Delayed C-Sections and Birth Injury Claims in Pennsylvania
A C-section can be a life-saving procedure in a complicated pregnancy – or if complications arise during labor. Delaying a C-section doesn’t always constitute a case of medical negligence. However, if the warning signs are not recognized in time and acted on, the risk of serious birth injuries becomes high.
In this case, a delayed C-section may be the basis of a birth injury claim in Pennsylvania.
Planned vs emergency C-section
A cesarean section, often referred to as a C-section, is a surgical procedure to deliver a baby via incisions on the mother’s abdomen and uterus.
A planned C-section is scheduled in advance. Common reasons include the breech position of the baby, a history of previous C-sections, or placenta previa (a condition in which the placenta fully or partially covers the cervix).
An emergency C-section is a cesarean delivery that needs to be performed quickly because carrying on with the pregnancy or labor has become unsafe for the baby, the mother, or both.
There have been lawsuits over the failure to schedule a C-section. However, lawsuits related to emergency C-sections are more common.
Common Reasons an Emergency C-section May Be Required
There are several reasons an emergency C-section may be required:
- Fetal distress: the baby’s heart rate (or other signs) suggest that they are not getting enough oxygen and need to be delivered immediately.
- Failure to progress in labor: it has slowed down, stopped, or the baby is in a difficult position for birth.
- Placental abruption: the placenta separates from the uterine lining, interfering with the baby getting enough oxygen and causing severe bleeding for the mother.
- Umbilical cord prolapse: the umbilical cord slips into the birth canal before the baby, becomes compressed, and limits blood flow and oxygen for the baby.
- Uterine rupture: there is a tear in the uterine wall that requires immediate surgery.
- Breech or transverse presentation of the baby that is discovered during labor.
- Cephalopelvic disproportion (CPD): the baby’s head or body is too large, or the mother’s pelvis is too small for a safe vaginal delivery.
- Preeclampsia or eclampsia: severe high blood pressure or seizures during pregnancy that require urgent delivery.
Signs of Fetal Distress And Delayed Medical Intervention
One of the main indications for an emergency C-section is fetal distress. The more accurate medical term for this is non-reassuring fetal status. It refers to situations when the baby is not tolerating labor well, which is often related to insufficient oxygen supply.
To monitor the baby, healthcare providers use electronic fetal heart rate monitoring (EFM). It continuously records the baby’s heart rate alongside the mother’s contractions. This offers key information about how the baby is coping with labor. In some cases, providers may also use internal fetal monitoring when a small electrode is attached to the baby’s scalp for more accurate measurements.
Other assessment methods include monitoring the mother’s vital signs, evaluating the frequency and strength of contractions, checking the color of the amniotic fluid, and performing cervical examinations.
Several signs may indicate to a medical professional that the baby is in distress:
- Persisting abnormal heart rate pattern: for example, bradycardia (the slowing of the heart rate) or tachycardia (an unusually fast heart rate).
- Repeated late decelerations: the baby’s heart rate appears slower after each contraction.
- Little normal fluctuation in the baby’s heart rate, which can be a sign that the baby is not receiving enough oxygen.
- Meconium-stained amniotic fluid, especially if thick meconium is present, as this often indicates fetal stress.
- Reduced fetal movement, particularly when accompanied by other concerning findings.
A single sign of fetal distress doesn’t necessarily mean that an emergency C-section is required. Medical professionals typically evaluate the overall clinical picture, which also includes the stage of labor, mother’s condition, underlying complications in the pregnancy, and others.
Delayed medical intervention occurs when the healthcare team fails to respond appropriately once the signs of fetal distress become apparent – and it can happen at any stage of labor and delivery.
They may not recognize an abnormal heart rate pattern, continue labor despite signs of distress, or wait too long to notify the attending obstetrician of the complications. Delays may also arise for administrative reasons: for example, there may be postponements in preparing an operating room or assembling a surgical team.
When a family believes that a C-section was delayed and it resulted in a birth injury that could have been prevented, consulting a Philadelphia birth injury lawyer is usually the best course of action. An attorney experienced in Pennsylvania birth injury litigation can help the family evaluate the specifics of their case and gather the necessary evidence to move forward.
Birth Injuries Linked to Delayed C-sections
Under Pennsylvania law, a birth injury is any physical harm a baby sustains before, during, or immediately after the delivery process that results from medical negligence.
Several birth injuries are linked directly to delayed C-sections:
- Hypoxic-ischemic encephalopathy (HIE) – a type of brain injury caused by insufficient oxygen and reduced blood flow to a newborn’s brain.
- Cerebral palsy – a group of illnesses that affect a baby’s ability to move, balance, and hold themselves upright.
- Seizure disorders – sudden abnormal instances of electrical activity in the brain.
- Brain damage – insufficient oxygen can harm brain tissue and potentially affect a child’s ability to learn, speak, and move.
- Developmental delays – some children may go on to experience delays in meeting developmental milestones such as speech, motor skills, and cognitive skills.
- Permanent neurological impairment – this is a lasting neurological disability that affects a child’s ability to walk, communicate, or live independently.m
- Stillbirth – severe oxygen deprivation may result in the loss of the baby before delivery.
Determining whether a delayed C-section contributed to a particular birth injury requires a detailed review of the medical records and expert medical evaluation.
How Negligence is Established in Birth Injury Cases
Under Pennsylvania law, birth injury claims require proof that the medical team did not deliver the accepted standard of obstetric and neonatal care.
To determine if the necessary standards of care were met, lawyers typically use
- electronic fetal monitoring strips
- medical records
- nursing notes,
- and the testimony of medical to professionals.
How Does Pennsylvania Law Treat Birth Injury Cases Differently?
There are several key moments where the way Pennsylvania law treats birth injury cases differently compared to other states.
- Pennsylvania law follows the “18 Plus 2” rule and gives families additional time to file a birth injury lawsuit. Medical malpractice claims for adults follow a two-year statute of limitations. However, this doesn’t apply to claims filed on behalf of minors. For birth injury claims, the two-year statute does not start running until the child turns 18.
This means that the family can file a birth injury claim up until the child’s 20th birthday. The law recognizes that there are birth injuries that cannot be fully diagnosed until years later – and Illnesses like cerebral palsy, developmental delays, and cognitive impairments may only become apparent as the child grows up.
Once the child turns 20, the right to file a birth injury claim expires permanently.
While the law does give families the right to extra time, waiting too long before filing a claim can create problems. It could become more difficult to obtain medical records, find witnesses, and remember details. Generally, the sooner legal action is taken, the stronger the case will be.
- While some states put limits on how much money a family can recover in non-economic damages such as pain and suffering, there is no cap on compensation in Pennsylvania. Only punitive damages are capped at 200% of the monetary compensation.
- Pennsylvania state law requires the claimant to provide a signed Certificate of Merit within 60 days of filing the lawsuit. The certificate should state that a licensed medical professional has studied the case and agrees that the provided care was below the accepted professional standard
What Compensation Can Families in Birth Injury Cases in Pennsylvania?
Under Pennsylvania law, the goal of compensation in a birth injury case is to help “restore” the injured person – as much as compensation can.
And as there is no cap on compensatory damages in birth injury cases, families have the opportunity to recover the full value of their losses.
Families can claim economic and non-economic damages in birth injury cases.
Economic damages are quantifiable expenses that the family incurs as a direct result of the child’s injury at birth. These include past and future medical expenses, assistive equipment (walkers, wheelchairs, communication boards), necessary home and vehicle modifications, special education and therapy, home care and long-term care. In severe cases, families can also request compensation for the child’s loss of ability to financially support themselves in later life.
Non-economic damages describe a less tangible loss such as pain, suffering, and emotional trauma. There is also a specific legal concept in Pennsylvania known as loss of life’s pleasures. Under it, the child may also be compensated for their inability to enjoy life’s pleasures: playing sports, swimming, reaching milestones as a child and adult.
To receive adequate compensation in a birth injury case, families need to present strong objective evidence. As birth injury cases rely on complex medical details, they often require attorneys who understand and have experience with obstetric medicine and neonatal care.
