Sam Proof Medical

Applying Forceps

Negligence as it Applies to Childbirth in Canada

As a personal injury lawyer in Toronto for over 25 years, I have been able to see what constitutes negligence as it applies to childbirth.

There is no greater joy than a healthy baby, boy or girl, so when something goes wrong, whether with the mother or the baby, it affects the whole family. A lot of first-time parents go to prenatal classes and are given the statistics about who is going to have a caesarean section. They don’t think it is going to happen to them, of course, and the next thing you know, the birth is becoming very difficult, the baby is in distress and you are having an emergency C-section.

In the past couple of decades, we have seen an increase in C-sections over natural childbirth. I think hospitals and doctors are putting the health and safety of the baby before the more difficult effects that the caesarean section may have on the mother. They are doing that for a number of reasons. First, obviously there’s great concern for the health of the baby. But they are also considering what happens if they use forceps in a difficult birth and something goes wrong. What happens if they delay too long and there is a lack of oxygen to the baby, and something goes terribly wrong?

Medical care is not an exact science. The question of negligence is not an emotional or legal one. We consult expert medical opinion to judge if doctors, nurses, and hospitals have met a reasonable standard of care. That is how we determine whether or not there has been negligence.

About the Author

Murray Tkatch LL.B. is a lawyer at Tkatch & Associates, a Personal Injury Law Firm in Toronto, Canada.

Is there a technical/clinical term for the action of rocking back&forth in nervousness or...?

...trying to soothe thyself ?
I had an uncle who would pet his hand and rock to and fro,during birth complications of a "stand-in doctor", using the forceps on my uncles head and pulling him out , of what was supposed to be a c-section delivery -turned out, was a natural birth. This caused brain damage to my uncle from the pressure applied to his skull and brain causing him to be an "idiot savant" what is this gesture called really?

Repetitive movements that are not fully under someone's control have a lot of possible names and causes. I will cover a few of them for you here.

IDIOT SAVANT:

The term you used to describe your uncle "idiot savant" is a term that is often used to describe autistic patients. The real definition of the term is a person who is mentally retarded in general but displays remarkable aptitude in some limited field (usually involving memory). This term used to be synonymous with Autism, but that is no longer the case. Is it possible that your uncle has been diagnosed with Autism? Another interpretation of what you wrote, might lead the concern to fall in the area of Obsessive Compulsive disorder (although that sounds less likely). There is also a diagnosis out there that specifically talks about Stereotypic Movements as the only symptom of the disorder (this is the most likely term that might be used to describe your Uncle's behaviors).

AUTISM:

Autism is tricky to diagnosis on its own and things can quickly get more complicated when other issues like a head injury are suspected to be co-occurring. A heard injury does not preclude the diagnosis of autism though. Autism is tricky because it is really three sets of symptom clusters that tend to be found together (as it is currently defined in the DSM - Diagnostic and Statistical Manual of Mental Disorders). For Autism, there have to be specific symptoms related to impairments in social interaction, communication (i.e. language) and repetitive/stereotyped movements. Furthermore, these impairments need to look a certain way. Complicating things further, there is a spectrum on which we tends to find Autistic features with some people having very mild symptoms in one or two areas and other people being totally incapacitated by the symptoms of autism. For this reason, there is said to be an Autistic Spectrum on which many people can fall. The thing about autism is that the DSM does not identify a specific cause that must be present for the diagnosis to be valid (in part because a specific cause has not been found, although we have several genetic leads). So, if someone had a head injury that is thought to have been the direct cause of Autism symptoms (hard to tell if it is related to his birth because we do not know if he would have developed these symptoms anyway), the Autism diagnosis is still possible even though that is not the path that most patients take to get to this diagnosis.

OBSESSIVE COMPULSIVE DISORDER:

Many people who do have symptoms that fall on the Autism Spectrum can have repetitive and self soothing behaviors that look a lot like compulsive component of Obsessive Compulsive Disorder (OCD). The diagnosis of OCD requires the presence of either compulsions (an irrational motive for performing trivial or repetitive actions, even against your will) or obsessions (recurrent thoughts, typically disturbing in some way, that you cannot get out of your head or cannot control), although both are typically present in most people with OCD.

STEREOTYPIC MOVEMENT DISORDER:

Stereotypic movement disorder is a disorder characterized by repeated, rhythmic, purposeless movements or activities such as head banging, nail biting, or body rocking. These movements either cause self-injury or severely interfere with normal activities. Until 1994, the American Psychiatric Association referred to stereotypic movement disorder as stereotypy/habit disorder. Stereotypic movements were first described as a psychiatric symptom in the early 1900s. Since then, they have been recognized as a symptom of both psychotic and neurological disorders. They may also arise from unexplained causes. These movements may include:
head banging nail biting playing with hair (but not hair pulling, which is considered the separate disorder of trichotillomania ) thumb sucking hand flapping nose picking whirling body rocking picking at the body self-biting object biting self-hitting compulsive scratching eye gouging teeth grinding (bruxism) breath holding stereotyped sound production It is important to note that this disorder requires the isolated presence of Stereotypic Movements in the absence of other symptoms that would allow for another diagnosis like Autism or OCD.

I hope this helps you to understand your Uncle's struggles a little more, but please to not take this as a master’s course in movement disorders. We should leave the formal diagnosing to the professionals who have spent decades studying the intricacies of these interrelated symptoms and diagnoses.

Check out the video below for an example of the type of Stereotypic Movements found in Autism (according to the person who posted the video).

Good luck in your endeavors.

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