Common Diagnostic Errors That Lead to Birth Injuries

August 17, 2025

A diagnostic error during childbirth happens when a healthcare provider does not correctly identify a medical condition, misinterprets test results, or delays a necessary diagnosis, leading to injury to the mother or baby. These situations are not always unavoidable complications; they are frequently the result of a breakdown in the expected standard of care.

These errors play a significant factor in birth injury cases. The consequences are devastating, leading to conditions like cerebral palsy or permanent brain damage.

Have questions about your specific case? Call us at (215) 569-0900 for a no-cost discussion about what happened.

What Does a “Diagnostic Error” Actually Mean in the Delivery Room?

A diagnostic error includes three main types of failures:

• Missed Diagnosis: Failing to recognize clear signs of a problem, like fetal distress or maternal infection.
• Wrong Diagnosis: Mistaking one condition for another, leading to incorrect and harmful treatment.
• Delayed Diagnosis: Identifying the problem correctly, but too late for effective intervention, such as delaying a C-section when the baby is in distress.

The Legal Standard: A Simple Explanation of “Standard of Care”

In legal terms, every medical decision is measured against the “standard of care.” This concept simply asks:

“What would a reasonably skilled and careful healthcare professional, with similar training, have done in the same situation?”

When a doctor or nurse’s actions fall below this standard, and that failure directly causes an injury, it may be considered medical malpractice.

Where Diagnostic Errors Most Often Occur

The risk is highest during labor and delivery, a period when timely decisions are paramount.

Failure to Interpret Fetal Monitoring Strips

These strips are the primary way doctors “see” how your baby is tolerating labor. They track the baby’s heart rate in response to contractions.

The Error

Doctors are trained to spot warning signs like prolonged decelerations (a drop in heart rate) or a lack of variability (a flat-lining heart rate). Misinterpreting these signs or dismissing them as normal might lead to a failure to act, starving the baby’s brain of oxygen.

Delayed Decision for a C-Section

A C-section is a tool when labor stalls, the baby is too large, or fetal distress is apparent.

The Error

Waiting too long to order the surgery is one of the most devastating and avoidable mistakes. Delay can result in brain damage, organ failure, or stillbirth.

Preeclampsia

This is a dangerous condition involving high maternal blood pressure during pregnancy or labor.

The Error

Failing to diagnose or manage preeclampsia can lead to eclampsia (seizures), placental abruption, or fetal growth restriction due to reduced placental blood flow.

Uterine Rupture

A tearing uterus is a known risk, especially in women with a history of C-section or uterine surgery.

The Error

Missing the signs—sudden pain, fetal distress, or abnormal contractions—can result in massive hemorrhage or death for the mother and child.

Infections

Some maternal infections, such as Group B Streptococcus, can be transmitted to the baby during delivery.

The Error

Failure to screen, diagnose, or treat these infections in time can lead to sepsis, pneumonia, or meningitis in the newborn.

Shoulder Dystocia

This condition occurs when the baby’s shoulder becomes lodged behind the mother’s pelvic bone during delivery.

The Error

Improper maneuvers or excessive pulling can cause brachial plexus injuries, leading to arm paralysis or permanent nerve damage.

Improper Use of Forceps or Vacuum Extractor

These tools are used to assist delivery when the baby is stuck in the birth canal.

The Error

Incorrect placement or excessive force can cause skull fractures, bleeding in the brain, or facial nerve damage.

Why These Mistakes Happen

It is easy to point to one doctor, but often the error is rooted in a larger systemic failure.

Communication Breakdowns

• The Nurse-Doctor Gap: A nurse at the bedside may notice subtle changes in the fetal heart monitor, but their concerns might be dismissed by a doctor who is not present in the room.
• Shift Change Handoffs: Critical information can be lost or miscommunicated when one medical team takes over for another.

System and Policy Failures

• Inadequate Staffing: An understaffed labor and delivery unit means nurses are stretched thin and doctors may not be immediately available in an emergency.
• Lack of Clear Protocols: Hospitals should have clear, evidence-based protocols for emergencies like shoulder dystocia or postpartum hemorrhage. When they don’t, or when staff fail to follow them, chaos might lead to injury.

The Lifelong Consequences of a Momentary Error

A diagnostic error that takes only minutes to occur could result in a lifetime of challenges and expenses.

The Human Cost: Common Injuries from Diagnostic Failures

• Cerebral Palsy: A group of disorders affecting movement and muscle tone, often caused by brain damage from oxygen deprivation during birth.
• Hypoxic-Ischemic Encephalopathy (HIE): Brain damage caused by a lack of oxygen or blood flow.
• Brachial Plexus Injuries (Erb’s Palsy): Weakness or paralysis in the arm resulting from nerve damage during delivery.
• Stillbirth: In the most tragic cases, a failure to diagnose fetal distress leads to the death of the infant.

The Financial Reality: Planning for a Lifetime of Care

The cost of caring for a child with a severe birth injury easily runs into the millions of dollars over their lifetime.

This includes costs for:

• Medical Treatment: Surgeries, doctor visits, medication.
• Therapies: Physical, occupational, and speech therapy.
• Mobility Aids and Home Modifications: Wheelchairs, ramps, and specialized vehicles.
• 24/7 Attendant Care: In some cases, a child may need round-the-clock assistance.
• Lost Parental Income: One parent often must stop working to become a full-time caregiver.

A legal claim seeks to establish a life care plan, which is a detailed projection of these future costs, to ensure your child has every resource they need to live the fullest life possible.

Comparative Law: Differences Between PA and NJ Medical Malpractice Procedures

In Pennsylvania and New Jersey, where our firm handles claims, the rules for pursuing a medical malpractice claim differ in several key ways.

Certificate of Merit (PA) vs. Affidavit of Merit (NJ)

Pennsylvania:

Plaintiffs must file a Certificate of Merit within 60 days of the complaint, signed by a medical expert, stating there is a “reasonable probability” the care fell below accepted standards. This requirement is strictly enforced and missing it will get your case dismissed.

New Jersey:

Plaintiffs must serve an Affidavit of Merit from an appropriately licensed healthcare professional within 60 days after the defendant’s answer, affirming that the care provided deviated from accepted practice. Extensions are rare, and missing this deadline almost always results in dismissal.

Pre-Suit Notice

Pennsylvania:

No formal pre-suit notice to the defendant is required.

New Jersey:

No pre-suit notice needed for medical malpractice claims, but strict compliance with the affidavit process is mandatory.

Damages Caps and Limits

Pennsylvania:

No cap on compensatory damages (economic and non-economic), but punitive damages are capped at two times the amount of actual damages or $500,000, whichever is greater.

New Jersey:

No cap on compensatory damages. Punitive damages are capped at $350,000 or five times the compensatory damages, whichever is greater.

Expert Qualifications

Both states require that expert witnesses must be actively practicing or teaching in the same specialty as the defendant at the time of the alleged negligence. New Jersey is particularly strict about “like specialty” requirements.

Unique Procedures

Pennsylvania:

All medical malpractice lawsuits are governed by the Medical Care Availability and Reduction of Error (MCARE) Act, which establishes a special fund for some damages when healthcare providers lack adequate insurance.

New Jersey:

The Conscientious Employee Protection Act (CEPA) can sometimes overlap if the error involves whistleblowing or retaliation.

Statute of Limitations

Both states generally allow two years from the date the injury was discovered (or should have been discovered), but minor children may have extended time. Failure to comply with these deadlines bars the claim.

Parental Rights and the Role of Guardians ad Litem

When a child suffers a birth injury, the law recognizes that minors cannot file lawsuits on their own. Special procedures are in place to protect their interests:

Who Can File a Lawsuit for a Child?

In both PA and NJ, only a parent or legal guardian can file a medical malpractice or birth injury lawsuit on behalf of a minor child. This is called bringing the suit “as next friend” of the child.

Parental Claims

Parents can also bring their own claims for out-of-pocket medical expenses, lost income due to caregiving, and other costs incurred as a result of their child’s injury. These are often joined with the child’s claim in a single lawsuit.

Role of a Guardian ad Litem

A guardian ad litem (GAL) is sometimes appointed by the court to independently represent the child’s interests, particularly when settlement negotiations occur. The GAL reviews the terms to ensure the proposed settlement is fair, reasonable, and truly in the child’s best interest.

Courts in both states must approve any settlement on behalf of a minor. The process usually involves a formal hearing where the GAL provides a recommendation and the judge reviews evidence regarding the child’s future needs.

How Settlement Funds Are Handled

Money awarded to a minor cannot simply be given to parents or guardians. Courts typically require these funds to be placed in a protected account, such as a structured settlement or trust, with strict rules for when and how the money can be accessed before adulthood.

Special Considerations

If a child turns 18 during litigation, they may take over the lawsuit themselves. The court will sometimes require regular reporting to ensure the child’s funds are properly managed.

Special Considerations for Multiple Births or High-Risk Pregnancies

Multiple pregnancies (twins, triplets, or more) and high-risk pregnancies create extra challenges and risks that doctors must recognize and manage with heightened vigilance:

Higher Risk, Higher Standard

Multiple births and high-risk pregnancies (such as those involving preeclampsia, gestational diabetes, advanced maternal age, or prior pregnancy complications) require doctors and hospitals to follow additional protocols and monitoring.

Failure to properly manage these pregnancies dramatically increases the risk of diagnostic errors, such as missing fetal distress in one twin while focusing on another.

Common Diagnostic Errors

• Failure to order appropriate ultrasounds or prenatal genetic testing.
• Not recognizing signs of twin-to-twin transfusion syndrome or growth restriction.
• Mismanagement of preterm labor, which is more common in multiples and high-risk cases.
• Overlooking or delaying treatment for maternal conditions that can endanger both mother and babies.

Expected Medical Protocols

• Use of high-level fetal monitoring for each baby, often requiring two or more monitors.
• Timely referral to maternal-fetal medicine specialists.
• Delivery in a hospital equipped for high-risk cases and neonatal intensive care.
• Clear emergency plans for scenarios like cord prolapse, placental abruption, or uterine rupture.

Legal Standards

The “standard of care” is elevated in these cases, since medical professionals know the risks are greater. Any deviation from well-established guidelines for managing multiples or high-risk pregnancies is strong evidence of negligence if harm results.

Documentation and Investigation

Multiple births generate more complex medical records, often requiring detailed expert review to identify where monitoring, communication, or intervention failed. Hospitals may try to blame adverse outcomes on the “inherent risks” of high-risk pregnancies, but the law requires them to do everything reasonably possible to prevent avoidable harm.

If You Suspect a Diagnostic Error

Save all records, including prenatal visit logs, ultrasound results, hospital admission notes, and any instructions or warnings given by your healthcare team.

How a Birth Injury Claim Uncovers the Truth

The hospital and its doctors are unlikely to admit that an error occurred. Proving it requires a meticulous, independent investigation into the medical evidence. This is the work our firm does.

Step 1: The Medical Record Review

We collect every piece of paper related to the pregnancy and birth: prenatal records, all labor and delivery notes, every strip from the fetal heart monitor, and the baby’s newborn care charts.

Step 2: Analysis by Medical Professionals

We work with a network of independent, highly qualified medical professionals—obstetricians, neonatologists, and labor and delivery nurses—who review the records. They look for deviations from the accepted standard of care. They can pinpoint the exact moment an error was made.

Step 3: Establishing Causation

This is the most important part. It’s not enough to show a doctor made a mistake. We must prove that the mistake directly caused your child’s injury. This is done by linking the error (e.g., the 45-minute delay in performing a C-section) to the outcome (e.g., the brain damage caused by oxygen deprivation during that 45-minute window).

Frequently Asked Questions About Diagnostic Errors and Birth Injuries

How can I know if my child’s injury was a preventable error or just an unavoidable complication?

It is nearly impossible for a parent to know for sure without a thorough review of the medical records by an independent medical professional. Many families are told an injury was “just one of those things” when, in fact, it was preventable. The only way to get a real answer is to have the records investigated.

What is a “life care plan” and why is it important?

A life care plan is a comprehensive document created by medical and financial planners that outlines every single anticipated medical and non-medical need for an injured child’s entire life. It projects the costs of therapies, equipment, medical procedures, and personal care. This plan becomes the foundation for calculating the financial compensation needed to ensure your child is cared for permanently.

How much does it cost to hire Wapner Newman for a birth injury case?

We handle birth injury cases on a contingency fee basis. This means you pay absolutely nothing upfront. We cover all the costs of the investigation and litigation. We only receive a fee if we successfully recover compensation for you and your child.

My child was diagnosed with a developmental delay months after birth. Is it too late to investigate a potential birth injury?

Not necessarily. Pennsylvania’s statute of limitations includes a “discovery rule,” which means the two-year clock may not start running until the date you knew, or reasonably should have known, that an injury was caused by a medical error. It is best to speak with an attorney as soon as you have a diagnosis to understand your specific timeline.

Secure Your Child’s Future, Let Us Handle the Fight

Your energy needs to be focused on your child. Our energy will be focused on ensuring they have the financial resources for a secure future. You do not have to uncover the truth of what happened in that delivery room alone. The burden of investigating medical records and holding a hospital accountable should not be yours to bear. Let us take it from here.

Call Wapner Newman today at (215) 569-0900 for a free, confidential conversation about your family’s situation.