Cleft Lip, Cleft Palate, and Medical Negligence in Chicago
Cleft lip and cleft palate are birth defects collectively known as orofacial clefts. They occur when tissues forming the baby’s upper lip or roof of the mouth do not join completely during early development.
A child may have a cleft lip, a cleft palate, or both. The size and location of the opening can vary considerably, as can the child’s feeding, hearing, dental, speech, surgical, and long-term treatment needs.
Most cases of cleft lip and cleft palate are not caused by medical malpractice. The causes remain unknown for many children and may involve a combination of genetic, developmental, maternal, and environmental factors. The diagnosis by itself does not demonstrate that a doctor, hospital, or another healthcare provider acted negligently.
A legal issue may exist in limited circumstances involving a specific prenatal testing or communication error, negligent medication management, or preventable harm caused during treatment or surgery.
Free legal evaluation: If your concern involves a particular medical error rather than the diagnosis alone, contact Sexner Injury Lawyers LLC or call (312) 243-9922.
What Are Cleft Lip and Cleft Palate?
Cleft Lip
The upper lip normally forms between approximately the fourth and seventh weeks of pregnancy. Tissues growing from each side of the developing face meet in the center to form the lip and other facial structures.
A cleft lip develops when the tissues forming the upper lip do not join completely. The opening may be a small notch or may extend through the lip toward the nose. It can occur on one side, both sides, or, less commonly, near the center of the lip.
Cleft Palate
The palate, or roof of the mouth, develops between approximately the sixth and ninth weeks of pregnancy. A cleft palate occurs when the tissues forming the palate do not join completely.
The opening may involve the front and back of the palate or only one portion. A cleft palate can occur with or without a cleft lip. Some less visible forms, such as a submucous cleft palate, may not be recognized until later.
Additional general information is available from the Centers for Disease Control and Prevention.
What Causes Orofacial Clefts?
The cause cannot be identified in many individual cases. Researchers generally believe that cleft lip and cleft palate can result from a combination of genes and other influences during early fetal development.
Factors associated with an increased likelihood of an orofacial cleft include:
- Smoking during pregnancy
- Diabetes that existed before pregnancy
- Use of certain medications for epilepsy during pregnancy
- Genetic conditions or syndromes in some children
- A family history of cleft lip, cleft palate, or a related condition
A risk factor only describes an association found among groups of patients. It does not prove why a particular child developed the condition, that the condition could have been prevented, or that anyone was negligent.
The prior version of this page broadly identified fertility medication, anti-nausea drugs, antidepressants, and other medication categories as causes of orofacial clefts. Those generalized statements have been removed because medication causation must be evaluated according to the specific drug, dosage, timing, medical reason for treatment, available alternatives, and scientific knowledge existing at that time.
Prenatal Diagnosis
Orofacial clefts, particularly cleft lip, may sometimes be identified during pregnancy through a routine ultrasound. Cleft palate without an accompanying cleft lip can be more difficult to detect prenatally, and certain forms may not be diagnosed until after birth or later in childhood.
Failure to identify a cleft during one ultrasound does not automatically establish malpractice. A medical review may need to consider:
- The stage of pregnancy when the ultrasound occurred
- The quality and completeness of the images
- The fetal position
- Which facial structures could reasonably be visualized
- The sonographer’s and interpreting physician’s responsibilities
- Whether an abnormal finding required follow-up imaging or specialist referral
- Whether the results were properly documented and communicated
A possible diagnostic-error claim normally requires expert evidence that the provider failed to meet the accepted standard of care and that the failure caused legally recognized harm.
Treatment and Long-Term Care
The treatment plan depends on the type and severity of the cleft, the child’s age and health, and whether another medical or genetic condition is present. Care is often coordinated by a cleft or craniofacial team that may include pediatricians, surgeons, dentists, orthodontists, audiologists, ear specialists, speech-language professionals, nurses, feeding specialists, and counselors.
Surgery to repair a cleft lip is usually performed during the first months of life and is generally recommended within the first year. Cleft palate repair is usually recommended within the first 18 months, or earlier when appropriate. The exact timing depends on the child’s medical condition and the treatment team’s judgment.
Additional treatment may include:
- Specialized feeding assistance
- Hearing evaluations and treatment of recurring ear problems
- Speech and language therapy
- Dental and orthodontic care
- Additional reconstructive surgery as the child develops
- Psychological or social support related to visible differences and self-esteem
With appropriate treatment, most children with cleft lip or cleft palate have good outcomes and lead healthy lives.
When Could Medical Negligence Be Relevant?
The existence of the cleft itself ordinarily does not establish negligence. A possible medical malpractice matter generally requires a separate and identifiable medical error that caused additional harm or deprived the family of important medical information.
Prenatal Testing and Communication Errors
A legal review may be appropriate when there is evidence that:
- An abnormal ultrasound finding was overlooked or interpreted incorrectly
- A provider failed to communicate a known or suspected abnormality
- Medically indicated follow-up imaging was not ordered
- A reasonable referral to maternal-fetal medicine, genetic counseling, or another specialist was delayed
- The patient received inaccurate information about the findings or limitations of prenatal testing
Even when an earlier diagnosis would not have prevented the condition, timely information may assist families with additional testing, delivery planning, specialist consultation, feeding preparation, and informed decision-making.
Medication Management During Pregnancy
Certain epilepsy medications have been associated with an increased risk of orofacial clefts. Prescribing one of these medications is not automatically negligent. Untreated seizures and other maternal medical conditions can also present serious dangers.
A possible medication-related claim may require review of:
- The medication and dose
- The timing of exposure
- The condition being treated
- The risks of leaving the condition untreated
- Reasonably available alternatives
- The medical knowledge available when the prescription was written
- The counseling, coordination, and monitoring provided
A pregnant patient should not stop taking prescribed medication without first discussing the risks and available alternatives with an appropriate healthcare provider. Learn more about preventable prescribing and dispensing mistakes on our medication and prescription error page.
Negligent Treatment After Birth
A child’s cleft may not have been caused by malpractice, but negligent care after birth can cause an additional injury. Potential issues may include:
- Failure to recognize or appropriately address serious feeding difficulties
- Failure to monitor growth, nutrition, hearing, or recurring ear infections
- Unreasonable delay in referring the child to a cleft or craniofacial team
- Failure to diagnose an associated medical condition
- Inadequate preparation for surgery
- A preventable surgical error that causes additional harm
- Failure to identify or treat a postoperative complication
The legal question in these circumstances is whether the treatment fell below accepted medical standards and caused harm beyond the underlying congenital condition.
Records Used to Evaluate a Possible Claim
A medical and legal review may require:
- Prenatal and obstetric records
- Ultrasound reports and original images
- Maternal-fetal medicine and genetic counseling records
- Prescription and pharmacy records
- Delivery and newborn records
- Pediatric, feeding, and growth records
- Hearing, dental, orthodontic, and speech evaluations
- Surgical reports, anesthesia records, and postoperative notes
- Patient-portal messages, telephone notes, and referral records
Medical experts may be needed to distinguish the underlying birth defect from any additional harm allegedly caused by negligent testing, communication, medication management, or treatment.
Contact Sexner Injury Lawyers LLC
Most children born with cleft lip or cleft palate do not have a medical malpractice claim. A legal review may be appropriate when the concern involves a specific prenatal diagnostic error, failure to communicate an abnormal finding, negligent medication management, or preventable injury during 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.
