Stillbirth

Medical Malpractice with Baltimore Stillbirth Lawyer Mark Kopec

1. Introduction and Definitions

The loss of a child before birth is one of the most profound tragedies a family can endure. A loss can occur late in pregnancy. Specifically, after the fetus has reached a stage where it could survive outside the womb. The emotional damage is worse due to difficult questions regarding whether the death was preventable. If you have suffered the loss of a viable baby, you may need Baltimore stillbirth lawyer Mark Kopec.

In clinical terms, this loss is a stillbirth. Broadly defined, a stillbirth is the death or loss of a fetus before or during delivery. The distinction between a miscarriage and a stillbirth is usually based on the length of the gestation. A loss happening before the 20th week of pregnancy is typically a miscarriage. A loss at 20 weeks or later is a stillbirth.

Stillbirths are further defined based on the gestational age at which the event occurs:

• Early Stillbirth: Occurs between 20 and 27 completed weeks of pregnancy.
• Late Stillbirth: Occurs between 28 and 36 completed weeks of pregnancy.
• Term Stillbirth: Occurs from 37 completed weeks of pregnancy and onward.

The Kopec Law Firm provides this webpage to specifically focus on stillbirths that occur after viability. That is the critical threshold where a fetus is legally and biologically recognized as capable of living outside the womb. A viable fetus can die due to the malpractice, omission, or poor care of medical providers. The tragedy crosses from an unavoidable natural event into the domain of medical malpractice and wrongful death cases.

2. The Concept of Viability

In both medicine and law, viability represents a pivotal point. Biologically, fetal viability is the point in development at which a fetus has reached such a stage of development as to be capable of living outside the uterus, with or without the aid of artificial life-support systems. Viability is not an instant, uniform calendar date. Rather, it exists as a biological continuum. It is influenced by birth weight, fetal sex, plural gestation, and the availability of advanced neonatal intensive care technology.

In contemporary medical practice, the threshold of viability is generally recognized to begin around 22 to 24 weeks of gestational age. At 22 weeks, neonatal survival rates are low and heavily dependent on aggressive resuscitation, whereas by 24 weeks, the statistical probability of survival increases a lot, provided that appropriate tertiary neonatal care is accessible. By the time a pregnancy reaches the late and term stages (28 to 40 weeks), the fetus is unquestionably viable, has fully developed respiratory, circulatory, and neurological systems capable of extrauterine life.

3. Etiology: Causes and Clinical Risk Factors – Baltimore Stillbirth Lawyer Mark Kopec

Understanding why stillbirths occur requires looking at underlying medical causes and epidemiological risk factors. While some stillbirths occur despite good medical management, a substantial portion involves identifiable pathologies that demand intentional clinical intervention.

A. Primary Clinical Causes

• Placental Abnormalities: The placenta is the vital organ giving oxygen and nutrients to the fetus. Placental insufficiency, abruptio placentae (where the placenta prematurely detaches from the uterine wall). Vasa previa can rapidly deprive the fetus of oxygen, leading to intrauterine fetal demise (IUFD).
• Umbilical Cord Accidents: Conditions such as a true knot in the cord, umbilical cord compression,tight nuchal cords (wrapped tightly around the fetal neck), or cord prolapse can physically block fetal blood flow and oxygenation.
• Maternal Infections: Systemic or localized intra-amniotic infections (chorioamnionitis) caused by pathogens such as Listeria monocytogenes, Group B Streptococcus (GBS), syphilis, or viral agents can cross the placental barrier, causing acute fetal sepsis or placental inflammation.
• Fetal Growth Restriction (FGR): Also known as Intrauterine Growth Restriction (IUGR), this occurs when a fetus does not reach its biological growth potential. This is often due to underlying placental dysfunction. An undiagnosed or unmonitored growth-restricted fetus is at a much higher risk of stillbirth.
• Maternal Medical Conditions: Chronic or gestational conditions including preeclampsia, eclampsia, chronic hypertension, and poorly controlled pregestational or gestational diabetes introduce systemic vascular and metabolic stressors that put fetal stability in danger.

B. Epidemiological Risk Factors

Certain demographic and medical profiles elevate a patient’s risk for stillbirth. These include advanced maternal age (35 years and older), maternal obesity (BMI ≥ 30), multiple gestations (twins, triplets), a history of previous pregnancy loss, and a history of maternal autoimmune or renal disorders. The presence of these risk factors requires obstetricians to implement enhanced surveillance protocols.

4. Medical Malpractice as a Proximate Cause – Baltimore Stillbirth Lawyer Mark Kopec

Medical malpractice occurs when doctors or other medical providers—such as an obstetrician, maternal-fetal medicine (MFM) specialist, labor and delivery nurse, or midwife—fails to adhere to the accepted standard of care in the medical community. This failure results in injury or death to the patient or fetus. In the context of a post-viability stillbirth, malpractice is rarely an intentional act. Instead, it appears as a failure to recognize, interpret, or appropriately manage maternal and fetal warning signs.

The Legal Standard of Care To establish a medical malpractice claim for stillbirth, a plaintiff must prove four core elements:

1. The existence of a provider-patient relationship establishing a duty of care.
2. A breach of duty, meaning the provider’s conduct fell below the recognized professional standard of care.
3. Causation, demonstrating that the breach was the proximate cause of the fetal demise.
4. Compensable damages.

Common Modalities of Obstetric Malpractice

• Misdiagnosis or Failure to Diagnose and Monitor Fetal Growth Restriction (FGR): FGR is one of the most reliable indicators of potential stillbirth. The standard of care requires providers to measure fundal height at every prenatal visit past 20 weeks. If fundal height lags, or if risk factors exist, an ultrasound must be ordered to assess fetal weight, amniotic fluid volume, and umbilical artery Doppler flows. Failure to diagnose FGR, or failure to initiate serial testing once diagnosed, constitutes a critical departure from standard care.
• Mismanagement of Maternal Preeclampsia and Gestational Diabetes: Preeclampsia is marked by sudden-onset hypertension and proteinuria after 20 weeks. If left without treatment, it reduces placental blood flow. Malpractice occurs when providers dismiss symptoms like severe headaches, visual disturbances, or sudden edema, or fail to timely deliver a viable fetus when preeclampsia worsens. Similarly, failing to screen for or aggressively manage gestational diabetes can lead to macrosomia, placental aging, and sudden unexplained fetal death.

Additional Failures

• Failure to Correctly Interpret Electronic Fetal Monitoring (EFM): During labor or during non-stress tests (NST), EFM strips provide a continuous reading of the fetal heart rate and uterine contractions. The standard of care requires nurses and physicians to identify non-reassuring patterns. Examples are repeat late decelerations, prolonged decelerations, or a loss of beat-to-beat variability, which signify fetal hypoxia (oxygen deprivation). Ignoring these patterns or delaying a necessary emergency Cesarean section violates the standard of care.
• Inadequate Response to Maternal Complaints: A drop in fetal movement (decreased fetal kick counts) is a classic warning sign of fetal distress. If a patient contacts her obstetric provider reporting that the baby is moving less, the standard of care mandates immediate evaluation via an NST or biophysical profile (BPP). Telling a patient to “wait and see” or dismissing her concerns without objective evaluation is a frequent basis for medical malpractice claims when a subsequent stillbirth occurs.

Baltimore stillbirth lawyer Mark Kopec can assess the medical providers’ conduct in the loss of your baby.

5. Preventative Strategies and Clinical Interventions

Reducing the number of post-viability stillbirth demands an adherence to protocols designed to identify and rescue the compromised fetus before irreversible injury occurs. Preventative care is divided into antenatal surveillance and timely delivery strategies.

Standardized Antenatal Surveillance

For pregnancies identified as high-risk due to maternal conditions (e.g., chronic hypertension, diabetes) or fetal conditions (e.g., FGR, oligohydramnios), standard care dictates the start of regular testing starting between 24 and 32 weeks of gestation. This testing includes:

• Non-Stress Test (NST): Monitors the fetal heart rate in response to fetal movement. A “reactive” NST indicates adequate fetal oxygenation and neurological integrity.
• Biophysical Profile (BPP): Combines an NST with ultrasound evaluation of fetal breathing movements, body movements, fetal tone, and amniotic fluid volume. A low BPP score (e.g., 4/10 or less) indicates acute distress and often mandates immediate delivery.
• Doppler Velocimetry: Measures the resistance of blood flow in the umbilical artery, providing critical data on placental functionality.

Timely and Managed Delivery

When antenatal testing demonstrates that the intrauterine environment poses a greater risk to the viable fetus than the risks associated with prematurity, delivery must be executed. For instance, in cases of severe preeclampsia or a non-reassuring BPP after viability, the standard of care moves away from expectant management toward induction of labor or Cesarean delivery. Delays in coordinating anesthesia, operating rooms, or surgical staff can constitute actionable negligence if the delay results in intrauterine demise.

6. Wrongful Death Law and Post-Viability Stillbirth – Baltimore Stillbirth Lawyer Mark Kopec

The legal framework for the death of an unborn fetus varies significantly across state jurisdictions. Historically, under common law, an unborn fetus was not recognized as a distinct legal entity, meaning that if a child died in utero due to a wrongful act, no independent civil action could be maintained for the child’s death. However, modern statutes and judicial cases have altered this landscape.

The Maryland Framework: Recognition of the Viable Fetus

In the State of Maryland, the legal standing of a stillborn child was established by the Supreme Court of Maryland (formerly the Court of Appeals) in the case of Group Health Ass’n v. Blumenthal (1983), and further by subsequent law. Maryland law establishes that a wrongful death action may be maintained for the demise of a fetus, provided the fetus had attained viability at the time of the negligent injury and subsequent death.

Under the Maryland Wrongful Death Statute (Md. Code Ann., Cts. & Jud. Proc. § 3-901 et seq.), the surviving parents of a viable stillborn fetus can bring a civil action against the negligent medical providers. Because the fetus was viable, the law treats the unborn child as a “person” for the limited purpose of the wrongful death statute.

In a Maryland wrongful death claim for a viable stillbirth, the parents can seek substantial financial compensation. These damages are generally:

• Pecuniary Damages: These are compensable financial losses. In the case of a stillbirth, they are typically limited to medical expenses related to the pregnancy, delivery, and subsequent funeral or burial costs.
• Solatium (Non-Pecuniary) Damages: These represent the core of a stillbirth claim. Parents can recover substantial damages for mental anguish, emotional pain and suffering, loss of society, companionship, comfort, guidance, and filial care. Maryland law recognizes that the severing of the parental-fetal bond causes extraordinary, psychological trauma.

Survival Actions Distinguished

It is important to distinguish a wrongful death claim from a survival action under Maryland law. A survival action (brought by the estate of the deceased under Md. Code Ann., Est. & Trusts § 7-401) seeks damages for the conscious pain and suffering experienced by the decedent prior to death.

In cases of sudden intrauterine stillbirth, proving that the fetus experienced conscious pain can be a complex evidentiary hurdle. It may require medical expert wiitness testimony. Therefore, while survival actions are occasionally filed concurrently, the primary vehicle for legal recovery remains the wrongful death claim brought by the parents.

Evidentiary Requirements in Maryland Litigation

To prevail in a Maryland courtroom, plaintiffs must retain qualified, expert witnesses. These are in obstetrics and gynecology, and potentially maternal-fetal medicine or placental pathology. These experts must review the prenatal medical records, EFM strips, and autopsy reports to explicitly testify regarding:

1. The exact standard of care required under the specific circumstances.
2. How the defendant provider breached that standard.
3. Proof that the fetus was viable at the time of the breach.
4. That the fetus would have survived born alive had the medical providers followed the standard of care.

You can read a report on a stillbirth case, Preeclampsia Stillbirth $25M, and Blog posts on other medical malpractice verdicts.

Next Step: Contact Baltimore Stillbirth Lawyer Mark Kopec

An instance of medical malpractice lies in the lack of diligence, responsiveness, and competence of the medical team. When a pregnancy reaches the stage of viability, medical providers possess both the technology and the professional obligation to monitor fetal well-being and intervene when distress is apparent.

When negligent omissions cut short a viable life, the legal system provides a vital mechanism for accountability. In Maryland, the law explicitly recognizes the profound loss experienced by parents. This ensures that the wrongful death of a viable unborn baby is met with full civil recourse and substantial legal remedies.

Visit our free consultation page or video. Then contact the Kopec Law Firm at 800-604-0704 to speak directly with Attorney Mark Kopec. He is a top-rated Baltimore medical malpractice lawyer. The Kopec Law Firm is in Baltimore and pursues cases throughout Maryland and Washington, D.C.