February 28, 2007

Cerebral Palsy Treatment - Selective Dorsal Rhizotomy (SDR) & Choices

by Robert D'Iorio

This is a video of a mother whose child has cerebral palsy discussing the treatments her child has gone through and the results they have seen.

Deciding which treatment is best for your child is an extremely difficult decision, especially when doctors have differing views of what may be best for your child. This decision gets even more difficult when the treatment is permanent. These topics as well as several treatment options are discussed in this video.

February 19, 2007

Child with Cerebral Palsy May File a $150M Medical Malpractice Lawsuit against the Military

by Robert D'Iorio

Birth injuries sustained to the second child born during a twin pregnancy, were allegedly caused when he did not receive enough oxygen during the delivery in May 2005 which led to the child developing Cerebral Palsy.

Here, the plaintiff’s contend that the medical Records indicate that limbs were blue and that the child was not breathing when he was delivered about an hour after his sister. In most situations a child’s medical record will contain an APGAR score (Activity, Pulse, Grimace, Appearance, and Respiration) this test was designed to quickly evaluate a newborn's physical condition after delivery and to determine any immediate need for medical or emergency care. A score of 8 or above at 1 and 5 minutes usually indicates a child is not in need for immediate help, however, this is not always the case.

The defense is claiming that the child had the condition in utero and for some time. To defeat this, the Plaintiffs are asserting that the damage to the brain was caused by oxygen deprivation at the time of delivery. To support this claim their attorney is stating that if cerebral palsy developed before delivery it would damage large portions of the brain, instead of localized damage that this child has suffered.

Due to the fact that this claim is against the Military it will fall under the Federal Tort Claim Act

(FTCA, August 2, 1946, ch. 753, title IV, 60 Stat. 842, 28 U.S.C. § 1346(b) and 28 U.S.C. §§ 2671-2680), a statute enacted by the United States Congress in 1946 permitting private parties to sue the United States in a federal court for torts committed by persons acting on behalf of the United States. Liability under the FTCA is limited to "circumstances where the United States, if a private person, would be liable to the claimant in accordance with the law of the place where the act or omission occurred." 28 U.S.C. § 1346(b).

As such, the Military has six months to respond to the claim. It can pay the full amount, offer a reduced settlement or pay nothing.

After the six-month period, if the family is not satisfied with the Military’s response, they
can file a lawsuit in U.S. District Court.

Although, in the past several medical malpractice cases involving cerebral palsy have had verdicts in excess of $100 million this case is only in its initial stages and will be defended vigorously. In fact, to demonstrate this, the military went to the media before the suit was even filed, a highly unusual move and one I have rarely seen.

February 18, 2007

Cerebral Palsy Risk Increased When E4 Allele Gene is Present

by Robert D'Iorio

Researchers determined that children are more likely to develop cerebral palsy following injury to the developing brain when E4 allele of the Apolipoprotein E, or APOE, gene is present.

To conduct this study, researchers at Children's Memorial Research Center compared the APOE gene in 209 children with cerebral palsy to healthy children of the same gender, race and ethnicity. They found that young children with the E4 allele who suffer a brain injury are more susceptible to developing cerebral palsy.

"The gene isn't causing the cerebral palsy. It's making you at greater risk to develop it, but another injury is needed." said Mark Wainwright, professor of pediatric neurology at Northwestern’s Feinberg School of Medicine.

The overall population has two of the three alleles of the APOE gene, which produces the E4 protein in the brain. The protein is involved in neural repair, but E4 creates a protein that is less able to regulate brain inflammation following an injury. Children with E4 are more likely to have brain damage following an injury and are less capable of repairing it, just as adults who carry the E4 form of the APOE gene may be more susceptible to developing Alzheimer's disease and have worse outcome after brain injury, including stroke and head injury.

The study, published in the journal Pediatrics, may benefit children who are at risk for poor neurodevelopmental outcome after brain injury as newborns and thus target those children for early therapeutic intervention.

Unfortunately, I believe the possible candidates for early intervention may be greatly reduced if the child suffered hypoxia (lack of oxygen at birth) or other preventable injuries due to the fact that the doctor may have been at fault and not want to accept the responsibility/liability. By stating that the child suffered an injury at birth and recommending the child for early intervention the doctor will inevitably be opening the door to questions from the parents about what caused the injury. If however, he/she remains silent the injury will most likely not be discovered for several years, if at all, as most instances of medical malpractice go undetected.

February 17, 2007

Spina Bifida Based Medical Malpractice Lawsuits May Increase as Folate Levels Decrease

by Robert D'Iorio

In 1998, a campaign was started to boost young women's intake of a B vitamin called folate. It is believed that this has saved an estimated 1,000 (32 percent) American babies from early death or lifelong disability. Furthermore, it is believed that if all women who may become pregnant took in 400 micrograms daily of folic acid, the incidence of spina bifida in the United States could be reduced by 70 percent. Lately, the drive to prevent neural-tube defects such as spina bifida in newborns has stalled.

In a report issued on Jan. 5, 2007 the CDC found that women in their childbearing years, blood folate levels had declined 16 percent by 2004 from the levels recorded in 2000.

I tend to believe that the decrease in vitamin B may be do to new diet trends such as eating fewer carbs and more protein.

This being the case I believe now it is more important then ever for a doctor prescribe prenatal vitamins to women of child bearing age and/or women expecting to get pregnant. At the very least, the physician should prescribe prenatal vitamins as soon as the doctor knows of the pregnancy.

Failure to Monitor Diabetes or Failure to Properly Monitor Medications may also bring rise to a malpractice suit.

February 16, 2007

Parents of Children with Disabilities Make a Difference at: The Parents’ Place of Maryland

by Robert D'Iorio

Jayne Matthews of the Baltimore Times recently wrote a heart warming story describing how The Parents’ Place of Maryland (a group comprised exclusively of parents of a child with a learning or developmental disability) began and how the effort continues. In her latest article Matthews describes some of the emotions parents of disabled children go through and the amazing efforts made by The Parents’ Place of Maryland to assist the parents and children.

Matthews discusses how, unfortunately, parents of disabled children often feel isolated by feelings of “distress of a bleak prognosis” coupled with “anxiety over the future (how will my child survive a lifetime of limitations?)” and “guilt of the past (did I do something to cause this?)” and a “sense of anger (why is this happening to my family?).”
Matthews further explains how The Parents’ Place of Maryland, Josie Thomas, Kim McKay, Kelly Meissner and so many others have helped over 45,000 families since its inception in 1990.

For the full article click Here.

The resources are offered to the children and parents of children with disabilities throughout Maryland, regardless of the nature of their child's disability or the age of their child. They include conducting regular parent education courses and workshops, helping parents find information, providing referrals to other individuals or organizations, working with parents directly to help them obtain the best possible services for their children, maintaining an up-to-date list of support groups for parents in Maryland and publishing a quarterly newsletter for everyone interested in childrens' needs

This is a great organization and I applaud their effort.

Here is their contact info:

Parents' Place of Maryland
801 Cromwell Park Drive, Suite 103,
Glen Burnie, MD 21061

Telephone (voice or TDD): (410) 768-9100
FAX: (410) 768-0830
Email: info@ppmd.org


February 16, 2007

Cerebral Palsy Discrimination Lawsuit Against Walmart Will Proceed

by Robert D'Iorio

Steven Bradley, who has had cerebral palsy since birth and was passed over for a job at Walmart several times, filed a lawsuit in conjunction with The Equal Employment Opportunity Commission (EEOC). Initially, the district court granted Walmart a summary judgment, finding that the EEOC had not established a prima facie case of discrimination; furthermore, the EEOC had not shown that Walmart’s non-discriminatory reasons for declining to hire Bradley were pretextual.

On appeal, the Eighth Circuit, a Court with a long track record of affirming summary judgments unanimously reversed the district courts decision. The court found that according to the evidence Bradley could have performed the necessary duties at Walmart with reasonable accommodations such as a wheelchair or crutches, and that Walmart’s reasons for not hiring Bradley were inconsistent at best.

Additionally, the Court rejected Walmart’s second and in my opinion much weaker argument that allowing a person with a disability such as Bradley’s to work while in a wheelchair or using crutches would pose a direct threat to himself/herself and/or others.

So as it stands the case will continue.

February 11, 2007

Spina Bifida afflicted Maryland Teen Wins Lawsuit - UPDATE:

by Robert D'Iorio

Ryan Mink of the Washington Post reported today that Tatyana McFadden, a Maryland teen with spina bifida could not earn points for her Track & Field team in regional and state tournaments due to the use of her wheel chair.

This decision came just over a month after Tatyana McFadden and the Howard County School system reached an agreement to allow the junior at Atholton High school to compete and earn points in county events this spring. The Maryland Public Secondary Schools Athletic Association however, ruled Thursday that athletes in wheelchairs will not be able to earn points for their team in regional and state tournaments.

So as it stands now, wheelchair participants can compete in the 100, 200, 400, 800, 1,600 and 3,200 meter races this spring (last year, they couldn't compete in the 100 and 200) however, wheelchair athletes can't score team points.

For the full article click here.