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Microcephaly is a neurodevelopmental disorder involving a person with a head circumference a certain percentage smaller than the average person of the same age and gender. Microencephaly means small brain.  The size of the head is usually determined by the size of the brain.  A child with microcephaly generally has a reduced life expectancy and less than normal brain function.

A neurodevelopmental disorder is an impairment of the development and growth of the brain or central nervous system.  This refers to problems with brain function that affects the ability to achieve developmental milestones including learning.   Neurodevelopmental disorders or disorders which may have neurodevelopmental implications include autism, microcephaly, Down syndrome, and traumatic brain injuries which can lead to cerebral palsy.

A child with microcephaly is likely to experience developmental delays and may experience additional symptoms including mental retardation, impaired motor function, seizures, hyperactivity, and an underweight much smaller body size or dwarfed body. Currently there is no cure for microcephaly, but there is supportive treatment to help the child better cope with the condition.

Microcephaly may be caused by genetics, a mother who has diabetes or abuses alcohol, or from a birth injury that causes serious brain injuries.  When a child is diagnosed with microcephaly, the brain will not grow or will only grow slightly.  The baby's head will remain the same size while the body and face will continue to grow.   

If you believe your child's microcephaly or neurodevelopmental disorder is the result of medical malpractice, you should consult with an experienced birth injury attorney such as Dr. Bruce G. Fagel immediately.  Dr. Fagel can review your child's medical records and all aspects of your case to determine if you have a claim that can be brought against the doctor or hospital if they are responsible.  

Dr. Bruce Fagel is a leading medical malpractice lawyer and a licensed medical doctor.  Dr. Fagel practiced emergency room medicine for over 10 years before becoming a medical malpractice attorney.

A doctor has a responsibility to provide the proper monitoring, medical care, and treatment to a woman and her baby during the pregnancy, delivery, and post-delivery.  When a doctor or nurse is negligent in these areas and the mother or infant is injured or dies as a result, the family may have grounds for a medical malpractice lawsuit.

It's important to understand that not all negligence related to pregnancy, delivery, or post-delivery will be detectable immediately.  Some birth injuries take months or even years to discover, including some of the cerebral palsy or developmental delay disorders.  If your child is showing signs of cerebral palsy or developmental delays / mental retardation, it is possible that a mistake made by the obstetrician or nurse during pregnancy or delivery led to the brain damage causing this disorder.  One example may be if the doctor or nurse failed to properly monitor the fetal heart rate monitor and take immediate action if there was a warning of a significant drop in the heart rate of the infant.  It's important to also understand that even if you aren't certain whether the disorder was the result of negligence, a highly experienced attorney who is also a licensed medical doctor such as Dr. Bruce Fagel can analyze the medical records and work with medical experts to determine if medical malpractice was responsible for the birth injury.

Many families come to the Law Offices of Dr. Bruce G. Fagel & Associates not specifically for the reason of obtaining a maximum settlement to pay for the medical bills, but because when a birth injury happens to a family, the medical staff immediately stops talking to the family, so they are left without answers to critical questions of importance.  For example, the parents need to know exactly what happened to their child, who is responsible for the injury, what legal and medical options do they have available to help their family, and will this type of injury happen again if they decide to have another child.  Since the hospital and medical personnel involved with a medical malpractice birth injury are going to hold back on the facts and stay silent to protect themselves legally, the parents are left completely helpless and unsure how to proceed.  This is where Dr. Fagel and his staff can help the family find the answers they need.

Another important area where Dr. Fagel and his attorneys help parents of a birth injury child with is freeing them up with the daily responsibilities and worry that accompany managing a medical malpractice case.  Medical malpractice lawsuits are extremely complex and the parent's who are grieving from a birth injury need to tend to their child and focus all their energy on helping their family grieve and cope with the stressful situation.  The families can now rest assured knowing the Law Offices of Dr. Bruce G. Fagel & Associates is highly knowledgeable with birth injuries and has several decades of experience obtaining maximum verdicts and settlements for their clients.  If a doctor, nurse, or hospital was negligent and this negligence seriously injured your child, taking legal action through a lawsuit will hold them accountable and allow the family to collect monetary compensation to pay for medical bills and continued medical treatment, even if this treatment is required for the rest of their lives.

If you believe your child's medical condition is the result of a birth injury caused by medical malpractice from a doctor, nurse, or hospital, you may have a medical malpractice case.  Contact Dr. Bruce G. Fagel immediately for a free consultation.  Dr. Fagel is a top birth injury attorney and a licensed physician.  So he understands exactly how the birth process should happen and where medical malpractice or medical negligence may have occurred in a birth injury.  

Gastric bypass surgery and other weight loss surgeries have become one of the most commonly used surgical procedures in the country.  Gastric bypass surgery is often used by people who are having difficulty losing weight through diet and exercise.  Gastric bypass surgery involves taking a loop of bowel and bypassing the major portion of the stomach, thereby creating a smaller pouch that contains approximately one or two ounces.  When a patient eats, they feel full with a much smaller consumption of food, leading to weight loss.  

Because gastric bypass surgery is such a common elective surgery, most people do not think about the risks involved.  All operations carry risks and weight loss surgery including gastric bypass surgery is a major procedure that can cause serious injuries if mistakes happen.  

Gastric bypass injuries can happen if the stomach leaks into the abdominal cavity which can result in infections or blood clots.  In addition, the patient can suffer from excessive bleeding, lung or breathing problems, and leaks in the gastrointestinal system.  Anesthesia mistakes can also occur with gastric bypass surgery, resulting in serious injuries to the patient.  In some cases, patients have died as a result of gastric bypass medical malpractice.  Long term risks include vomiting, gallstones, hernia, ulcers, bowel obstruction, and malnutrition.

Anesthesia malpractice can happen not only with elective weight loss surgeries such as gastric bypass, but lap band, and stomach stapling.  With the increasing number of requests for gastric bypass surgeries, many new doctors have entered the field, creating a number of physicians with inadequate training.  Also, many doctors use anesthetists who are not as highly trained as anesthesiologists.  

Many gastric bypass surgeries are conducted outside of a hospital setting, such as a doctor's office.  If a medical emergency occurs, the doctor's offices usually do not have access to emergency room surgeons, critical care nurses, or other resources that a hospital may have available.  Therefore, a patient may be kept waiting many precious minutes for an ambulance to arrive to transport them to a hospital.  During this time, a patient's condition may escalate from a serious problem to a catastrophic emergency.  Medical malpractice lawyers such as Dr. Bruce Fagel often handle medical malpractice cases related to anesthesia errors that resulted in serious injuries or death to the patients.   

If you or someone you care about has suffered a serious injury or died from a gastric bypass operation, plastic surgery, or other medical procedure, you may have a medical malpractice case.  Contact the Law Offices of Dr. Bruce G. Fagel & Associates for a free consultation.  Dr. Fagel is a leading medical malpractice attorney and a licensed medical doctor.

There is nothing more difficult and heart-breaking for a family than having to consider end of life care or signing a do not resuscitate form for a loved one who is seriously injured and not responding to medical treatment.  A patient can be placed on life support for a variety of reasons, such as a newborn baby who suffers serious brain injuries from a lack of oxygen during birth to a patient who does not come out of anesthesia after an operation to someone who simply will not survive a serious accident or injury.

When someone you love is placed on life support and is not responding to treatment, family members are placed in a very stressful and life altering situation; should they turn off life support or sign a do not resuscitate form if the idea is brought up by the doctor?  When the doctor meets with the family and recommends they remove the family member from life support or requests they sign a do not resuscitate form, family members usually do not question the doctor's possible reasons for the request.  But when it comes to a family member or someone you love, making this decision prematurely may not be in your best interests.  For example, if the family member is on life support due to medical malpractice from a doctor, nurse, medical professional, hospital or medical facility, their request to remove your loved one may involve a financial motive rather than what is in the best interest of the patient.

For example, in the state of California, if a patient dies because of medical malpractice from a doctor, nurse, or hospital, the maximum non-economic damages for wrongful death the family can collect is $250,000. Only when there are economic damages involved can the family collect more than $250,000.  If the patient is on life support due to the negligence of the doctor, nurse, or hospital, with no immediate recovery foreseen, or with a long recovery, it could cost the hospital a great deal more to keep the patient alive and provide the necessary medical care than to simply let the patient die.  If the victim happens to be a newborn with a serious birth injury, such as a severe form of cerebral palsy, there is a life time of medical care and lost economic wages the doctor or hospital will be responsible for which could cost millions of dollars.  However, if the patient on the life support were to be disconnected from the life support or the do not resuscitate form was filled out; the cost to the medical facility may be capped at $250,000.  Nobody wants to think that millions of dollars could influence a life or death situation, but before you allow that decision to be made for someone you love, you should consider getting a second opinion, including that of an experienced medical malpractice attorney who is also a licensed medical doctor.  Dr. Fagel will provide you with an independent opinion regarding whether medical malpractice was the cause of the catastrophic injury and what your legal rights are, and allow you to make up your own mind without the influence of someone who may be biased and not serving your family's best interests.

If you have questions about a family member who is on life support or died because of medical malpractice, contact the Law Offices of Dr. Bruce G. Fagel & Associates for a free consultation.  Dr. Fagel has extensive experience handling cases like this and can help provide the answers you need.

Sometimes newborn infants are born under challenging medical conditions, including umbilical or placental problems, a difficult delivery, or an illness with the mother.  If the baby is asphyxiated either before or during birth, the lack of oxygen to the brain can result in Hypoxic Ischemic Encephalopathy or HIE. 

HIE can be broken down into the following terms:

Hypoxia - a decreased amount of oxygen

Ischemia - a decreased amount of blood perfusing the brain

Encephalopathy - any dysfunction of the brain

It is important to understand that the birthing process frequently causes a small reduction in the supply of oxygen to the brain of the infant, and many babies are born with some amount of hypoxia at birth, which is referred to as birth depression.  However, a reserve blood and oxygen supply is provided to the baby in the uterus via the placenta. 

Babies who are born with a minor level of hypoxia can be stimulated so they don't suffer any serious injuries to their brain.  If the baby is born with severe hypoxia before or during birth, HIE may occur.  HIE can range from mild to severe.  After several hours of HIE, the brain damage can become permanent.  With the exception of babies who are the most seriously injured by HIE, brain cooling can help minimize the risk of damage to babies deprived of oxygen at birth, including a dramatic reduction in cerebral palsy outcomes, even reducing the number of deaths.

Brain cooling involves giving the infant a cool fluid filled blanket or a water cooled cap that lowers the temperature of the baby by 3 to 4 degrees Celsius for approximately 72 hours after birth; in essence putting the infant into a mild form of hypothermia.  This is important because research has shown that damage to the brain does not occur immediately after the brain is deprived of oxygen, but rather is the result of a cascade of chemical reactions; thereby giving a window of several hours before it becomes permanent. It is believed that cooling slows down these chemical reactions, giving the cell repair mechanisms the ability to repair the damage without being overwhelmed.

Currently, brain cooling appears to be the only medical treatment available for an infant who has suffered extensive birth asphyxiation.  After the brain cooling procedure has been initiated for 72 hours, the infant is slowly warmed back up to a normal body temperature over the next 6 hours.  Doctors need to exercise caution when treating babies with brain cooling.  In order for brain cooling to be successful, it is important that the following conditions are met:

• The gestation period of the infant must be greater than 36 weeks
• The infant suffering from HIE must receive brain cooling within 6 hours of birth

If the doctor does not implement this procedure correctly or under the proper conditions, the baby could suffer additional brain damage and even die. 

If you believe your baby suffered serious birth injuries including cerebral palsy, because of doctor, nurse, or hospital medical negligence, you may have a medical malpractice case. You should contact the best medical malpractice attorney possible, such as Dr. Bruce Fagel right away for a free consultation.  Dr. Fagel is a top birth injury attorney and a licensed medical doctor with over 10 year's emergency room experience. Dr. Fagel understands exactly how the birthing process should occur and where medical malpractice happened during a birth injury. 

If you or a family member has been seriously injured by what you believe to be the fault of a doctor, nurse, or medical facility, you probably have a lot of questions.  The most important question very likely is do I have a medical malpractice case?  Three issues must be met for a medical malpractice case to be proven: 

• That negligence was caused by at least one or more health care providers involved with the patient's care
• The negligence was the cause of injury or death
• The damages were the result of negligence

In order to prove negligence, it will be required to prove the facts of the case and to use expert testimony to demonstrate that the medical care was below an acceptable standard of care for physicians in the community or hospitals.  The cost of retaining medical experts in medical malpractice cases can easily exceed $200,000 or more before trial.  This is why it is important for anyone considering filing a medical malpractice case to find an attorney who can afford and is willing to front the money for the medical experts and understands how to ask the right questions of the medical experts. 

This is where being both a licensed medical doctor and a medical malpractice lawyer provides Dr. Bruce Fagel an enormous advantage over most other attorneys. Dr. Fagel understands the medical terminology and knows exactly what to look for in the medical records and what questions to ask the medical experts and defendants.  Much of the evidence necessary to prove the case will be located in the medical records and this evidence allow medical experts to base their opinions about the standard of medical care provided in your case.

A medical malpractice attorney must determine whether your case will likely prevail by resulting in a verdict or settlement in your favor.  If it is determined that the case likely would not obtain a verdict or settlement, then there is no reason to move forward.

A California medical malpractice attorney such as Dr. Fagel will examine the medical records very early in the case. Usually, the medical professionals responsible for the negligence will deny that they were negligent; therefore, it will require an experienced medical malpractice attorney to make a determination to see if this is true or not.  Proving negligence in a medical malpractice case will require analyzing the facts and using expert testimony to demonstrate the medical care was below an acceptable level.

If Dr. Fagel determines negligent care was a cause of the injury or death, his law firm has the ability to pursue these types of cases to a successful conclusion, regardless of the resources the medical professionals or hospitals may have at their disposal to defend themselves.  Medical malpractice cases can be some of the most expensive cases to pursue and most medical professionals, medical facilities, and insurance carriers retain top defense attorneys to protect their interests, therefore it is critical that you hire an attorney who knows how to take on these types of attorneys to protect your interests.

If you or someone you love has been injured or died because of the negligence of a doctor, nurse, or medical facility, contact The Law Offices of Dr. Bruce G. Fagel & Associates for a free consultation.

Developmental milestones are specific skills or tasks that every child learns such as walking, talking, speaking, thinking, and self-help skills.  Every child achieves these milestones at a slightly different time period in their lives.  Pediatricians refer to developmental milestones to help gauge how a child is developing.  If a child is significantly slower at reaching any of these milestones than other children of the same age range, this may be a sign of a developmental delay.  Other terms used for developmental delay may include intellectual disability, developmental disability, or mental retardation.  If a developmental delay is recognized and treatment begins early, the child will be able to adapt and cope with the condition more effectively.

Developmental delays can occur from a number of causes including infections, chromosomal abnormalities, genetic abnormalities, metabolic problems, malnutrition, drug or alcohol abuse by the mother, lack of oxygen in the brain before or after birth, or head trauma.  Sometimes birth injuries, including developmental delays or cerebral palsy may not even be detected at birth, but instead may take months or even years to be discovered.

If medical negligence is responsible for the birth injury, the two major causes are lack of oxygen to the brain or trauma.  When an infant does not receive an adequate supply of oxygen to the brain, this can lead to cerebral palsy.  Depending on how much oxygen was deprived from the infant, how long the problem persisted until corrected, and how much damage occurred to the brain, the condition of the cerebral palsy can range from mild to severe.

One challenge for the family of a child with cerebral palsy or developmental delays that result from medical malpractice is the time it takes to discover the problem.  Not only does a delay in diagnosis make it more difficult to help the child adapt to the medical condition, it poses a legal challenge as well.  Each state has its own statute of limitations for medical malpractice cases which creates a time period by which the family must file the lawsuit or lose their right to collect for damages.  This is one reason why any family that discovers their child has cerebral palsy or developmental delays and suspects this may be from medical negligence, needs to consult with an experienced medical malpractice attorney who specializes in birth injuries.

Developmental delays and cerebral palsy may require a lifetime of medical care for the child.  If medical negligence was responsible for the condition, you may have a medical malpractice case.  Dr. Bruce Fagel is a top medical malpractice attorney specializing in birth injuries, and a licensed medical doctor.  Contact Dr. Fagel for a free consultation.

Kernicterus is a form of brain damage that happens in some newborn babies with severe jaundice (a yellow coloring of the skin and other tissue).  Kernicterus occurs as a result of untreated high levels of bilirubin. The bilirubin can move from the blood into the brain tissues where it causes brain damage.

Bilirubin is a substance found in bile that is created when the liver breaks down old red blood cells.  It is then removed from the body through the stool.  When bilirubin levels are elevated, jaundice may occur.  Jaundice can be caused by a number of factors including blockage of the tubes that allow bile to pass from the liver to the small intestine, blood disorders, or liver disease.  If too much bilirubin builds up, it can result in serious damage to the baby, including brain damage (kernicterus), hearing loss, damage to muscles that control eye movement, physical abnormalities, developmental delays, even death. 

Kernicterus can be prevented.  When newborn infants develop jaundice, they can be treated by phototherapy, which uses special lights, or a blood transfusion to lower the bilirubin levels. 

A minor increase in bilirubin levels is usually not a problem.  Nearly half of all newborn babies have an increase in their bilirubin levels, due to the fact that their liver is not yet mature enough to break down the excess red blood cells they were born with.  However, if hyperbilirubinemia is not treated promptly, it can cause serious injuries or lead to the death of the baby.

If the elevated bilirubin has lead to the development of kernicterus, then the brain damage is already occurring.  It is critical that parents pay attention to these signs and seek medical attention for their baby immediately before greater damage occurs.

Signs of kernicterus:

• The baby is excessively lethargic
• The baby is very sleepy and difficult to awake.  Once awake, the baby can't stay awake
• The baby has a high pitched cry
• The baby does not respond to touching or startle from sudden movements
• The baby has poor muscle tone, including unusual muscle flexing
• The baby suffers from seizures
• The baby has a fever

If kernicterus has developed, prompt treatment can help prevent additional brain damage from occurring.  If kernicterus has developed, there are treatments available, including speech therapy, physical therapy, and special education. 

If your child has developed kernicterus, it may be a result of medical malpractice. You should immediately consult with the best birth injury attorney possible, such as Dr. Bruce Fagel.  Visit Kernicterus Video for an informative video featuring Dr. Fagel.

Anesthesia malpractice happens every day in doctor's offices, surgical centers, and hospitals.  Although people facing surgery naturally fear the surgery itself, almost nobody thinks about the anesthesia used during the surgery and mistakes made by the anesthetist or anesthesiologist during or after the surgery that can result in serious injuries including permanent brain damage or death of the patient.

Anesthetists and anesthesiologists play an important role in every surgery.  They provide both the pain relief for the patient and have control over the patient's life functions during the surgery and after the surgery, including controlling the breathing, heart rate, blood pressure, and body temperature.  The anesthesiologist also is responsible for waking the patient up after the surgery is finished.

This places an enormous responsibility for the anesthetist or anesthesiologist as a simple mistake could wind up placing a patient in a coma, suffering irreversible injuries, including brain damage, paralysis, or death.  Anesthesia mistakes often can be corrected and won't cause any detectable harm to the patient.  However, it's the situations where the mistakes are not noticed or correct in time that is of concern.

What is the difference between an anesthetist and an anesthesiologist?

Anesthetists are registered nurses with an advancement of studies in anesthesia.  Since they are not doctors, they are required to work under the supervision of a physician.  

Anesthesiologists are medical doctors who are licensed to administer anesthesia; and are licensed to practice without the order of any other physician. Because of their extensive training, they are trained to handle the administration of any operation requiring anesthesia.  They also oversee operations and anesthesia teams where applicable.  Being that anesthesiologists are physicians, they are generally held to a higher standard of medical care than an anesthetist.

It's important to understand that a poorly trained anesthetist can cause serious injuries to a patient if they make a mistake and don't quickly correct the error.  Anesthesia injuries often occur in the post anesthesia recover room whereby the patient came through the operation successfully, but the anesthetist makes a mistake that injures the patient.

Places where anesthesia mistakes often occur is in doctor's offices, cosmetic clinics, and surgical centers for elective surgeries, including cosmetic surgery and bariatric surgery.  Cosmetic surgery includes breast augmentation, nose jobs, facelifts, and liposuction.  Bariatric surgery includes lap band, gastric bypass, and stomach stapling.  One of the reasons for the large number of anesthesia injuries in places like these is because of the increasing number of elective surgeries being performed every year and that these operations are often done without the presence of a board-certified anesthesiologist and a staff of nurses, critical care nurses, and other trained medical professionals that may be available in a hospital. If there is a medical emergency, the patient may be kept waiting a dangerous amount of time, until they can be transported to a hospital for emergency care.  Most people think because these are common procedures being done by so many people and that one can't turn on the television or look at a magazine without seeing people who have had these procedures, that these surgeries are safe.  It is important to understand that any operation carries a risk of serious injury, even death.   

If you or someone you love has been seriously injured or died as a result of an anesthesia mistake or other form of medical negligence, you may have a medical malpractice case.  Contact the Law Offices of Dr. Bruce G. Fagel & Associates right away for a free consultation.  Dr. Bruce Fagel is a top medical malpractice attorney and a licensed medical doctor who only handles medical malpractice cases.

Emergency rooms are a necessary lifeline for millions of people throughout the country that require medical care.  Hospital emergency rooms have seen a steady increase in the volume of patients; thereby creating a chaotic environment for those who require medical care, including emergency medical care.  Most people would be shocked if they visited their local hospital emergency room, as they would likely see an entire room filled with people waiting hours for medical care.

Because there is such a large volume of patients who need help, this can result in a tired, overworked, and understaffed group of doctors and nurses who are forced to rush quickly from patient to patient.  This type of situation can lead to patients who need serious medical attention not being attended to for hours, therefore their condition can worsen, or the failure of the medical staff to diagnose a medical condition or even misdiagnosing a medical condition.  Overcrowded emergency rooms are at an increased risk for hospital negligence and hospital malpractice. This type of environment can result in serious injuries or death to patients.

Dr. Bruce Fagel is a top medical malpractice attorney and a licensed physician.  Prior to becoming a lawyer, Dr. Fagel practiced emergency medicine for over 10 years, so he understands exactly how emergency rooms function in hospitals.  Dr. Fagel was able to obtain extensive first-hand experience as to how hospital emergency rooms handle overcrowding and how doctors, nurses, and hospital staff deal with negligence. In situations involving doctor malpractice, nursing malpractice, and hospital malpractice, Dr. Fagel understands how to ask the pertinent questions from the medical staff and get the answers necessary to defend his clients.  Doctors often use their medical expertise to confuse attorneys and juries by throwing out complicated medical jargon; however, with Dr. Fagel being a licensed medical doctor, this strategy does not work.  Dr. Fagel understands the medical facts and with his nearly 30 years experience as a leading medical malpractice attorney, he knows how to obtain the maximum verdicts and settlements for his clients.

When dealing with medical malpractice claims, it's important for people to understand that medical malpractice cases are extremely complicated and expensive to handle.  Attorneys representing doctors and hospitals invest a great deal of money and resources defending their clients; therefore, it is critical that a victim of medical malpractice retains the services of an attorney that understands how to take on these powerful attorneys and has the resources necessary to win.  The Law Offices of Dr. Bruce G. Fagel & Associates only handles medical malpractice cases, so this allows them to focus 100% of their resources in one area and one area only, medical malpractice.

If you or someone you care about was the victim of doctor malpractice or hospital malpractice in an emergency room, contact the Law Offices of Dr. Bruce G. Fagel & Associates right away for a free consultation.