Understanding the Long-Term Impact of Brain Damage Caused by Birth Injuries
Brain damage caused by a birth injury can change the course of a child’s life before that child has even left the hospital. Some newborns experience relatively mild neurological problems and make substantial progress with treatment. Others suffer permanent brain damage that affects movement, communication, cognition, behavior, learning, and independence throughout their lives.
When brain damage results from oxygen deprivation, trauma, untreated medical complications, or a failure to respond appropriately to fetal distress, families may face decades of medical treatment and other expenses. Determining what happened during labor and delivery—and whether the injury could have been prevented—is therefore critical. At Kalfayan Merjanian, LLP, we represent families in California birth injury malpractice cases and work with medical and other experts to investigate the cause and long-term consequences of a child’s injury.
What Causes Brain Damage During Childbirth?
A newborn’s brain can be injured in several ways before, during, or immediately after delivery. Some brain injuries result from complications that cannot be prevented. Others may occur because healthcare providers fail to recognize or appropriately respond to a developing emergency.
Potential causes include oxygen deprivation, reduced blood flow to the brain, intracranial bleeding, infection, and physical trauma. Medical negligence may be involved when providers fail to monitor the mother or fetus appropriately, fail to recognize warning signs, delay an emergency delivery, improperly manage complications, or otherwise deviate from the applicable standard of care.
One important cause of neonatal brain injury is hypoxic-ischemic encephalopathy (HIE), which occurs when the brain does not receive enough oxygen or blood. HIE can produce permanent neurological impairment depending on its severity and duration.
What Is HIE and How Can It Affect a Child?
Hypoxic-ischemic encephalopathy is a type of brain dysfunction caused by inadequate oxygen and blood flow to the brain. It can occur during pregnancy, labor, delivery, or shortly after birth. HIE may cause seizures, abnormal muscle tone, feeding difficulties, problems with alertness, and other neurological abnormalities. More severe cases can result in permanent disabilities.
When HIE occurs during labor or delivery, medical records and fetal monitoring may become particularly important. A medical expert may evaluate whether there were signs that the baby was not receiving adequate oxygen and whether healthcare providers responded appropriately.
How Can Oxygen Deprivation Cause Permanent Brain Damage?
The brain requires a continuous supply of oxygen and blood to function normally. When that supply is significantly reduced, brain cells can become damaged or die. The consequences depend on factors including the severity and duration of oxygen deprivation and which areas of the brain are affected. A newborn who experiences prolonged oxygen deprivation may develop permanent neurological disabilities even if the child survives the immediate medical emergency.
In some cases, the effects are not fully apparent immediately after birth. Developmental differences may become increasingly noticeable as the child grows and reaches milestones involving movement, language, learning, and social development.
What Long-Term Disabilities Can Result From Birth-Related Brain Damage?
The consequences vary substantially from child to child. Depending on the location and severity of the brain injury, a child may experience, for example:
- Cerebral palsy
- Seizure disorders
- Cognitive impairment
- Developmental delays
- Speech and language difficulties
- Problems with vision or hearing
- Motor impairment
- Difficulty with balance and coordination
- Learning disabilities
- Behavioral or emotional difficulties
- Feeding and swallowing problems
Some children may require assistance with basic activities of daily living for the rest of their lives.
Can Birth-Related Brain Damage Cause Cerebral Palsy?
Certain forms of brain injury occurring before, during, or shortly after birth can cause cerebral palsy. Cerebral palsy refers to a group of neurological disorders affecting movement, balance, posture, and muscle coordination. Some children with cerebral palsy have relatively mild physical limitations, while others require wheelchairs, communication devices, extensive assistance, and lifelong care. Brain damage associated with oxygen deprivation is one potential cause, although cerebral palsy has multiple possible causes and the medical circumstances must be carefully evaluated.
When Do the Effects of a Brain Injury Become Apparent?
Some neurological impairments are immediately apparent, while others become clearer as a child develops. A newborn may initially appear relatively healthy but later experience difficulty reaching developmental milestones. Parents may notice problems with sitting, crawling, walking, speaking, feeding, coordination, or interacting with others.
This does not necessarily mean that the brain injury occurred after birth. Neurological damage sustained during labor or delivery may become more apparent as the child’s developmental demands increase. Long-term medical and developmental evaluations can help determine the nature of the child’s limitations and the services that may be necessary.
What Medical Care May a Child With Brain Damage Need?
The treatment required depends on the child’s individual condition. Long-term care may include physical therapy, occupational therapy, speech and language therapy, behavioral therapy, medications, neurological care, orthopedic treatment, nutritional support, and specialized educational services. Some children may eventually require surgeries or other interventions. Others may need assistive technology, mobility equipment, communication devices, specialized transportation, or modifications to their home. These needs can continue for decades, making it important to consider future expenses when evaluating a birth injury claim.
How Can Brain Damage Affect a Child’s Education?
A brain injury may affect learning even when a child has relatively limited physical disabilities. Cognitive impairment, memory problems, attention difficulties, speech and language limitations, and other neurological effects may make traditional educational environments challenging. A child may require an individualized education program, specialized instruction, additional classroom support, speech therapy, or other educational services.
Educational needs may also change as the child grows. An evaluation of future damages should therefore account for the possibility of changing developmental and educational requirements.
Can Brain Damage Affect a Child’s Ability to Work as an Adult?
A severe birth-related brain injury may prevent a person from entering the workforce or substantially limit the type of employment they can perform. Even a child who is eventually capable of working may have reduced earning capacity because of cognitive, physical, communication, or behavioral limitations. When evaluating a birth injury case, experts may consider the child’s expected education, abilities, functional limitations, and likely employment prospects. The economic consequences can extend throughout the person’s expected working lifetime.
Who Pays for Lifelong Care After a Birth Injury?
The answer depends on the circumstances. Health insurance and public programs may cover some medical services, but families can still face substantial out-of-pocket expenses. Some services may have coverage limitations, while other long-term needs may not be fully covered. When medical negligence caused a preventable birth injury, a medical malpractice claim may seek damages intended to compensate the child and family for legally recoverable losses resulting from the injury. Determining those losses requires looking beyond the child’s current medical bills.
How Are Future Medical and Financial Needs Calculated?
A severe birth injury may require a comprehensive assessment of the child’s expected needs over the course of a lifetime. A life care planner may review medical records and consult with treating physicians and other healthcare professionals to identify anticipated future medical treatment, therapies, medications, equipment, attendant care, transportation, and other services. Economists may then calculate the projected financial cost of those needs. Vocational experts may also evaluate the child’s future earning capacity when the injury is expected to affect employment. These experts can help establish why a child who currently requires relatively modest assistance may nevertheless face substantial expenses in adulthood.
How Is Medical Malpractice Established in a Birth Injury Case?
A serious birth injury does not automatically establish medical malpractice. The central question is whether healthcare providers failed to meet the applicable standard of care and whether that failure caused or contributed to the child’s injury. An investigation may examine prenatal records, maternal medical records, fetal monitoring strips, nursing notes, medication records, physician documentation, delivery records, neonatal records, imaging studies, and other evidence.
Obstetrical and neonatal experts can evaluate whether providers appropriately recognized and responded to signs of fetal distress, maternal complications, or other developing emergencies. For example, if fetal monitoring showed persistent signs of distress and providers failed to respond promptly when an emergency delivery was necessary, experts may be asked whether that delay contributed to the child’s brain injury.
Why Is Fetal Monitoring Important in These Cases?
Fetal monitoring can provide important evidence about how a baby was tolerating labor. For example, changes in the fetal heart rate may indicate that the baby is experiencing difficulty obtaining sufficient oxygen. Healthcare providers must interpret monitoring results in the context of the entire clinical situation and determine whether intervention is necessary. When a child later suffers HIE or another neurological injury, medical experts may review the fetal monitoring strips to determine whether there were warning signs and whether the healthcare team responded appropriately. Fetal monitoring is only one part of the investigation, however. Other evidence, including maternal vital signs, medications, labor progression, delivery records, and the newborn’s condition after birth, may also be significant.
What Compensation May Be Available for a Birth-Related Brain Injury?
When medical negligence causes a compensable birth injury, damages may address both the immediate and lifelong consequences of the child’s condition. Depending on the circumstances, damages may include medical and rehabilitation expenses, future medical care, assistive equipment, therapy, educational services, home modifications, attendant care, and other economic losses. A claim may also seek compensation for legally recognized noneconomic losses. Because the impact of a severe brain injury can extend for the child’s entire lifetime, accurately evaluating future needs is especially important.
Why Is Early Investigation Important?
Evidence in a birth injury case can be extensive and medically complex. Records may include hundreds or thousands of pages of documentation, while fetal monitoring strips and other electronic information may require careful preservation and review. Early investigation gives an attorney an opportunity to obtain relevant medical records, preserve available evidence, identify potential witnesses, and consult appropriate experts. It also allows the family to begin developing a clearer understanding of the child’s prognosis and future needs rather than evaluating the claim solely based on the child’s condition immediately after birth.
Contact Kalfayan Merjanian, LLP
The consequences of brain damage caused by a birth injury can extend far beyond the delivery room, affecting a child’s health, development, education, independence, and ability to earn a living. If you believe your child’s brain injury may have resulted from negligent medical care, Kalfayan Merjanian, LLP can investigate the circumstances surrounding the pregnancy, labor, delivery, and neonatal care and work with qualified experts to determine whether malpractice occurred. Contact Kalfayan Merjanian, LLP today to discuss your child’s birth injury and learn about your family’s legal options.
