Medical Malpractice
When delivery of an infant becomes somehow complicated, like when the baby’s head gets stuck momentarily, the sensitive bones and tendons of a child can quickly become injured.
Although swelling from delivery complications usually decreases in a few days, some more severe cases may result in permanent birth injuries. This is especially true when the brain is involved.
After this, it is not uncommon to observe acquired scalp swelling. When considering potential diagnoses, medical professionals typically look at caput succedaneum, cephalhaematoma, subgaleal hemorrhage, and subgaleal CSF collection.
Caput succedaneum, the focus of this article, is one swelling that may lead to permanent injuries in rare cases.
This Article Addresses:
- What Is Caput Succedaneum and How Does This Type of Injury Usually Occur?
- What are Some Examples of Permanent Injuries Caused by Swelling Associated with Caput Succedaneum?
- How Can Occur Caput Succedaneum?
- What is Caput Succedaneum?
- What Causes Caput Succedaneum?
- Is Caput Succedaneum Evidence of a Birth Injury?
- What is the Difference Between Caput Succedaneum and Cephalohematoma?
- Example of a Classic Caput Succedaneum Birth Injury Case
- Sample Verdicts and Settlements in These Cases
What Is Caput Succedaneum and How Does This Type of Injury Usually Occur?
When a baby becomes stuck during delivery, physicians sometimes use a device known as a vacuum to help dislodge the infant. Sometimes the force of this vacuum impacts the infant’s soft skull, causing severe swelling that may result in permanent brain injuries if the swelling does not subside in a few days.
Caput succedaneum is severe swelling of an infant’s skull caused by some impact during childbirth. The good news is that this injury usually is temporary and has no lasting impact on the child. But it can be a marker for trouble.
Caput succedaneum occurred significantly more often in infants who had abnormal neurological signs. Although no harmful effects could be attributed to the caput succedaneum per se, we believe that it is likely to be an indication that similar circulatory disturbances occur at deeper structures or the fetal head (e.g., arachnoidal hemorrhage or localized brain swelling).
There is no correlation between abnormal neurological signs and plain cephalhaematoma. The latter is often seen after a normal delivery but is not usually associated with abnormal neurological findings.
If the swelling does not subside, it could lead to permanent brain damage. Brain damage in an infant is a tragic injury that forever changes a child’s future.
Who Is Responsible?
But who is to blame? Sometimes the physician may have used negligent delivery methods that caused the baby to be stuck, or the doctor may have used too much force in dislodging the infant with a vacuum or other device, both capable of causing caput succedaneum injuries.
An interesting thing about caput succedaneum is that doctors have found a relationship between caput and mode of delivery. The larger the caput, the greater the likelihood of the obstetrician ordering an operative delivery with cesarean section or vacuum extraction.
Examples of Serious Injuries and Deaths from Caput Succedaneum
- An infant who gets stuck during delivery is dislodged with overly excessive force, resulting in severe brain swelling that causes mental retardation in the infant.
- An infant’s head gets stuck during delivery and becomes swollen so severely that the baby’s skull becomes permanently impacted and deformed.
- An infant negligently delivered suffers severe swelling in his head that causes nerve damage in his brain and sadly leads to paralysis.
How Can Occur Caput Succedaneum?
Mary is going to a Baltimore hospital to have her second baby. Her first baby, who was born four years prior, was born with shoulder dystocia after he got stuck in the birth canal. When Mary presented to the hospital to have her second baby, she told the nurse about the complications from her prior childbirth. Once the doctor came in, Mary began to experience pain, and her contractions were getting closer and closer. The physicians decided it was time to induce delivery.
The physicians, however, never looked at Mary’s chart to see that her first child was stuck in the birth canal during delivery. If they had looked, they would have realized that Mary may have a narrow birth canal, and a C-section might be most appropriate for delivering her second child. The doctors instead performed the delivery in the customary fashion. During delivery, Mary’s baby became stuck in her birth canal. The doctors used forceps to remove the infant, but those forceps caused the infant’s head to swell severely. The doctors diagnosed the injury as caput succedaneum.
Mary’s loss – and her baby’s loss – is unimaginable. Her baby will now have brain damage for the rest of his life. Mary wants to sue, and she wants to know how much her case is worth. She likely can sue because the physicians here were negligent in failing to consider her medical history in delivering her second baby. That negligence caused the baby’s injuries. These cases may be worth a lot of money because the injuries are of such a severe and permanent nature.
What is Caput Succedaneum?
Caput succedaneum is localized swelling of an infant’s head and scalp caused by external impact trauma during childbirth. This injury is not considered severe and usually goes away without any treatment. However, caput succedaneum is often one of the first indicators that a baby went through a stressful birth and that there may be more severe issues.
What Causes Caput Succedaneum?
Caput succedaneum is caused by external pressure on the baby’s head during labor and delivery. This pressure can result from the baby’s head passing through a tight birth canal. The pressure can also be caused by using a vacuum pump extractor to facilitate delivery.
Is Caput Succedaneum Evidence of a Birth Injury?
Caput succedaneum is a very common condition in newborns, and 98% of the time babies with caput are perfectly fine and healthy. However, in some cases caput succedaneum can be one of the earliest indicators of birth trauma, resulting in more serious underlying injuries. Most babies with neurologic damage during birth also display caput succedaneum.
What is the Difference Between Caput Succedaneum and Cephalohematoma?
The main difference is that caput succedaneum is common and not severe, whereas cephalohematoma is uncommon and can be very serious. Both conditions result in swelling of the baby’s head, but cephalohematoma is caused by the pooling of blood just outside the skull and can cause brain damage.
Examples of Verdicts and Settlements in Caput Succedaneum Cases
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- Pennsylvania: $1,800,000 Settlement. In this Pennsylvania birth injury case, the plaintiffs alleged that the doctors and hospital failed to properly manage her labor and failed to recognize and respond to fetal distress, including caput succedaneum. The baby suffered hypoxic-ischemic encephalopathy due to the delay before eventually performing an emergency c-section. The injury allegedly caused developmental delays, requiring various therapies and support services. The defendants claimed they did not breach the standard of care but eventually settled the case for $1.8 million.
- Wisconsin: $23,200,000 Verdict. A mother alleged that her baby suffered brain injuries caused by caput succedaneum when the doctor performing her delivery failed to timely order a C-section in a timely manner. The mother had difficulty inducing labor, but the physicians did not notice until it was too late. The physicians instead used a vacuum to remove the baby, who then became stuck in the birth canal. When the baby was forcefully dislodged, it suffered a large caput succedaneum injury as well as shoulder dystocia. The parents sued the doctors and hospital, claiming they were negligent in failing to perform a c-section delivery at the first sign of distress. The claim the jury apparently believed is that Defendant OBGYN left the delivery room and was in his office when significant caput succedaneum presented during delivery, resulting in a series of complications. Juries quickly lose patience with doctors who do not seem to be doing everything they can. When the doctor eventually came back to the delivery room, he attempted several times to extract the baby with forceps without success. He then used a vacuum to facilitate delivery, at which point the baby became stuck in the birth canal again. The baby was delivered with multiple skull fractures and eventually diagnosed with cerebral palsy. The defense lawyers argued in vain that the baby’s type of CP was caused by a stroke and not anything related to the complicated delivery. To establish causation, the plaintiff presented several prominent expert witnesses, including a top pediatric neuroradiologist. Good experts are often crucial, and they were in this case. The jury ruled in favor of the plaintiff and awarded $23.2 million in damages.
- New York: $5,000,000 Settlement. Plaintiff mom, 36, was admitted to St. Lukes-Roosevelt Hospital in New York, by her obstetrician, Dr. Mary Wilson, for a vaginal birth induction. She was more than a week overdue at the time. Before induction, the fetal heart monitor revealed abnormal activity in the mother’s uterus. The baby was born with caput succedaneum and permanent brain damage. The mom alleged that Dr. Wilson never considered the abnormal uterine activity when selecting induction methods. Plaintiff alleged that OBGYN and hospital failed to properly monitor and manage uterine activity. Specifically, the plaintiff claimed that fetal monitors showed hyperstimulated uterine activity, but the defendants went ahead and gave her Pitocin to induce labor instead of doing a c-section, resulting in a long and stressful delivery. As a result, the baby was eventually born with caput succedaneum, conjunctival hemorrhages, and other injuries, which required two separate surgeries to correct. Sometime later he was diagnosed with hypotonic cerebral palsy. The doctors contended that the baby’s cerebral palsy was not caused by anything during delivery. After a jury was selected for the trial, the insurance company (CCC Insurance) agreed to settle the case for $5 million.
- Pennsylvania: $2,000,000 Verdict. The mother was diagnosed as having a high-risk pregnancy. She went to Rolling Hill Hospital in Philadelphia after going into labor. During labor, her physicians administered Pitocin to induce contractions. The fetus reportedly became wedged in her pelvis and developed caput succedaneum. An emergency C-section was performed, but the child suffered caput succedaneum and was sadly diagnosed with cerebral palsy and decreased cognitive functioning.
The Attorneys at Miller & Zois Are Experienced in Handling Birth Injuries
Birth injuries are complex cases. They are painful and emotional for everyone, including the attorneys. But they are also potentially worth significant compensation for children and their families who desperately need money to care for their child.
If you are a parent whose infant has been injured during delivery, please contact Miller & Zois for a free claim evaluation. We are experienced and dedicated advocates who will fight to bring you justice. You can contact us at 800-553-8082 or get a free case evaluation online.
More Information
- Learn more about medical malpractice claims in Maryland
- Learn more about birth injury claims in Maryland, Minnesota, Pennsylvania, and Washington, D.C. (We handle birth injury cases in every state in the country.)
- Failure to perform c-section lawsuit: An explanation of these claims and an example lawsuit