Failure to Detect Irregular Cord Blood Gasses Causes Lifelong Neurological Damage

ByMichael Talve, CEO

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Updated onOctober 19, 2017

Failure to Detect Irregular Cord Blood Gasses Causes Lifelong Neurological Damage

This child neurology case involves the failure of physicians to detect irregular cord blood gasses in a neonatal patient. The arterial cord blood values were indicative of severe fetal acidemia but there was no intervention attempted by the neonatal hospital staff. The case also involves a delayed diagnosis of the infant’s neurological deficits. The parents made regular complaints to the pediatricians concerning the patient’s gait and his overall body posture. The patient finally underwent an MRI after the parents consulted another pediatrician for an independent evaluation. The MRI revealed neurological injury consistent with an in utero hypoxic event.

Question(s) For Expert Witness

1. Should the in utero hypoxic event have been noticed sooner?

Expert Witness Response E-000764

inline imageThis is a very interesting case with a diagnosis that was clearly delayed. By doing so, a window of opportunity for therapeutic interventions (whole body cooling, physical and occupational therapy, etc) was likely missed, impacting the long term use of his right arm/hand, gait, or other areas of the child's development. A base deficit of >16mEq/L is biochemical evidence of birth asphyxia, thereby warranting further diagnostic tests in the neonatal period, especially if there are other concerning factors (an acute perinatal event, low apgar scores, respiratory distress, any slightly abnormal neuro exam, etc.). Additional tests might include arterial blood gas, lactate, LFTs, electrolytes, cranial ultrasound, brain MRI. Certainly, when problems in his motor development became apparent (arm use/positioning, abnormal gait, etc) an MRI and/or a thorough evaluation by a pediatric neurologist, developmental pediatrician, or NICU follow-up specialist should have been done.

About the author

Michael Talve, CEO

Michael Talve, CEO

Michael Talve stands at the forefront of legal innovation as the CEO and Managing Director of Expert Institute. Under his leadership, the Expert Institute has established itself as a vital player in the legal technology arena, revolutionizing how lawyers connect with world-class experts and access advanced legal technology. Michael's role involves not only steering the company's strategic direction but also ensuring the delivery of unparalleled intelligence and cutting-edge solutions to legal professionals. His work at Expert Institute has been instrumental in enhancing the capabilities of attorneys in case preparation and execution, making a significant impact on the legal industry's approach to expert consultation and technological integration. Michael's vision and execution have positioned the Expert Institute as a key facilitator in the intersection of law and technology.

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