Miami birth injury attorneys at Kaire & Heffernan, LLC today.

Florida Hospitals: Top Three Birth Injuries

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Having a baby can be the most beautiful, exciting, magical time in your life. However, it may also be the most worrisome time of your life as well. As a new parent, you do everything in your power to make sure your newborn comes into the world as healthy and happy as possible.

How much of this is in your control and how much do you have to leave in the hands of the doctors, nurses and hospital you choose? Sadly, birth injuries are more common than you would think both in Florida and throughout the nation.

Three Most Common Types of Birth Injuries

In Florida, there are three birthing injuries that are most commonly seen, due to negligence of medical staff, the hospital or sometimes both. Among these three are cerebral palsy, erb’s palsy, and hypoxia.

  1. Cerebral palsy can be caused by any injury that cuts off the infant’s oxygen. If these injuries occur at birth or during birth, it could be a result of medical malpractice. This lack of oxygen can lead to seizures, poor bladder control, poor motor skills and breathing issues. All of these have the possibility of resulting in this permanent disability.
  2. Erb’s palsy can occur when the infant’s brachial plexus nerve (located by the shoulder) is damaged. This nerve is responsible for sensation and movement in the arms and injury to this nerve can not only cause loss of muscle control but can lead to permanent upper body paralysis.
  3. Hypoxia can occur when there is not enough oxygen going to the brain and can have traumatic, long term effects on your baby’s life. Hypoxia can lead to seizures, a coma, and sometimes even death.

How Common Is Common?

According to the Center for Disease Control and Prevention, there are four million babies born in the United States each year. Of every thousand babies born, six to eight of them are born with a birth injury. This means of those four million babies born every year, an average of twenty eight thousand are born with birth injuries, often caused by negligence of medical staff.

In a National Healthcare Quality Report, it was found that nearly one hundred and fifty seven thousand birth injuries (to either the baby or the mother) could have been avoided.

If you believe you or your baby have suffered from a birth injury due to negligence, schedule a free consultation with the lawyers at Kaire & Heffernan today.

 

Samantha Heffernan

TV Producer Dies From Infection After Childbirth

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Sara Porter had it all.  She was a successful TV producer, and had just given birth to her 3rd child.  Sadly,  what was to be one of the happiest moments of her life turned into a tragedy.

Following the birth of her 3rd child Sara Porter experienced something unlike her previous two deliveries.   She was vomiting and had stomach pain which eventually spread to her back. It wasn’t until her organs began to malfunction that a uterine bacterial infection was found. Sara’s heart stopped,  just five days after delivering her baby son Jonas.

Sepsis is a complication caused by the body’s overwhelming and life-threatening response to infection, which can lead to tissue damage, organ failure, and death. It is difficult to predict, diagnose, and treat.

Gram-negative bacterial infections are particularly associated with the urinary tract. Acute pyelonephritis should be treated aggressively.Although not all women may warrant hospital admission, those with signs of sepsis, those who are unable to remain hydrated and those who are vomiting should be admitted.

Definitive diagnosis of sepsis depends on a positive blood culture for an infectious agent and at least two of the criteria. However, other helpful tests depend on lab analysis such as white blood cell examinations, procalcitonin levels, and PaCO2. These tests, like blood cultures, are measured in clinical laboratories.

Identification of urinary sepsis is primarily clinical but the presence of leucocytes, protein and blood in a mid- stream specimen of urine may be suggestive of current infection and a specimen should be sent for culture.

According to The Sepsis Alliance detecting an infection in women post childbirth is challenging. Many of the symptoms associated with this are synonymous with symptoms that would normally occur post-delivery; rapid heartbeat, changes in blood pressure, dizziness and frequency to urinate.  However, in this case, Sara was vomiting and had belly pain.  These are signs and symptoms of a UTI, and medical professionals must always try to rule out or diagnose the WORST FIRST.
Dr. Andy W. Wong reported that 94% of postpartum infections are diagnosed after women are discharged from the hospital. Porter’s husband insisted his wife not be discharged from the hospital based on her symptoms, yet her infection still was not diagnosed in time.
Our deepest thoughts and condolences go out to her husband Dominic, and her three young boys Mateo, Luca, and Jonas.

Common Types of Florida Birth Injury

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Miami birth injuryPregnancy is a special, magical time for expectant parents. Months of planning, preparing, trips to the doctor’s office, anxiety, expectation, and joy all culminate in the big day. It’s a momentous occasion for anyone, and it should be one of the happiest days in our lives.

Unfortunately, childbirth doesn’t always go smoothly. Every year, parents face the terrible reality of a birth injury — pain or trauma inflicted on a newborn during or just after pregnancy, often resulting in long-term disability or occasionally even death.

Birth injury is almost always caused by a doctor or nurse’s negligence. Modern medical science has made it possible for nearly all parents to expect a safe and successful delivery for their children, but when medical professionals fail to exercise proper care, the impact can be devastating.

Most Common Types of Birth Injury

Birth injuries occur across a wide medical spectrum. Some are self-limiting and relatively mild. Many others are painful and potentially permanent. Regardless of the extent of injuries, parents and their children may be entitled to significant financial compensation for their suffering.

The most common types of birth injury in Miami include:

Doctors and nurses may be liable either for their actions or for a failure to take action. This may include failure to properly diagnose, treat, or prevent a medical condition (such as preeclampsia) before it develops into a more serious problem. Kaire & Heffernan, LLC can help you determine potential liability in your own case.

Learn More About Birth Injuries

At Kaire & Heffernan LLC, we understand how terrifying the prospect of a Miami birth injury can be. That’s why we’ve dedicated a portion of our practice to helping parents deal with the consequences of professional negligence. Drawing on our experience in personal injury and medical malpractice, we’ve cultivated extensive experience in handling these unique and very demanding cases.

If you’d like to learn more, please feel free to get in touch with our attorneys right away. We’re happy to offer free consultations to discuss the potential for your claim, and if we do accept your case, we won’t charge for our services unless and until there is a successful outcome in your case. Contact us today.

Florida’s Neurological Injury Compensation Association (NICA): Pricing Competence

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florida nica birth injuryThe birth of a child is the greatest joy for parents.  However, sometimes, bad outcomes occur during the birth process, and a child will be born with a neurological injury.  The injury may be malpractice based upon the choices or conduct of the medical professionals attending to the birth. In Florida, most neurological birth injury cases are governed by NICA.   The Neurological Injury Compensation Association (NICA) was established in 1988 by the Florida legislature, and it can help your child receive much needed medical care.  However, the plan DOES NOT allow for the recovery of compensatory damages, i.e. pain and suffering, loss of enjoyment of life, etc.

NICA’s Function

NICA was established to administer the state’s Birth-Related Neurological Injury Compensation Plan, which provides no-fault coverage to parents of children who have sustained neurological injuries. There are strict requirements that must be met before a NICA claim will be approved, and if your claim is denied by NICA, your remedy is to bring a standard medical malpractice suit in civil court.   Yes, a standard medical malpractice suit is more expensive and time consuming, but a malpractice suit does allow for recovery of compensatory damages.

There are eleven requirements your case must meet for your NICA claim to be granted. Very little variation is permissible. They are:

  • The injury must be neurological;
  • It must have occurred at birth;
  • It must be due to oxygen deprivation or ‘mechanical injury’;
  • The injury must be a substantial physical and/or mental impairment (impairment is defined elsewhere in Florida law);
  • The child must be born alive, in a hospital where the alleged injury took place;
  • The injury must not be due to any genetic abnormality or congenital problem;
  • The child must weigh at least 2500 grams (2000 if not a single birth);
  • The health care providers must be participating in the plan – that is, the hospital and doctor must be part of NICA;
  • The patient (or their representative, if appropriate) must consent to treatment under NICA;
  • The child must be younger than five years old at the time of the claim; and
  • There must be no bad faith or malice – for example, a parent cannot make a claim to NICA solely to make a doctor appear incompetent or allege misconduct that never occurred.

It is important to keep in mind that neurological injury is a very strict term – it applies only to an injury to the brain or spine. Even if another type of injury later results in brain trauma or damage, such as a brachial plexus injury, shoulder dystocia, or a cephalohematoma, it is not an acceptable claim to bring under NICA because the injury itself was not to the brain or spine, even if it later caused one.

How NICA Judges Claims

If a claim is deemed acceptable to bring under NICA, two major factors will change. Firstly, the claim must now be judged not by a civil court or jury, but by an administrative law judge. Secondly, the maximum amount recoverable is $100,000, as per Florida statute – there may be a later benefit of up to $10,000, but the NICP cannot be tapped for more than that.

It is thus important to make certain that your case belongs under NICA.  Alternatively, medical malpractice cases in Florida can be quite substantial. While NICA is a more certain option, a civil jury verdict will usually result in a larger award.  However, it is important to remember that in a medical malpractice claim, the Plaintiff must prove that the treatment rendered fell below the standard of care, that is not a requirement under NICA

Contact A Personal Injury Attorney

If you or a loved one has a child who has possibly suffered birth injury, we can help. The firm of Kaire & Heffernan, LLC is staffed with experts, and we will put our knowledge to work for you. Contact our Miami office today for a free consultation.

 

Photo Credit: Steve Corey cc

What is NICA?

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NICA is an acronym that stands for Florida’s birth-related “Neurological Injury Compensation Association.” Section 766.303 of the Florida Statutes establishes NICA as a statutory organization that manages a state fund created to pay the expenses of babies who were born with certain types of neurological injuries. The program is available to families throughout Florida, and parents or guardians do not have to file a lawsuit or go to court to obtain compensation for their child’s injuries. NICA claims to ensure that neurologically-injured babies receive the medical care they need and to reduce the financial burden on health care providers and families. However, it is questionable whether NICA has met its objectives.

What is Wrong with NICA?

While the information that NICA provides on its website makes the program appear to be a very good thing, you should consider some of the important limitations on this program that are presented below.

  • NICA will not pay for what might otherwise be covered by insurance or any similar private or governmental programs. Many severely injured Florida children are either covered by insurance or programs such as Children’s Medical Services or Medicaid, so there may be many conditions or treatments that NICA does not cover.
  • NICA will only pay for care that it determines to be “medically necessary.” This limitation means that families may have disputes with NICA about the care that the injured child needs.
  • By receiving care from a doctor that participates in NICA, a family gives up its right to file a malpractice lawsuit against a medical professional whose negligence may have caused a child’s neurological injuries.
  • By applying for compensation from NICA and giving up the right to file a medical malpractice lawsuit, a family may give up its claim to damages that can be in the millions of dollars for children who suffer catastrophic neurological injuries. The types of damages that a family may forgo by obtaining compensation from NICA include the following:
    • Disfigurement;
    • Loss of enjoyment of life;
    • Mental anguish; and
    • Pain and suffering.
    • Past and Future Medical care

Seeking Compensation from NICA for Birth Neurological Injuries?

The decision to file a claim with NICA or file a malpractice lawsuit to seek compensation for your child is a complex choice that involves many considerations. It is not possible for a single webpage about this topic to give you enough information to make that decision.

Contact a Miami Attorney Today

If your child suffered a birth-related neurological injury, please obtain appropriate medical treatment for your child immediately. Additionally, please contact us for a consultation. You can call us at 305-372-0123 (local) or 866-769-0123 (toll-free) or contact us online or to arrange your confidential consultation, free of charge. You can tell us about your experience and your child’s injuries, and you will also learn how a court deciding a lawsuit on behalf of your child may handle your case and the kinds of outcomes you can expect from filing a claim for compensation with NICA.