Birth Injuries and the Umbilical Cord: Understanding Your Legal Options
Medical malpractice can arise in how umbilical cord complications are handled
By Andra DelMonico, J.D. | Reviewed by Canaan Suitt, J.D. | Last updated on March 19, 2024 Featuring practical insights from contributing attorney Paul A. SlagerUse these links to jump to different sections:
- Contributing Factors to Umbilical Cord Injuries
- Medical Interventions to Detect and Prevent Umbilical Cord Injury
- Injuries Suffered from Cord Complications
- Proving Medical Malpractice Resulted in Umbilical Cord Birth Injuries
- Possible Damages for an Umbilical Cord Injury
- Consult a Birth Injury Attorney
About four weeks into pregnancy, the umbilical cord starts to form. The umbilical cord delivers vital nutrients and oxygen to the growing baby. Because of this central role in the baby’s development, umbilical cord complications can cause devastating birth injuries.
While the majority of umbilical cord issues are diagnosed and addressed by medical professionals, the failure to do so can result in lifelong complications, disabilities, and possible death.
Contributing Factors to Umbilical Cord Injuries
Umbilical cord complications on their own do not cause injury or inherently signal malpractice. However, cord complications can cause a child’s birth injury when there are additional contributing factors.
The delivery process can be a time when a baby is at high risk of injury. A doctor may try to speed up the birthing process with the use of forceps or vacuum extractors. This can create additional birth trauma as the baby moves through the birth canal. Many providers will choose to avoid these common causes by recommending a cesarean section.
Medical Interventions to Detect and Prevent Umbilical Cord Injury
Umbilical cord issues do not typically occur because of medical malpractice. Instead, the malpractice typically takes place once there is an issue. Malpractice happens when the medical care provider fails to identify or treat the problem once it is recognized.
Medical professionals will perform an in-depth ultrasound around the midpoint of pregnancy. This is when the obstetrician will identify many birth defects, abnormalities, and potential complications. Many of these complications have specific treatment plans that will significantly increase the mother’s odds of having a healthy gestation.
Injuries Suffered from Cord Complications
Babies are at risk of several injuries when there are cord complications before or during birth. The umbilical cord provides nutrients and oxygen to the baby, so complications can stop blood flow, which results in a lack of oxygen. This can lead to brain damage or other neurological injuries. Depending on the cord complication, injuries could include asphyxia, hemorrhage, hypoxic-ischemic encephalopathy, Erb’s palsy, cerebral palsy, or brachial plexus injuries.
While your medical provider cannot prevent umbilical cord complications, they can diagnose and treat them. A failure to diagnose and treat could result in preventable injuries that may support a medical malpractice claim.
Cord Compression
Umbilical cord compression happens when the cord gets pressed against another surface or object. This can occur in the womb when the baby moves. It can also happen during birth when the baby moves through the birth canal. If compression is quickly addressed, injury is unlikely. However, if compression is extended, oxygen deprivation can cause injury.
Nuchal Cord
A nuchal cord is when it gets wrapped around the baby’s neck in the womb or during birth. This condition will not cause long-term complications unless the cord gets too tight. Then, there is a risk of the cord cutting off the oxygen supply to the baby’s brain, potentially causing brain injury. A healthcare professional should see a nuchal cord on ultrasound imaging. Once diagnosed, the doctor should be able to remove the cord from the neck without issue.
True Knot
When the baby moves around a lot or the cord is longer than usual, there is a risk of a true knot. The cord loops over itself and creates a knot. If the knot remains loose, it isn’t an issue. However, if the knot becomes tight, it will become a problem. The tight knot restricts or stops blood flow. The injuries can include disabilities, miscarriage, or stillbirth. A miscarriage is a fetal death before 20 weeks of pregnancy. A stillbirth is a fetal death at or after 20 weeks of pregnancy.
Cord Prolapse
A cord prolapse happens when the cord delivers before the baby. It puts the cord at risk of compression in the birth canal, which can cut off blood flow to the baby. A healthcare professional should be able to identify a prolapsed cord by performing a pelvic exam and monitoring the baby’s heart rate. Depending on the situation, the doctor could change the baby’s position or recommend a C-section.
Vasa Previa
While it is one of the rarer cord conditions, it is also one of the most serious. Vasa previa happens when the cord’s blood vessels are too close to the cervix. It puts the blood vessels at risk of rupturing or tearing during birth because they lack the protection of the placenta that they would typically have.
A doctor may diagnose this condition during an ultrasound or pelvic exam. If left unaddressed, the baby could suffer significant and potentially fatal bleeding.
Proving Medical Malpractice Resulted in Umbilical Cord Birth Injuries
Proving a medical malpractice case when your baby suffers a birthing injury requires extensive evidence. This is because birth injury cases involve serious injuries that will impact the child’s entire life. Several types of injuries can occur from an umbilical cord injury. Not all of them are a result of medical errors. To have a successful claim, you will have to prove four elements:
- The healthcare provider owed a duty to the patient;
- The provider breached that duty;
- That breach caused an injury; and
- There were damages.
Generally, medical professionals must meet a standard of care. If they do not meet that standard, it could be argued that they breached their duty to the patient. Then, medical experts can assist in making the connection between the breach and the injury. Typically, it is a result of medical negligence.
Your attorney can help you identify the professionals that might be liable in your claim. It could be your obstetrician monitoring your pregnancy, a doctor at the hospital overseeing your birth, nurses, other hospital staff, and the hospital itself. Who is liable will depend on each party’s duties and how they relate to the baby’s injury.
“It’s important to look at the medical records to locate and identify the aspects of the pregnancy and treatment that suggest where the injury happened,” says Paul Slager, who is a medical malpractice attorney at Silver Golub & Teitell in Stamford, Connecticut. “This will help with the common defenses that the injury is the result of a developmental issue or that the injury happened long before the medical care professional began treating the mother and baby.”
Failure to Monitor
Your medical providers should monitor your pregnancy and the baby’s status. This begins with the first positive pregnancy test and continues through delivery. If your doctors fail to monitor you and your baby’s condition properly, this could lead to a claim of negligence. A common sign of failure to monitor is failure to run the standard diagnostics.
Failure to Diagnose
A step further than monitoring is the failure to diagnose. In this situation, the medical professionals run the appropriate diagnostic testing but fail to identify potentially harmful conditions. This failure to identify potential risks can lead to the failure to address preventable birth injuries.
Failure to Take Proper Action
A medical professional may run the appropriate tests and identify potential issues, then fail to take the appropriate action. For example, there are some conditions where the baby will have a better chance of survival or a significantly lower risk of some types of birth injuries when delivered through C-section versus through the birth canal. If the doctor diagnoses the mother or baby with one of these conditions and fails to change the birthing plan, injury as a result could be medical malpractice. Another example could be recognizing fetal distress in the bay and failing to take appropriate steps to address it.
Slager states that he looks at the medical records for indicators that the medical team should have taken action. “We look at the blood gas measurements, the baby’s physical growth measurements, and fetal heart rate tracking that will signal fetal distress. It is also important to look at how the fetus responded to interventions.”
Delivery Issues
Some umbilical cord issues are unpredictable. For example, a prolapsed cord is unpredictable and not in itself malpractice. However, how the hospital staff handles the prolapsed cord could lead to a malpractice claim. When it happens during delivery, the medical team should identify it and take the appropriate steps to prevent injury and harm to the baby. If they fail to do this, and the child suffers an injury, it could be a potential medical malpractice lawsuit.
Possible Damages for an Umbilical Cord Injury
Several damages are available to parents of a child who suffered an umbilical cord injury. Because damages are case-specific, speaking with an experienced birth injury attorney can help you better understand what you can ask for. In medical malpractice cases, you can seek compensation for injuries, medical expenses, and future medical care. Some states also allow for pain and suffering and loss of enjoyment damages.
You will need to provide documentation of your child’s loss for your legal action. This could include medical records, financial records, witness statements, and expert testimony.
Consult a Birth Injury Attorney
If you believe you have a birth injury claim, speak with an experienced lawyer. They will walk through the facts of your claim and determine if you have a legal medical malpractice claim. Your attorney will explain your legal rights and help you decide the best course of action for your legal options.
Visit the Super Lawyers directory to begin your search for an experienced medical malpractice lawyer. For more information on these legal issues, see our overviews on medical malpractice and birth injuries.
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