title: Shoulder dystocia.
abstract: Using an evidence-based, medical approach, the strengths and pitfalls of the causation- and standard-of-care-based arguments proffered by plaintiff and defense counsel in shoulder dystocia- associated birth injury litigation are reviewed based on medical plausibility. The role of the expert witness as arbiter of the relationship between medical care rendered and the untoward outcome of such care is distinguished from that of other court members. Proposed solutions to the medical malpractice litigation crisis are also examined in light of relevant differences in the pathogenetic bases for birth injuries of various types.
authors.affiliation: Department of Gynecology/Obstetrics, Division of Maternal Fetal Medicine, The Johns Hopkins University School of Medicine, The Johns Hopkins Hospital, Baltimore, MD 21287, USA. egurewi@jhmi.edu
authors.forename: Edith D
authors.initials: ED
authors.lastname: Gurewitsch
authors.forename: Robert H
authors.initials: RH
authors.lastname: Allen
mesh_terms: D001720:Birth Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D001917:Brachial Plexus / Q000293:injuries*; D004420:Dystocia / Q000453:epidemiology*; D005113:Extraction, Obstetrical / Q000009:adverse effects; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D015601:Injury Severity Score; D011247:Pregnancy; D011256:Pregnancy Outcome; D012307:Risk Factors