Sunday, January 08, 2006

Viruses to blame for palsy in babies

Doctors sued for delivering babies with cerebral palsy may have been wrongly accused of medical negligence, with new research showing a virus in the womb, rather than oxygen starvation, is to blame in most cases.

The findings raise the prospect of a vaccination to cut the rate of cerebral palsy but also have the potential to slash the estimated $100 million a year that is paid out in medical negligence settlements. About 600 Australian babies are born each year with the debilitating brain and motor disorder, which has traditionally been attributed to birth asphyxia - a lack of oxygen caused by improper delivery.

However, a study of 443 Australian children with cerebral palsy and 883 babies without the condition has found that exposure to viruses before and directly after birth can trigger the disorder, which can affect movement, sight, hearing, perception and learning.

Alastair Maclennan, leader of the South Australian Cerebral Palsy Research Group, which published the work in the British Medical Journal, said the findings proved that cases of cerebral palsy should not be dealt with by courts. "Judgments are made in total ignorance," he said. "(Cerebral palsy) is very rarely due to birth asphyxia." Professor Maclennan, an obstetrician and gynaecologist based at the University of Adelaide, criticised "rogue expert witnesses" for swaying courts. "It's always possible to find hired-gun expert witnesses, usually retired, who say that if they'd delivered the baby a half-hour earlier, there would be no cerebral palsy."

The strongest link to cerebral palsy was found with herpes group B viruses, which include varicella zoster, the virus responsible for chicken pox and shingles. The risk of the condition almost doubled with exposure to these viruses. In Australia, medical negligence cases brought when babies are born with cerebral palsy cost more than $100 million a year. One such case in 2001 attracted the nation's biggest medical negligence payout of $14.2million. NSW woman Calandre Simpson was awarded the payout after she sued obstetrician Robert Diamond for a botched forceps delivery. Her payment, reduced to $11 million on appeal, revealed the vulnerability of the medical insurance industry. Months later, her medical indemnity provider, United Medical Protection, went into provisional liquidation.

Professor Maclennan said the fear of lawsuits was driving obstetricians out of the field and forcing maternity ward closures. Australian Medical Association medical indemnity chairman Andrew Pesce said: "Hopefully, as more and more evidence like this stacks up, fewer doctors will be successfully sued for negligence in cerebral palsy cases."



For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

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