Negligent Newborn Resuscitation

It’s music to the ears of new parents and everyone else in or near the delivery room: a baby’s ear-piercing cry. While the sound of a crying baby will likely sound a little less melodic in the weeks and months of sleepless nights that will follow, that first cry is the baby has taking that all-important first breath.

When there is silence after a delivery, or concerning sounds like gasps, medical practitioners must assess the situation, refer to their training, and determine if the baby needs any assistance to start receiving the breath of life. Up to one in 10 babies born require simple stimulation (drying and rubbing) to help them breath. Three to six percent of newborns require basic resuscitation (bag-and-mask ventilation). Less than one percent need more serious interventions, including: endotracheal intubation, chest compressions and/or medication.

Without prompt attention and the correct level of care required, newborns requiring resuscitation can suffer severe birth injuries or death. In some cases, even the most valiant efforts of a medical team cannot prevent these injuries or death. However, if medical providers are negligent and breach accepted standards of care, a baby who would otherwise have a good prognosis could suffer irreparable harm.

If you or a loved one has given birth to child who received (or should have received) resuscitation at birth and suffered serious injuries as a result of this medical care, you may be able to access compensation and damages for the tragedy that you have experienced.

Resuscitation at birth.

Why do some babies require resuscitation?

Although any newborn could require resuscitation and breathing assistance at birth, there are several conditions and complications that put some babies at greater risk. These factors include:

• unduly stressful labour, some resulting in instrument delivery (forceps/vacuum).
• pre-term or post-term labour.
• meconium aspiration syndrome.
• umbilical cord prolapse.
• large birth size/weight.
• Shoulder dystocia.
• Intrauterine Growth Restriction (IUGR).
• concerning vital signs.

Maternal risk factors include:

• gestational diabetes.
• a maternal age under 16 or over 40.
• prior high-risk births.
• infections or disease.
• placenta previa.
• placental abruption.
• sudden onset of severe bleeding during pregnancy.
• rupture of membranes.

How do medical practitioners determine if resuscitation is needed?

If a baby is delivered at or near term, is breathing or crying normally, and has a healthy colour or skin tone, usually routine afterbirth care (drying, clearing airways and warming) is all that is needed. In the event that one or more of these conditions is lacking, additional care may be required. If the baby’s heart rate is less than 100 beats per minute, some level of resuscitation effort is likely needed.

Positive-pressure ventilation (a self-inflating bag, a flow-inflating bag, or a T-piece resuscitator) is usually sufficient for basic resuscitation. Medical providers will likely judge the success of this resuscitation by looking for the baby’s heart rate to increase above the 100 beats per minute (bpm) mark and/or for improvements on Apgar scores.

More significant interventions are required if the baby’s heart rate falls below 60 bpm. In these cases, the first line of treatment is chest compressions. If this action is insufficient, the medical provider may consider intubation. As a last resort, the baby may receive epinephrine in hopes of increasing its heart rate or a defibrillator.

Resuscitation birth injuries.

If maternal health or pre-delivery monitoring of the fetus reveals risk factors, more than one medical provider trained in advanced resuscitation techniques should ideally be present in the delivery room. Failure to call for such resources, if they are available, could be an indication of negligence.

During delivery, careful monitoring of maternal and fetal vital signs is necessary to allow medical practitioners to act as quickly as possible if abnormalities are detected. Failure to detect and promptly act when resuscitation if needed immediately after birth can cause injury and/or worsen odds for successful resuscitation efforts.

Finally, even when infant resuscitation does take place, injuries can result from improper technique and/or failure to assess the required level of intervention in a timely manner. For example, a baby with a shallow or laboured breath at birth will require a different resuscitation protocol than a baby not breathing on its own. Since the potential for brain damage due to hypoxia increases by the minute, beginning with the wrong type of resuscitation could waste precious time.

When intubation is required, there are multiple points at which a mistake could be made. The tube used must be sized according to weight and gestational age. A tube placed too far down the trachea could enter the bronchial space and either limit oxygen exchange or cause a pneumonthorax. A tube placed in the esophagus rather than the trachea can hinder breathing. Obstructions of the tube and perforations of organs are also possible injuries during negligent intubation procedures.

Permanent damage and disability.

Within a matter of minutes, a newborn’s life can change forever. Resuscitation errors can result in infant mortality or a myriad of disabilities. Brain damage from hypoxia is the most serious long-term injury from negligent resuscitations. This damage can cause cerebral palsy, autism, intellectual disabilities, cognitive disabilities, physical disabilities, or functional disorders such as ADD or ADHD.

The extent of such disabilities may not be immediately apparent. Sometimes it’s only as a child ages that abnormal development is recognized. Living with a serious disability is very challenging for both the injured child and their loved ones. Assistive devices, therapies and medications can help many people as they navigate these conditions, but some severely disabled people will not be able to live independently, hold employment, and may require significant support throughout their lives.

While these treatments and other supports can be very costly, if the child’s injuries or disabilities were the result of negligent resuscitation, they and/or their loved ones may be able to receive compensation and damages for their losses and the cost of future care.

Here to help.

When the joy and excitement of a new birth turns to worry, sadness and despair, you may not know what to do or where to turn. As one of Canada’s leading birth injury law firms, Gluckstein Personal Injury Lawyers can help you as you make sense of what happened and learn and understand your rights and various options.

Our team of knowledgeable, experienced and skilled birth injury lawyers have handled many cases where negligent resuscitation caused serious harm to a newborn. Drawing on our network of healthcare experts, we determine whether standards of care were breached during pregnancy, at the time of delivery, or in the critical first minutes after birth that would have caused your child’s injuries.

Establishing how substandard care led to injury can be challenging as there are many variables during a birth that can sometimes obscure the way medical negligence affected the outcome. Gluckstein Personal Injury Lawyers’ decades of experience and our focus on cases within this field will give you confidence in our representation.

A strong reputation among peers and clients.

Recognized by our peers in the legal field as one of Canada’s Top 10 Personal Injury Firms, Gluckstein Personal Injury Lawyers is known for our innovation, for ability to handle even the most complex cases, and for our commitment to full-circle client care.

When you first contact us, a member of our team will listen to your story with great attentive concern and empathy. We will explain your rights and options and discuss possible next steps if you would like to file a claim against a medical practitioner and/or institutional provider.

You may be concerned about the cost to pursue a lawsuit; however, when Gluckstein Lawyers take on a case it's because we believe strongly that we will be able to achieve a positive outcome for our client. Therefore, we only accept payment if we are successful in negotiating a settlement or winning a court award for you.

If we become your legal representative, you will benefit from our renowned client liaisons - some of whom have their own experience with family members who have sustained serious personal injuries. These liaisons will be there to answer any and all questions you have about the process or simply to check in to see how you are managing.

Even after your case has been settled or decided at trial, Gluckstein Personal Injury Lawyers are always here for our clients. Why? We see and treat our clients as if they are family and we care about your well-being both now and into the future.

Trust our team to be on your side during this difficult time in your life. Contact Gluckstein Personal Injury Lawyers today to learn more about what we can do for you.