Whenever a baby is born or is discovered subsequent to birth to sufferdelayed development or evidence of cerebral palsy, brain injury orbrain damage, or paralyzing symptoms of Erbs palsy or other brachialplexus injury, the California obstetrical malpractice lawyers or birthinjury attorneys should always conduct the appropriate investigation todetermine whether the injury was caused bymedical or hospital employee negligence. The following discussion alsoapplies to obstetrical malpractice and birth injury cases generally,including in most other states than California, although the parentshould contact appropriately qualified counsel in the state where theirchild was born to assure that the advice they receive is absolutelyaccurate under the applicable state laws. For example, under Californialaw, a medical malpractice case must be supported by the testimony of alicensed and qualified medical practitioner. This may not be requiredby the laws of every state, but whether required or not under statelaw, we would urge that it is an element of good legal practice formedical malpractice attorneys generally and obstetrical malpracticelawyers in particular.



 Sometimes birth injuries can occur in the absence of obstetricalmalpractice or hospital negligence, so in most cases it cannot beinferred by the parent or attorney with certainty that theobstetrician, physician or other health care practitioner "fell belowthe standard of care" solely because the child suffered serious braininjury, cerebral palsy, or even a brachial plexus injury. The firststep in the investigation undertaken by obstetrical malpractice lawyersis to interview the mother and others present during the prenataldoctor visits, the delivery, and post delivery time periods, to gaintheir information with regard to the indicators of high risk, themedical events, including prenatal treatment and discussions with thephysicians, the events occurring before, during and after the delivery,and the parents conclusions, impressions and even speculation as toaspects of the medical care that may have contributed to the child'sbirth injury.

 In the process of this inquiry into the parents' and other'srecollections of the potentially significant medical events, theCalifornia obstetrical malpractice lawyer will be aware of the child'sdiagnosed birth injury and therefore will be able also to ask specificquestions with regard to the common medical errors the family orfriends might have observed that would be most likely to be associatedwith the particular birth injury. For example, brain injury sustainedduring the delivery process may occur as the result of hypoxia, oroxygen deprivation, and so the obstetrical malpractice attorney may askthe mother, father and others present during the delivery if a fetalmonitor was employed, and whether the hospital staff and physicianspresent during the delivery process were observed to discuss, forexample, "fetal distress," and then what they observed in terms of thehospital staff and physician response to the fetal distress. Thecritical time period for inquiry would be the time period between whenthe family members first noticed this concern among the health careproviders through the time the baby was delivered by cesarean sectionor other action taken by the obstetrician or hospital staff to relievethe fetal distress. In other obstetrical traumatic brain injury casesthe malpractice lawyers may want to inquire about whether thephysicians were required to manipulate the baby's head, possibly withforceps, in the process of extracting the baby from the birth canal.

In an Erbs palsy or other brachial plexus injury cases, because theseinjuries commonly occur because of the baby's presentation withshoulder dystocia, where one of the baby's shoulder's becomes lodgedbehind the mother's pubic bone, the obstetrical malpractice lawyerswill often want to inquire whether they heard the physicians orhospital staff mention the words "shoulder dystocia" or whatobstetrician's call the "turtle sign," a term they use to describe theresemblance to a turtle attempting to pull its head back into itsshell, with the baby's cheeks commonly bulging. Erbs palsy, a type ofparalysis affecting the shoulder and arm, as well as other brachialplexus injuries, most commonly result from the obstetrician's failureto follow the standard of care maneuvers to free the baby's shoulderfrom its entrapment behind the mother's pubic bone without excessiveuse of force. One benign procedure, which is the first procedure thatshould be used by obstetricians as soon as shoulder dystocia isrecognized, is the McRoberts procedure. The obstetrical malpracticeattorneys and birth injury lawyers should be aware of the obstetricalstandards of care to be able to elicit all the information known to themother, father and other family members that may be useful in theirsubsequent investigation of the birth injury case. For more informationyou may wish to consult At that page we also discuss theCalifornia obstetrical malpractice lawyers investigation andinterpretation of the prenatal, hospital and obstetrical records inbirth injury cases involving brain injury and brachial plexus injurycases, as well as physician specialist expert review of the medicalrecords as essential to the obstetrical malpractice lawyers preparationof the birth injury case.

Very briefly, following the aspect of his investigation in obtainingthe recollections of the mother, father, and others present during therelevant prenatal, delivery and postnatal periods, the obstetricalmalpractice lawyers will then obtain and review the medical records.Often times birth injury lawyers will be able to recognize indicationsin the medical records suggesting that the hospital staff orobstetrician failed to comply with the applicable standards of care.But often too, even for the most highly experienced Californiaobstetrical malpractice lawyers there will be aspects of theinformation contained in the records that may be beyond their expertiseto interpret. For example, analysis of the fetal heat monitor stripsusually requires the interpretation of qualified medical specialists todetermine whether there was fetal distress for a time period sufficientto account for the child's brain damage. In California it is a legalrequirement that appropriately qualified medical experts be consultedprior to filing a medical malpractice claim, and our Californiaobstetrical malpractice lawyers and birth injury attorneys certainlyconsider that it is essential to the proper preparation of everymedical malpractice case, and in particular every obstetricalmalpractice case, that highly qualified medical experts be consultedearly on both with regard to the failures of the involved physicians toconform to the obstetrical standards of care, and to establish that theobstetrical negligence was the "cause" of the baby's birth injury. Allappropriate expert consultations should also certainly be obtainedprior to taking the depositions of the obstetrician, other physiciansand the hospital staff present during the hospitalization leading up tothe delivery and in the immediate postnatal period. The specificcriticisms of the experts are essential for the obstetrical malpracticelawyers in order to properly frame their deposition interrogation ofthe involved health care providers.

 Obstetrical malpractice cases also commonly involve serious orcatastrophic birth injuries that may require a lifetime of medicalexpense and loss of earning capacity measured over the child's "worklife expectancy." The California obstetrical malpractice lawyers andbirth injury attorneys therefore must also prepare to present atsettlement conferences and at trial the evidence of the child'sinjuries, his pain and suffering, his loss of enjoyment of lifedamages, his past and future medical expenses and future loss ofearning capacity to assure that the child will be compensated for thefull measure of his or her damages. This involves again the preparationand presentation of the testimony of a number of medical experts, aswell as "life care planners" to assess all of the future medicalexpenses that the child is likely to incur during every month of theremainder of his life.The California obstetrical malpractice lawyer inserious birth injury cases will also engage "vocational rehabilitationexperts" to assess the range of occupations the child will bedisqualified by his or her injuries to enter and those occupationswhich he or she might be capable of entering, in arriving at the "netlost earning capacity," as well as forensic economists to apply medicalcost inflation statistics and wage growth statistics and discount thetotals of medical expense and earnings losses to present dollarfigures.

The preparation and presentation of birth injury cases is a complexlegal endeavor for the obstetrical malpractice lawyer, but these arelegal tasks for which malpractice lawyers in every state are highlyexperienced and appropriately qualified to undertake and perform well.Obstetrical malpractice attorneys cannot turn back time and reverse thebrain damage or paralysis of the child, but we can do our very best toassure that the child will have the funds to assure that he receivesall the medical care that he will require over the course of his life,and permit the child and his or her parents the dignity of choice inmedical options and the security that the child will be well cared forafter the parents are no longer alive to help manage the child's care.