In some circumstances, but not all, cerebral palsy can be a result of a brain injury sustained during birth.

Our Clinical Negligence and Personal Injury team have outlined some of the key questions surrounding Cerebral Palsy below.

What is Cerebral Palsy?

The Mayo Clinic describes Cerebral Palsy as ‘a disorder of movement, muscle tone or posture that is caused by damage that occurs to the immature, developing brain, most often before birth. Signs and symptoms appear during infancy or preschool years’.

The three main types of Cerebral Palsy are as follows:

1. Spastic – meaning stiff muscle
2. Dyskinetic or athetoid – meaning an uncontrolled muscle contraction of the limbs
3. Ataxic – meaning uncoordinated limb movements

It is possible to be diagnosed with a mixture of these types, however, Spastic Cerebral Palsy represents the most common physical disability in childhood.

What causes Cerebral Palsy?

There are known to be different causes of Cerebral Palsy including:

• Genetic susceptibility
• Infection
• Inflammation
• Metabolic
• Physical injury
• Lack of oxygen around the time of birth

Some of these causes can be due to substandard treatment and clinical negligence.

Erb’s Palsy is usually caused during childbirth and may be a consequence of inappropriate treatment during delivery.

What is Erb’s Palsy?

Erb’s Palsy is a paralysis of the arm caused by injury to the upper group of the arm’s main nerves.

What causes Erb’s Palsy?

Erb’s Palsy injuries most frequently arise following an episode of what is known as shoulder dystocia when the baby is delivered. Typically, the baby is large (over 4 kilograms) and its shoulders become stuck. Traction is then applied to attempt to deliver the baby and if this is unsuccessful various other manoeuvres can be tried to attempt to achieve delivery. The pressure placed on the shoulders during delivery leads to nerves in the brachial plexus being damaged and, on occasion, brain damage can arise due to delays in delivery.

Can a claim be made in relation to Erb’s Palsy?

Erb’s Palsy claims can be quite complex. At one time, all newborn injuries, also known as obstetric brachial plexus injuries (OBPI), were thought to be the fault of the midwife or doctor on the basis that too much force was used during the delivery of the shoulders. However, over the past decade there have been increasing reports of OBPI in the absence of excessive force having been applied. Medical literature has suggested that some OPBI can in fact be caused by pressure caused through contractions when the mother is pushing. This means it is more important to instruct a solicitor who knows what they are doing.

Neonatal hypoglycemia is a condition where a newborn baby’s blood sugar (glucose – the main fuel for the brain and the body) falls to a very low level. Once the baby’s umbilical cord has been cut, they no longer receive a supply of glucose from their mother, so they need to maintain their own blood sugar levels through feeds. 

A transient reduction in blood glucose is expected as part of metabolic adaption following birth. This should resolve itself within the first 48 to 72 hours of life. However, a minority of newborn babies experience prolonged and severe hypoglycemia if the symptoms are not recognised and the baby’s blood levels are not monitored and restored through feeding, or, in more acute circumstances, an intravenous glucose drip.

A prolonged and severe state of hypoglycemia can result in permanent brain damage leaving the baby with severe and long term neurological and cognitive disabilities, seizures and developmental delay. The extent of the injuries is dependent on the extremity of the index injury.

Whilst all babies are at risk of developing neonatal hypoglycemia, certain babies are at a higher risk. Most babies with hypoglycemia are initially asymptotic and detection is based on surveillance of babies who are at high risk of developing hypoglycemia, such as:

• Babies born to mothers with diabetes
• Babies who are born premature or with a low birth weight
• Babies who are born under significant stress
• Babies who have an inadequate amount of external feeding i.e. have a poor suck and/or are vomiting
• Babies who have a low body temperature shortly after birth
• Babies who suffer a hypoxic-ischaemic event during birth (In other words, they are born with significant stress)

A newborn’s blood sugars can be tested by a simple blood test. Symptoms of a baby suffering from neonatal hypoglycemia include:

• Difficulty maintaining a normal body temperature
• Lethargy, pale and floppy
• Trembling
• Poor feeding
• Vomiting
• Irritability, jitteriness, or grunting

The consequences of neonatal hypoglycemia can be extremely serious, resulting in long term disabilities and in grave circumstances, death as a result of complete energy failure.

A clinical negligence case can be brought against a trust where there have been delays in obtaining blood glucose test results, delays in taking subsequent action, delays in administration of IV glucose, giving an insufficient or incorrect dosage of IV glucose, delayed attendance by the paediatrician, and failures to address the mother’s concerns, and as a result; a child has suffered from permanent and serious injuries. In our experience, problems typically seem to arise after the midwifery team fail to notice that the baby is not feeding properly after birth, either by not feeding at all or by failing to latch & suck. The problems seem to arise more frequently in first-time mothers as they are not as familiar with the typical feeding patterns of a newborn.   

Our specialist clinical negligence team are experienced in obtaining compensation for children whose neurological disability has been caused as a result of substandard care during or shortly after birth. We are dedicated to assessing the full impact of the injury and ensuring our clients are fully compensated alongside obtaining rehabilitative therapies to aid with a child’s development.

To establish liability, it has to be proven that the care received was substandard and what ultimately caused the injury. Our clinical negligence solicitors are able to assess the medical treatment to determine whether there is a valid claim.

In cases where liability is admitted we obtain Interim Payments and Rehabilitation to allow the family to buy properly adapted accommodation, equipment, and pay for therapies and care. Case managers are employed to advise on equipment, care, and vehicles.

Find out more by visiting our Medical Mondays hub, designed to provide up-to-date information on the different injuries, accidents, and claims that are commonly encountered by our team.