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Cerebral Palsy and Clinical Negligence Cases

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    This blog is the first in a series of informative blogs in which we will be looking at the different types of cerebral palsy and circumstances that may give rise to a legal case.

    By Hannah Blackwell

Cerebral Palsy is a neurological disorder caused by injury to a baby’s brain while it is still developing. The damage to the brain, or abnormal development of the brain, can occur before birth, during birth or in the early period after birth.

Cerebral Palsy is often referred to as “CP”. It is an umbrella term because there are different types of cerebral palsy that commonly effect body movement, muscle control, muscle coordination, muscle tone reflex, posture and balance. It can also impact on fine motor skills, gross motor skills and oral motor functioning.

For parents, being informed that your child has a brain injury is devastating and can lead to uncertainty as to what the future might hold. While some severe cases of cerebral palsy may be diagnosed soon after their child’s birth, for others diagnosis takes time and can be a long process. This can be a difficult time for parents who often suspect something might be different about their child or they notice that they have fallen behind with one of their developmental milestones.

Classifications of Cerebral Palsy

Cerebral Palsy is an umbrella term because it refers to a group of conditions characterised by abnormalities of movement and posture. It is a permanent life-long condition.

There are 3 main classifications of cerebral palsy:

  • Spastic Cerebral Palsy – Spasticity means that the muscle tone is tight and stiff causing a decreased range of movement. This occurs because the messages sent to the muscles are sent incorrectly through the damaged part of the brain. As the muscle tone is tight, spasticity can be very painful and the muscles often go into spasm. It can effect the upper limbs, lower limbs and speech.
  • Dyskinetic Cerebral Palsy – Sometimes also called dystonic, athetoid or choreoathetoid cerebral palsy. It causes uncontrolled, involuntary, sustained or intermittent muscle contractions as the muscle tone changes from tight to loose. The whole body can be affected which can make it difficult to maintain an upright position. Speech can be affected as the person may experience difficulty in controlling the tongue, vocal cords and breathing.
  • Ataxic Cerebral Palsy – A type of Cerebral Palsy in which the principle problem is with balance. The brain is not able to activate the correct pattern of muscle during movement. A person with Ataxic Cerebral Palsy may have poor spatial awareness or find it difficult to judge their body position in relation to things around them. Speech and language can also be affected.

Some people with Cerebral Palsy will have a combination of the above types.

Other terms that are commonly referred to when looking at the different types of cerebral palsy are hemiplegia (where a person is affected on one side of the body), diplegia (where two limbs are affected) and quadriplegia (where all four limbs are affected).

Cerebral Palsy may then be further classified according to severity: mild, moderate or severe.

Causes of cerebral palsy

There is sometimes no obvious reason why a child has cerebral palsy but the main causes are considered to be:

  • Lack of oxygen to the brain;
  • Abnormal brain development;
  • A genetic link (although this is quite rare);
  • Infection.

When might Cerebral Palsy arise from negligent medical treatment?

In order to establish that Cerebral Palsy is due to negligent treatment, it is necessary to show the following:

1. There was a breach of duty of care (also known as negligence). It must be shown that the medical treatment received fell below the standard for a reasonably competent practitioner, working within their field at the relevant time. If the practitioner can show that other reasonable practitioners would have acted in the same way as they did, they can use this as a defence and there is no breach of duty of care.  In cases involving brain injury suffered around the time of birth, the treatment to be investigated is usually that provided by either the midwife or obstetrician involved in the treatment.

Examples that I have come across include a failure to appropriately monitor a baby’s condition causing the baby to suffer a lack of oxygen, failure to treat infection during pregnancy or the neonatal period or failures to recognise placental abruption. My colleagues will be looking at the types of incidence that give rise to cerebral palsy claims in more detail in the subsequent blogs in this series.

2. If it can be established that there was a breach of duty of care in the medical treatment provided, then we must also establish causation and this means that there must be a link between the substandard treatment and the brain injury suffered.  In relation to causation we have to establish that it is more likely than not that the negligent treatment caused or contributed to the brain injury suffered.

In the forthcoming blogs in this series, my colleagues will be considering the following:

We hope that these blogs will be useful and informative.  If you have any questions about making a claim or anything you have read then please contact me or one of my colleagues.

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