A birth injury is any type of harm to a baby that occurs during or near the time of birth. Many can be the causes, including fetal oxygen deprivation, trauma from impact during delivery, premature birth, med/ical negligence, and more. These injuries can impair the baby’s internal systems, with impacts ranging from mild bruising and lacerations to permanent injury or lifelong disability.


Types and causes of birth injury

Anoxia: this is where a baby is completely deprived of oxygen. Oxygen deprivation to the baby’s brain may cause brain injury and just a few minutes without oxygen may be enough to have a lifelong impact.

Hypoxia: This is where there is a decreased flow of oxygen to the brain. A reduction in the supply of oxygen to the baby’s brain even for just a few minutes may be enough to have a lifelong impact.

Physical trauma to the head: physical damage to the baby’s neck or head can cause brain injury. For example, improper use of instruments such as forceps or ventouse can cause damage to a baby’s brain.

Infections and health problems in the mother: if a mother suffers a health problem before or during pregnancy it can affect the baby’s health, and depending on the nature of the problem, it could cause brain injury to her baby. Caregivers must recognize health problems in a mother and offer timely and appropriate treatment.

Shoulder dystocia: is a rare complication that occurs during delivery. It can happen during vaginal delivery and affects about 1 in every 150 deliveries. Shoulder dystocia occurs when the baby’s head is born but one shoulder becomes stuck behind the mother’s pubic bone. Shoulder dystocia is not a birth injury in its own right, but if not managed appropriately it can cause injury to the baby. Shoulder dystocia can damage the nerves in a baby’s neck, causing temporary or permanent loss of movement in the arm (Erb’s palsy). Minor injuries may heal in time but in major nerve injury cases, there can be permanent damage to the arm.

Obstetric brachial plexus injury (BPI): occurs when the nerves in the baby’s neck are damaged during delivery. The result of such an injury is a loss of movement and sensation in the arm.

The brachial plexus is a network of nerves around the shoulder, which controls movement and sensation throughout the shoulder, arm, and hand. Nerve damage can occur if the nerves are stretched, compressed or (in severe cases) separated from the spinal cord. In severe cases, brachial plexus injury can cause permanent damage to the arm. The most common type of brachial plexus injury is called Erb’s palsy that normally affects the shoulder and the upper arm. It can cause partial or complete paralysis of the arm, weakness of the arm resolves within a short period.

Broken bones during delivery: babies are at risk of broken bones (fractures) during labor and delivery. Fractures in the collar bone are the most common type of fracture babies suffer during delivery. Rarer types of fracture include the skull, the arm, and the spine.

Common causes of fractures during delivery include:

  • Excessive twisting or pulling of the baby during delivery;
  • Improper use of instruments, such as forceps
  • Shoulder dystocia.
  • Babies with bone diseases are particularly at risk of fractures. Certain types of bone diseases can be detected on ultrasound scanning but this is not possible in every case, particularly if the symptoms are mild.

Some fractures are unavoidable, as birth can be physically tough on mother and baby. Sometimes, the natural force of a mother’s contractions as the baby is delivered is enough to cause a fracture. Fortunately, this is rare and with proper treatment, babies should make a full and speedy recovery.

Stillbirth and neonatal death: birth injuries can be so severe that they cause the baby to be stillborn. In other cases, the baby might survive for a short time but sadly die soon after birth. In some cases, the cause of death is not known.

Losing a baby is a devastating and traumatic event. It can be incredibly difficult for bereaved parents and their families to come to terms with what’s happened. Most parents want to know what happened during their baby’s birth, and the reason why their baby did not survive.

If a baby is stillborn or dies shortly after delivery, it can be difficult for doctors to establish the exact cause of death. A post-mortem (autopsy) might be recommended. In some cases, where the cause of death isn’t clear, the coroner may order a post-mortem.

Potential causes of stillbirth and neonatal (newborn) death include:

  • Meconium aspiration syndrome
  • Umbilical cord prolapse
  • Placental abruption
  • Placenta praevia
  • Severe hypoxia
  • Traumatic injury before or during delivery
  • Severe infection
  • Complications due to premature birth or low birth weight
  • A developmental or genetic problem which means the baby could not survive outside of the womb.

Unfortunately, 7,000 babies die each year in the world and a large percentage of this figure belongs to the United States, the causes complications in childbirth and postpartum, which was not dealt with well by the doctors. Research suggests that many of these deaths can be avoided with better care.

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Maryland’s Horrendous Law Capping Damages

In a recent blog post, I wrote about the ridiculous law in Virginia that limits the amount of money medical malpractice victims may receive for their injuries. (This law caps “damages.”) But I’ll tell you a secret about the damages caps in Virginia: in some ways, they are much fairer than they are in Maryland.

To be clear, they are not fairer in medical malpractice cases. However, in other kinds of personal injury cases–car crash cases, premises liability cases, truck collision cases, elder abuse cases, and so on–the damages caps in Virginia are significantly fairer. In fact, in some ways, the damages caps in Maryland are some of the least fair in the nation.   

Could this really be true?

Could it, considering the Maryland legislature is overwhelmingly Democratic? (There are two Democrats for every one Republican in both the Senate and the House of Delegates.)

It is true.

Individuals who have suffered catastrophic injuries might find it unfortunate that they were injured if they were injured because of someone else’s negligence; they may find it especially unfortunate if they were injured in Maryland.

I’ll tell you why.

Maryland caps the amount injured plaintiffs can recover for non-economic damages. Non-economic damages cover losses like the loss of the enjoyment of life, physical pain and suffering, and mental anguish.

Maryland law caps recovery for non-economic damages to only $845,000. (The cap increases by $15,000 every year.)

Imagine: you’re driving a hatchback, you’re stopped in traffic, and suddenly you get hit from behind–obliterated–by a big SUV. You get medical treatment, of course. But after all the treatment you receive, a doctor tells you that you’ll have severe pain for the rest of your life and she recommends you use a wheelchair.

Activities you used to love, like running every morning and playing a round of golf with your friends on weekends, are now off limits to you. You feel like you’re a burden on your family. You’ll likely live another 40 years.

Now, consider someone gives you a check for $845,000 in exchange for the severe pain, the mental anguish, and the loss of your enjoyment of life. That check would, spread over 40 years, equal about $20,000 a year.

Who in their right mind would consider that amount to be fair?

Make no mistake about it: none of Maryland’s neighboring states limit non-economic damages in all personal injury cases–not DC, not Delaware, not Virginia, not New Jersey, not New York, not Pennsylvania. In fact, only 10 other states in the nation have such a cap on non-economic damages: Alaska, Colorado, Hawaii, Idaho, Kansas, Mississippi, Ohio, Oklahoma, Oregon, and Tennessee.

Maryland is an outlier.

The Democratic legislature ought to end the caps on non-economic damages, bringing Maryland in line with the vast majority of states and all of its neighbors.

Serious Injury–Needed for a Successful Birth Injury Case

The only birth injury cases a personal injury lawyer will likely accept are those that have a strong likelihood of success, and all successful birth injury cases must have four elements. One of those elements is damages. (The other three are liability, causation, and insurance coverage.) When it comes to evaluating damages, I ask myself certain questions. Here, let’s look at the main question.

The main question asks whether the plaintiff (usually the child) has suffered a very serious injury. (As a result of the negligence of a doctor or nurse or other healthcare provider, a child, his or her mother, or both of them, may suffer a very serious injury.)

Look: most personal injury law firms will decline far, far more cases than they will accept. They will accept only a small number of cases.

Think about it like this: ultimately, birth injury cases require so much time that a personal injury lawyer cannot reasonably work on many of them at a time, if he plans to investigate and develop them fully and he plans to try them in court. Without serious injuries, the financial recovery, if any, will be so minimal that it will barely cover expenses and not justify the time the client and the lawyer will have to spend on the litigation.

If there is no serious injury, most personal injury lawyers will reject the case.

While it is hard to explain to a person who has been injured due to the negligence of medical personnel that the negligent parties may not have to pay a dime in compensation, it is much easier to do that before accepting the case than after a year of litigation.

It is unfortunate how many children and mothers are injured at birth due to negligent medical care. If you or your child suffered a serious birth injury due to negligent medical care, you may have questions about legal options. If you have not yet started a lawsuit and are contemplating bringing one, I encourage you to contact me today. I can answer your legal questions and would love to talk with you. You can reach me at 410-513-9978 or by email at stefan.akorli@fintusinjuryfirm.com.

New Research Shows Black Doctors Matter for Black Babies

An article this weekend in The Washington Post brought attention to a new study about race-based differences in US infant mortality. The article, which is worth reading in its entirety, revealed the results of the study.

Through the study, its researchers determined that the rate that black infants die drops dramatically–over 50%–when the infant was delivered by a black doctor.

When black doctors delivered them, the infant mortality rate fell from 430 deaths per 100,000 live births to 173 death per 100,000.

In a previous blog post, I mentioned the large disparity between black infant mortality rate and that of white infants. One of the researchers of the study highlighted by The Washington Post gave an opinion on the cause of this disparity: the root of the problem is structural racism, she said. She went on to define structural racism as the “normalization and legitimization of an array of dynamics–historical, cultural, institutional and interpersonal–that routinely advantage Whites while producing cumulative and chronic adverse outcomes for people of color.”

As to why black doctors seem to outperform their white counterparts, the researchers wrote that more research is needed to understand.

Causation–Needed for a Successful Birth Injury Case

Negligent conduct is not enough to ensure a successful birth injury case. A doctor, a nurse, or a hospital may commit an awful, avoidable, and obvious error, but that alone is not enough. There must also be, among other things, “causation.”

With this in mind, a Maryland attorney might ask himself the following question: Can I prove that the defendant’s negligence was a substantial factor, rather than a remote factor, in causing the injury or harm?

Even when negligence can be shown, if it was not a substantial factor in bringing about the injury, there is not a strong case. For example, parents may tragically lose their newborn. They may think that their loss was caused by the hospital’s negligence. They may point to the hospital’s error of failing to comply with its own policy that required a neonatologist at all c-section births. However, if there is no showing that the newborn died as a result of the neonatologist’s absence, the case will not be successful. The hospital’s lawyers will certainly argue that the absence of the neonatologist was not a substantial factor in the newborn’s death.  

If you or your child suffered a birth injury due to negligent medical care, you may have questions about legal options. If you have not yet started a lawsuit and are contemplating bringing one, I encourage you to contact me today. I can answer your legal questions and would love to talk with you. You can reach me at 410-513-9978 or by email at stefan.akorli@fintusinjuryfirm.com.

Why Birth Injuries Are a Special Risk for So Many in the US

As Americans, we like to think of ourselves as belonging to the greatest country in the world. However, the dispiriting truth is that when it comes to many facets of life, we’re just a middling, average, not-so-special group. The pandemic has laid this bare. While the world’s most populous nation, China, has successfully escaped the grips of the COVID-19 pandemic, we’re still losing thousands of parents, siblings, grandparents, and cousins every day.  

Should it be surprising that America is not exceptional when it comes to dealing with the pandemic, a health crisis? Absolutely not.

Just look at birth injury statistics.

When it comes to maternal death rates among developed nations, the United States is worst. To put it plainly, the United States is the most dangerous place in the developed world to give birth. About 700 mothers die, and more than 50,000 mothers suffer severe injuries during childbirth each year. Significantly, according to a USA Today investigation, a least half of these deaths could have been prevented and half of the injuries reduced or prevented with better care. What’s more, the maternal death and injury rate in the US has continued to climb; the maternal death and injury rate in the world’s other developed nations, they’ve been decreasing.

When it comes to birth injuries suffered by infants, the statistics also present a gloomy picture for the United States. Look at the statistic for injuries suffered per thousand births. In the United States, there are 47.8 injuries to infants for each 1,000 births. In France there are 39.7. In Austria, 41.6. In Australia, 41.7. In Italy, 43.2. In Spain, 43.4. In Finland, 43.8. In the UK, 43.8. In Germany, 43.8.

What can be done?

We can and should hold doctors accountable for the errors they make. All too often individuals who are injured by doctors never seek the help of a medical malpractice attorney. Suing a doctor for his or her negligence is not about putting the doctor out of business; it’s about putting justice and good healthcare practices into business.

The Purpose of a Med Mal Lawsuit–To Put Justice in Business

The most basic purpose of any personal injury lawsuit is to make the injured man, woman, or child “whole.” Stated simply, the law tries to put the injured person as nearly as possible in the same position as he or she would be in if the medical malpractice had not happened. In medical malpractice cases, the primary way this happens is through payment of money.

Through money, a plaintiff may be compensated for a variety of things he or she has lost or will lose. A plaintiff may be compensated for concrete things, like future medical expenses, and intangible things, like the loss of the ability to enjoy life.

But compensation is not all. Lawsuits have another great benefit–a societal benefit. When you sue a hospital, or a doctor, you do your part in helping improve the quality of local healthcare. This will benefit our community. After all, nearly all of us can envision needing medical care in the future, and we’d like to receive non-negligent medical care. For the sake of illustration, let’s look at the story of Libby Zion.

Dr. Paul Ruggieri, in his book Confessions of a Surgeon, notes the impact that a lawsuit filed by the family of Ms. Zion had:

Times have changed for [medical] residents. It all changed because of the unexpected death of a patient in a New York city hospital in 1984. Libby Zion walked into an emergency room, ill and looking for care. She left in a body bag. Her father was a high-profile citizen of the city and would not accept the initial explanations of her death as fact. At his legal and political urging, state authorities investigated the details of Libby’s care (helped along by his vigorous lawsuit). In the end, the legal case and investigation uncovered what most residents already knew and lived.

Libby Zion’s death exposed the exhaustive pressures and lack of supervision that were the norm in many training programs, both of which increased the potential for serious mistakes, and led to reforms including the number of hours residents could work continuously without sleep. Libby’s death ultimately closed the door on residencies rooted in the old way of thinking ….

For your community, a medical malpractice lawsuit you file can have a profound effect.

If you have suffered an injury due to the negligence of a medical professional in Maryland, you may have questions about your legal options. If you have not yet started a lawsuit and are contemplating bringing one, I encourage you to contact me today. I can answer your legal questions and would love to talk with you. You can reach me at 410-513-9978 or by email at stefan.akorli@fintusinjuryfirm.com.

Coverage–Needed for a Successful Birth Injury Case

The only birth injury cases a personal injury lawyer will probably accept are those that have a strong likelihood of success, and all successful birth injury cases must have four elements. One of those elements is coverage. At least one question a Maryland personal injury lawyer will ask himself related to “coverage” is whether the plaintiff will be able to collect a good-sized judgment (money damages awarded to the plaintiff) if the plaintiff prevails at trial? 

This question is significant, because if a plaintiff wins against a defendant who is bankrupt and who does not have medical malpractice insurance, then there will be no financial recovery.

Does this mean the victory would be meaningless? No, not exactly. Some legal victories can be cathartic or liberating for the plaintiff and the plaintiff’s family. However, it does mean that the case, which would have required a lot of money, time, and effort, will result in financial losses for the personal injury attorney, the plaintiff’s attorney.

Thus, it’s important that a Maryland personal injury attorney determine whether or not the defendant or defendants have adequate insurance.

Typically, doctors purchase medical malpractice insurance from big insurance companies, and then those insurance companies handle the medical malpractice cases as they arise. When there is a settlement of a case or a damages award that must be paid, it is generally the insurance company that pays.

However, Maryland does not require that all doctors have medical malpractice insurance. Unsurprisingly, some doctors make the choice to go without insurance. Further, even doctors who are not uninsured may be underinsured. In the cases where the doctor has no insurance coverage or insufficient insurance coverage, the personal assets of the doctor may come into play. It is in these cases that the doctor might, theoretically, have to pay the damages award or settlement out of her pocket. However, in practice, it is typically difficult to collect from the doctor when the award must be paid out of her pocket. Why? Doctors are adept at shielding their wealth, making it hard for victims of medical malpractice, including those who have suffered birth injuries, to receive the compensation they deserve. 

Ultimately, without a satisfactory answer to the coverage question, a victim of medical malpractice who has suffered a birth injury may find it difficult to find a personal injury attorney who will accept the case.


It is unfortunate how many children and mothers are injured at birth due to negligent medical care. If you or your child suffered a birth injury due to negligent medical care, you may have questions about legal options. If you have not yet started a lawsuit and are contemplating bringing one, I encourage you to contact me today. I can answer your legal questions and would love to talk with you. You can reach me at 410-513-9978 or by email at stefan.akorli@fintusinjuryfirm.com.

Black College-Educated Parents and the Mortality Rates of Black Infants

In the United States, there is a disturbing disparity between black and white infant mortality rates.[1] In 2016, the likelihood that a black infant would die of causes attributable to perinatal events was more than 230% higher than the likelihood a white infant would.

Unsurprisingly, the disparity between black and white infant mortality rates in the US is not a new phenomenon: in the 19th century, W. E. B. Du Bois studied the racial disparity in infant mortality rates. At that time, the black infant mortality rate was 340 per 1,000 live births, while the white infant mortality rate was 217 per 1,000.

What may be slightly more surprising is that the disparity in mortality rates is present within the demographic of infants born to two college-educated parents. Put plainly, even black infants born to two college-educated parents fare worse than similarly situated white infants.

In a 1992 study, researchers used the National Linked Birth and Infant Death Files for 1983 through 1985 to calculate infant mortality rates for children born to two college-educated parents. The population in the study consisted of 865,128 white infants and 42,230 black infants.

The researchers found that, in this population, the infant mortality rate was 10.2 per 1,000 live births for black infants and 5.4 per 1,000 live births for white infants.  

Low birth weight infants drove the disparity: the rate of low birth weight was more than twice as high among blacks (7 percent) as among whites (3 percent). Meanwhile, the researchers found that the mortality rates for black and white infants was equal among those infants who were not low birth weight infants.[2]

The researchers appropriately noted that “[t]he excess rate of low birth weight among black infants and the excess deaths of black infants due to perinatal causes raise concern about the health of black college-educated women and the perinatal care they receive.”

When black women receive substandard healthcare from physicians or other healthcare personnel, it’s a serious problem. When standard medical care does not adequately address the needs of black women, it’s a serious problem. When the psychological toll of being black and a woman in America results in physiological risks, it’s a serious problem.

What can be done to improve things?

One thing we can and should do is to hold our lawmakers–especially when they come from blue states–accountable. For example, there should be a steep political price for behaving as the Governor of Rhode Island has behaved recently.

Governor Gina Raimondo has (1) bashed proposals to expand Medicare to cover everyone, (2) approved health insurance companies’ steep premium increases, during the pandemic, and (3) jumped at the chance to help lobbyists by shielding nursing homes from coronavirus-related lawsuits. In short, she has supported policies that are harmful to the health of black women.

Miraculously, a few days ago, there was speculation that she would receive the nomination to be president-elect Biden’s secretary of Health and Human Services! Ultimately, she did not get the nomination. Those of us who care about the health of black infants and black women may fantasize, dream, hope that it was a healthcare litmus test that doomed Governor Raimondo’s chances.


[1] Infant mortality is the death of an infant before his or her first birthday. The infant mortality rate is the number of infant deaths for every 1,000 live births.

[2] However, the researchers pointed out, “[i]n the general population, on the other hand, black infants with normal birth weights have almost twice the mortality rate of their white counterparts.

Liability–Needed for a Successful Birth Injury Case

The only birth injury cases a personal injury lawyer will likely accept are those that have a strong likelihood of success, and all successful birth injury cases must have four elements. One of those elements is liability. When it comes to evaluating liability, I ask myself certain questions. Here, we’ll look at two of these questions–perhaps the most important two.

Question #1

When it comes to liability, I first ask, can I prove that the defendant was negligent?

To assess the liability aspect of a case, an attorney must determine whether he can show that the defendant’s conduct, his action or inaction, was negligent under the particular circumstances. Negligence is a breach of the “standard of care.” The plaintiff must establish what the standard of care is.

Question #2

In Maryland, another question is important to answer even after being convinced the defendant’s conduct was negligent. The additional question asks whether the plaintiff’s negligence was a significant cause of the harm or injuries he or she suffered? This question is as relevant, because Maryland is one of only a few states where “contributory negligence” is a bar to financial recovery, a bar to success.  “Contributory negligence” is some negligence on the part of the plaintiff which directly contributes to the occurrence of the plaintiff’s injury. However, to bar recovery, the plaintiff’s contributory negligence must have significantly contributed to the injury.

For example, a mother and father begin a medical malpractice case against a doctor, claiming that the doctor’s failure to diagnose the mother’s gestational diabetes caused the stillbirth of their child. However, the doctor claims that the mother failed to disclose her family history of diabetes and failed to follow his medical instructions. Here, a jury might conclude that the mother was contributorily negligent.

It is unfortunate how many children and mothers are injured at birth due to negligent medical care. If you or your child suffered a birth injury due to negligent medical care, you may have questions about legal options. If you have not yet started a lawsuit and are contemplating bringing one, I encourage you to contact me today. I can answer your legal questions and would love to talk with you. You can reach me at 410-513-9978 or by email at stefan.akorli@fintusinjuryfirm.com.

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