The Birth Injury Case: Proving Malpractice (Part I)


There is nothing more devastating than having a child born with a hypoxic brain injury. The mere fact that your child has a devastating injury or defect does not, however, mean that a doctor or nurse did something wrong. Separating the instances of unpreventable, unfortunate outcomes from true medical malpractice typically requires the assistance of an experienced birth injury lawyer. Most lawyers, once provided with the medical records, will undertake to evaluate your circumstance at no charge to you, and with the help of medical consultants will determine whether there is a provable claim. In Part I of this article, we we will discuss the information needed to evaluate a medical malpractice binrth injury claim.

a. Mother’s Prenatal Records Before the Birth of the Baby

Typically, the mothers have had prenatal care, and have been seen by an OB/GYN, either privately or through a clinic, and have had ultrasounds or other imaging performed during their pregnancy. These records must be reviewed and analyzed for signs of problems during the pregnancy that may not have been properly addressed, or for evidence of a genetic condition which may have caused the poor outcome. Whether you have been properly screened for gestational diabetes, pre-eclampsia (high blood pressure associated with pregnancies) or other conditions which might have affected the birth will be apparent in the prenatal record. These records will also identify the baby’s due date and whether the baby was overdue or pre-mature.

b. Mother’s Hospital Records

Hospital records of the labor and delivery will document when the doctors and nurses saw you and what they did to evaluate your baby immediately before and during the delivery. These records will show your status as well as the baby’s during the course of your labor. Whether your labor was progressing normally or abnormally, whether the baby was descending at an acceptable rate, whether there were signs that the baby was having difficulty getting through the birth canal, whether the power or frequency of the contractions were appropriate and whether medications such as Pitocin were being properly given, are issues to be reviewed in these records.

c. Electronic Fetal Heart Tracings

Typically, you and your baby will have been monitored through an electronic fetal heart monitor which records the baby’s heart rate, your contractions and vital signs. The electronic fetal monitor is intended to serve as an early warning system for potential problems with you or your baby. An expert can review these tracings to determine if there were signs of potential problems which went undetected and/or unresolved. The monitor tracings may reveal whether your contractions were occurring too close together, whether the baby was exhibiting signs of fetal distress and the extent to which nurses or physicians involved in the care were properly monitoring you and your baby and responding to any signs of danger. A hard copy of these monitoring strips are typically maintained by the hospital with the medical chart, and may contain hand written notations by the nursing staff with regard to what, if anything, was being done. These tracings can be the most significant evidence of negligence in a legal case.

d. The Baby’s Records

The baby’s records will document the baby’s APGAR scores which assess the status of the baby at one and five minutes after birth, as well as the pH and oxygenation levels of the baby’s blood. They will reveal when and if your baby suffered seizures consistent with a hypoxic injury, during the post-partum period.

eImaging Studies

Ultrasounds, CT scans, and MRIs of the baby’s brain taken after the birth may reveal the presence of an anoxic brain injury and whether the damage was an acute event. These studies may provide a basis for determining the window of time within which your baby’s injury occurred. Pediatric neurologists are typically consulted to review these studies.


Proving malpractice as a cause of a birth defect or injury is a difficult matter. The process of evaluating whether or not negligence occurred can be a long one. A thorough analysis of the records by an experienced birth injury lawyer working with medical experts is necessary to determine whether or not the claim can be proved. While an evaluation may not find that there was negligence, an evaluation by the professionals can at least give you some answers, as to why,the injury occurred.

This handy Pennsylvania medical malpractice tip is provided by the Philadelphia medical malpractice law firm, The Law Offices of Judy Greenwood, P.C., at 1800 JFK Boulevard, Suite 1500A, Philadelphia, PA 19103,, email [email protected].

About the author: Philadelphia medical malpractice attorneys Judy Greenwood & Stephen Ulan have represented victims of medical negligence and catastrophic injuries for 25 years. Their office is located at 1800 JFK Blvd., Suite 1500A, Phila., PA 19103,, email [email protected].

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