Failure to Monitor Risk Signs
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Birth injuries can result from damage inflicted on the infant’s body before, during, or after birth. Injuries can range from minor bruises and skin irritations to severe damage to the brain that may result in the death of the infant. Specific causes of birth injury include: Failure to monitor or respond to fetal distress during pregnancy, labor, or delivery; failure to have emergency protocols in place in the event that a C-section is required to rescue a fetus in distress; misdiagnosis of, or failure to diagnose gestational diabetes or preeclampsia; medication errors before or during labor; and misuse of forceps and vacuum extraction devices during delivery.
Cephalopelvic disproportion (CPD) occurs when a baby’s body is too large to fit into the mother’s pelvis or birth canal during labor. Failure to diagnose CPD during pregnancy or at the time of labor can lead to prolonged labor and fetal distress, causing serious injuries to the mother and infant including oxygen deprivation, respiratory distress and even death.
The fetus’s well-being during labor and delivery is monitored by a fetal monitoring system. Physicians and nurses are trained to recognize subtle variations in the data strips of this monitoring system. It is the responsibility of the physician to perform a timely C-section if the fetus is in distress. Failure to recognize fetal distress can result in brain damage to your newborn, or result in the stillbirth of your child.
Infections can occur both during pregnancy and at birth. During the labor and delivery process a failure to recognize a current infection in the mother, a failure to diagnose infections or failing to conduct proper test or review test results, or failure to properly treat infections that were diagnosed, can be the cause of a medical malpractice claim. Infections that may cause injury to the mother include complications related to wound infection after cesarean section. Infections that may cause injury to the child include the contraction of E-coli as the baby passes through the birth canal. If your child contracted E-coli leading to neonatal meningitis or if you suffered an infection of the bloodstream, septic shock, or soft tissue infections such as necrotizing fasciitis then you may have a medical malpractice claim.
Although nurse midwives are qualified to handle low-risk pregnancies, physicians should always be involved when things start to go wrong. Waiting too long to call a physician or failing to recognize the signs of fetal distress can be considered medical malpractice. The nurse midwife is held to a standard of care under the law requiring that he or she acts as a reasonable healthcare provider would. If a nurse midwife was negligent and your child suffered permanent injury, you should contact an experienced medical malpractice attorney to discuss your rights.
Nurses are responsible for helping to diagnose problems, treat symptoms and prescribe medication often without the direct supervision of a doctor. However, nurses who work for hospitals have a legal responsibility to follow their hospital’s chain of command policies. When a nurse recognizes a problem, he or she must invoke the chain of command in order to prevent injury. If going to one supervisor does not work, the nurse must go to the next in line until appropriate action is taken. Nurses who fail to go up the chain of command are committing medical malpractice.
Although oxygen deficiency may occur at any time during the pregnancy it most frequently occurs during the labor and delivery process. It may be the result of placental abruption, uterine rupture, preeclampsia, delays in delivery and low amniotic fluid. It is the responsibility of the physician and nurses to properly monitor the incident and to act quickly in cases of fetal distress before oxygen deprivation occurs. Failure to act quickly may result in problems with speech or movement, including the ability to walk or control balance, as well as autism or epilepsy.
If the placenta separates from the uterine wall during pregnancy this is considered a placental abruption. Placental abruption may be caused by trauma sustained in a car wreck, fall or other accident, previous uterine surgery, placental previa, untreated hypertension, or uterine malformation. However, the root cause of placental abruption is not as important as a physician recognizing and treating the placental abruption in an appropriate manner. If a woman has complained of bleeding, abdominal pain, tenderness or contractions at any time during her pregnancy a physician should be on the lookout for placental abruption. Basic precautions a physician should take to conduct a differential diagnosis to rule out a serious complication such as an abrupted placenta include an ultrasound and monitoring of the fetus’s condition for any signs of distress.
Preeclampsia is a very serious and dangerous condition to both the mother and the unborn fetus. This condition is caused by high blood pressure in the mother which can result in development problems of the fetus including intrauterine growth restrictions and brain damage due to fetal hypoxia. This happens when the expectant mother’s blood pressure gets so high that the fetus is deprived of adequate oxygen. Sometimes an emergency C-section is the only way to save the life of the mother and the child even if it means a premature birth. Failure to induce birth or perform a C-section in order to save the fetus and the life of the mother experiencing preeclampsia may be the basis of a medical malpractice claim.
An expectant mothers “water breaks” when her fetal membranes rupture. If these membranes rupture prior to the 37th week of pregnancy it is known as the premature rupture of membranes. Care for the premature rupture of membranes includes hospitalization of the mother and placing both the mother and the fetus on monitoring equipment. Amniotic infusion may be required. Depending on the stage of the pregnancy at which the premature rupture of the membrane occurs, it maybe necessary to deliver the baby preterm by Caesarian section.
Prenatal care errors may include: failure to diagnose and treat maternal hypertension; failure to diagnose and treat gestational diabetes; failure to conduct regular fetal ultrasound in order to monitor fetal size and weight; failure to recognize the symptoms of a serious condition such as placental abruption, preeclampsia, or premature rupture of membranes.
When the prevention of a preterm delivery is not possible the physician must take appropriate steps to minimize risk to both mother and child. This may include the administration of a tocolytic agent in order to arrest labor, during which time the mother should be transferred to a facility that is equipped and staffed appropriately to handle preterm delivery. Failure to meet the standard of care may lead to fetal brain bleed, subdural hematoma, or respiratory distress syndrome.
Uterine rupture is a devastating complication. The initial symptoms are abdominal pain, bleeding during childbirth and changes in fetal heart monitor tracing-can be subtle and may be negligently confused with a less serious condition. Physicians should always look at a differential diagnosis, in which the most serious condition such as a uterine rupture is ruled out first. If a doctor ignores these symptoms or other risk factors, and uterine rupture causes harm to the mother or child, medical malpractice may have occurred.