Cerebral Palsy | Medical Negligence Solicitors
Cerebral palsy represents a collection of neurological abnormalities that begin in infancy or early childhood. Cerebral palsy affects the coordination of muscles and the movement of the body, including speech and limb movement. The problem has nothing really to do with the nerves or muscles but instead it is damage to the brain that causes the symptoms you see with the disease. Most children with cerebral palsy are in fact born with the disease although it might not show up for several months. Some children do not develop the disease until they reach the age of three. The most common symptoms are coordination difficulties, involuntary movements of the muscles, stiff muscles or spasticity (stiff muscles). While most children are born with the disease, some children can develop cerebral palsy if they suffer from a bacterial meningitis or viral encephalitis at a young age, or if they sustain a head injury from child abuse or a motor vehicle accident. Most cerebral palsy is not as a result of medical negligence and in the majority cases it will not be possible to make make a solicitors compensation claim.
This condition is caused by irreversible damage to the brain as a result of an injury caused before, during or shortly after birth. There is nothing that can reverse the damage to the brain, although it may be possible to lessen the discomfort to the victim by therapy, including surgery and pharmaceuticals. In most cases this condition is a naturally occurring event with no obvious cause however there are some victims whose injury has been caused by inadequate clinical procedure by a healthcare provider. In these cases it may possible for a cerebral palsy medical negligence solicitor to make a compensation claim and whilst an award of damages can never make up for the damage done, it can ensure the patients lifestyle is improved and may provide care and sustenance at a level that might otherwise not be possible. If you would like legal advice on medical negligence compensation claims at no cost and with no further obligation just contact our personal injury solicitors.
This condition is a catastrophic injury altering the lives of both victims and their families forever. Most families don't have the resources to cover all of the expenses and provide for the child over his or her lifetime. That's where a cerebral palsy medical negligence solicitor can assist your child to claim the compensation they deserve. If the cause of your child's condition resulted from medical negligence, we can help you assert your child's rights and get the compensation that your child needs and deserves to ensure the best ongoing treatment. Our cerebral palsy medical negligence solicitors are currently reviewing compensation claims and arranging legal representation for people from all around Australia whose children suffer from this debilitating condition.
Our cerebral palsy medical negligence solicitors have offices situated in Adelaide, Brisbane, Canberra, Melbourne, Perth, Darwin, and Sydney.
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No one has discovered specific events in the birth process that definitely lead to cerebral palsy. In fact, in developing countries where the neonatal death rate is high, there is no more CP than in developed countries. Interventions like Caesarean sections and foetal monitoring have done much to reduce infant mortality but have done nothing to change the rate of cerebral palsy. The incidence of having the cord around the neck is about 25 percent and the incidence of meconium at birth is about 16 percent. There is an extremely small correlation between these events and the development of cerebral palsy. Babies with low Apgar scores, on the other hand, had 250 times the incidence of CP than those infants with normal Apgar scores. Fifty percent of the infants who had severe asphyxia during the birth process did not develop CP at all. Some doctors believe that the low Apgar score is a sign of an already sick baby that may go on to show the signs and symptoms of CP. Suffice it to say that CP is more than likely due to prenatal abnormalities. Most cases of cerebral palsy will not give rise to a solicitors compensation claim due to the lack of evidence of negligence on the part of the healthcare provider.
Most cases of cerebral palsy have no known cause. This is especially true of cerebral palsy a child was born with. Preterm babies who don’t cry shortly after delivery or who need ventilator treatment shortly after birth for four weeks or longer have a higher risk of CP. In addition, infants who have bleeding in the brain have a higher risk of developing the disease. Birth trauma can rarely cause CP and children who have other abnormalities, such as heart, spine or kidney problems have CP as part of their disease cluster. Newborns with a seizure disorder can also get CP. Incidentally, some children have no newborn problems whatsoever and still go on to develop cerebral palsy, learning disabilities or even mental retardation.
A great deal of children with cerebral palsy have an identifiable congenital malformation that existed at birth and was not due to any specific birth abnormality. This means that parents with a child who has CP shouldn’t feel guilty about something they did or didn’t do during pregnancy or around the time of delivery. On the other hand, the foetal brain is really susceptible to toxins and medications taken during pregnancy so if this is the case in pregnancy, cerebral palsy can result. Even maternal trauma during pregnancy can make a difference in the incidence of cerebral palsy in the child. Alcohol used in pregnancy can get into the foetal brain and can result in CP. Cigarette smoking has less of an effect but it does carry a risk of cerebral palsy. Malnutrition in the mother is also related to the development of CP. Pregnancy-related infections, such as rubella, cytomegalovirus or toxoplasmosis seem to be related to the onset of cerebral palsy. Infants under 1500 grams are 25 times more likely to develop CP than a full term, normal-sized newborn.
The diagnosis of cerebral palsy is usually a clinical one. The doctor determines whether or not the child has reached infant milestones. Things like spasticity are looked for. The doctor looks for abnormal reflexes. Gait abnormalities will be noted in older children. Most children can get a diagnosis of cerebral palsy or not by the time they reach 18 months. This is true unless the child suffers from cerebral palsy due to head trauma as a toddler. They can have severe symptoms in the beginning that settle down to a diagnosis of cerebral palsy secondary to trauma. The same child can be normal within another year, thus negating the initial diagnosis of post-traumatic cerebral palsy.
Many children who develop signs and symptoms of cerebral palsy get a MRI scan or CT scan of the head. There are no blood tests that tell if there is cerebral palsy or not, although chromosome studies might be helpful. The CT scan or MRI might show excess fluid on the brain, called hydrocephalus. Other things in the brain that might be causing the symptoms can be discovered or excluded. There is no single CT or MRI finding that shows the presence of cerebral palsy. In some cases, a scar can be seen on the CT scan that might indicate the presence of motor difficulties consistent with cerebral palsy.
There are no medications to treat cerebral palsy although some anti-spastic drugs exist that can loosen the spastic muscles. The mainstay of treatment for cerebral palsy involves intensive physical and occupational therapy. The physical therapy is for strengthening the muscles and preventing excessive spasticity. The mainstay of occupational therapy involves using appliances, splints and other devices that make life easier for the cerebral palsy patient. Both physical and occupational therapy should be started as soon as the child is diagnosed with a movement disorder.
FAQs - Frequently Asked Questions
For answers to frequently asked questions about cerebral palsy please click on the links below :-
Following review of medical records and current symptoms you will be advised whether your child has a reasonable claim, and if so, what steps you should take to protect your legal rights. Our cerebral palsy medical negligence solicitors use no win no fee arrangements to represent their clients in Australian personal injury claims, which means that if your lawyer doesn't achieve settlement then he doesn't get paid his professional costs. If you would like advice at no cost just use the helpline or complete the contact form and a cerebral palsy medical negligence solicitor will telephone you with no charge and no obligation.
In general terms, medical negligence is defined as any act or omission that falls below the standard of a reasonably competent doctor. In some parts of Australia the common law applies whilst in other states there is relevant legislation however in all cases for a cerebral palsy solicitor to obtain a legal judgement, prior to an award of compensation, it is necessary to prove that the doctor's conduct did not conform to the standard of care demanded by the law.
There is no national legislation relating to cerebral palsy claims based on medical negligence passed by the Government of Australia which applies on a federal basis. Some states and territories have passed local legislation and have changed the pre-existing law to ensure that a doctor is not negligent if they acted in a rational way that is supported by a significant peer group of competent doctors. This applies even if the treatment that was chosen fails and alternative treatment may have succeeded. In these cases the court must decide what amounts to a reasonable standard of care and will determine competence after consideration of the evidence and expert opinion.
A cerebral palsy claim is an application to a court of law to award damages as a result of medical negligence by a healthcare provider. The claim can be against any healthcare provider who does not necessarily have to be a doctor, specialist or consultant. A healthcare provider which includes doctors, midwives, nurses and technicians who fails to take reasonable care which causes losses, may be held liable in negligence to pay compensation for those losses. In the context of cerebral palsy claims the following examples may be considered as sufficient to base a claim for medical negligence :-
- lack of oxygen to the brain during delivery
- failure to treat seizures following birth
- failure to detect a prolapsed umbilical cord
- excessive or inappropriate use of vacuum extraction
- excessive or improper use of delivery forceps
- failure to plan an anticipated caesarean section
- failure to perform an emergency caesarean section
- not responding to changes in the foetal heart rate
- failure to respond to maternal high blood pressure
- failure to diagnose and treat jaundice or meningitis
In order to obtain a judgement, a cerebral palsy lawyer must show that a healthcare professional’s conduct did not conform to the standard of reasonable care required in that particular location. In all cases the court will determine what it considers to be the appropriate and reasonable standard of care after hearing all of the evidence including statements from those concerned and expert medical opinion. A cerebral palsy lawyer must carefully consider all liability issues and it is a fact that the vast majority of the sufferers of this condition have not been the victims of medical negligence.
If your child has been diagnosed as suffering from this condition our cerebral palsy solicitors can offer legal advice on medical negligence compensation claims at no cost. Our cerebral palsy lawyers deal with claims using the no win no fee scheme. If you would like to discuss your potential damages claim with a specialist, with no further obligation, just use the helpline or email or complete the contact form.
Doctors can define cerebral palsy by the type of movement problem noted, such as spastic CP or athetoid CP. It can also be defined by the parts of the body involved, such as hemiplegic CP, diplegic CP or quadriplegic CP. These involve cerebral palsy that affects either half of the body, the arms or legs only or all of the extremities. The CP may or may not result in ataxia, which is the balance and coordination part of movement. There can be some overlap in diagnosing cerebral palsy with so many different ways of identifying the disease.
There are 4 main types of cerebral palsy which are on occasion difficult to distinguish as there may be some overlap between the four main types which are as follows :-
Spastic cerebral palsy is one of several types of cerebral palsy caused by increased muscle tone, which accounts for over 70% of all cases. Spastic cerebral palsy causes stiffness and tightness of the muscles which restricts motion causing abrupt and jerky movement. Spastic cerebral palsy may not always occur in isolation but can occur in conjunction with the other two distinct types. This condition is not progressive and there are therapies available that may be capable of reducing the unpleasant symptoms. -
Ataxic cerebral palsy is one of the three distinct types of this condition representing about 10% of all cases. People who suffer from ataxic cerebral palsy exhibit low muscle tone and the condition is characterised by problems with balance, co-ordination and movement. Ataxic cerebral palsy often manifests itself with shaky hand and feet movements, jerky speech, poor depth perception and difficulty with refined tasks requiring use of the hand or fingers such as writing.
Dyskinetic or athetoid cerebral palsy accounts for over 10% of all cases and is characterised by mixed muscle tone which is sometimes high and sometimes low. Athetoid cerebral palsy manifests itself by spontaneous and unwanted movements particularly of the face arms and upper body. Those who suffer from athetoid cerebral palsy exhibit disrupted posture control ensuring difficulty in maintaining an upright steady position.
Almost 10% of children who suffer from this condition will exhibit symptoms that indicate mixed cerebral palsy which may be a combination of two or more of the athetoid, ataxic and spastic types. The most common combination seen in mixed cerebral palsy is a mixture of the tight muscle tone of the spastic variant together with the involuntary movement of the athetoid variant. Mixed cerebral palsy is caused by damage to two separate areas of the brain and in severe cases is difficult to treat.
Cerebral palsy may affect different parts of the body categorised as follows:-
Monoplegia cerebral palsy is a relatively rare form of this condition where only one limb is affected. It may be considered as a form of hemiplegia with extremely mild involvement of a second limb. The symptoms of monoplegia cerebral palsy are often confused with damage to the nerves including brachial plexus palsy, rather than the actuallity of a lesion to the motor cortex of the brain. Accurate diagnosis of monoplegia cerebral palsy requires extreme skill, care and patience.
Diplegia cerebral palsy is a form of this condition that mainly affects the legs however there may also be minor involvement of the arms. Most children who suffer from diplegia cerebral palsy have spasticity due to high muscle tone with difficulty in balance and co-ordination together with a reducing range of motion. Suffers of diplegia cerebral palsy are at greater risk of hip dislocation.
Triplegia cerebral palsy is a very rare form of this condition which affects three limbs, usually both legs and one arm. Some physicians classify triplegia cerebral palsy as a combination of diplegia and hemiplegia or quadriplegia with minor involvement of one limb. Triplegia cerebral palsy usually manifests itself in the spastic form with high muscle tone creating stiff, jerky movement associated with an overall lack of co-ordination.
Quadriplegia cerebral palsy is a form of this condition which involves all four limbs with arms often more affected than legs. Quadriplegia cerebral palsy is usually associated with severe motor dysfunction and mental disability. Most children suffering from this condition have serious difficulties and may require constant care and attention. Quadriplegia cerebral palsy is usually spastic in nature with high muscle tone causing uncoordinated stiff and jerky movement.
Hemiplegia cerebral palsy is one of 5 different classifications of this condition dependent on the parts of the body that are involved. Hemiplegia cerebral palsy affects the leg and arm on one side of the body with usually more involvement of the arm when compared with the leg. Double hemiplegia cerebral palsy occurs when all four limbs are involved with the left and right sides being asymmetric and affected differently.
In most individual cases it is not possible to say exactly what causes this condition and by far the majority of cases seem to be naturally occurring. There are however a small number of cases that are caused as a result of errors by healthcare providers, which can lead to a successful compensation claim for losses and expenses caused as a result of clinical negligence. In regards to cases where there is suspicion that the cause may be due to clinical errors there are cerebral palsy risk factors which may predispose certain infants to suffer from this condition in the absence of appropriate medical care.
In cases where cerebral palsy risk factors are present it is incumbent on health care providers to be aware of them and to take appropriate action in advance of any potential medical emergency. Cerebral palsy risk factors are associated with the infant and with both of the parents and if a cerebral palsy risk factor is present healthcare providers should take appropriate remedial action or prepare for a worst case scenario. Failure to take such action or failure to properly investigate medical history may be sufficient for a cerebral palsy medical negligence solicitor to prove a compensation claim and justify an award of damages.
Cerebral palsy risk factors may only come to light upon detailed enquiry of the parents or detailed perusal of the mothers medical history. The following items represent some of the matters that may be considered to be cerebral palsy risk factors :-
- breech birth
- complicated labour
- complicated delivery
- vascular problems during labour and delivery
- respiratory problems during labour and delivery
- first child
- fifth or later child
- low Apgar score
- twins where one has died
- multiple births
- obvious nervous system malformation
- low birth weight less than 3.5 pounds
- premature birth less than 37 weeks
- mother/child blood incompatibility
- infant micro-organism infection
- late severe proteinuria
- late maternal bleeding
- maternal hyperthyroidism
- maternal seisures
- maternal German measles/viruses
- mother aged over 40 years
- mother aged less than 21 years
- father aged less than 21 years
- African-Caucasian ethnicity
Kernicterus is a preventable condition, usually caused by medical negligence involving irreparable damage to the brain as a result of failure to treat jaundice in a newborn child. The brain damage resulting from this disorder causes athetoid cerebral palsy of varying degrees of severity. Most newborn children suffer from jaundice to some degree however kernicterus only results in the case of severe jaundice that is not identified and is not adequately treated.
The condition arises as a result of unusually high levels a naturally occurring substance called bilirubin which is a breakdown product of blood that manifests itself as jaundice. Treatment of mild jaundice in a newborn infant is a relatively simple matter and placing the child in direct sunlight for a time will often be sufficient to alleviate the symptoms although more severe case are treated with artificial light from a blue lamp. The most serious cases may require an exchange of blood to urgently remove the damaging toxins.
Healthcare professionals involved in postnatal care should be aware of the damage caused by untreated jaundice in a newborn infant and should ensure that the child is properly examined on a regular basis. Failure to do so is of itself medical negligence which is actionable by a solicitor in a court of law. Even if the symptoms do occur, it is not too late to effect emergency treatment that will stop the condition progressing to a worse situation. Failure to identify this condition or failure to treat properly or in a timely manner may be classed as kernicterus medical negligence entitling the child to receive compensation for the injury which can have very serious consequences.
There are several areas for concern in regards to a child who may be suffering from jaundice.
Mistakes made by physicians that may be kernicterus medical negligence include :-
- repeating contentious laboratory results and delaying treatment
- interrupting treatment for further diagnostic testing
- failure to examine for signs of jaundice or kernicterus
- failing to properly interpret laboratory results
- failure to understand high bilirubin risk thereby delaying treatment
- not understanding varying risk associated with hourly time post birth
Kernicterus is totally preventable and most cases will result in a successful kernicterus medical negligence compensation claim. If you would like advice at no cost and without further obligation just use the helpline or email our offices or complete the contact form and a cerebral palsy lawyer will phone you with information on how to preserve your child�s legal rights to claim an award of damages.
A positive diagnosis often takes time as doctors are unwilling to confirm this serious condition until they are absolutely certain that the symptoms are not representative of one of the other medical conditions that may mimic cerebral palsy. Diagnosis is only confirmed after detailed studies and testing of motor skills and intellect and may not be finalised until a child is more than two years old. If you have received a positive diagnosis for your child our cerebral palsy lawyers offer on advice on medical negligence compensation claims at no cost and with no further obligation.
There are time limits for taking cerebral palsy compensation claims before a court of law and in general terms a medical negligence claim must either be settled or proceedings must have been issued in a court of law within three years of the negligent incident however there are exceptions for infants and the mentally disabled. The three year period for cerebral palsy compensation claims does not start to run until the eighteenth birthday and does not run against a claimant with a severe mental handicap.
Cerebral Palsy Medical Overview
Cerebral palsy is a group of conditions that occur at the time of birth, before birth or sometime within the first two years of life that are the result of brain injury and nervous system dysfunction. It affects one's thoughts, motor skills, hearing, seeing and learning abilities. There are several types of cerebral palsy, including spastic cerebral palsy, dyskinetic cerebral palsy, hypotonic, ataxic and mixed-type cerebral palsy.
The cause of cerebral palsy is injuries to portions of the brain. This can be due to trauma to the brain or to a lack of blood supply to the brain while the brain is still under development. In some cases, both conditions can occur at once to cause a brain injury.
Specific causes of brain injury that can lead to cerebral palsy include brain infections with herpes simplex, or bacteria or viruses that cause encephalitis or meningitis. Bleeding in the brain can cause problems with cerebral palsy as can head injury or maternal infection, such as rubella. Severe jaundice after birth can contribute to cerebral palsy. In a few cases, it is never determined what causes the cerebral palsy.
The symptoms of cerebral palsy vary depending on the site of the injury and the type of cerebral palsy. The symptoms may be severe or very minor and can involve both sides or one side of the body. It can involve both the arms at the legs or the arms only or legs only. One arm or one leg can be involved as well. The more limbs involved, the more severe is the cerebral palsy. If mental disturbances such as speech and learning deficits are present, this can add to the severity of the disease.
The symptoms can occur as early as three months of age and but can occur as late as two years of age. Developmental milestones such as rolling, sitting, crawling or walking can be delayed or not reached as all.
As mentioned, symptoms depend on the type of cerebral palsy the child has. It can involve really tight muscles that don't stretch well. The gait can be abnormal and can involve the arms tucked into the sides of the body or knees crossed, making for a scissors walk. Joints can become contractured or bent and stuck into one position. Muscles tend to be weakened and can be paralyzed completely. Usually an entire arm, leg or combination of arms and legs are affected.
Other symptoms of cerebral palsy include twisting, writhing or jerking of the extremities, tremors of the extremities, an unsteady gait, a lack of coordination and floppy muscles at rest. Joints can be tight or too loose. There can be learning and intelligence problems, speech difficulties, seizures, vision and hearing problems, and muscle or joint pain.
Babies can have problems swallowing or difficulty sucking. Chewing or swallowing can be impaired in all ages. Vomiting and constipation can be a rare complication. Drooling, slow bodily growth, irregular breathing and urinary incontinence are all possible complications.
The tests for cerebral palsy include a full neurological examination to ascertain what the strengths and weaknesses are. A CT scan or MRI scan of the head can show a brain abnormality and doctors often do an EEG to evaluate the electrical activity of the brain. Hearing and vision screening are also done.
There is no cure for the disease of cerebral palsy; however, treatment is available to control symptoms and maximize activity. It often takes a team approach, including the care of a doctor and dentist, a social worker, nursing staff and physical or occupational therapy. Speech therapy can help as well. Treatment is designed to control the symptoms and to prevent the common complications of cerebral palsy.
Home care is done to prevent complications and to get the person with cerebral palsy the best nutrition, a safe home, a strong body and proper bowel care. The joints need to be protected from injury in the home.
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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here