Hard Cases - Incest / Rape / Congenital Anomalies / Life of Mother

Hydrocephalic Baby

Question:

My family and I have a claim against — regarding the birth of our child (severe hydrocephalus).  Five sloppily performed ultrasounds missed the diagnosis (as late as 26 weeks).  If we had known, we would have delivered our child much earlier.  All the lawyers (and expert MDs) seem to be hung up on the fact that the only thing we could have done was have an abortion.  We are trying to make the case that an early delivery (32 weeks vs 36 weeks) would have also made a huge difference.  We are looking for an expert witness…

Physician Responses: 

I am not an OBGYN, but the case you have put out for support probably has a lot more involved than just whether a delivery at 32 weeks, with all the problems associated with immature lung tissue, than 36 weeks, which is essentially full term but not necessarily so.  I wonder about the language used in the email:  “5 sloppily performed ultrasounds missed the diagnosis as late as 26 weeks”, too.  Hydrocephalus can develop late in a pregnancy, and severe hydrocephalus leads to the brain tissue being forced to thin out against the inside of the skull, leading to severe cognitive and developmental problems.  Indeed, this can develop after birth, as I witnessed during my residency time.  It may not be that anyone was to blame and this is an opportunity for the parents of this child to grow in nurturing a special needs child. 

 

You need a perinatologist… I think that this child probably has a major health issue and a lawsuit on a technicality would be in theory at best…i.e. is there a theoretical possibility that an earlier delivery would help this child?  no one really knows…my advice to this family is to move forward; love their child to the best of their ability; look towards the future NOT the past; …a lawsuit is not going to make the child better and it is only going to make it harder on the family…especially in a questionable situation like this where there probably is not any malpractice and most certainly is not any deliberate malpractice.

 

This man would have to know both what KIND of hydrocephalus, and have the ultrasound records.  He would also have to prove that this type of hydrocephalus carries a better prognosis if not allowed to worsen.  What is the condition of the child, now?  The better prognosis would have to be outweighed by possible other complications of prematurity.

 

The baby would have been hydrocephalic at 32 weeks, just as at 36 weeks.   The child would have needed a shunt procedure, and have been much less able to withstand that relatively minor procedure.    Many hydrocephalic babies turn out pretty well after a shunt procedure. The shunts have improved remarkably since I was doing them more than 20 years ago.  
Please don't listen to an attorney, but consult a neurosurgeon who specializes in pediatric neurosurgery if one is available.  Any neurosurgeon can do a shunt procedure quite well, but a pediatric neurosurgeon may have done a few more.
Please don't sue!!!  It will just be a very expensive, messy, heart breaking experience which will not benefit you or the baby in the least. The only one who will come out a winner is the attorney who undertakes such a useless law suit.
Love your baby!!!   Get the best medical attention available to you, and put your trust in caring doctors, not uncaring courts.      
 (Retired Neurosurgeon)

I'm not sure I understand why earlier preterm delivery would have been better. Had the hydrocephalus worsened in those 4 weeks? Risk of prematurity at 32 weeks is greater than at 36. Could there have been a procedure done earlier to decompress the hydrocephalus in utero? Not being in OB anymore, I'm not sure what in utero surgical options are feasible.