Jornal de Neurologia Pediátrica e Medicina

Obstetric/Paediatric Interaction in Brain Damage Litigation: Learning from the Courts

Abstract

George Gregory Buttigieg

The multifaceted relationship between obstetrician and paediatrician is looked at within the framework of Court medico-legal action concerning neonatal brain damage, as exemplified by cerebral palsy. Antenatal and intra-partum aspects are analysed, and the potential for a preventive role in inter-disciplinary antenatal consultations advocated. It is suggested that, those instances of HIE with possible antenatal identifiable risk factors, could benefit from a combined obstetrician-paediatrician as part of antenatal management. The crucial importance of the paediatric role in optimal resuscitation, and later management is also stressed as benefitting both the neonate and limiting possible future obstetric liability. The paediatrician’s roles in establishing HIE along the ACOG–AAP 2003/2014 Classification is also evaluated. Borrowing extensively from UK Court archives, frequent reference is also made to specific Court case examples, oriented around obstetric/paediatric liability based on alleged, and at times, upheld medical malpractice.