Gastroschisis and Medical Negligence in Chicago
Gastroschisis is a birth defect involving an opening in the baby’s abdominal wall, usually located beside and to the right of the belly button. The intestines extend through this opening and remain outside the body without a protective membrane. In some cases, the stomach or another abdominal organ may also be outside the abdomen.
Because the exposed intestine comes into contact with amniotic fluid during pregnancy, it may become irritated, swollen, shortened, or damaged. The condition requires specialized care and surgical treatment after birth.
Most cases of gastroschisis are not caused by medical malpractice. Researchers do not know the precise cause in most pregnancies. The diagnosis alone does not establish that an obstetrician, hospital, radiologist, surgeon, or another healthcare provider did anything wrong.
A legal concern may exist in limited circumstances when a significant prenatal finding was overlooked, an abnormal result was not communicated, delivery planning was inadequate, immediate newborn care was delayed, or negligent surgery or postoperative treatment caused additional preventable harm.
Free legal evaluation: If your concern involves a specific medical error rather than the congenital condition alone, contact Sexner Injury Lawyers LLC or call (312) 243-9922.
What Is Gastroschisis?
During fetal development, the abdominal wall normally closes around the organs contained within the abdomen. With gastroschisis, an opening remains beside the umbilical cord. The intestines pass through that opening and develop outside the abdominal cavity.
There is no membrane covering the exposed intestine. This distinguishes gastroschisis from omphalocele, another abdominal-wall defect in which the organs protrude through the area of the umbilical cord and are usually enclosed within a protective sac.
Gastroschisis frequently occurs without a chromosomal disorder or a major abnormality involving another organ system. However, the exposed bowel itself can develop serious complications.
General medical information is available from the Centers for Disease Control and Prevention.
Possible Causes and Risk Factors
The cause of gastroschisis cannot be determined in most individual cases. Researchers believe that a combination of genetic, developmental, maternal, and environmental influences may be involved.
Factors that have been associated with a greater likelihood of gastroschisis include:
- Younger maternal age
- Tobacco use during early pregnancy
- Alcohol use during early pregnancy
- Certain urinary or sexually transmitted infections during early pregnancy
- Other influences that remain under study
The condition occurs more frequently among babies born to younger mothers, but it is incorrect to state that it virtually never occurs in women over age 30.
A statistical association does not establish the cause of a particular child’s condition. It also does not prove that gastroschisis was preventable or that a healthcare provider acted negligently.
Medication Use During Pregnancy
The former version of this page identified SSRI antidepressants such as Prozac and Zoloft as drugs linked to gastroschisis. That generalized statement has been removed because it does not establish that these medications caused an individual child’s condition or that prescribing them constituted malpractice.
Any medication-related investigation would require a case-specific review of:
- The particular medication and dosage
- Why the medication was prescribed
- When it was used in relation to fetal development
- The risks of leaving the mother’s condition untreated
- Reasonably available alternatives
- The medical information available when the decision was made
- The counseling and monitoring provided
A pregnant patient should not stop a prescribed medication without first discussing the risks and alternatives with an appropriate healthcare provider.
Prenatal Screening and Diagnosis
Gastroschisis can often be identified before birth. It may produce an abnormal maternal serum-screening result, and an ultrasound may show loops of bowel floating outside the baby’s abdomen.
Once the condition is suspected, additional ultrasound examinations and consultation with maternal-fetal medicine specialists may be used to evaluate:
- The location and size of the abdominal opening
- Which organs are outside the abdomen
- The appearance and condition of the exposed intestine
- Fetal growth
- Amniotic-fluid levels
- Other possible abnormalities
- The timing and location of delivery
Failure to identify gastroschisis during a particular ultrasound does not automatically establish negligence. A proper review may consider the stage of pregnancy, fetal position, image quality, the views obtained, the provider’s responsibilities, and whether an abnormal finding should reasonably have led to additional testing.
A potential claim involving ultrasound performance or interpretation may overlap with a broader radiology error or diagnostic error matter.
Delivery Planning and Immediate Care
When gastroschisis is diagnosed prenatally, the medical team can plan for delivery at a hospital with neonatal intensive care and pediatric surgical services. The timing and method of delivery should be individualized according to the baby’s condition, fetal monitoring, obstetric considerations, and the recommendations of the treating specialists.
Immediately after birth, the exposed organs must be protected from trauma, contamination, drying, and heat loss. Care may include:
- Covering the bowel with sterile protective material
- Careful control of the newborn’s body temperature
- Intravenous fluids and nutrition
- Antibiotics when appropriate
- A tube to remove air and fluid from the stomach
- Breathing assistance when needed
- Prompt evaluation by a pediatric surgeon
Surgical Treatment
The goal of treatment is to place the exposed organs inside the abdominal cavity and close the opening safely.
Primary Closure
If the bowel is not severely swollen and the abdominal cavity has enough space, the surgeon may be able to return the organs and close the opening during one operation.
Staged Closure
When a large amount of bowel is exposed, the intestine is very swollen, or the abdominal cavity is too small, the organs may be placed inside a sterile pouch called a silo. Over several days, they are gradually moved into the abdomen before the opening is closed.
The gradual approach helps avoid excessive pressure on the lungs, heart, kidneys, and intestinal blood supply.
Possible Complications
Gastroschisis can affect the intestine before birth and during the newborn period. Possible complications include:
- Inflammation and swelling of the exposed bowel
- Intestinal atresia, in which part of the bowel is blocked or did not form normally
- Volvulus, or twisting of the intestine
- Reduced blood flow and intestinal tissue damage
- Perforation of the bowel
- Infection
- Difficulty beginning or tolerating feedings
- Problems digesting food or absorbing nutrients
- Prolonged need for intravenous nutrition
- Short bowel syndrome when a significant amount of damaged intestine must be removed
- Additional surgery or prolonged hospitalization
Many babies recover well after treatment, although intestinal function may take time to develop and some children require continued nutritional, gastrointestinal, or surgical care.
Most Gastroschisis Cases Do Not Involve Malpractice
A healthcare provider generally does not cause gastroschisis simply because the condition developed during pregnancy. The legal question is usually whether a separate and identifiable medical error caused harm beyond the underlying birth defect.
A delayed prenatal diagnosis also does not automatically create a viable claim. Earlier identification ordinarily does not eliminate the abdominal-wall defect. A legal case would generally require evidence that the delay changed delivery planning, deprived the family of important medical information, or caused an avoidable worsening of the baby’s condition.
When Could Medical Negligence Be Relevant?
Prenatal Imaging or Communication Errors
A legal review may be appropriate when:
- Clearly abnormal bowel outside the abdomen was visible but overlooked
- An ultrasound was interpreted incorrectly
- An abnormal serum-screening result was not investigated
- Recommended follow-up imaging was not arranged
- A significant finding was not communicated to the patient or treating providers
- A referral to maternal-fetal medicine or pediatric surgery was unreasonably delayed
Inadequate Delivery Planning or Newborn Care
Potential concerns may include:
- Failure to plan delivery at a facility capable of treating the condition when transfer was reasonably possible
- Unnecessary delay in obtaining neonatal or pediatric surgical care
- Failure to protect the exposed bowel after delivery
- Failure to control temperature, fluids, infection risk, or breathing
- Trauma to the exposed organs during delivery or initial handling
Negligent Surgery or Postoperative Treatment
A poor outcome does not itself prove negligence. Gastroschisis surgery involves serious risks even when performed appropriately. A possible legal issue may exist, however, when additional preventable harm results from:
- Inadequate surgical planning
- Returning the organs too rapidly and creating unsafe abdominal pressure
- Damage to viable intestine or another organ
- A preventable surgical error
- An anesthesia, medication, or monitoring error
- Failure to recognize reduced intestinal blood flow, infection, perforation, obstruction, or another complication
- Inadequate nutritional or postoperative follow-up
Records Used to Evaluate a Potential Case
A medical and legal review may require:
- Prenatal and obstetric records
- Maternal serum-screening results
- Ultrasound reports and original images
- Maternal-fetal medicine consultations
- Fetal-monitoring records
- Delivery-planning and hospital-transfer records
- Newborn and neonatal intensive-care records
- Pediatric surgical reports
- Anesthesia, medication, and monitoring records
- Imaging, laboratory, feeding, and nutritional records
- Postoperative and long-term follow-up documentation
Qualified medical experts may need to distinguish intestinal injury caused by the congenital condition from any additional harm allegedly caused by delayed diagnosis, inadequate newborn care, or negligent treatment.
Contact Sexner Injury Lawyers LLC
Most children born with gastroschisis do not have a medical malpractice claim. A legal review may be appropriate when there is a specific concern involving prenatal imaging, communication of results, delivery planning, immediate newborn care, surgery, or postoperative treatment.
Contact Sexner Injury Lawyers LLC or call (312) 243-9922 for a free and confidential evaluation. We will explain honestly whether the circumstances appear to justify further investigation.
