Vacuum Extractor, Forceps & Pitocin Misuse, Untreated Group B Strep (GBS) & Delayed Delivery Cause Baby to have Seizures & Hypoxic Ischemic Encephalopathy (HIE)

Award-Winning Birth Injury Lawyers Helping Babies Injured by Vacuum Extractors, Pitocin, Mismanaged Group B Strep (GBS), Chorioamnionitis, Sepsis, Meningitis, Delayed Delivery & Hypoxic Ischemic Encephalopathy (HIE) | Serving Michigan & All 50 States

A new mother named Alice was very excited about the birth of her baby, who she named June as soon as she learned the baby was a girl.  During pregnancy, there was no sign that anything was wrong.  When Alice’s water broke, the midwife visited her at home to test her amniotic fluid for infection and told her she could labor there for up to 5 days if she wanted.  About 24 hours later, a different midwife called Alice at home and told her that her amniotic fluid had tested positive for Group B Strep (GBS).  The midwife warned her that this infection can kill babies and she urged Alice to go to the hospital.  Over 36 hours after her water first broke, Alice was admitted to the labor and delivery unit.

In the hospital, Alice waited another 5 hours before the GBS was treated; she was given a penicillin drip 41 hours after her infected water broke.  Alice had no contractions at this point, so the medical team decided to use Pitocin to induce labor.  After she was given Pitocin, Alice’s contractions went from none at all to “full torture” in under 10 minutes. Alice pushed for a long time before a physician finally realized she was not fully dilated.  This was the first time since Alice arrived that she saw a physician.  By this point, it had been over 60 hours since her water broke.  The physician told her she could keep pushing or move to the operating room for further assistance.  Alice was exhausted and the physician attempted to use a vacuum extractor, with no luck.  Forceps were used next, and June was finally born.

The newborn had a gash on her head from the failed vacuum extraction that lasted for days.  June did not want to feed and she had shallow breathing and was shaking a lot.  It took another day for a nurse to realize that newborn was having seizures.  June was rushed to the neonatal intensive care unit (NICU) where she stayed for 6 weeks.

Alice was told that June had hypoxic ischemic encephalopathy (HIE) and permanent brain damage, and that June would be severely disabled and would never be able to do things such as eat or hold her head up.  The little girl is now 5 years old.  Although the road has been filled with numerous specialists and therapists, June is superseding the physicians’ predictions.  She can eat and hold her head up, she enjoys vigorous bounces in her crib and she squeals with delight whenever she sees her father.

WHAT IS GROUP B STREP (GBS) & HOW IS IT TREATED?

Group B Strep is a genital tract infection in the mother that is extremely dangerous for the baby.  GBS can be transmitted to the baby during labor and delivery and it can cause the baby to have sepsis, meningitis, brain damage and cerebral palsy.

If a mother has GBS when her water breaks or if the mother is even suspected of having GBS at this time, antibiotics – usually penicillin – must be given as soon as possible.  Since it was known that Alice had GBS, she should have been given antibiotics as soon as she arrived at the hospital since her water had already broken.  And indeed, if GBS is simply suspected (i.e., the mother had a previous GBS infection during pregnancy), antibiotics should be given as soon as the mother is admitted to the hospital in labor.  The sooner the antibiotics are given, the better.  For best protection, a mother with GBS should receive penicillin or other IV antibiotics at least 4 – 6 hours before delivery.

The longer a baby is exposed to GBS, the higher the risk of the baby becoming infected.  When a mother’s water remains intact, the baby is not exposed to the GBS.  Once the water breaks, the baby is exposed.  Antibiotics must be given as soon as possible to minimize the baby’s risk of infection.  The antibiotics wipe out the bacteria in the vagina and they transfer to the baby to help the infant fight a possible infection.After delivery, the baby must be closely monitored and tested for infection.  Failure to properly treat a mother for GBS infection and failure to properly monitor and treat a newborn who had a potential GBS exposure is negligence.

Testing Pregnant Women for Group B Strep (GBS)

Most women who have GBS have no symptoms.  It is thus the standard of care to test all pregnant women for GBS at 35 – 37 weeks of pregnancy by collecting a sample from the vagina and rectum.  This is called GBS screening.  Pregnant women may test positive at certain times during pregnancy and not others, which is why it is important that all mothers get tested at 35 – 37 weeks.

At least one culture from the urine should be taken during early pregnancy because GBS bacteria in the urine (called GBS bacteriuria) is a marker for heavy genital colonization (GBS in the genital tract).  If this culture is positive for GBS, a 3 – 7 day treatment with antibiotics should be given.  The physician must retest the urine after treatment to make sure the treatment worked.  If a mother tests positive for GBS during pregnancy, she does not need to be tested again and should receive penicillin or another antibiotic treatment at the time of delivery.

Anitibiotics should be given to:

  • Women who delivered a previous baby with GBS infection
  • Women with GBS bacteriuria in the current pregnancy
  • Women with a GBS-positive screening result in the current pregnancy
  • Women with unknown GBS status who deliver at less than 37 weeks’ gestation, have an intrapartum temperature of 38º C (100.4º F) or greater, or have rupture of membranes for 18 hours or longer

It is important to remember that GBS bacteria can grow back quickly, so if antibiotics are given before labor, they must be given again during labor.

In Alice’s case, she was not given penicillin until 41 hours after her water broke, thereby exposing her baby to the infection for almost 2 days. GBS can cause chorioamnionitis, which is an infection of the amniotic fluid and the membranes that surround the baby in the womb (the chorion and amnion).  Chorioamnionits can cause membrane rupture (the water breaking), which can cause premature birth.  Chorioamnionitis can also cause a baby to have birth injuries, such as sepsis, meningitis, seizures, cerebral palsy and periventricular leukomalacia (PVL – usually seen in preterm babies).

VACUUM EXTRACTORS, FORCEPS & PITOCIN USE DURING DELIVERY CAN CAUSE BRAIN BLEEDS, BIRTH ASPHYXIA & HYPOXIC ISCHEMIC ENCEPHALOPATHY (HIE)

Pitocin can cause birth injuries if not properly used.Baby June was exposed to numerous risks during delivery.  Pitocin is a labor induction drug that can cause contractions to be too strong, long and frequent, which is called hyperstimulation.  Hyperstimulation puts the baby at risk of experiencing a lack of oxygen to her brain because these types of contractions do not allow the placenta to properly recharge with a fresh supply of oxygen-rich blood for the baby.  Ongoing hyperstimulation can cause oxygen deprivation that gets progressively worse.  This will manifest on the fetal heart rate monitor as a non-reassuring heart tracing, and when this type of tracing occurs, the baby needs to be delivered by emergency C-section right away.  Pitocin must only be administered when standards of care are followed, which includes having the ability to quickly deliver the baby by C-section when fetal distress is present.

Failure to quickly deliver a baby when Pitocin is used and fetal distress occurs can cause the baby to experience birth asphyxia, which can cause hypoxic ischemic encephalopathy (HIE), seizures, cerebral palsy and other birth injuries.

Vacuum extractors and forceps are very risky operative devices used to facilitate a vaginal delivery.  Forceps look like salad tongs and the tongs are placed on each side of the baby’s head to help the physician pull the baby out of the birth canal.  A vacuum extractor has a cup that attaches to the baby’s head, and suction tubing is attached to the cup.  The physician applies traction to the baby’s head via the cup and then pulls the baby out of the birth canal.  Since these devices attach directly to the baby’s head and are extremely risky, only physicians very skilled in their use should attempt operative vaginal deliveries.  Standards of care must be followed at all times, and it most certainly is against the standard of care to use both devices during a delivery.  If one device does not lead to delivery of the baby, the physician must quickly move on to delivery by C-section.  The physician may not use a vacuum extractor, and when that fails, move on to use of forceps, as Alice’s physician did.  In addition, it is against the standard of care to use a vacuum extractor when the mother is exhausted; vacuum extraction delivery requires maternal participation.

These violations of standards of care greatly increased baby June’s risk of having a birth injury.  When misused, forceps and vacuum extractors can cause head trauma, brain bleeds, clots and strokes, which can cause a baby to have hypoxic ischemic encephalopathy (HIE), seizures, brain damage, cerebral palsy and other birth injuries.

AWARD-WINNING BIRTH INJURY ATTORNEYS HELPING CHILDREN WHO HAVE HIE & CEREBRAL PALSY FOR ALMOST 3 DECADES

If you are seeking the help of a birth injury lawyer, it is very important to choose a lawyer and firm that focus solely on birth injury cases.  Reiter & Walsh ABC Law Centers is a national birth injury law firm that has been helping children for almost 3 decades.  Jesse Reiter, president of ABC Law Centers, has been focusing solely on birth injury cases for over 28 years, and most of his cases involve hypoxic ischemic encephalopathy (HIE) and cerebral palsy.  Jesse is currently recognized as one of the best medical malpractice lawyers in America by U.S. News and World Report 2015, which also recognized ABC Law Centers as one of the best medical malpractice law firms in the nation.  The lawyers at ABC Law Centers have won numerous awards for their advocacy of children and are members of the Birth Trauma Litigation Group (BTLG) and the Michigan Association for Justice (MAJ). In fact, Jesse is one of only 2 attorneys in Michigan to have been elected Chair of the BTLG.

If your child was diagnosed with a birth injury, such as cerebral palsy, a seizure disorder or hypoxic ischemic encephalopathy (HIE), the award-winning birth injury lawyers at ABC Law Centers can help.  We have helped children throughout the country obtain compensation for lifelong treatment, therapy and a secure future, and we give personal attention to each child and family we represent. Our nationally recognized birth injury firm has numerous multi-million dollar verdicts and settlements that attest to our success and no fees are ever paid to our firm until we win your case.  Email or call Reiter & Walsh ABC Law Centers at 888-419-2229 for a free case evaluation.  Our firm’s award-winning birth injury lawyers are available 24 / 7 to speak with you.

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