Cerebral palsy is the most common motor disability in
children and, unfortunately, frequently occurs when healthcare providers make
mistakes. When your child is diagnosed with cerebral palsy, the news is
devastating, and you are likely searching for answers as to how and why the
condition occurred, whether it could have been prevented, and what the future
holds for your child.
Below are answers to the 17 most common questions asked by parents
after their child is diagnosed with cerebral palsy or if they think their child
might have cerebral palsy.
What Is Cerebral
Cerebral palsy is a group of disorders that affect a
person’s ability to move and to maintain balance and posture. “Cerebral” means
having to do with the brain. “Palsy” refers to weakness or tightness or other problems
with using the muscles. Most people with cerebral palsy are born with it, and
that is called “congenital” cerebral palsy. Cerebral palsy that starts after
birth is called “acquired.”
People with cerebral palsy may have related conditions
Are There Different
Types of Cerebral Palsy?
There are four main types of cerebral palsy:
Cerebral palsy that involves symptoms of more than one type is
called mixed cerebral palsy.
Is Cerebral Palsy
Caused by Healthcare Provider Mistakes?
Yes, it often can be. Cerebral palsy can be caused by damage
to the infant’s brain, often from a lack of oxygen, which can occur when
medical professionals make mistakes. Birth
asphyxia is a severe lack of oxygen to a baby during childbirth. This
severe oxygen deficiency is also
known as birth hypoxia or intrauterine hypoxia. When the infant’s
body lacks oxygen, its cells cannot work properly, and therefore birth asphyxia
can often result in brain damage and even death. This brain damage is called hypoxic-ischemic encephalopathy, known
Infants who suffer from hypoxic-ischemic encephalopathy
(HIE) can end up with life-altering impairments or disabilities including cerebral
palsy, cognitive deficits, and hearing and/or vision loss. Even without
detectable brain damage, children who’ve had birth asphyxia are at increased
risk for learning disabilities, language delays and other issues later in life.
Healthcare provider errors that can result in cerebral palsy
generally fall under three categories:
How Do Medical
Conditions of the Expectant Mother Put an Infant at Risk for Cerebral Palsy?
Poorly managed medical conditions of the expectant mother that
can put an infant at risk for cerebral palsy include:
How Do Complications
During Childbirth Put an Infant at Risk for Cerebral Palsy?
Complications during childbirth can put an infant at risk for
cerebral palsy caused by birth asphyxia. These complications include:
How Does Failure to
Properly Interpret and Act upon Fetal Heart Rate Monitoring Cause Cerebral
Fetal heart rate monitoring allows healthcare providers to
assess whether an unborn baby is receiving sufficient oxygen during childbirth.
Fetal monitoring and monitoring of uterine contractions can be done either
externally, by wrapping a pair of belts around the mother’s abdomen, or
internally by attaching a small electrode to the baby’s head and inserting an
intra-uterine pressure catheter once the mother’s amniotic sac is ruptured and
her cervix is dilated 2-3 centimeters.
Reassuring baseline heart rates are within a normal range of
110-160 with accelerations and no repetitive decelerations.
If the heart rate is high, called tachycardia, the baby’s heart may be working faster than normal to
compensate for low oxygen levels. If the heart rate is low, called bradycardia, the baby may not be
receiving enough oxygen. Tachycardia and bradycardia may be signs that the baby
is in distress and at risk for permanent brain injury due to lack of oxygen and
a caesarean section may be necessary.
Repetitive decelerations including variable decelerations
(consistent with nuchal cord or cord compression) and late decelerations
(consistent with placental dysfunction) — particularly if associated with other
non-reassuring signs such as decreased variability and/or tachycardia or
bradycardia — may be an indication for urgent/emergent delivery.
When medical professionals fail to properly interpret and
act upon crucial data provided by the fetal heart rate monitor and the baby’s
oxygen deprivation is severe and prolonged, cerebral palsy may occur.
What Do the Apgar
At the 1 and 5 minute marks after birth, all babies undergo
a quick assessment of their well-being that is known as an Apgar score. The
following five conditions are scored 0 to 2, with 0 signifying the worst
medical state, and 2 signifying the best:
The scores for each condition are added together. At the
1-minute mark, the total Apgar score is interpreted as follows:
At the 5-minute mark, a total Apgar score between 7 and 10
is considered normal; a score of 6 or lower means further medical intervention
such as admission to the neonatal intensive care unit (NICU) for further
support and evaluation or hypothermia treatment may be warranted.
Low Apgar scores may be indicative of birth hypoxia or
asphyxia, which can cause cerebral palsy.
What Is the Significance
of a Cord Blood Gas/Cord pH?
A small sample of blood may be taken from a baby’s umbilical
cord immediately following delivery. A normal cord pH ranges from 7.18 to 7.38.
A more detailed study called arterial blood gases (ABG) can also be done in the
hospital lab. A low cord pH and/or abnormal ABGs may be consistent with hypoxic
brain injury which can cause cerebral palsy.
What Are the Signs
That My Child Might Have Cerebral Palsy?
A delay in reaching motor or movement milestones (such as rolling
over, sitting, standing, or walking) can be an early sign that a child might
have cerebral palsy. Note that there can be many reasons why a child misses
milestones, and you should discuss your concerns with a pediatrician.
Similarly, infants and children with cerebral palsy may
exhibit other deficits and delays such as poor feeding or delayed or absent
speech. Again, these problems may be attributable to cerebral palsy or other
issues, so you should discuss with your pediatrician.
How Is Cerebral Palsy
As part of routine pediatric care, physicians will track a
child’s growth and development over time and screen for developmental delays.
If they suspect a problem, they will use brain-imaging technologies and other
advanced tests including:
Is Cerebral Palsy
There is no cure for cerebral palsy, but early,
comprehensive treatment can significantly improve a child’s life after
How Is Cerebral Palsy
Treatment for cerebral palsy can include:
How Can Early
Intervention Services Help My Child with Cerebral Palsy?
(EI) services are available under our nation’s special education law — the
Individuals with Disabilities Education Act (IDEA) — and can significantly
improve the outcome for children with cerebral palsy.
Early intervention is available to children from birth
through 36 months who are afflicted with cognitive, motor and movement delays even
if they have not been diagnosed with cerebral palsy, as well as to children
with a cerebral palsy diagnosis. Depending upon the child’s needs, early
intervention might include family training, counseling, and home visits;
occupational, physical and/or speech therapy; hearing loss services; health,
nutrition, social work and assistance with service coordination; assistive
technology devices and services; and transportation.
Before early intervention starts, an Individual Family Service Plan (IFSP) is developed by a team, which
includes the parents and all providers who work with the child and the family.
The IFSP describes the child’s present level of development, the family’s
strengths and needs and the specific services to be provided to the child and
Whether (and how much) parents must pay for early invention
services depends upon a number of factors including their state of residency, income
level, and whether the services are covered by their health insurance. Funds
obtained from a lawsuit can be used to pay for early intervention and can,
consequently, significantly improve the child’s long-term outlook.
What Is an
Individualized Education Plan?
In addition to early intervention, the Individuals with Disabilities
Education Act (IDEA) also mandates that public school systems provide services
free of charge to school-aged children (ages 3 through 21) with developmental
disabilities. These services include special education; related services such
as physical, occupational, and speech therapy; and supplementary aids and
services, such as adaptive equipment or special communication systems.
Before these services can start, a team of individuals — including
parents, teachers and others —must develop an Individualized Education Plan (IEP). The IEP establishes reasonable
learning goals for the child and sets forth specific services the school
district will supply. By law, the IEP must be reviewed at least annually to
assess whether the annual goals are being achieved and revised if necessary.
Will Cerebral Palsy
Affect My Child’s Intellectual Abilities?
Some people with cerebral palsy will have difficulty
speaking, and others may have intellectual deficits. However, many patients
with cerebral palsy have normal intelligence.
What Type of Adaptive
Equipment Can Help My Child with Cerebral Palsy?
Adaptive equipment and assistive technology can help better a
child’s quality of life by improving mobility, communications, the ability to
perform daily living activities and the ability to engage in the joys of
childhood play. Examples of adaptive equipment and assistive technology include:
What Happens If My
Child Is Diagnosed with Cerebral Palsy?
The severity of cerebral palsy varies from case-to-case,
with patients requiring various levels of treatment and assistance. Not every
case is attributable to healthcare provider errors, and it is important to rule
out other causes such as metabolic or genetic factors.
If your child has cerebral palsy, you may have a medical malpractice claim against
healthcare providers who caused this birth
injury. The malpractice claim is for the harm your child has suffered, and
for the cost of care and treatment for your child.
The lawyers at Feldman
Shepherd Wohlgelernter Tanner Weinstock & Dodig LLP are pursuing
medical malpractice claims for children suffering from cerebral palsy. The
lawsuits filed on behalf of cerebral palsy victims and families seek damages
for medical bills, loss of earning potential, pain and suffering, and loss of
the pleasures of life.
A sampling of recent results achieved by Feldman Shepherd attorneys Carol Nelson Shepherd, Daniel S. Weinstock, Patricia M. Giordano, G. Scott Vezina and Carolyn M. Chopko in cerebral palsy cases includes:
If you or a loved one has been injured and would like to speak with a Feldman Shepherd attorney, please contact us.
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