Did your child suffer a birth injury?
Did medical negligence cause your baby’s injury and the financial and emotional devastation to your family?
Britcher, Leone & Sergio, LLC is a New Jersey law firm with expertise in birth injury due to medical malpractice. Our birth injury attorneys help NJ families handle the responsibility for the care, comfort, and development of their children with special needs.
Our NJ medical malpractice firm is staffed with legal and medical professionals with established records of achieving positive outcomes in birth injury cases.
- Firm Co-Founder Armand Leone is a board-certified diagnostic radiologist and an attorney. His unique training and experience in both medicine and law bring meaningful insight into our client’s birth injury matters.
- Co-Founder Drew Britcher, a Certified Civil Trial Attorney, has tried more than 100 cases and been counsel or amicus counsel on more than 40 reported decisions. He helped draft the language of New Jersey’s Patients First and Patient Safety Acts and teaches medical malpractice law and medical malpractice litigation at Seton Hall Law School.
- Partner Tyrone Sergio is an experienced trial lawyer who focuses his practice on personal injury matters, including medical malpractice and wrongful death cases.
- Kathy Nicita, RN serves as a nurse paralegal assisting our attorneys in gathering the necessary medical proofs to succeed.
What is a Birth Injury?
Birth injury is an injury to the newborn leading up to, during labor, and shortly after delivery. Appropriate medical care can avoid conditions and situations that cause injury to the newborn child. Mismanagement of the mother’s prenatal care or medical negligence can result in conditions ranging from permanent brain injury to paralysis and death.
Our New Jersey birth injury attorneys handle cases involving lasting harm, pain, disability, and suffering to the baby and family. The child often requires extensive medical attention, lengthy hospital stays, and a lifetime of therapies and supportive care.
When Can Birth Injuries Occur?
Birth injuries can occur before and during labor, as well as shortly after birth. We now know that medical negligence often plays a key role in certain birth injuries.
- Lack of oxygen to the fetus during labor and delivery is most often due to improper management of the birth process itself. Many cases of hypoxic brain injury can be prevented with proper obstetrical care.
- Failure to diagnose and appropriately treat infections, high blood pressure, or diabetes during pregnancy can lead to birth injury.
- Genetic irregularities can cause malformations that result in severe handicap and death. These can be diagnosed before or during pregnancy, which allows parents to decide whether to conceive or potential terminate a pregnancy.
Birth Injury During Pregnancy
Birth injuries often occur because of neglected or overlooked issues during pregnancy due to medical negligence. Even women who were healthy before becoming pregnant can experience problems that cause a high-risk pregnancy. Quality prenatal care includes tests that alert doctors to the presence of these common medical conditions during pregnancy; equally important is monitoring the mother and fetus to assess the severity of these conditions and determine proper treatment before the delivery date.
- Genetic /chromosome abnormalities can create serious medical conditions and prevent the child from developing normally or die in infancy. Screening for chromosomal abnormalities using family history and common medical tests can detect many of the more debilitating syndromes while options to terminate exist.
- Hypertension, or elevated blood pressure (chronic or gestational), creates risk of serious injury to both the mother and the developing baby. Pregnant women must be checked for signs of hypertension and have medication prescribed to control it if necessary. Acute-onset severe hypertension is a medical emergency that requires treatment during the pregnancy and may require early delivery.
- Preeclampsia is a condition that arises during pregnancy, evidenced by high blood pressure and protein in the urine indicating kidney damage. Left untreated, preeclampsia can lead to serious (even fatal) complications for both the mother and baby.
- Gestational diabetes usually shows up in the middle of pregnancy; doctors most often test for it using a glucose tolerance test. If not well controlled, gestational diabetes can result in pre-eclampsia. It can also elevate the baby’s blood sugar level, causing the baby to grow extra-large, with difficulty passing through the birth canal. A C-section may be necessary to avoid shoulder dystocia, Erb’s Palsy or Klumpke’s Palsy.
- Infections can occur in a fetus during pregnancy or passfrom mother to infant in the birth canal. If an OB-GYN fails to diagnose or treat a mother’s preexisting infection, a baby may become infected and injured even as it passes through the birth canal. This occurs with Group B streptococcal (GBS) infection that can cause sepsis or meningitis in the infected baby. Delayed diagnosis and treatment can lead to permanent brain damage.
Birth Injury During Labor
The most common cause of birth injury during labor (or delivery) is undetected or unaddressed fetal distress. Failure to take proper action when fetal distress or prolonged labor occur can result in hypoxic brain injuries such as hypoxic ischemic encephalopathy (HIE) and cerebral palsy. The use of forceps or a vacuum extractor can also injure the baby during dleivery. Maternal injury during labor can include maternal fever, uterine hemorrhage, sphincter injury, and urinary and bowel problems.
Birth Injury During Delivery
Delayed and improper deliveries put the baby and mother at high risk for birth injury during delivery.
- If fetal distress occurs and operative delivery (Cesarean section) should be performed and is not, the ensuing lack of blood flow and oxygen can cause permanent neurological and multi-organ injury.
- Failure to perform a necessary episiotomy can cause the mother to suffer bowel and/or bladder incontinence and/or to develop a fistula between her vagina and rectum.
- If the obstetrician does not recognize a shoulder dystocia (where the baby’s shoulder gets stuck on the mom’s pubic bone)and tries to deliver the baby vaginally without properly performing maneuvers to free the baby from the obstruction, the baby may suffer permanent neurological injuries to the arm and/or brain.
- Improper use of forceps or a vacuum extractor during delivery can injure the baby’s scalp and cause intracranial hemorrhage and facial nerve palsies.
- An overlooked prolapsed umbilical cord can result in cord compression that, if it persists too long, will cause permanent brain injury due to lack of blood flow and oxygen. The same goes foran umbilical cord wrapped around a baby’s neck(a nuchal cord). .
Postnatal Birth Injury
Failures to recognize and address undiagnosed or untreated respiratory distress, neonatal hypoglycemia (low blood sugar), or neonatal hyperbilirubinemia (jaundice from elevated bilirubin). immediately by the neonatologists, anesthesiologists, or NICU nurses lead to postnatal birth injury—and in some cases, irreparable harm to the newborn.
- Newborn respiratory distress causes postnatal birth injury from lack of oxygenated blood flowing from the baby’s lungs to the heart, brain, and body. Respiratory distress syndrome, meconium aspiration, pneumonia, sepsis, pneumothorax (collapsed lung), persistent pulmonary hypertension of the newborn, and/or delayed transition are underlying causes. These conditions require prompt accurate diagnosis and intervention. Premature babies are particularly at risk because their lungs are immature. Surfactant medication placed directly into the airways can help premature lungs to open and prevent hypoxia. When a premature delivery is expected, treatment with corticosteroids prior to the birth can help lessen the risk. of
- Improper intubation can occur when the wrong-size endotracheal tube is used or the breathing tube can is improperly placed.
- Neonatal hypoglycemia caused by low glucose can cause varying degrees of postnatal brain injury. Checking for and maintaining sufficient oxygenation and blood glucose levels during the postnatal period is important for healthy development.
- Meconium aspiration syndrome Meconium is the baby’s bowel movement. It is very thick and sticky and a fetus under distress can expel large amounts of thick meconium. This causes respiratory distress because it clogs the airways and oxygen cannot reach the lungs. Prevention by timely delivery is the best way to avoid this nirth injury, but proper resuscitation and respiratory care can help. Improper care can lead to pneumothoraxes, hypoxic injuries, and death.
- Hyperbilirubinemia (neonatal jaundice) is evidenced by a yellowish discoloration of the white part of the eyes and skin in a newborn baby. It is caused by high bilirubin levels. The baby may be sleepy or feed poorly. If severe and untreated, hyperbilirubinemia cause brain damage resulting in seizures, visual problems, hearing loss, and intellectual disabilities.
Types of Birth Injuries
In birth asphyxia, a baby’s brain and other organs are deprived of oxygen before, during, or immediately after birth. This triggers cell death, which can lead to temporary or permanent brain damage such as hypoxic ischemic encephalopathy, seizure disorders, heart failure, cerebral palsy, learning disabilities, or paralysis.
When the medical professional does not recognize signs of fetal distress or birth asphyxia during labor and delivery, and fails to perform an emergency C-section in these cases, those scenarios constitute medical negligence.
Birth defects are visible, internal, or chemically abnormal conditions in a newborn. They can be caused by genetics, infection, radiation, or drug exposure, or no known reason. They can occur at any stage of pregnancy and may not be evident at birth.
The severity and location of the defect may affect the baby’s expected lifespan and quality of life. If your baby’s birth defect could have been detected by a physician during pregnancy through screenings and genetic testing, you may have a valid lawsuit.
This group of nerves starts in the neck and shoulder; it controls movement of the shoulder, elbow, forearm, wrist, and hand. When these nerves are damaged, stretched or torn, a child may suffer partial or complete paralysis to these regions. Surgery or other treatment may improve this condition in some situations. Many children, unfortunately, suffer lifelong disability to the shoulder, arm, and hand due such as Erb’s palsy and Klimpke’s palsy, due to brachial plexus injuries.
Cerebral palsy is a lifelong disability that affects motor function and muscle coordination. Cerebral palsy may also present with excessive drooling, problems with swallowing, sucking or eating, delayed speech development, and learning difficulties. It is brain damage caused by lack of oxygen to the baby.
Erb’s palsy is a nerve condition that causes muscle weakness or loss of function in the arm or shoulder after the nerves are stretched or torn during birth. In newborns, it can occur because of undiagnosed or improperly handled shoulder dystocia, a condition where the baby’s shoulder gets caught on the mother’s pubic bone during delivery. The diagnosis may also be called brachial plexus birth palsy, obstetric brachial plexus palsy, or brachial plexus birth injury.
Mild cases may resolve on their own, and physical therapy exercises can help prevent permanent stiffness. Many cases, however, require surgery for nerve or muscle repair.
Damage to a baby’s seventh cranial nerve, which controls sensation and movement of all facial muscles, can lead to infant facial paralysis. This may be a partial or total loss of function, mild or severe, temporary, or permanent. You may see drooping on one side of the face, an asymmetrical smile or facial expression, drooling, difficulty feeding, or the inability to blink.
Infant facial paralysis can occur from pressure on the infant’s face during a difficult delivery, especially if forceps were used improperly. Many cases resolve on their own, but severe cases may require specialized surgical procedures.
Forceps or Vacuum Injury
Forceps and vacuum extractors are used when the baby is having trouble exiting the birth canal. However, they carry a relatively high risk of birth trauma and serious birth injuries (and in rare cases, infant death). Common forcep injury presents as facial paralysis, brain injury, eye trauma, and hemorrhaging in the skull. Common vacuum injury conditions also include fractures and cerebral palsy.
Hypoxic Ischemic Encephalopathy
Hypoxic ischemic encephalopathy (HIE) is brain damage caused when the baby’s brain does not receive enough oxygen or blood. Without immediate medical attention, the damage could be permanent and substantial.
HIE is often due to the physician failing to respond to fetal distress, or a pre-existing condition or infection in the mother that deprives the fetus or newborn baby of oxygen. Symptoms may occur immediately or take time to develop; they include lethargy, seizures, trouble breathing, poor muscle tone, abnormal blood pressure, acidotic blood, and low heart rate.
Klumpke’s palsy (or Klumpke’s paralysis) is a lower brachial plexus birth injury that affects the muscles of the forearm, wrist, and hand. Klumpke’s palsy can involve partial or complete paralysis. These can occur when the physician tries to forcibly remove the baby from the birth canal during a difficult vaginal delivery.
Symptoms include muscle atrophy, claw hand, numbness, weakness, or loss of function of the affected limb, and stiff joints or pain. Some babies exhibit Horner’s syndrome characterized by a drooping eyelid, iris heterochromia (differently colored eyes), and facial paralysis.
Shoulder dystocia occurs when a baby’s shoulder catches on the mother’s pubic bone during labor, preventing delivery of the child. Standard medical practice requires that doctors recognize when shoulder dystocia occurs and undertake properly perform certain maneuvers to avoid birth injury. Risk factors for shoulder dystocia include macrosomia (large baby), pre-existing or gestational diabetes, breech birth, twins/multiples, and being overweight. The most common complication is a brachial plexus injury such as Erb’s palsy.
Torticollis occurs when the baby’s neck muscles cause the head to turn and rotate to one side. The neck may be rotated at an odd angle, and the head and chin tilt in opposite directions. Torticollis may be present at birth or develop later and can result from a difficult delivery.
Torticollis usually becomes more noticeable as the baby gains more control over head movements. Symptoms include stiff and /or swollen neck muscles, limited head and neck movement, shoulder asymmetry or asymmetrical facial features, and a pea-sized lump in a neck muscle. Gentle muscle stretches and position changes are standard treatments.
Wrongful Birth and Wrongful Life
When a fetus is discovered to have profound genetic or congenital defects via ultrasound, screening blood tests, amniocentesis, , and other tests, parents have the right to decide whether to terminate the pregnancy. When they are not offered the testing or it is improperly interpreted, New Jersey law recognizes these medical malpractice lawsuits:
- Wrongful birth: The claim of a parent for emotional distress related to their child being born with severe defects after being deprived of information that would have resulted in their decision to terminate the pregnancy.
- Wrongful life: Claims brought on behalf of the child who was born with severe defects for their extraordinary medical care, special education, and other special needs required by their disabilities.
How Long Do You Have to File a Birth Injury Claim?
In New Jersey, a medical malpractice claim must normally be filed within two years of what is called the “ accrual of the cause of action.” In the case of birth injuries in New Jersey, there are exceptions to the two-year rule for children injured due to medical malpractice.
- The malpractice claim must be brought within two years of an injured minor’s 18th birthday unless the injury occurred at birth.
- If the baby sustained an injury during birth caused by medical malpractice, the lawsuit must be filed by the child’s 13th birthday.
- In wrongful death cases resulting from a physician’s negligence, a claim must be filed within two years of the child’s death.
Our NJ birth injury lawyers will explain all of this to you when we meet.
Contact an Experienced Birth Injury Attorney
At Britcher, Leone & Sergio, LLC, our NJ birth injury lawyers understand how difficult it can be to have your child suffer a birth injury and the emotional and financial toll it can take on you and your family. As a law firm specializing in birth injuries and medical malpractice, our attorneys― combining the work of a Board Certified Diagnostic Radiologist Attorney and two seasoned trial lawyers―have helped many families whose lives have been irrevocably changed after a serious birth injury. Contact our firm to learn about your rights.