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Birth Injury - Cerebral Palsy - Toronto Lawyers


TORONTO LAWYER HELPLINE: ☎ 855 804 7142



Medical mistakes are responsible for many birth injury cases and it would be impossible for a parent, alone, to determine if medical malpractice caused their child's injury. It is only through the concerted and dedicated efforts of a legal and medical team that the cause can be ascertained.

Please consider cerebral palsy information which contains FAQs and if you believe that your child's condition is as a result of medical malpractice in Ontario and you would like advice at no cost on compensation claim settlements from a Toronto birth injury lawyer just call the helpline or complete the contact form or email our Toronto offices and a specialist medical malpractice lawyer based in Toronto will telephone to discuss your child's potential birth injury compensation claim at no cost and with no further obligation.

The Cause of Cerebral Palsy

The cause of cerebral palsy is an injury to an infants brain occurring before, during or shortly after delivery. This birth injury is irreversible and nothing can be done to undo the damage to the brain. The two main causes of this condition are failure of the brain to develop which is a naturally occurring phenomena and neurological damage to the child's brain which may be as a result of medical malpractice.

Congenital Malformation?

Many infants have a natural dysfunction of the brain which is often referred to as a birth defect as opposed to having been injured as a result of medical malpractice. A naturally occurring congenital malformation is almost always initially suspected especially when there is an absence of any of the well known medical negligence risk factors. Good prenatal care reduces the risk of birth defects although they can occur even when the mother has strictly followed good advice during pregnancy. The hard facts are that medical malpractice causing a birth injury is the cause of cerebral palsy in only 10% of cases with the remaining 90% of cases being attributed to a natural birth defect.

Symptoms

Different types of cerebral palsy symptoms divide this condition into four main categories which are :-

    Athetoid CP is caused by damage to the areas of the brain that enable smooth, coordinated movements and maintain body posture. This condition causes involuntary, purposeless movements, especially in the face, arms, and trunk which often interfere with speaking, feeding, reaching, grasping and other skills requiring coordinated movements.

    Spastic CP affects 70-80% of patients and is the most common form. The muscles remain in a constant state of increased involuntary reflex with one or more tight muscle groups which cause stiff and jerky movements. There may be difficulty moving from one position to another or holding and letting go of objects.

    Ataxic CP is characterised by poor muscle tone and altered sense of balance and depth perception, leading to slow, uncoordinated, unsteady and shaky movement.

    Mixed CP is a combination of the above types but is most often a mixture of spasticity and athetoid movements, with tight muscle tone and involuntary reflex.

Diagnosis

Infant cerebral palsy diagnosis is often a difficult and slow process that takes time to establish with certainty as there other health problems that can mimic the condition. Children under the age of six months may demonstrate some or all of the following indicative symptoms however a positive diagnosis does not necessarily follow :-

  • irritability
  • lethargy
  • abnormal crying
  • feeding difficulties
  • arms and legs trembling
  • poor muscle tone
  • seizures which may include staring spells, eye fluttering or body twitching
  • abnormal posture
  • abnormal reflexes
  • hand held in tight fist
  • muscle tone changing from floppy to very stiff
  • asymmetry of movement

Children suffering from brain injury are often slow to reach developmental milestones including rolling over, sitting up, crawling, walking and talking. Healthcare professionals are often hesitant to reach an early cerebral palsy diagnosis because the child may recover and they may use other, less emotive terms such as:

  • neuromotor dysfunction
  • developmental delay
  • motor disability
  • static encephalopathy
  • central nervous system dysfunction

Prior to making an infant cerebral palsy diagnosis other disorders that cause movement problems must be eliminated and there are a number of techniques available:

    Cerebral palsy is a static condition and declining motor skills may indicate other problems including genetic disease, muscle or metabolic disorder, or tumour in the nervous system.

    Electromyography and nerve conduction studies which are a type scan may reveal disorders of the nerves or muscles.

    An electroencephalogram (EEG) which is an electrical scan of the brain may reveal patterns that suggest a seizure disorder.

    Chromosome analysis should be carried out to eliminate hereditary genetic disorders which may be mimicking the condition thereby hiding a genetic anomaly.

    Analysis of the blood may show a high level of ammonia which is toxic to the central nervous system and may be due to a liver disorder or a defect in metabolism.

    Thyroid tests may show inadequate levels of thyroid hormone, which may produce congenital defects and mental disability.

    Imaging tests may diagnose hydrocephalus, structural abnormalities, and tumours.

    CT scans of the head can show congenital malformations, haemorrhage, and periventricular leukomalacia.

    Magnetic resonance imaging (MRI) may show abnormalities of the structure of the brain.

    Ultrasound scan of the brain can detect cysts and abnormal structures.

Infant cerebral palsy diagnosis is not confirmed until there is absolute certainty because the extent of the child's problems may not become clear for some time. Doctors must test the child's motor skills, using many of the techniques outlined above and carefully consider the medical history and in particular look for evidence of slow development, abnormal muscle tone, and unusual posture. Healthcare professionals will move slowly and carefully towards a positive diagnosis only after eliminating all other possible causes of the child's condition

Cerebral Palsy Treatment

The idea and concept of cerebral palsy treatment is difficult to define because there is nothing that can undo irreversible brain damage, however there are many therapies available to help an injured child function at the highest level possible. These therapies include different approaches to help better manage and control physical and mental disability and may include :-

    Physical Therapy:

      A physical therapist specializes in improving the development of the large muscles of the body, such as those in the legs, arms and abdomen and helps children to learn better ways to move and balance. Physical therapists also work on play skills including running, kicking and throwing, or learning to ride a bike. Cerebral palsy treatment and therapy is normally started soon after a diagnosis is made, usually in the early years of a childs life and is used to prevent contracture complications by stretching the affected muscles and is used in certain other situations to improve motor development. Exercises can help to avoid contractures which is one of the most serious and unpleasant as well as common, complications. Contractures can disrupt previous achievements or affect balance and stability and exercises help to keep the muscles from becoming weakened or from deteriorating due to lack of use.

    Drug Therapy:

      Cerebral palsy treatment includes the use of a wide range of medications.

      • tranquilisers may be used to relax tightened muscles
      • antispasmodics may be used to reduce spasms
      • seizures can be treated with an anticonvulsant medication
      • patients with the athetoid form are sometimes prescribed medication to reduce the abnormal movements that they experience

    Occupational Therapy:

      An occupational therapist attempts to improve the control and motion of the small muscles of the body including the hands, feet, face, fingers and toes. The aim is to improve daily living skills including dressing and eating and and also to help develop easier ways to write, draw and do other fun things. Occupational therapists will also recommend the right special equipment to make everyday jobs easier.

    Surgery:

      Some contractures can cause problems in movement and in appropriate circumstances surgery can be used to alter muscle structure. Surgery may also be used as part of cerebral palsy treatment to reduce the amount of nervous stimulation that can reach the muscles.

    Speech and Language Therapy:

      A speech therapist assists in the development of better control of the muscles around the mouth and jaw, which can improve speech, language skills and eating abilities. A speech and language therapist will work on communication skills and will also help develop creative communication methods for those who are unable to speak including talking, using sign language or using a communication aid. Children who are able to talk may be taught more clear speech or may have language skills improved by learning new words or learning to speak in sentences.

Birth Injury Risk Factors

In assessing the cause of this condition both medical practitioners and cerebral palsy lawyers will consider the recognized risk factors of medical malpractice which may predispose an unborn child to a brain injury including :-

  • contraction of infections including rubella, toxoplasmosis and cytomegalovirus
  • low birth weight
  • exposure during pregnancy to alcohol, cigarettes, cocaine and other chemicals
  • severe physical trauma during pregnancy
  • the child being born pre-term

Cerebral Palsy Indicators

A birth injury lawyer will consider a number of possible indicators that all was not well during the delivery. Whilst the items on the following list are not exhaustive it may be sensible to investigate the possibility of medical malpractice if any of them occurred during delivery:

  • emergency delivery by caesarian section
  • emergency delivery with forceps
  • resuscitation or CPR after birth
  • seizures immediately after birth
  • seizures within the first 3-4 days of life
  • transfer to an intensive care unit
  • special testing after birth
  • oxygen required to facilitate breathing shortly after birth
  • MRI scan, CT scan or brain scan
  • a specialist was in attendance

Delivery Errors

The delivery of a child can result in numerous problems many of which can cause serious injury or death. A cerebral palsy attorney will initially obtain and review the medical records relating to the delivery and in particular will be looking for evidence of the most obvious causes of negligence before sending the records on for detailed consideration by a specialist physician. The most common errors made during delivery that may cause a birth injury include:

  • failure to treat seizures following delivery
  • leaving the child in the birth canal for an excessive period
  • improper vacuum extraction
  • failure to detect a prolapsed umbilical cord reducing oxygen supply
  • improper use of delivery forceps
  • failure to respond to changes in the fetal heart rate
  • failure to plan a caesarean section for a potentially large birth weight
  • failure to perform a caesarean section in the presence of fetal distress
  • failure to diagnose and treat kernicterus or meningitis
  • failure to respond to the mother's high blood pressure or toxemia

Medical Errors

Some of the errors made by healthcare professionals during delivery that can contribute to birth injury include:

  • failure to recognize and treat seizures following delivery
  • leaving the child in the birth canal too long causing a lack of oxygen to the brain
  • excessive use of vacuum extraction
  • failure to detect a prolapsed umbilical cord reducing oxygen supply
  • improper use of delivery forceps
  • not responding to changes in the fetal heart rate
  • failure to perform a c-section in the presence of fetal distress
  • failure to plan a c-section for a potentially large birth weight
  • failure to diagnose and treat jaundice or meningitis
  • failure to respond to the mother's high blood pressure or toxemia

Negligence Indicators

The following factors may indicate medical malpractice and may justify further investigation into the cause of cerebral palsy:

  • resuscitation (CPR) after birth
  • emergency delivery with forceps, or by c-section
  • seizures immediately after birth, or within the first 3-4 days of life
  • special testing after birth, such as an MRI scan, CT scan or brain scan
  • transfer to an intensive care unit
  • a specialist was called to care for your baby
  • oxygen required to facilitate breathing after birth


TORONTO LAWYER HELPLINE: ☎ 855 804 7142