December 2010 Archives

December 27, 2010

Developmental Delays Following Birth Addressed Through New York State Department of Health Early Intervention

In the State of New York, children with developmental delays following birth are referred to the New York State Department of Health "Early Intervention" Program.

To be eligible for services, a child must be less than three years old and have a "confirmed disability" or "established development delay" that is (1) physical, (2) cognitive, (3) communicative, (4) social-emotional, and/or (5) adaptive.
Following an evaluation and development of an individualized family service plan (IFSP) services begin almost immediately. Typically within days.

"Many of our clients receive services from Early Intervention," said New York cerebral palsy lawyer Michael A. Bottar, Esq., of Syracuse-based Bottar Leone, PLLC. "EI does a great job providing physical, occupational and speech therapy to children diagnosed with cerebral palsy, Erb's palsy, Down syndrome and other physical/cognitive deficits including blindness, deafness, and poor muscle tone or feeding. It is comforting to know that children, many of whom have disabilities because of something that went wrong during childbirth, have a safety net."

In addition to therapy, EI provides family education and counseling, parent support groups, audiology, psychological services, nursing services, nutrition services, vision services, social work services and assistive technology devices and services. Additional detail about EI can be found in The Parent's Guide to Early Intervention (pdf).

Continue reading "Developmental Delays Following Birth Addressed Through New York State Department of Health Early Intervention" »

December 23, 2010

Therapeutic Hypothermia To Decrease Baby Brain Damage Known As Hypoxic Ischemic Encephalopathy

"If your baby has been diagnosed with hypoxic ischemic encephalopathy after birth, then s/he has brain damage because of inadequate oxygen during delivery," said Syracuse New York birth injury lawyer Michael A. Bottar, Esq., of Bottar Leone, PLLC. "HIE is a birth injury that can be prevented."

Babies diagnosed with HIE after birth may show a decreased level of consciousness, altered spontaneous activity and abnormal posture. This is because a period of low oxygen has injured the brain, causing cerebral edema (i.e., swelling) that may lead to learning disabilities, mental retardation, epilepsy, poor motor control and spastic quadriplegic cerebral palsy. 80% of babies who survive HIE have a permanent cognitive or physiological impairment. HIE can also lead to death (50% mortality).

Therapeutic hypothermia is now available to decrease the damage caused by an HIE birth injury. TH involves cooling the baby (on a mattress) to a body temperature of 92.3 degrees for approximately 72 hours. The cooling slows down the metabolic process and decreases the damage caused by swelling. TH must start within 6 hours of birth to be effective.

HIE may be the result of medical malpractice if an obstetrician failed to appropriately respond to fetal distress marked by a non-reassuring increase or decrease in fetal heart rate. An appropriate response includes repositioning, oxygen and, if the heart rate does not improve, delivery by cesarean section as discussed in our prior post titled New York C-Section Lawyer Review of Rising Surgery Rate To Prevent Syracuse Birth Injury.

Continue reading "Therapeutic Hypothermia To Decrease Baby Brain Damage Known As Hypoxic Ischemic Encephalopathy" »

December 20, 2010

Low APGAR Score At Birth May Be Due To Umbilical Cord Compression: New York Birth Injury Lawyer Explains Mechanics

The umbilical cord connects an unborn fetus to the placenta. It typically contains two arteries and one vein, encased in a durable substance known as Wharton's Jelly. Most umbilical cords measure 20 inches in length, nearly 1 inch thick and may have as many as 380 helices (i.e., coils).

"The primary purpose of the umbilical cord is to deliver oxygen-rich blood and nutrients to the fetus, and to remove waste," said Syracuse birth injury lawyer Michael A. Bottar, Esq., of Bottar Leone, PLLC. Where there is umbilical cord compression during labor and delivery, an unborn baby may receive inadequate oxygen (hypoxia) or no oxygen (asphyxia). Hypoxia and asphyxia are associated with birth injuries such as cerebral palsy, blindness and deafness.

Umbilical cord compression is very common. It occurs in 10% of deliveries when, in most cases, the cord is compressed between a baby's head and the mother's pelvic bone. The umbilical cord may also be compressed if it becomes wrapped around a baby's neck, as discussed in a prior blog post titled Umbilical Cord Around Baby's Neck Is A Common Cause of Syracuse New York Birth Injury. This is known as a nuchal cord.

Fortunately, umbilical cord compression can be identified by review of fetal heart monitor tracings. In the usual case, periods of low fetal oxygenation will be marked by an increase (accelerations) or decrease (decelerations) in the fetal heart rate. Obstetricians and labor and delivery nurses can then take steps to remedy the problem by, e.g., repositioning the mother or administering oxygen. Where a baby experiences prolonged hypoxia s/he may be born depressed, with low APGAR scores discussed in a prior post titled Low APGAR Scores and Medical Malpractice In Syracuse New York. A baby born with low APGAR scores is at risk for developmental delays.

Continue reading "Low APGAR Score At Birth May Be Due To Umbilical Cord Compression: New York Birth Injury Lawyer Explains Mechanics" »

December 17, 2010

Rapid Group B Strep Diagnosis Critical To Preventing Sepsis and Meningitis Following Delivery

Group B strep (GBS) is a bacteria that can be found in a woman's vagina or rectum. It is found in as many as 40% of health women.

"Pregnant women who test positive for GBS are said to be 'colonized,'" said New York birth injury lawyer Michael A. Bottar, Esq. "Colonized mothers can pass GBS to their babies during labor and delivery which can cause meningitis, sepsis or pneumonia in newborns. GBS can also cause maternal infection and death."

Because of the risk of transmission, the Centers for Disease Control and Prevention recommends that all pregnant women be tested between the 35th and 37th week of pregnancy. Testing sooner or later is not effective.

A new test gives obstetricians and labor and delivery nurses more rapid results and should decrease the need for doctors to assume that a pregnant mother is colonized an administer antibiotics until they know otherwise. The new test promises results in as few as 4 hours. The old way took 48-72 hours. The failure to timely test for and/or treat GBS is medical malpractice.

Continue reading "Rapid Group B Strep Diagnosis Critical To Preventing Sepsis and Meningitis Following Delivery" »

December 14, 2010

New York Birth Injuries From Fetal Distress May Decline With AirStrip OB

Many babies are diagnosed with cerebral palsy and other birth injuries due to a period of fetal distress during labor and delivery. "Every year, our legal team investigates claims arising out of a failure to respond to dangerous decelerations recorded on fetal heart monitor tracings," said Syracuse birth injury lawyer Michael A. Bottar, Esq., of Bottar Leone, PLLC, a law firm with a practice limited to medical malpractice and catastrophic injury cases throughout the State of New York.

"Historically, obstetricians and labor and delivery nurses had to review fetal heart monitor tracings in a specific location, whether it was at the bedside or on a remote computer monitor," Bottar said. When these individuals are unavailable, timely and appropriate review of the tracings can overlooked and even minutes of delay can lead permanent disability, including cerebral palsy, Erb's palsy and global developmental delays.

Recently, a monitoring system was released that allows obstetricians to monitor the vital signs of a laboring mother and unborn baby through a smart phone application known as AirStrip OB. The system, which is being tested at Summit Medical Center in Tennessee, delivers various vital signs including fetal heart rate and maternal contractions in real-time. The application also affords doctors an opportunity to review nursing notes.

"AirStrip OB is a great development. It should cut down on the number of missed opportunities to prevent a birth injury stemming from, e.g., insufficient oxygen (hypoxia) or poor blood flow (ischemia). Soon, all busy obstetricians will need to do to avoid malpractice is look at their iPhone to see - instantly - how a labor is progressing. Or, more importantly, if it is not proceeding as planned. As the fetal brain can be permanently damaged in minutes, it is encouraging to know that help for a struggling baby may now been only a phone call away."

Continue reading "New York Birth Injuries From Fetal Distress May Decline With AirStrip OB" »

December 12, 2010

New York Medication Mistakes On the Rise In Syracuse, Utica, Binghamton and Watertown

"Baby boomers are spending more and more time in hospital emergency rooms because of the medications that they take," said New York medication error lawyer Michael A. Bottar, Esq., an attorney with Syracuse-based Bottar Leone, PLLC, a team of lawyers handling New York emergency room lawsuits. "Unfortunately," Bottar added, "many of the medications that seniors take do more harm than good."

According to Dr. Carolyn Clancy, the Director of the Agency of Healthcare Research and Quality, Americans take a record number of medications to maintain their health. This is because many medical problems can now be treated with drugs that were not available years ago. However, a constellation of drugs used to treat virtually all ailments have been linked to three troublesome conditions, including: (1) drug-induced delirium, (2) drug overdose, and (3) drug withdrawal.

Often, when seniors present to emergency rooms with complaints, they are prescribed drugs that are not compatible (i.e., contraindicated) with their current medication regimen. For example, seniors on blood thinners should not receive tPA, a stroke drug we blogged about previously in a post titled "What Is tPA and Is It Available In Central New York Emergency Rooms." Likewise, prescriptions are frequently discontinued in the emergency room setting even through the patient should not stop taking a drug. "Either scenario can have devastating consequences," said Bottar, whose office is currently prosecuting several medication error lawsuits involving severe personal injury and permanent disability, including stroke and blindness.

Continue reading "New York Medication Mistakes On the Rise In Syracuse, Utica, Binghamton and Watertown" »

December 11, 2010

Antibiotics One Hour Before Cesarean Section Now Standard Of Care In New York To Prevent Infection

On August 23, 2010, the American College of Obstetricians and Gynecologists announced in Committee Opinion #465 that all pregnant women should receive antibiotics one (1) hour before having a cesarean delivery.

"Certainly, the antibiotics will cut down on the number of post-operative wound infections," said Syracuse birth injury lawyer Michael A. Bottar, Esq., an attorney with Bottar Leone, PLLC, a law firm prosecuting New York obstetrical malpractice lawsuits. "At the same time, we are concerned that unborn babies experiencing fetal distress may suffer a brain injury due to a delayed c-section. Setting aside the risk of infection, if a baby is experiencing oxygen deprivation, known as hypoxia, we would like to see an abdominal or vaginal delivery occur as soon as possible because prolonged hypoxia can cause cerebral palsy and other permanent brain damage."

Infection is a well-documented complication of a cesarean delivery, occurring in 10-40% cases. Historically, antibiotics were administered to women having a c-section, but not until after the baby was born. This was because physicians were concerned about antibiotics passing into baby's bloodstream.

Continue reading "Antibiotics One Hour Before Cesarean Section Now Standard Of Care In New York To Prevent Infection" »

December 10, 2010

Fight Watertown Birth Injury Disabilities By Supporting Northern New York Cerebral Palsy Association

"7 out of every 1,000 children experience a birth injury," said Watertown cerebral palsy lawyer Michael A. Bottar, Esq., an attorney with Syracuse-based Bottar Leone, PLLC, a law firm prosecuting New York birth injury lawsuits throughout the State, including those arising out of a failure to diagnose preeclampsia discussed in our blog post titled "Watertown New York Women With Gestational Diabetes At Risk For Preeclampsia, Palsy and Birth Injury."

"Caring for these children takes time and costs money." Many organizations exist to aid children permanently disabled following a difficult birth. These organizations, like the Northern New York Cerebral Palsy Association, provide services to children with conditions such as cerebral palsy while, at the same time, acting as a resource to families with children who have developmental disabilities.

Not-for-profit organizations cannot exist unless the community donates time and/or money. "Even in difficult times, we must remember to take care of those who cannot take care of themselves."

Continue reading "Fight Watertown Birth Injury Disabilities By Supporting Northern New York Cerebral Palsy Association" »

December 9, 2010

New York Persistent Pulmonary Hypertension of the Newborn Risk High If Induced Before 39 Weeks

Persistent pulmonary hypertension of the newborn is a potentially fatal condition where a baby's circulatory system fails to adapt to life outside of the womb. According to Michael A. Bottar, Esq., a Syracuse birth injury lawyer with Bottar Leone, PLLC, an upstate New York law firm handling medical malpractice lawsuits through the State, "PPHN accounts for 2-9% of admissions to neonatal intensive care units."

A baby's failure to transition from a high pulmonary vascular resistance to a normal low pulmonary vascular resistance causes PPHN. Our team of New York PPHN lawyers is familiar with the labor and delivery complications that are associated with persistent fetal circulation, including meconium aspiration syndrome (MAS), severe intrapartum asphyxia, pulmonary vasoconstriction, hypoxia, acidosis and exposure to SSRIs discussed in our blog post titled "Syracuse New York Persistent Pulmonary Hypertension of the Newborn Lawyers Survey Connection To Birth Injury and SSRIs." Prompt diagnosis of PPHN is critical because, if timely identified and treated, much of the disease process can be reversed.

A pregnant mother is considered full term at 37 weeks. Until recently, a woman could elect to deliver early by c-section at that time. Recently, published data suggests that babies born at 37 and 38 weeks are at a greater risk for developing respiratory problems and pulmonary hypertension than babies born at 39+ weeks gestation. As a result, doctors in Florida and other states are stopping elective early induction.

Continue reading "New York Persistent Pulmonary Hypertension of the Newborn Risk High If Induced Before 39 Weeks" »

December 8, 2010

Folic Acid Reduces Premature Deliveries And Risk For Syracuse New York Birth Injury

"Consumption of folic acid is very important during pregnancy," said Michael A. Bottar, Esq., a New York birth injury lawyer presently investigating Syracuse PPHN lawsuits and Watertown retinopathy of prematurity claims. "Folic acid helps to prevent birth defects."

Folic acid, also known as folate, is a B9 vitamin found mostly in green leafy vegetables. According to a recent UK study, folic acid supplementation during protects against low birth weight babies, as well as neural tube defects (brain and spinal cord defects) such as spina bifida. Repeated studies have shown that women who consume 400 micrograms daily prior to conception, as well as during early pregnancy, may reduce the risk that their baby will be born with a serious neural tube defect by up to 70%.

Babies born premature (i.e., before 37 weeks) are at high risk for respiratory distress and circulatory problems, some of which we discussed in our blog post titled "New York Persistent Pulmonary Hypertension of the Newborn Risk High If Induced Before 39 Weeks." Babies born premature are also at risk for cerebral palsy, as discussed in our blog post titled "New York Premature Birth Injury Report Card."

Continue reading "Folic Acid Reduces Premature Deliveries And Risk For Syracuse New York Birth Injury" »

December 7, 2010

Premature Birth Lawyers On Binghamton New York Child Behavioral Problems

"Binghamton children born prematurely are at high risk for behavioral and health problems," said Syracuse birth injury lawyer Michael A. Bottar, Esq., of Bottar Leone, PLLC, a team of trial lawyers handling New York medical malpractice lawsuits sounding in cerebral palsy and global developmental delays.

"Right now we are investigating several claims that involve premature deliveries. Each emergent delivery could have been avoided had medical personnel timely identified the risk of prematurity and taken steps to delay birth." Even though advancements in medicine have improved preterm newborn survival rates, recent studies have uncovered long-term challenges that preemies will face, such as lower IQ scores and higher rates of behavioral problems including anxiety, depression and hyperactivity. As many as 18% of preterm children had hyperactivity/inattention problems and 14% had anxiety/depression. "Prematurity is also associated with cerebral palsy and other disorders, such as retinopathy of prematurity," said Bottar.

Appropriate prenatal care is critical to the healthy development of a fetus and to the timely diagnosis of problems with fetal growth and development and conditions affecting pregnant mothers, e.g., preeclampsia, gestational diabetes, and intrauterine growth restriction (IUGR). The failure to diagnose preeclampsia can lead to an emergency c-section to prevent irreversible maternal heart damage. Likewise, the failure to diagnose IUGR can lead to a dangerously low-birth weight baby.

Continue reading "Premature Birth Lawyers On Binghamton New York Child Behavioral Problems" »

December 7, 2010

Birth Control May Increase Cancer Risk For Women Living In Syracuse, Utica, Watertown and Binghamton New York

While it is well-known that birth control pills may increase the risk of a stroke, a new dangerous side-effect is receiving the attention of the medical field. According to a physician who spoke at the "50 Years of the Pill" conference last week in Washington, D.C., there is a strong link between the pill and an increased risk of breast cancer, as well as cervical cancer and liver cancer.

"The 'pill' was developed in the 1950s. Data suggests an astounding 660% increase in non-invasive breast cancer since 1973," said Michael A. Bottar, Esq., a New York medical malpractice lawyer with Bottar Leone, PLLC, a Syracuse-based law firm with decades of experience handling cases involving avoidable metastastic cancer. "Doctors should be aware of the potential association between the pill and cancer so that they can help their patients avoid the consequences of a failure to diagnose breast cancer, cervical cancer misdiagnosis, or late diagnosis of liver cancer."

Breast cancer, in particular, presents a very real risk for women, especially following a confusing U.S Preventive Service Task Force recommendation against yearly mammograms and breast self-examinations which we blogged previously in a post titled "Failures To Diagnose Breast Cancer May Increase Following Task Force Recommendations." Risk factors for breast cancer in women include increasing age, a prior breast cancer diagnosis, a family history of breast cancer, high breast tissue density, high-dose chest radiation, no children (or first child after age 30), and a long menstrual history.

Continue reading "Birth Control May Increase Cancer Risk For Women Living In Syracuse, Utica, Watertown and Binghamton New York" »

December 7, 2010

Palsy Following Shoulder Dystocia May Decrease In New York When CALM Software To Prevent Birth Injury Arrives

"Approximately 1% of all births are complicated by a shoulder dystocia," said Michael A. Bottar, Esq., a Syracuse birth injury lawyer with Bottar Leone, PLLC, a law firm with decades of experience representing babies diagnosed with Erb's palsy following a brachial plexus injury during birth.

A shoulder dystocia occurs when a baby's head passes into the birth canal but the anterior shoulder becomes stuck behind the mother's pubic bone. At this critical point in time, a baby typically has a compromised oxygen supply because of umbilical cord compression and is not yet breathing room air. In turn, medical staff has only minutes to perform maneuvers to free the baby or risk oxygen deprivation and permanent brain damage which can lead to cerebral palsy, or physical injuries such as collar bone fractures and nerve damage leading to Erb's palsy and Klumpke's paralysis.

Approximately 20% of all shoulder dystocias result in an injury to the baby. Often times, a shoulder dystocia is unpredictable. However, there are know risk factors including: a prior shoulder dystocia, diabetes, an inadequate pelvis, fetal macrosomia, post-date gestation, preeclampsia, and maternal obesity.

Recently, a Montreal physician developed an algorithm that can calculate risk for a shoulder dystocia. That algorithm can be incorporated into computer software, known as the CALM Shoulder Screen, to help obstetricians and nurses predict labor and delivery complications. The web-based program is reported to be effective at 37 weeks gestation.

Continue reading "Palsy Following Shoulder Dystocia May Decrease In New York When CALM Software To Prevent Birth Injury Arrives" »

December 6, 2010

New York Premature Birth Injury Report Card: March of Dimes Grade "D"

"More than 31,000 babies were born prematurely last year," said Syracuse birth injury lawyer Michael A. Bottar, Esq., an attorney with Syracuse-based Bottar Leone, PLLC, a team of attorneys representing families throughout New York who have a baby diagnosed with a disability after being born early.

"That means that 12% of infants born in this State are born early." According to the 2010 March of Dimes Premature Birth report card released last week, New York received a "D" grade because the New York preterm birth rate was greater than 11.3% but less than 13.2%. Premature birth is one of the leading causes of death in newborns, as well as other lifelong health problems including cerebral palsy, global developmental delay, gastrointestinal problems, intraventricular hemorrhaging, respiratory problems, retinopathy of prematurity, blindness and deafness.

Where physicians and nurses fail to protect an unborn baby from the risks of being born early, or from the injuries that may accompany a premature birth, permanent injuries may follow. "While our Syracuse New york birth injury attorneys understand that it is not possible to eliminate preterm births, medicine has advanced to the point where there are modalities available to lessen or mitigate harm."

Continue reading "New York Premature Birth Injury Report Card: March of Dimes Grade "D"" »

December 5, 2010

Upstate Cerebal Palsy Offers Inclusive Preschool In Utica New York

Upstate Cerebral Palsy, a private not-for-profit based in Utica, New York, recently announced the availability of inclusive preschool programs through six New Discoveries Learning Centers in Utica, Barneveld, Rome, Chadwicks and Clinton.

Inclusive preschool programs usually consist of 3-5 year old children, half of whom are typically developing and half of whom are "special needs." Special needs may include learning disabilities, profound retardation and/or cerebral palsy, as well as terminal illnesses and psychiatric problems. According to Utica birth injury lawyer Michael A. Bottar, and attorney with Bottar Leone, PLLC, a law firm with nearly three decades of experience handling New York birth injury lawsuits, "research suggests that inclusive preschools help special needs children with development because they are in close, direct contact with other children who may act as behavioral role models. At the same time, these children can receive essentially therapy."

Special needs children come from all walks of life. Some children with special needs suffer from unavoidable birth defects, while others are disabled because they sustained brain damage during birth and were born with low APGARs following fetal distress marked by prolonged fetal heart rate decelerations. No matter what the cause of a child's disability, it is well known that early intervention with speech, physical and occupational therapy, as well as child peer contact, can accelerate development.

Continue reading "Upstate Cerebal Palsy Offers Inclusive Preschool In Utica New York" »

December 4, 2010

Birth At Night Increases Cerebral Palsy Risk From Baby Brain Injury In Syracuse New York

Syracuse birth injury lawyer Michael A. Bottar, Esq., an attorney with Bottar Leone, PLLC, a team of New York cerebral palsy attorneys, reports that the findings of a new study suggest that children born at night are at greater risk for being diagnosed with "neonatal encephalopathy,"

"Neonatal encephalopathy is a rare brain disorder marked by symptoms including abnormal consciousness, tone, reflexes, breathing and feeding. It can lead to cerebral palsy or epilepsy," said Bottar. According to a study published in the November edition of the American Journal of Obstetrics & Gynecology, babies born between the hours of 10 p.m. and 4 a.m. were 22% more likely to experience a brain problem. The study examined more than 2,000,000 births over a period of 14 years.

Prior studies have linked birth injuries to night time deliveries, with some suggesting that medical residents (i.e., new doctors), tired obstetricians, and understaffed hospital labor and delivery units may contribute to New York labor and delivery complications, including fetal distress, low APGAR scores from hypoxia and hypoxic ischemic encephalopathy, which may form the basis of a New York birth injury lawsuit seeking compensation for permanent disability, such as cerebral palsy or persistent pulmonary hypertension of the newborn (PPHN).

Conditions like cerebral palsy and PPHN typically are caused by an injury to the infant's brain that can occur before, during, or shortly after birth. When a baby's brain does not receive enough oxygen, it can sustain permanent damage that can lead to seizures, global developmental delays, cognitive impairment, loss of vision, and other life-long disabilities.

Continue reading "Birth At Night Increases Cerebral Palsy Risk From Baby Brain Injury In Syracuse New York" »

December 1, 2010

Syracuse DePuy ASR Hip Recall Lawyers Encourage New York Implant Recipients Not To Sign Medical Release

On August 24, 2010, DePuy Orthopaedics, Inc., a company owned by Johnson & Johnson, issued a recall for its ASR XL Acetabular System and its DePuy ASR Hip Resurfacing System because of higher than average revision rates, discussed in detail here on our website, and in our blog post entitled Syracuse DePuy ASR Hip Implant Lawyers Review Timing of Recall In New York.

New York defective DePuy ASR hip implant lawsuits are soon to follow. According to a Medical Quack press release, two days before DePuy announced the recall it sent a letter to orthopedic surgeons to alert them of the impending recall. Apparently, the letter was accompanied by an informational packet and a medical release form for doctors to provide to the patients who received DePuy implants. The Medical Quack press release also reported that DePuy offered orthopedic surgeons $50.00 for every medical release signed by one of their patients.

The Syracuse defective implant lawyers at Bottar Leone, PLLC, want to know why, if true, there is a need to compensate surgeons for securing patient medical records. "We strongly encourage patients with a DePuy hip to avoid signing that form," said Anthony S. Bottar, Esq. a New York defective hip recall lawyer with Syracuse-based Bottar Leone, PLLC. Bottar is a DePuy hip recall lawyer with experience handling other mass tort cases. "By signing that form, a patient gives DePuy the right to review all of the patients confidential medical records and x-rays. It may even give DePuy the right to take control of the explanted hip device after a revision surgery."

Continue reading "Syracuse DePuy ASR Hip Recall Lawyers Encourage New York Implant Recipients Not To Sign Medical Release" »