Articles Posted in Labor and Delivery Negligence

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A7GEAW_2378638bNovember is National Diabetes Awareness Month, so a recent report published in JAMA Pediatrics, revealing that pregnant woman with elevated blood sugar levels are more likely to have babies with congenital cardiovascular defects, even if their blood sugar is below the cut off for diabetes, could not come at a more appropriate time.

The study was conducted over four years out of the Stanford University Medical Center, where researchers examined blood samples taken from 277 California women during their second-trimester of pregnancy. Out of the 277 women, 180 were carrying infants without congenital heart disease, and the others had infants affected by one of two serious heart defects. Specifically, 55 had tetralogy of fallot, where a baby is getting too little oxygen, and 42 had dextrotransposition of the great arteries, where the position of the two main arteries leading form the hart are swamped, preventing oxygenated blood from the lungs to circulate throughout the body.

The women’s levels of glucose and insulin were measured and used to test the association between those levels and the odds of having a baby with a heart defect. The results revealed that women who had fetuses with tetralogy of fallot had higher average blood glucose levels, but there was no significant finding in the relationship between dextrotranspostition of the great arteries and glucose levels.

In sum, women who have elevated glucose values during pregnancy, but do not meet the current diagnostic criteria for diabetes, still face an increased risk of having children with congenital heart disease, and more research should be done to further evaluate this correlation.

The trial lawyers at Bottar Leone, PLLC, have decades of experience investigating, prosecuting and trying to verdict all types of medical malpractice and birth injury cases, including those arising out of a failure to treat and/or diagnose a risk to a fetus. To speak with us about a potential medical malpractice or birth injury claim, please contact the Firm by telephone, email, or by submitting an online contact form.

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According to a recent lawsuit filed in the U.S. District Court of Tennessee, defendant health care providers failed to properly handle the delivery of the minor plaintiff, resulting in extended fetal oxygen deprivation and brain injury at birth. Specifically, the complaint alleges that during the mother’s labor and delivery, medical personnel failed recognize and respond to clear signs of declining fetal response, indicating the need for an emergency C-section.

The mother plaintiff gave birth to her first child via Cesarean section, and shortly thereafter she became pregnant again. According to the lawsuit, despite her risk factors, including short stature; previously unsuccessful attempt at vaginal birth; and a brief time between the two pregnancies; the mother plaintiff was advised that she was a good candidate for a vaginal birth after C-section (VBAC).

The mother plaintiff went into labor early, and within the first half hour the EFM strip indicated minimal variability and loss of accelerations (two signs of fetal compromise). According to the lawsuit, rather than being admitted to the Labor & Delivery ward, the fetal monitoring was stopped and the mother plaintiff was advised to walk around the hospital for an hour or so. About two hours later, she was admitted whereupon labor progression was slow and the fetal monitoring continued to show repetitive late decelerations. After several hours, a C-section delivery was ordered.

According to the lawsuit, upon delivery, the infant plaintiff was limp, with bluish-tinged skin and no pulse. He wasn’t breathing and had a high blood acid level indicative of acidosis. The infant plaintiff was sent to the NICU ward, where he spent nearly a month and during which time brain cooling was utilized in attempts to mitigate the damage to the baby’s cells, to no avail. The infant plaintiff was diagnosed with hypoxic ischemic encephalopathy caused by intrapartum asphyxia. He has since been diagnosed with spastic quadriplegic cerebral palsy and suffers serious developmental delays.

The trial lawyers at Bottar Leone, PLLC, have decades of experience investigating, prosecuting and trying to verdict all types of medical malpractice cases including babies injured following a complicated labor and delivery. If your child has been diagnosed with a disability, you and/or your family may be entitled to compensation. To discuss your case or concerns with an experienced Central New York medical malpractice lawyer, contact Bottar Leone, PLLC.

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World Cerebral Palsy Day is a global innovation project created to improve quality of life for people living with cerebral families, and their families. The project is led by a group of non-profit cerebral palsy charities, and supported by organizations in over 45 countries.

Cerebral palsy is a neurological disorder caused by abnormalities in parts of the brain that control muscle movements, hearing, vision and cognition. It is the most common physical disability in childhood. The majority of children with cerebral palsy were born with it, although the diagnosis may not be made until a child reaches three years of age. According to, at least two thirds of children with cerebral palsy will have movement difficulties affecting one or both arms, 1 in 4 children with cerebral palsy cannot talk, 1 in 3 cannot walk, 1 in 2 have an intellectual disability, and 1 in 4 have epilepsy. In the most severe cases, children born with cerebral palsy will live their lives dependent upon others for every aspect of daily living.

Causes of cerebral palsy include hypoxia or ischemia during childbirth, genetic disorders, stroke, infection and trauma. Where cerebral palsy is caused by a preventable medical error during labor and delivery, the child and his or her family may have a claim for medical malpractice.
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Preeclampsia, also known as toxemia, is a condition that complicates as many as 10% of pregnancies. Typical symptoms during pregnancy and the immediate post-partum period include high blood pressure, protein in the urine (i.e., proteinuria), foot, leg and hand swelling (i.e., edema), nausea, severe headaches and abdominal pain.

A dangerous variant of preeclampsia is known as H.E.L.L.P. syndrome. A woman with H.E.L.L.P. syndrome may have a low platelet count and elevated liver enzymes. Women who suffer from H.E.L.L.P. syndrome may not exhibit the primary indicators for preeclampsia, such as high blood pressure and proteinuria. Because a pregnant woman with H.E.L.L.P. may not have symptoms that doctors typically look for, a woman suffering from preeclampsia may be misdiagnosed with the flu and treatment may be delayed.

Preeclampsia affects pregnant women everywhere, including in central New York. According to, in the weeks before she gave birth by cesarean section on August 1, 2011, Cato resident Kristie Rubino experienced several preeclampsia symptoms. She presented to St. Joseph’s Hospital Health Center on July 28, 2011, but was discharged. Days later, she underwent an abdominal delivery performed under general anesthesia. Shortly thereafter, her blood pressure escalated and she passed away.

A failure to diagnose preeclampsia early can lead to life-threatening complications for a pregnant mother and her unborn baby. “The misdiagnosis of H.E.L.L.P. syndrome can be even more dangerous, because it has a 25% mortality rate,” said Michael A. Bottar, Esq., a Syracuse medical malpractice lawyer. Significant labor and delivery complications include premature birth and, while rare, maternal death from problems such as seizures, cerebral hemorrhaging and stroke. The only “cure” for preeclampsia is delivery. While there is no “cure,” preeclampsia can be treated by monitoring maternal fluid intake and through the administration of magnesium for seizures and anti-hypertensive medication for elevated blood pressure.

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“Bottar Leone, PLLC is presently handling several New York birth injury cases involving permanent disabilities caused by new york obstetrical malpractice and labor and delivery nurses errors made during a nighttime labor and delivery,” said Syracuse birth injury attorney Michael A. Bottar, Esq. “Certainly, the outcome of a birth is linked to the time of day a baby is born.”

An article published in the Journal of Obstetrics and Gynecology entitled “The Night—A Dangerous Time To Be Born?,” reported that babies were twice as likely to sustain a birth injury if born during the night (between 7:00 p.m. and 6:59 a.m.), as compared to a daytime birth (between 7:00 a.m. and 6:59 p.m.). A Queensland study
entitled “The Impact of Time of Delivery On Perinatal Outcomes,” reported additional troubling statistics. That is, that fetal death rates were highest between 1:00 a.m. and 2:59 a.m. Of note, was that the rate of fetal death was lowest between 11:00 a.m. and 12:59 p.m., and the rate of neonatal death was lowest between 5:00 p.m. and 6:59 p.m.

A German study reported in 2003 linked nighttime delivery dangers to the delivery of substandard medical care, also known as obstetrical medical malpractice and labor and delivery mistakes.According to The March of Dimes, low birth weight babies are at high risk for respiratory distress syndrome (i.e., RSD), intraventricular hemorrhaging (i.e., bleeding in the brain), patent ductus arteriosus (i.e., PDA), necrotizing enterocolitis (i.e., NEC), and retinopathy of prematurity (i.e., ROP).
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Jaundice, which is the clinical manifestation of hyperbilirubinemia (too much bilirubin in the blood), occurs in about one-half of term newborns as well as most premature babies (85%). Elevated bilirubin levels are also associated with low birth weight babies, sepsis, delivery requiring instrumentation, and history of maternal diabetes.

Hyperbilirubinemia is also associated with epidural anesthesia and Oxtyocin,” said Syracuse birth injury lawyer Michael A. Bottar, Esq., of Bottar Leone, PLLC. “Epidural anesthesia is the most popular mode of pain relief during labor and, while it is widely believed that regional anesthetics present little if any risk to an unborn baby, this is not true in all cases.” Epidural anesthesia is associated with fetal respiratory depression, decreased fetal heart rate, fetal malpresentation, and difficulty breastfeeding after birth. Likewise, Oxytocin (i.e., Pitocin) may also cause hyperbilirubinemia.

Where a pregnant mother receives an epidural, or where labor is augmented by Oxytocin to stimulate contractions, the obstetrician and labor and delivery nurses should be on alert for newborn hyperbilirubinemia Neonatologists and pediatricians should also conduct appropriate surveillance by testing serum bilirubin levels.

While too much bilirubin in a baby’s blood is easily treated by phototherapy (or an exchange transfusion in severe cases), it can lead to permanent brain damage if the diagnosis is not made early. Baby brain damage caused by exposure to too much bilirubin is known as kernicterus. Kernicterus can cause cerebral palsy and other permanent disabilities such as long-term hearing loss, behavioral problems, and bilirubin induced neurological dysfunction (BIND).
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