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Group B strep (GBS) is a bacteria that can be found in a woman’s vagina or rectum. It is found in as many as 40% of health women.

“Pregnant women who test positive for GBS are said to be ‘colonized,'” said New York birth injury lawyer Michael A. Bottar, Esq. “Colonized mothers can pass GBS to their babies during labor and delivery which can cause meningitis, sepsis or pneumonia in newborns. GBS can also cause maternal infection and death.”

Because of the risk of transmission, the Centers for Disease Control and Prevention recommends that all pregnant women be tested between the 35th and 37th week of pregnancy. Testing sooner or later is not effective.

A new test gives obstetricians and labor and delivery nurses more rapid results and should decrease the need for doctors to assume that a pregnant mother is colonized an administer antibiotics until they know otherwise. The new test promises results in as few as 4 hours. The old way took 48-72 hours. The failure to timely test for and/or treat GBS is medical malpractice.
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Many babies are diagnosed with cerebral palsy and other birth injuries due to a period of fetal distress during labor and delivery. “Every year, our legal team investigates claims arising out of a failure to respond to dangerous decelerations recorded on fetal heart monitor tracings,” said Syracuse birth injury lawyer Michael A. Bottar, Esq., of Bottar Law, PLLC, a law firm with a practice limited to medical malpractice and catastrophic injury cases throughout the State of New York.

“Historically, obstetricians and labor and delivery nurses had to review fetal heart monitor tracings in a specific location, whether it was at the bedside or on a remote computer monitor,” Bottar said. When these individuals are unavailable, timely and appropriate review of the tracings can overlooked and even minutes of delay can lead permanent disability, including cerebral palsy, Erb’s palsy and global developmental delays.

Recently, a monitoring system was released that allows obstetricians to monitor the vital signs of a laboring mother and unborn baby through a smart phone application known as AirStrip OB. The system, which is being tested at Summit Medical Center in Tennessee, delivers various vital signs including fetal heart rate and maternal contractions in real-time. The application also affords doctors an opportunity to review nursing notes.

“AirStrip OB is a great development. It should cut down on the number of missed opportunities to prevent a birth injury stemming from, e.g., insufficient oxygen (hypoxia) or poor blood flow (ischemia). Soon, all busy obstetricians will need to do to avoid malpractice is look at their iPhone to see – instantly – how a labor is progressing. Or, more importantly, if it is not proceeding as planned. As the fetal brain can be permanently damaged in minutes, it is encouraging to know that help for a struggling baby may now been only a phone call away.”
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“Baby boomers are spending more and more time in hospital emergency rooms because of the medications that they take,” said New York medication error lawyer Michael A. Bottar, Esq., an attorney with Syracuse-based Bottar Law, PLLC, a team of lawyers handling New York emergency room lawsuits. “Unfortunately,” Bottar added, “many of the medications that seniors take do more harm than good.”

According to Dr. Carolyn Clancy, the Director of the Agency of Healthcare Research and Quality, Americans take a record number of medications to maintain their health. This is because many medical problems can now be treated with drugs that were not available years ago. However, a constellation of drugs used to treat virtually all ailments have been linked to three troublesome conditions, including: (1) drug-induced delirium, (2) drug overdose, and (3) drug withdrawal.

Often, when seniors present to emergency rooms with complaints, they are prescribed drugs that are not compatible (i.e., contraindicated) with their current medication regimen. For example, seniors on blood thinners should not receive tPA, a stroke drug we blogged about previously in a post titled “What Is tPA and Is It Available In Central New York Emergency Rooms.” Likewise, prescriptions are frequently discontinued in the emergency room setting even through the patient should not stop taking a drug. “Either scenario can have devastating consequences,” said Bottar, whose office is currently prosecuting several medication error lawsuits involving severe personal injury and permanent disability, including stroke and blindness.
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On August 23, 2010, the American College of Obstetricians and Gynecologists announced in Committee Opinion #465 that all pregnant women should receive antibiotics one (1) hour before having a cesarean delivery.

“Certainly, the antibiotics will cut down on the number of post-operative wound infections,” said Syracuse birth injury lawyer Michael A. Bottar, Esq., an attorney with Bottar Law, PLLC, a law firm prosecuting New York obstetrical malpractice lawsuits. “At the same time, we are concerned that unborn babies experiencing fetal distress may suffer a brain injury due to a delayed c-section. Setting aside the risk of infection, if a baby is experiencing oxygen deprivation, known as hypoxia, we would like to see an abdominal or vaginal delivery occur as soon as possible because prolonged hypoxia can cause cerebral palsy and other permanent brain damage.”

Infection is a well-documented complication of a cesarean delivery, occurring in 10-40% cases. Historically, antibiotics were administered to women having a c-section, but not until after the baby was born. This was because physicians were concerned about antibiotics passing into baby’s bloodstream.
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“7 out of every 1,000 children experience a birth injury,” said Watertown cerebral palsy lawyer Michael A. Bottar, Esq., an attorney with Syracuse-based Bottar Law, PLLC, a law firm prosecuting New York birth injury lawsuits throughout the State, including those arising out of a failure to diagnose preeclampsia discussed in our blog post titled “Watertown New York Women With Gestational Diabetes At Risk For Preeclampsia, Palsy and Birth Injury.”

“Caring for these children takes time and costs money.” Many organizations exist to aid children permanently disabled following a difficult birth. These organizations, like the Northern New York Cerebral Palsy Association, provide services to children with conditions such as cerebral palsy while, at the same time, acting as a resource to families with children who have developmental disabilities.

Not-for-profit organizations cannot exist unless the community donates time and/or money. “Even in difficult times, we must remember to take care of those who cannot take care of themselves.”
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Persistent pulmonary hypertension of the newborn is a potentially fatal condition where a baby’s circulatory system fails to adapt to life outside of the womb. According to Michael A. Bottar, Esq., a Syracuse birth injury lawyer with Bottar Law, PLLC, an upstate New York law firm handling medical malpractice lawsuits through the State, “PPHN accounts for 2-9% of admissions to neonatal intensive care units.”

A baby’s failure to transition from a high pulmonary vascular resistance to a normal low pulmonary vascular resistance causes PPHN. Our team of New York PPHN lawyers is familiar with the labor and delivery complications that are associated with persistent fetal circulation, including meconium aspiration syndrome (MAS), severe intrapartum asphyxia, pulmonary vasoconstriction, hypoxia, acidosis and exposure to SSRIs discussed in our blog post titled “Syracuse New York Persistent Pulmonary Hypertension of the Newborn Lawyers Survey Connection To Birth Injury and SSRIs.” Prompt diagnosis of PPHN is critical because, if timely identified and treated, much of the disease process can be reversed.

A pregnant mother is considered full term at 37 weeks. Until recently, a woman could elect to deliver early by c-section at that time. Recently, published data suggests that babies born at 37 and 38 weeks are at a greater risk for developing respiratory problems and pulmonary hypertension than babies born at 39+ weeks gestation. As a result, doctors in Florida and other states are stopping elective early induction.
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“Consumption of folic acid is very important during pregnancy,” said Michael A. Bottar, Esq., a New York birth injury lawyer presently investigating Syracuse PPHN lawsuits and Watertown retinopathy of prematurity claims. “Folic acid helps to prevent birth defects.”

Folic acid, also known as folate, is a B9 vitamin found mostly in green leafy vegetables. According to a recent UK study, folic acid supplementation during protects against low birth weight babies, as well as neural tube defects (brain and spinal cord defects) such as spina bifida. Repeated studies have shown that women who consume 400 micrograms daily prior to conception, as well as during early pregnancy, may reduce the risk that their baby will be born with a serious neural tube defect by up to 70%.

Babies born premature (i.e., before 37 weeks) are at high risk for respiratory distress and circulatory problems, some of which we discussed in our blog post titled “New York Persistent Pulmonary Hypertension of the Newborn Risk High If Induced Before 39 Weeks.” Babies born premature are also at risk for cerebral palsy, as discussed in our blog post titled “New York Premature Birth Injury Report Card.”
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“Binghamton children born prematurely are at high risk for behavioral and health problems,” said Syracuse birth injury lawyer Michael A. Bottar, Esq., of Bottar Law, PLLC, a team of trial lawyers handling New York medical malpractice lawsuits sounding in cerebral palsy and global developmental delays.

“Right now we are investigating several claims that involve premature deliveries. Each emergent delivery could have been avoided had medical personnel timely identified the risk of prematurity and taken steps to delay birth.” Even though advancements in medicine have improved preterm newborn survival rates, recent studies have uncovered long-term challenges that preemies will face, such as lower IQ scores and higher rates of behavioral problems including anxiety, depression and hyperactivity. As many as 18% of preterm children had hyperactivity/inattention problems and 14% had anxiety/depression. “Prematurity is also associated with cerebral palsy and other disorders, such as retinopathy of prematurity,” said Bottar.

Appropriate prenatal care is critical to the healthy development of a fetus and to the timely diagnosis of problems with fetal growth and development and conditions affecting pregnant mothers, e.g., preeclampsia, gestational diabetes, and intrauterine growth restriction (IUGR). The failure to diagnose preeclampsia can lead to an emergency c-section to prevent irreversible maternal heart damage. Likewise, the failure to diagnose IUGR can lead to a dangerously low-birth weight baby.
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While it is well-known that birth control pills may increase the risk of a stroke, a new dangerous side-effect is receiving the attention of the medical field. According to a physician who spoke at the “50 Years of the Pill” conference last week in Washington, D.C., there is a strong link between the pill and an increased risk of breast cancer, as well as cervical cancer and liver cancer.

“The ‘pill’ was developed in the 1950s. Data suggests an astounding 660% increase in non-invasive breast cancer since 1973,” said Michael A. Bottar, Esq., a New York medical malpractice lawyer with Bottar Law, PLLC, a Syracuse-based law firm with decades of experience handling cases involving avoidable metastastic cancer. “Doctors should be aware of the potential association between the pill and cancer so that they can help their patients avoid the consequences of a failure to diagnose breast cancer, cervical cancer misdiagnosis, or late diagnosis of liver cancer.”

Breast cancer, in particular, presents a very real risk for women, especially following a confusing U.S Preventive Service Task Force recommendation against yearly mammograms and breast self-examinations which we blogged previously in a post titled “Failures To Diagnose Breast Cancer May Increase Following Task Force Recommendations.” Risk factors for breast cancer in women include increasing age, a prior breast cancer diagnosis, a family history of breast cancer, high breast tissue density, high-dose chest radiation, no children (or first child after age 30), and a long menstrual history.
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“Approximately 1% of all births are complicated by a shoulder dystocia,” said Michael A. Bottar, Esq., a Syracuse birth injury lawyer with Bottar Law, PLLC, a law firm with decades of experience representing babies diagnosed with Erb’s palsy following a brachial plexus injury during birth.

A shoulder dystocia occurs when a baby’s head passes into the birth canal but the anterior shoulder becomes stuck behind the mother’s pubic bone. At this critical point in time, a baby typically has a compromised oxygen supply because of umbilical cord compression and is not yet breathing room air. In turn, medical staff has only minutes to perform maneuvers to free the baby or risk oxygen deprivation and permanent brain damage which can lead to cerebral palsy, or physical injuries such as collar bone fractures and nerve damage leading to Erb’s palsy and Klumpke’s paralysis.

Approximately 20% of all shoulder dystocias result in an injury to the baby. Often times, a shoulder dystocia is unpredictable. However, there are know risk factors including: a prior shoulder dystocia, diabetes, an inadequate pelvis, fetal macrosomia, post-date gestation, preeclampsia, and maternal obesity.

Recently, a Montreal physician developed an algorithm that can calculate risk for a shoulder dystocia. That algorithm can be incorporated into computer software, known as the CALM Shoulder Screen, to help obstetricians and nurses predict labor and delivery complications. The web-based program is reported to be effective at 37 weeks gestation.
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