In today’s educational video we will discuss causation, or the birth injury cause. As one person asked me, if there is a bad result does that mean that medical malpractice is why my family has this injury? Causation is an issue that is generally hotly contested in medical malpractice cases, which includes birth trauma cases.


At the conclusion of this article you should have a better understanding of what is needed to prove these types of cases. Understanding these issues can also help a family get a good idea of some of the issues which may present themselves in an initial investigation into their baby’s injury at birth. With that said, in short, a bad result in a medical setting does not automatically mean that medical malpractice has occurred.




In the law of negligence, there are four distinct elements which must be proven. Those elements are the following:


  • DUTY


If a plaintiff, the person(s) bringing a lawsuit in this context, has a problem proving all these elements, the case will not be success. In the area of causation, there must be evidence that ties the actions of the medical professionals to the injury. This is causation in its most basic breakdown.


In birth injury cases, medical experts must give medical opinions as to these issues. For example, there must be medical expert testimony that departure from the standard of care is what caused the injury for the plaintiff. A medical expert can give an opinion as to causation by reviewing all the relevant information available in the medical records and the facts associated with the case. The defendant(s) in the lawsuit will have an opportunity to understand the plaintiff’s causation opinions through discovery, and this includes review of written reports and deposition testimony.




When investigating the birth injury cause, there are areas of immediate analysis. One of the main areas of focus during an investigation into the birth injury cause is the medical record. We want to know what the picture was going into labor and delivery through birth. An area of important investigation is the readings from the electronic fetal heart monitor because one of the jobs of this machine is to help doctors and nurses interpret fetal well-being. It monitors things like the baby’s heart rate, acceleration and deceleration patterns, and variability, among other things. When this device suggests that a baby is in a condition called fetal distress, doctors and nurses must act accordingly because failing to act within the standard of care can cause injury to a baby during labor and delivery.


The most common injury we are asked to investigate for parents in a birth trauma context is an HIE, or hypoxic ischemic encephalopathy, diagnosis. Depending on the severity of this diagnosis, a CP, or cerebral palsy, diagnosis is also a possible subsequent diagnosis. When looking to determine the birth injury cause, we must be able to rule out other issues. For example, is there a genetic or developmental issue(s) which is the underlying cause of the injury? Because HIE is a blood and oxygen problem, reviewing the readings of the fetal heart monitor is essential to see how well the baby was tolerating the vaginal delivery and if there were problems, what did the doctors and nurse do about said problems? If there are no developmental, or genetic problems, then we have to turn our attention to the actions of the doctor and nurses and look to see of their actions were within the standard of care and whether they are the birth injury cause.


If you have more questions you can reach me at 301-850-4832.


Marcus B. Boston, Esq.

Boston Law Group, LLC

2 Wisconsin Circle, Suite 700

Chevy Chase, Maryland 20815


1-833-4 BABY HELP

Marcus Boston is a Maryland medical malpractice attorney who helps people navigate the Maryland childbirth injury and medical malpractice process to get money for their injuries caused by the carelessness of doctors and hospitals. BLG handles cases in Prince George’s County, Baltimore City, Montgomery County, Howard County, Anne Arundel County, and all other Maryland Counties. blgesq Maryland birth injury attorneys