Articles Posted in Labor and Delivery Negligence

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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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