Types of Birth Injuries in New York

Cerebral Palsy

What it is: Cerebral palsy is a group of movement disorders caused by brain damage before, during, or shortly after birth. It affects muscle tone, movement, posture, and coordination.

Common Causes of Preventable Cerebral Palsy:

• Oxygen deprivation (hypoxia) - Failure to monitor fetal distress, delayed emergency C-section, umbilical cord complications
• Untreated maternal infections - Infections like chorioamnionitis that spread to the baby
• Jaundice/kernicterus - Failure to treat severe jaundice leading to brain damage
• Trauma during delivery - Excessive force, improper use of forceps or vacuum extractors
• Placental abruption - Failure to respond quickly when placenta detaches

Signs & Symptoms:

Developmental delays, abnormal muscle tone (too stiff or too floppy), difficulty with coordination and movement, speech difficulties, seizures, intellectual disabilities (in some cases).

Legal Considerations:

If cerebral palsy was caused by medical negligence (such as failure to perform timely C-section when fetal distress was evident), families may be entitled to compensation for lifelong medical care, therapy, assistive devices, and pain and suffering.

Erb's Palsy (Brachial Plexus Injury)

What it is: Erb's palsy is nerve damage affecting the shoulder, arm, and hand, caused by stretching or tearing of the brachial plexus nerves during delivery.

Common Causes:

• Shoulder dystocia - Baby's shoulder gets stuck behind the mother's pubic bone
• Excessive pulling during delivery - Using too much force to deliver the baby
• Improper use of forceps or vacuum extractors
• Failure to perform C-section - When vaginal delivery risks are too high (large baby, small pelvis)
• Breech delivery complications

Signs & Symptoms:

Weakness or paralysis of the affected arm, lack of muscle control, impaired reflexes, arm hangs limply or is turned inward, loss of sensation in the arm or hand.

Prognosis & Treatment:

Mild cases may improve with physical therapy. Severe cases may require nerve grafts, muscle transfers, or other surgeries. Some children experience permanent weakness or disability.

Legal Considerations:

If Erb's palsy resulted from excessive force during delivery or failure to perform a C-section when shoulder dystocia was predictable, it may constitute medical malpractice.

Hypoxic-Ischemic Encephalopathy (HIE)

What it is: HIE is brain damage caused by oxygen deprivation (hypoxia) and reduced blood flow (ischemia) to the brain during birth.

Common Causes:

• Prolonged labor - Failure to intervene when labor stalls
• Umbilical cord problems - Cord wrapped around neck (nuchal cord), cord prolapse, compressed cord
• Placental abruption or insufficiency
• Maternal blood pressure issues - Untreated preeclampsia or eclampsia
• Uterine rupture - Especially after previous C-section (VBAC complications)
• Failure to monitor fetal heart rate - Missing signs of fetal distress

Signs & Symptoms:

Seizures within 24-48 hours of birth, low Apgar scores, difficulty breathing, abnormal muscle tone, feeding difficulties, organ dysfunction.

Long-Term Effects:

Cerebral palsy, developmental delays, cognitive impairments, vision or hearing problems, epilepsy, learning disabilities.

Legal Considerations:

If medical staff failed to recognize or respond to signs of fetal distress (abnormal heart rate patterns, late decelerations), delayed emergency C-section, or failed to properly monitor labor, HIE may be the result of medical negligence.

Shoulder Dystocia Injuries

What it is: Shoulder dystocia occurs when the baby's shoulder becomes stuck behind the mother's pubic bone during delivery, preventing the baby from being born.

Risk Factors & Negligence:

• Large baby (macrosomia) - Especially over 9 pounds
• Maternal diabetes - Gestational or pre-existing
• Prolonged labor or pushing stage
• Previous shoulder dystocia
• Failure to recognize risk factors and recommend C-section

Potential Injuries from Mismanaged Shoulder Dystocia:

• Brachial plexus injuries (Erb's palsy, Klumpke's palsy)
• Clavicle fractures
• Oxygen deprivation leading to brain damage or HIE
• Humerus fractures

Proper Management:

Medical staff should be trained in specific maneuvers (McRoberts maneuver, suprapubic pressure, etc.) to safely deliver the baby. Excessive pulling or twisting can cause permanent nerve damage.

Legal Considerations:

If doctors failed to identify risk factors, didn't offer C-section as an option, or used excessive force during delivery, resulting injuries may be grounds for a malpractice claim.

Kernicterus (Severe Jaundice Brain Damage)

What it is: Kernicterus is a type of brain damage caused by extremely high levels of bilirubin (severe jaundice) in newborns.

How It Happens (Negligence):

• Failure to monitor bilirubin levels after birth
• Delayed treatment of jaundice with phototherapy or exchange transfusion
• Dismissing parental concerns about yellowing skin
• Failure to recognize risk factors (blood type incompatibility, premature birth, bruising)

Signs & Symptoms:

Extreme yellowing of skin and eyes, poor feeding, lethargy, high-pitched crying, arching of the back and neck (opisthotonus), seizures.

Long-Term Effects:

Cerebral palsy (especially athetoid type), hearing loss, vision problems, dental enamel defects, intellectual disabilities.

Prevention:

Kernicterus is almost always preventable with proper monitoring and timely treatment. All newborns should be screened for jaundice before discharge.

Legal Considerations:

If kernicterus developed due to failure to monitor, diagnose, or treat jaundice, it is a clear case of medical negligence.

Fetal Stroke & Brain Bleeding

What it is: Bleeding in the brain (intracranial hemorrhage) or blood clots blocking blood flow to the brain (ischemic stroke) during pregnancy or delivery.

Common Causes:

• Trauma during delivery - Excessive force, forceps/vacuum injuries
• Uncontrolled maternal blood pressure - Preeclampsia, eclampsia
• Blood clotting disorders - Failure to diagnose or treat
• Prolonged oxygen deprivation
• Premature rupture of membranes with infection

Signs & Symptoms:

Seizures in the first days of life, abnormal muscle tone, developmental delays, weakness on one side of the body (hemiparesis).

Long-Term Effects:

Cerebral palsy, developmental delays, learning disabilities, speech problems, vision problems, epilepsy.

Legal Considerations:

If brain bleeding resulted from improper use of delivery instruments, failure to monitor maternal conditions, or birth trauma, families may have a medical malpractice claim.

Facial Nerve Injuries (Facial Palsy)

What it is: Damage to the facial nerve during delivery, causing weakness or paralysis on one side of the baby's face.

Common Causes:

• Pressure on the face during delivery
• Improper use of forceps
• Prolonged pressure against the mother's pelvis

Signs & Symptoms:

Asymmetry when baby cries (one side of face doesn't move), difficulty closing one eye, drooping mouth on one side.

Prognosis:

Most cases resolve within a few weeks to months. Severe cases may require surgery (nerve grafts) or result in permanent facial weakness.

Legal Considerations:

While some facial nerve injuries are unavoidable, those caused by excessive force or improper use of delivery instruments may constitute negligence.

Cephalohematoma & Subgaleal Hemorrhage

What it is: Bleeding under the scalp caused by trauma during delivery.

Types:

• Cephalohematoma: Blood collection between skull bone and periosteum (usually mild, resolves on its own)
• Subgaleal hemorrhage: Blood collection under the scalp covering (can be life-threatening, requires emergency treatment)

Common Causes:

• Vacuum extractor use - Especially with multiple attempts or prolonged use
• Forceps delivery
• Difficult or prolonged labor

Signs & Symptoms:

Swelling on baby's head, soft bulge that increases in size, pale skin, low blood pressure, rapid heart rate (in severe cases).

Legal Considerations:

If subgaleal hemorrhage resulted from excessive or improper use of vacuum extractors, failure to recognize complications, or delayed treatment, it may constitute medical malpractice.

Bone Fractures (Clavicle, Skull, Long Bones)

What it is: Broken bones during delivery, most commonly the clavicle (collarbone).

Common Causes:

• Shoulder dystocia - Clavicle may be intentionally broken to free baby (acceptable in emergency)
• Excessive force during delivery
• Improper use of forceps
• Breech delivery - Fractures to arms or legs

Signs & Symptoms:

Baby doesn't move affected arm, cries when arm is moved, visible deformity, swelling or bruising over fracture site.

Prognosis:

Most clavicle fractures heal completely within 2-3 weeks with no long-term effects. Skull fractures and long bone fractures may require more intensive treatment.

Legal Considerations:

While some fractures are unavoidable emergencies (breaking clavicle to save baby's life), those caused by excessive force or failure to perform timely C-section may be negligence.