Cerebral Palsy Solicitor - Medical Negligence Injury Compensation Claims

Cerebral Palsy (CP) is one of the most tragic conditions to affect both the victim and their family and the emotional suffering involved only increases when the condition is the result of medical negligence. If you want to obtain compensation, our medical negligence solicitors can help you to make a compensation claim. Our cerebral palsy solicitors operate the no win no fee* scheme otherwise known as a conditional fee agreement. No legal charge is payable unless the legal case is won and the client obtains an award of compensation. In the event that the legal claim is lost there is no charge made to the client.

Legal aid is available to pursue a cerebral palsy compensation claim and almost all children (minors under the age of 18 years) will qualify, as it is the income of the victim and not the income of the parents that is taken into consideration in the financial assessment of means to determine eligibility for legal aid to pursue a compensation claim.

This condition occurs when areas of the brain that control certain bodily functions are impaired, often caused by oxygen starvation during birth, preventing them from being properly utilised. If these problems are caused by medical negligence, a compensation claim should be made to safeguard the financial future of the victim and to ensure that carers have sufficient funds to properly care for the victim in the future.

Cerebral Palsy

Cerebral palsy refers to a variety of motor conditions that affect physical coordination, movement and muscle tone of an individual resulting in a physical disability. This condition is usually caused by damage to the brain, particularly injury to the motor control portions of the brain while it is still developing. Cerebral palsy can develop during pregnancy and childbirth, as well as following birth up to age three; it can occur spontaneously often with no obvious cause or it may be as a result of medical negligence thereby justifying a compensation claim for damages.

Most cases of cerebral palsy occur naturally and are not the result of medical negligence however a not insignificant proportion of cases are caused by medical errors that could have been avoided. If you have any suspicion at all that your child’s condition may have been caused as a result of negligence by a health care practitioner, our cerebral palsy solicitors are able to investigate the clinical history and give full and detailed advice as to whether or not you have a viable case for a medical negligence compensation claim.

Cerebral means “of the brain” and, in this case, more specifically relates to the cerebrum. The cerebrum is the area of the brain that is most affected by the disorder, along with the cerebellum and cortex. Palsy refers to a problem with movement.

Cerebral palsy causes an individual to have limitations with physical activity. The condition affects a variety of movement and posture capabilities. It may also affect communication, perception, behaviour, sensation, cognition and perception. CP is a non-progressive disability that is not contagious. It can lead to secondary musculo-skeletal issues or epilepsy.

Recent studies have estimated that nearly two out of every 1,000 children born will have some degree of CP. There has been some advancement in neonatal care and technology; however, these improvements have not significantly reduced the incidences of CP. This is often due to nurses and doctors making errors during and after the birthing process thereby justifying a cerebral palsy compensation claim. Babies born with very low birth weights also have a much greater chance of developing CP. While none of the variations of CP has a definitive cure, there are medical treatments, therapy and education methods that can help manage the effects.

Common Causes

The main causes of cerebral palsy include a lack of oxygen to the brain due to spending too long in the birth canal during delivery, a badly performed vacuum delivery extraction, badly judged use of delivery forceps, a delay in deciding to use a caesarean section, a failure to recognise the changes in the foetal heart rate and a prolapsed umbilical cord which denies the passage of oxygen to the baby child's brain.

A small percentage of children diagnosed with CP develop the condition due to some form of brain damage that occurs in the first few months or years following birth. This can include damage from viral infections (such as viral encephalitis), bacterial infections (such as bacterial meningitis) or a head injury resulting from child abuse, fall or motor vehicle collision.

Modern science cannot discern the cause of about 80% of cases of cerebral palsy, meaning that, difficult as that is for most parents, the majority cases of cerebral palsy have an unknown aetiology. There are some causes that can be pinpointed, like cerebral palsy due to infection, metabolic disorders, acute jaundice, trauma and head injury during labour and delivery. It can and does happen, but only a very small percentage of cases are triggered by medical negligence. Whether it is due to lack of oxygen to the brain, trauma or infection, they all impact on different areas of the brain and lead to the condition known as cerebral palsy (CP). This variation in how and where the brain is affected is the primary reason why so many cases cannot be given a definite cause.

Less than 10% of CP is caused as a result of inadequate clinical care however if you have suspicions that all is not how it should be our medical negligence solicitors will take a detailed statement from you and after consideration of your medical records will obtain written opinions from experienced clinicians in an attempt to establish the cause of the injury. If you would like advice at no cost from a specialist cerebral palsy solicitor without further any obligation just use the helpline or contact our solicitors offices by email.

CP Classification

Outlining a definition of cerebral palsy is a difficult task because the term is an expansive expression that describes several different chronic disorders, which affect the body's ability to move and coordinate its posture. The name was formed from cerebral, meaning "of the brain", and palsy, meaning "a disorder of movement and/or posture". The condition is caused by damage or injury to certain areas of the brain, typically during foetal development or in early infancy. It is thought CP may also occur before, during or immediately after birth. A complete cerebral palsy definition cannot be made without mentioning the characteristics of the different types of this condition which are referable to the area of the brain that is damaged and the extent of that damage.

In its most simple terms a cerebral palsy refers to the meaning of the two words that comprise the term. When someone is diagnosed with cerebral palsy, it means there has been some sort of injury to the brain (cerebral) and they are no longer able to use or control certain muscles of the body in the proper way (palsy). Children affected with the condition may have difficulty or an inability to walk, talk, play normally or eat in a manner similar to other children.

It is important to realise that a definition will never refer to the condition as a disease because it is not communicable or progressive and it is generally not considered curable. That being said, specific types of therapy, technological advances and specialised education can assist individuals with cerebral palsy to the extent they can live a more productive life.

On a more technical basis a definition may include reference to a lack of ability to completely control different motor functions; more specifically, coordination and muscle control. Depending on which portion of the brain is injured or damaged, individuals with the condition may experience one or more of these symptoms :

• involuntary movements
• improper gait
• decreased mobility
• impaired sight, hearing or speech abilities
• seizures
• muscle spasms and/or tightness
• atypical sensations and perception

Cerebral palsy is usually classified into one of four distinct categories. These categories describe different types of impairments and disabilities and are reflective of the area of the brain that has been damaged. The categories are as follows :

Spastic Cerebral Palsy

This is the most commonly occurring form of the condition and makes up between 70 and 80 percent of all cases. In addition to these cases, spastic CP is also associated with one of the other forms of CP in about 30 percent of all patients. Individuals who have this type of cerebral palsy are hypertonic and have damage to the corticospinal area of the brain, also known as the motor cortex. This damage results in a neuromuscular condition that prevents gamma amino butyric acid from reaching the areas of the body that are affected, thus resulting in nervous system disabilities. Spastic CP can be further classified by the following characteristics :

Spastic Hemiplegia: This means one side of the body is affected. If the muscle nerves located in the left side of the brain are injured, the right side of the body becomes disabled. The left side of the body is affected if the muscle nerves on the right side of the brain are damaged. Individuals affected with spastic hemiplegia are the most ambulatory of CP cases; however, they usually have ankle and foot deformities and may require orthotics to help with this issue.

Spastic Diplegia: This means the lower extremities of the body is affected, with little or no disability to the upper body. This is the most common category of spastic CP. Individuals affected with spastic diplegia are usually fully ambulatory; however, they have a “scissors gait”. A scissors gait is identifiable by varying degrees of flexed hips and knees. Some individuals may have problems with hip dislocations, and strabismus (crossed eyes). People with spastic diplegia function at normal cognitive levels.

Spastic Quadriplegia: This means all four limbs of the body are equally affected. These individuals are likely unable to walk and if they try to walk, their muscles are usually too tight to do so properly. In some cases, children with spastic quadriplegia also experience hemi-paretic tremors, which are characterised by uncontrollable shaking of the limbs of the body on one side.

Ataxic Cerebral Palsy

Ataxic CP symptoms are a direct result of damage that occurs in the cerebellum. This form of CP is not very common and makes up about ten percent of all cases. Individuals suffering with ataxic CP usually experience tremors and hypotonia. This greatly affects general motor skills needed for writing, using dinnerware, typing, walking and general balance. People with this form of the condition also have problems with auditory processing and vision.

Athetoid or Dyskinetic CP

Athetoid or Dyskinetic CP simply means individuals experience mixed muscle tone. It is believed untreated high levels of bilirubin in the blood of new-borns leads to brain damage that causes athetoid or dyskinetic cerebral palsy. About twenty-five percent of all people with CP have this form of the condition. Mixed muscle tone results in the person experiencing difficulty standing, holding in an upright position, walking and sitting. People who suffer with athetoid or dyskinetic CP often have involuntary movements, and expend a great deal of energy and concentration to perform simple tasks such as moving a hand to a certain location (such as to grasp a fork or to scratch an itch). Due to the fact their muscle tone is mixed, they are often not able to hold on to objects.

Hypotonic CP

Individuals suffering with hypotonic cerebral palsy are often limp and have extremely limited movement or no movement whatsoever.

Cerebral palsy also has several different classifications based on the level of spasticity (the inability to relax the muscles.) Major classifications include :

Hemiplegia

This condition occurs when spasticity only affects the limbs on one side of the body leaving the other side relatively normal. Most children with this form of cerebral palsy have more problems with the ends of the affected limbs than in the middle. For example, the affected hand and wrist are more affected than the elbow or shoulder. Similarly the knee and hip are less severely affected than the ankle and foot. Most of the children affected by hemiplegia are in all other ways normal, attend conventional schools, have average intellect and can expect to live reasonably customary lives as adults.

Diplegia

The legs are affected by spasticity in diplegia, but the upper body is mostly unaffected. However, in the majority of cases, the arms are also slightly affected. These children have difficulty with coordination and balance. The range of motion in their legs delays the growth of muscles, so these muscles are short and, therefore, motion range decreases and the joints become inflexible as the child ages. Toe walking is the most common problem with diplegia as the Achilles tendon is too short. There is also risk of dislocated hips with this condition and careful monitoring of the joints is necessary throughout the child's developmental years. There are three classifications for the severity of diplegia:



1. Mild: The child can walk normally without assistance and can keep up with many children of the same age group.
2. Moderate: Child can walk mostly unassisted, but will require a walker, crutches or a wheel chair during lengthy walks.
3. Severe: These children require a walking aid continuously and permanently. They can walk, but only on level areas like paving and in a straight line. When out in public, children affected with severe diplegia need a wheelchair.

Quadriplegia

This form is also known as Full Body Involvement (FBI) or Pentaplegia. All four limbs are unable to move normally, though sometimes some movement in one or other limb is better than the others, so quadriplegia does not always mean complete incapacitation. With FBI, there are often other difficulties involving breathing and eating. This is due to insufficient muscle control and/or interruption to the rhythm and pattern of movement and contraction in particular. It is fair to say that children with FBI cerebral palsy are likely to develop further motor dysfunction as a result of the medication used to treat their constant symptoms.

Monoplegia

Children with monoplegia develop spasticity in only one limb. This is a rare occurrence and it can be dramatically improved early in the child's life by providing manipulative toys to encourage double-handed activities. These cases, more often than not, affect the end of the limb like the hand. An arm is more likely to be affected than a leg.

Developmental Disability

Due to the fact that cerebral palsy usually shows up quite early in children, it is considered a form of developmental disability. Recent studies have shown this condition affects more children than other types of developmental disabilities, such as epilepsy, autism or Down's syndrome. Systems for monitoring the numbers of cerebral palsy cases are either non-existent or difficult to track; therefore, there is no definitive method to determine if the overall numbers are declining, increasing or remaining constant.

Advances in prenatal treatment, such as the use of foetal heart rate monitors during labour and delivery, have not lowered the chances of cerebral palsy developing which is often due to errors during the birthing process by nurses, doctors and other medical attendants.

Cerebral palsy is generally considered to be a disability that will last throughout a person's entire life; even though some children who have been diagnosed with very mild CP may recover to varying degrees by the time they are four or five years old. The majority of cases, however, will continue to affect movement, muscle tone and coordination of the individual, possibly affecting the child's learning ability and physical capabilities throughout his or her life.

Symptoms

The condition known as cerebral palsy actually refers any one form of a large number of neurological conditions typically first recognised in infancy or very early childhood. These conditions affect bodily movements, muscle tone and general coordination; however, they are not contagious and do not progress to a worse state with time.

While CP affects muscle movement and coordination; it does not have anything to do with problems in the actual muscles or nerves. The condition is caused by an abnormality in a particular part of the brain that controls specific bodily movement. The vast majority of CP cases are diagnosed in children who are born with the condition, although it may not be immediately detected. The signs of cerebral palsy generally emerge before the age of three.

If an infant or child experiences some type of brain damage, there are a variety of symptoms that can cause both parents and physicians alarm. Initial symptoms may be noticed in the first few months following birth. Children may exhibit some or all of the following symptoms:

• General lethargy or a lack of interest and alertness;
• Low muscle tone;
• Posture that appears abnormal, such as the child favouring just one side of the body;
• Irritability or fussiness that cannot otherwise be explained;
• Reflexes that do not respond normally;
• Seizures;
• Eye fluttering;
• Body twitches or trembling, especially in the arms and legs;
• Staring spells;
• An inability to properly feed, due to difficulty with sucking and swallowing;
• A high pitched, abnormal cry.

Over the course of the first six months following birth, other symptoms may also begin to appear. These symptoms have more to do with posture and general muscle tone, and may include the following:

• Muscle tone that changes over time, from low to tone i.e. baby going from very floppy to very stiff;
• The child has a difficult time feeding and his or her tongue seems to push food out of the mouth with force;
• The child often balls hands into tight fists.
• Movement appears to be asymmetrical, with one side moving quite easily and freely, while the other seems stiff and rigid;

Once the child has reached the age of six months, it should be quite evident as to whether or not motor skills and movement are normal when compared to other children. Those affected with cerebral palsy are typically slower to achieve particular developmental milestones. Simple movements, such as sitting up, crawling, rolling over, walking and talking, are delayed. Parents typically notice these delays, and other forms of atypical behaviour, especially if they have had other children and know what is considered normal. In some cases, when the parents express their concerns to a health care professional, the child is automatically diagnosed with CP however in most cases, health care professionals hold off on making a diagnosis and rather than immediately use the term cerebral palsy, many physicians prefer to use more vague medical terms such as:

• Motor disabilities, which indicate a potential for long term problems with movement;
• Central nervous system dysfunctions, which covers any type of brain function considered abnormal;
• Static encephalopathy, indicating there is some type of abnormal static brain functioning;
• Neuromotor dysfunctions, manifested as some type of delay in the development of the nervous system.
• Developmental delays, which simply mean the child is developing at a slower pace than other children in movement skill areas, such as sitting up, or rolling over;

As this is a non-progressive condition, the symptoms a child exhibits early on typically do not change or worsen with time. It is possible for other secondary complications to occur, however, such as:

• Epilepsy, which is a seizure disorder;
• Contractures, which occurs when the muscles pull tightly on the bones causing the limbs to curl inward;
• Malnutrition, which results from feeding problems stemming from an inability to suck or swallow;
• Urinary incontinence;
• Skin irritation, typically present on the face, lips, chin and chest area from drooling.
• Dental problems, which result from excessive pain and sensitivity, as well as inability to apply proper motor skills for teeth brushing;

Treatment

While there is no cure for cerebral palsy, there are treatments that may improve a person's quality of life and help manage the condition. In fact, many children diagnosed with CP go on to enjoy adult lives that are very close to normal.

Treatment commenced as soon as possible gives a child the best chance of overcoming developmental and learning disabilities. These treatments help individuals to learn how to deal with their physical symptoms, while teaching them how to carry out basic tasks. The treatment programs can include physical and occupational therapy, which teach basic life skills, and speech therapy to help correct any issues with language. Certain drugs may also be prescribed in an effort to control muscle spasms and seizures or to control pain. There are also surgical procedures to correct physical malformations or release muscle tightness. Braces, wheelchairs, orthotic devices and walkers may also help with movement. Communication aids, such as computers with voice synthesizers, can help a great deal with compromised speech.

While there is no cure for cerebral palsy, the condition does not worsen over time. That said, there are some secondary complications that can crop up due to abnormal muscle tone and motor skills. Today, there are several different types of treatment aimed at improving overall quality of life, while teaching individuals how to be as independent as possible. Treatment is designed to improve social interaction, increase physical strength, assist with personal hygiene and prevent further prevent complications, such as joint issues and stunted growth. Each individual treatment plan is specifically designed for each patient to meet his or her exact needs. Some of the most common forms of CP treatment are explained below.

Physical Therapy :

This type of treatment is perhaps the most important form of therapy. Physical therapy programs work to strengthen muscles in an effort to improve total bodily strength, mobility and balance to increase personal independence. Stretching is a major component of physical therapy, as it helps to improve range of motion and joint strength, while slowing contracture formation. Physical therapy treatments can begin as soon as abnormal muscle tone or developmental delays are noticed, and continue over the course of a lifetime. Therapists can also provide guidance regarding other forms of mobility devices or wheelchairs, if required.

Orthotic Assistance:

Individuals suffering with cerebral palsy face issues with muscle growth unable to keep pace with bone growth. This results in contracture, which can cause limb deformities, leading to balance issues and a loss of coordination. Special braces and other orthotic devices can be combined with physical therapy treatments to help prevent contracture by keeping muscles stretched.

Medication:

Medications can be used in a variety of ways to control muscle spasms and tremors and relax tightened muscles. Medications, such as phenol and Botox can be injected into problem areas to reduce some muscle spasticity. Anti-seizure, or anti-convulsion, medication can be helpful as well. Other medications may also be needed should other medical conditions arise.

Surgery:

Surgery as a form of treatment can help correct issues such as uneven bone growth, spine curvature and loosen tight or stiff muscles. Spasticity can also be controlled by implantation of a pump that delivers medications directly to nerve roots or the spinal cord, in an effort to increase muscle tone. Surgery can be performed on muscles, nerves, joints and tendons to help correct posture. Surgery can also correct walking or sitting, while improving motor skills of the hands. This form of treatment can be used to ease pain as well. Surgical implantation of a feeding tube may also be needed to control gastro-oesophageal reflux.

Speech Therapy:

Speech therapy can be quite beneficial to improving general language and communication skills. Therapists can also educate patients on how to make use of alternative communication methods.

Occupational Therapy:

This form of therapy typically centres on improving hand function, hand fine motor skills and basic self-care skills. The goal is to improve the patient's everyday life, while teaching independence. Mobility training will be included in these treatments. Issues with eating, such as swallowing, will also be addressed during therapy sessions.

Assistive Devices:

Items such as eye glasses and hearing aids can benefit patients with cerebral palsy a great deal. If eye glasses do not adequately correct vision problems, surgical eye treatments may be offered to correct focusing issues (sometimes referred to as strabismus) or crossed eyes.

Funding a Cerebral Palsy Claim

When considering whether or not to make a medical negligence claim against the NHS one of the primary concerns is who is going to pay for the cerebral palsy solicitors legal action. Public funding in the form of legal aid could be available for qualifying applicants and for those who do not qualify it may be possible to deal with matters using the no win no fee* scheme. There may also be other funding options including insurance cover and trades union membership benefits.

Legal Aid

In order to be successful an application for legal aid for a clinical negligence claim must fall within the financial parameters dictated by the Legal Services Commission (LSC) which administers and determines legal aid applications. Only applicants on low income will qualify however a clinical negligence claim for someone under the age of 18 years will almost always be eligible for public funding. The following specific points must also be satisfied before an application will succeed :-

• Cost Benefits - The costs involved in a clinical negligence claim should bear a reasonable relationship to the anticipated gains should the case be won. If the legal costs are anticipated to be double the amount of any award, the two figures do not relate well and the application is unlikely to succeed.
• Prospects of Success - The LSC will expect there to be a better than fifty percent probability of the clinical negligence case being won. If the case is of exceptional importance or damages are likely to be substantial this relationship may be reconsidered.
• Importance of the Case - The LSC must adjudicate on the importance of the clinical negligence case to a reasonable person in the same circumstances without allowing emotions into the equation. This judgement will also include consideration of the consequences involved in not winning compensation as it might be that losing the clinical negligence claim might severely damage the applicant.

no win no fee*

If you do not qualify for public funding to pursue a clinical negligence claim then the no win no fee* system may be available whereby our medical negligence solicitors are only paid if a clinical negligence claim is won and you gain compensation. We operate the no win no fee* scheme otherwise known as a conditional fee agreement. No legal charge is payable unless the legal case is won and the client obtains an award of compensation. In the event that the legal claim is lost there is no charge made to the client. Consideration for the no win no fee* scheme involves a detailed risk assessment being carried out by the cerebral palsy solicitor.

Alternative Funding

There are some other funding alternatives that may be available to particular individuals in order to pursue a clinical negligence claim :-

• In the absence of legal aid private funding used to be the norm in personal injury claims however private funding is now rarely used due to the availability of the no win no fee* scheme.
• Some trades unions will provide members with their own legal aid which can be used to pursue a civil case through the courts. It is definitely worth making enquiries with the union representative.
• Many policies of insurance now cover the cost of legal expenses for pursuing damages claims in the civil court. In particular, household policies should be scrutinised in detail. This cover is known as 'legal expenses insurance' (LSI) or 'before the event' (BTE) insurance.

Medical Negligence Solicitors

If you or your child have suffered personal injury and you fear you may have been the victim of medical negligence there is no time for delay. In order to know what options you have you should seek expert legal advice as soon as possible. Our medical negligence solicitors operate a comprehensive service whereby you can meet us in person or chat over the telephone and obtain advice at no cost. If you subsequently decide to proceed no further then that is your right and you will not be charged.

Cerebral Palsy Overview

Cerebral palsy or CP is used to describe a wide variety of chronic disorders of movement due to damage to the movement centers of the brain that is developing. It usually reaches its full potential by age 2-3. Once present, it is nonprogressive so it doesn�t appreciably worsen over time. Symptoms, however, do change over time palsy is one of the more common. Cerebral causes of chronic childhood disabilities.

In terms of incidence, over 1,000 infants are diagnosed each year and an additional 200 preschoolers are diagnosed in the UK with cerebral palsy. In terms of prevalence, it is estimated that over 100,000 British people have cerebral palsy. Between 35 and 50 percent of children with cerebral palsy will also have a seizure disorder and some degree of mental impairment. They may also have learning disabilities and defects in speech, vision, language or hearing.

There is a lot unknown about how cerebral palsy is caused but evidence is supporting birth injuries, infection and poor oxygen supply to the brain before, during and after birth as probable causes. Preterm infants are especially vulnerable to such insults. Insults to the brain such as seen in meningitis in the first years of life, physical injury, and severe dehydration can result in brain injury and secondary cerebral palsy.

Early signs of cerebral palsy usually start before the age of three but are definitely present by the time the patient turns 3 years old. Infants who develop CP usually fail to reach developmental milestones, such as rolling over, crawling, sitting, smiling or walking. Some babies appear unusually stiff and may have an unusual posture. They may favor one side of the body over the other.

There are three main types of cerebral palsy:

• Spastic CP. This is the most common type of CP. Muscles are very stiff and weak. It mostly seen in both legs or in one leg and one arm on the same side.
• Dyskinetic or athetoid CP: voluntary muscle control is lost. They often exhibit bizarre twisting motions of the body as well as tremors.
• Mixed cerebral palsy is a combination of the above.

Causes of cerebral palsy include brain injury during development in the womb. While it is present at birth, it may not show up for several months. About 70 percent of babies are diagnosed with prenatal cerebral palsy and an additional 20 percent of kids are diagnosed with congenital cerebral palsy, due to birth trauma. Ten percent are diagnosed because of trauma or illness after birth.

Common causes are infections during pregnancy, such as rubella or German measles, cytomegalovirus and toxoplasmosis, all of which affect the mother and the foetus. Some infections are completely undetected in pregnancy but are being detected now that it seems these are important. Severe jaundice in the infant can be a cause of cerebral palsy. Newborns need a few days to filter out the bilirubin that builds up in the blood and this can take longer in a baby who is sick or premature.

Rh incompatibility between mother and infant can cause cerebral palsy. More serious problems can occur as well. The physical and metabolic trauma of birth can precipitate brain damage in infants who would otherwise be health. Breech deliveries can lead to birth trauma and CP. Oxygen deprivation at the time of birth or trauma to the head in labor and delivery can lead to brain damage and CP.

Ten percent of cerebral palsy cases happen after birth. It�s due to brain trauma within the first few years of life. Infections such as bacterial meningitis or viral encephalitis can cause cerebral palsy. It also can be the result of head injury in a baby such as child abuse.

The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here