Microcephaly and Medical Negligence in Chicago
Microcephaly is a condition in which a baby’s head circumference is substantially smaller than expected for the child’s age, sex, and stage of development. Head size often reflects brain growth, although a small measurement by itself does not reveal the cause, severity, or likely outcome.
The condition may be present at birth because the brain did not develop normally during pregnancy. In other children, the head may initially measure within the expected range but grow more slowly because brain growth becomes impaired after birth.
Most cases of microcephaly are not caused by medical malpractice. Genetic changes, prenatal infections, harmful exposures, nutritional problems, interruptions in blood flow to the developing brain, and other developmental influences may be involved. In many cases, no precise cause can be identified.
A legal issue may arise in limited circumstances involving a specific prenatal imaging error, failure to communicate an abnormal finding, negligent management of a known maternal condition, a preventable birth-related brain injury, or failure to diagnose and treat an infection or other medical problem that caused additional harm.
Free legal evaluation: If your concern involves an identifiable medical error rather than the diagnosis alone, contact Sexner Injury Lawyers LLC or call (312) 243-9922.
What Does a Diagnosis of Microcephaly Mean?
Healthcare providers diagnose microcephaly by measuring the distance around the widest part of the child’s head and comparing the result with standardized growth charts. The measurement is considered together with gestational age, sex, overall body growth, family characteristics, and changes observed over time.
A single measurement may need to be repeated. The shape of a newborn’s head can temporarily be affected by labor and delivery, and an inaccurate placement of the measuring tape can also produce an unreliable result.
Microcephaly ranges from mild to severe. Some children with a mildly reduced head circumference have no major related medical problems. Others have abnormalities of brain development and require extensive neurological, developmental, feeding, vision, hearing, or mobility support.
General medical information is available from the Centers for Disease Control and Prevention.
Possible Medical and Developmental Effects
The effects depend largely on the underlying cause and the degree to which brain development has been affected. A child may experience one or more of the following:
- Developmental delays involving movement, speech, or learning
- Seizures
- Difficulty with balance or coordination
- Muscle stiffness, weakness, or abnormal muscle tone
- Feeding or swallowing problems
- Hearing loss
- Vision problems
- Intellectual disability
- Slow physical growth
These problems are not universal. A diagnosis does not predict exactly what abilities a particular child will develop or what level of assistance will be needed.
Possible Causes of Microcephaly
The cause remains unknown in many children. Conditions or exposures that can interfere with brain development include:
- Genetic or chromosomal conditions
- Infections during pregnancy, including Zika virus, cytomegalovirus, toxoplasmosis, and rubella
- Severe malnutrition during pregnancy or infancy
- Alcohol or certain other harmful substance exposures
- Problems with blood flow to the brain during fetal development
- Maternal phenylketonuria that is not adequately controlled before or during pregnancy
- Serious brain infections or injuries that impair continued brain growth after birth
The presence of one of these factors does not prove why an individual child developed microcephaly. It also does not establish that the condition was preventable or that a healthcare provider acted negligently.
Zika Virus and Microcephaly
Zika infection during pregnancy is a recognized cause of serious fetal brain abnormalities, including microcephaly. However, not every pregnancy involving Zika exposure results in congenital Zika syndrome or a birth defect.
Evaluation of a possible Zika-related condition may depend on travel or exposure history, the timing of the pregnancy, maternal testing, prenatal imaging, newborn examinations, and neurological or eye findings.
Medication Use During Pregnancy
A medication should not be identified as the cause of an individual child’s condition without reliable, case-specific medical evidence. A reported association in a study does not necessarily establish causation or negligent prescribing.
A medication-related evaluation may consider:
- The exact medication and dosage
- The condition being treated
- When the medication was used
- The risks of leaving the maternal condition untreated
- Reasonably available alternatives
- The medical evidence available at the time
- The information and monitoring provided to the patient
- Whether specialists can reliably connect the exposure to the child’s condition
A pregnant patient should not stop a prescribed medication without first discussing the risks and alternatives with an appropriate healthcare provider.
Diagnosis During Pregnancy
Microcephaly may sometimes be suspected through prenatal ultrasound, but it frequently cannot be identified until late in the second trimester or during the third trimester. Earlier studies may appear normal because the difference in fetal head growth has not yet developed or become measurable.
When ultrasound findings raise concern, the medical team may consider:
- Confirming gestational age
- Repeating measurements over time
- Performing a detailed examination of the fetal brain and anatomy
- Reviewing maternal infections, health conditions, medications, and exposures
- Ordering laboratory or genetic testing when medically appropriate
- Obtaining a fetal MRI to answer specific questions raised by ultrasound
- Referring the patient to maternal-fetal medicine, genetics, or pediatric neurology
Failure to diagnose microcephaly during a particular ultrasound does not automatically establish negligence. A proper review must consider the stage of pregnancy, fetal position, image quality, accuracy of pregnancy dating, the views obtained, and what could reasonably have been detected at that time.
Diagnosis After Birth
After delivery, the baby’s head circumference is measured and compared with appropriate growth standards. Continued measurements during pediatric visits can show whether the head is growing at the expected rate.
When microcephaly is suspected, additional evaluation may include:
- A detailed medical and family history
- Neurological and developmental examinations
- MRI or other brain imaging
- Genetic testing
- Testing for congenital infections
- Vision and hearing assessments
- Feeding and swallowing evaluations
The purpose is not merely to confirm a small measurement but to identify the underlying cause, associated brain abnormalities, and services the child may need.
Treatment and Developmental Support
There is no single treatment that increases head size or reverses an underlying abnormality of brain development. Care is directed toward the child’s particular symptoms and abilities.
A child with mild microcephaly may need only regular monitoring of growth and development. Other children may benefit from:
- Physical therapy
- Occupational therapy
- Speech and language therapy
- Feeding or swallowing therapy
- Early-intervention and educational services
- Medication for seizures or muscle problems
- Vision and hearing treatment
- Nutritional and developmental monitoring
Early identification of associated problems can help the family obtain appropriate medical, therapeutic, and educational support.
Microcephaly and Birth Injury Are Not the Same
Congenital microcephaly generally begins during fetal brain development. A birth injury is separate harm that may occur before, during, or shortly after delivery because of trauma, reduced oxygen or blood flow, infection, or another complication.
A difficult delivery or the use of forceps or vacuum extraction does not, by itself, explain congenital microcephaly. Improper instrument use can cause skull trauma, bleeding, or brain injury, but the medical records must establish what injury actually occurred and whether it later interfered with brain and head growth.
Most Microcephaly Cases Do Not Involve Malpractice
The diagnosis does not establish that a doctor caused the condition. A potential malpractice claim generally requires a separate failure to meet the applicable standard of care and reliable evidence that the failure caused additional, preventable harm.
When Could Medical Negligence Be Relevant?
Prenatal Imaging or Communication Errors
A legal review may be appropriate when:
- A significant and reasonably visible abnormality was overlooked
- Fetal measurements were recorded or interpreted incorrectly
- Gestational age was calculated incorrectly and affected the interpretation
- Recommended follow-up imaging was not arranged
- An abnormal result was not communicated to the patient or another provider
- A medically indicated specialist referral was unreasonably delayed
A possible diagnostic-error claim ordinarily requires expert evidence that the provider’s conduct was unreasonable and that acting appropriately would have made a legally meaningful difference.
Failure to Manage a Known Maternal Condition or Infection
A case-specific review may be appropriate when a provider failed to manage a known condition associated with fetal brain injury, failed to investigate clinically important signs of infection, or failed to respond to abnormal prenatal findings.
The existence of maternal illness or infection does not establish negligence. Medical experts must determine what care was required and whether a failure probably contributed to the child’s condition or caused additional harm.
Preventable Brain Injury Around the Time of Birth
A separate birth-injury claim may be relevant when negligent care caused severe oxygen deprivation, impaired blood flow, infection, intracranial bleeding, or another brain injury that interfered with later growth.
Potential concerns may include:
- Failure to respond to significant fetal distress
- Unreasonable delay in medically necessary delivery
- Improper newborn resuscitation
- Negligent use of forceps or vacuum extraction causing a documented brain injury
- Failure to diagnose and treat a serious newborn infection
- Failure to recognize seizures, bleeding, or neurological deterioration
Failure to Monitor Growth After Birth
Failure to measure or follow an infant’s head growth can delay neurological evaluation and early-intervention services. A delay alone is not necessarily malpractice; there must generally be proof that appropriate monitoring was required and that the delay caused additional harm.
Records Used to Evaluate a Potential Case
A medical and legal review may require:
- Prenatal and obstetric records
- Pregnancy-dating information
- Ultrasound reports and original images
- Maternal-fetal medicine and genetic records
- Infection, medication, and laboratory records
- Fetal-monitoring and delivery records
- Newborn resuscitation and intensive-care records
- Head-circumference measurements and growth charts
- MRI, CT, ultrasound, and other neurological studies
- Pediatric, neurological, developmental, and therapy records
Qualified experts may need to distinguish congenital brain development from any separate injury allegedly caused by delayed diagnosis, improper treatment, or negligent care around the time of birth.
Contact Sexner Injury Lawyers LLC
Most children with microcephaly do not have a medical malpractice claim. A legal evaluation may be appropriate when there is a specific concern involving prenatal imaging, failure to communicate results, management of a known maternal condition, preventable brain injury, or delayed postnatal diagnosis that caused additional harm.
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.
