Spina Bifida Lawyers: Missed Diagnosis & Birth Defect Malpractice Claims

Can You Sue for Spina Bifida?

You can, when the harm was preventable. The defect itself is congenital, but a spina bifida claim does not rest on causing it. It rests on the prenatal, delivery, and neonatal care that was supposed to catch it, counsel the family about it, and protect the exposed spinal cord at birth.

The claim turns on the same four elements as any medical malpractice case: a provider-patient duty, a breach of the accepted standard of care, a causal link between that breach and the worsened injury, and damages.

The contested element is rarely the diagnosis of spina bifida. It is whether a competent provider would have found it earlier, said something sooner, or delivered the baby differently, and whether that failure made your child's condition worse than it had to be.

Modern prenatal medicine is built to find open spina bifida in the second trimester. The screening tools are routine, the imaging markers are well known, and the standard of care expects providers to find the lesion early enough to give families real choices, not to deliver the diagnosis in the delivery room.

The Medical Failures Behind a Spina Bifida Claim

Spina bifida cases that reach our attorneys rarely involve mystery. They involve specific, identifiable departures from the standard of prenatal, intrapartum, and neonatal care. The recurring ones:

• Failure to order or follow up on the maternal serum AFP (alpha-fetoprotein) screen
• A misread or under-performed anatomy ultrasound at 18 to 22 weeks
• Radiologist failure to identify the "lemon sign," "banana sign," or ventriculomegaly
• No referral to maternal-fetal medicine after an abnormal screen
• Inadequate preconception and prenatal folic acid counseling
• Negligent prescribing of a teratogenic medication during pregnancy
• Failure to plan a controlled cesarean for a known open neural tube defect
• Delayed neonatal surgical closure of the open lesion
• Failure to diagnose and shunt hydrocephalus from a Chiari II malformation

Four of these drive most of the litigation.

A missed diagnosis on the anatomy ultrasound.   The 18-to-22-week scan is built to detect open spina bifida. Sonographers and radiologists are trained to recognize the cranial markers, the "lemon sign" (frontal bone scalloping) and "banana sign" (cerebellar deformation), alongside direct view of the spinal lesion. When the scan is run by an inadequately trained technician, when poor image quality is accepted instead of a repeat study, or when a radiologist signs out a normal report on an abnormal one, the family loses the entire window in which fetal intervention is possible.

A failure to act on an elevated AFP.   Elevated maternal serum AFP at 16 to 18 weeks is the single strongest biochemical signal of an open neural tube defect. The standard of care calls for prompt follow-up: a targeted Level II ultrasound, a maternal-fetal medicine consult, and in some cases amniocentesis for amniotic AFP and acetylcholinesterase. Buried lab values, ignored results, and "we will watch it next visit" are textbook deviations.

A mismanaged delivery of a known lesion.   Once spina bifida is diagnosed prenatally, the delivery plan matters. Vaginal delivery of an open lesion can rupture the sac, contaminate the exposed cord, and worsen the neurological injury. The standard of care typically calls for a planned cesarean at a tertiary center with neonatal neurosurgery on standby and surgical closure within 24 to 72 hours. An unplanned vaginal birth, a delayed closure, or a transfer delay that leaves the lesion exposed is a recurring theme in these cases.

Negligent prescribing and toxic exposure.   A smaller subset of claims involves drugs and exposures in early pregnancy. Valproic acid (Depakote) and carbamazepine (Tegretol) carry well-documented neural tube defect risk. The standard of care also expects a provider to identify high-risk patients (those with diabetes, obesity, a family history of neural tube defects, or on certain anticonvulsants) and counsel them on folic acid: 400 micrograms daily for women of reproductive age, and 4 milligrams for those with a prior affected pregnancy or on qualifying medications.^[1] The cases we handle turn on what a doctor missed, not on what a drug company hid.

The broader category of missed-diagnosis claims is covered on our failure-to-diagnose page, and the recurring institutional warning signs are laid out in our look at the signs of hospital negligence.

The Chance a Missed Diagnosis Takes Away

An early diagnosis is not paperwork. It is the difference between a planned path and an emergency.

Found in time, an open neural tube defect opens real options. The family can consider in-utero fetal surgery, the intervention shown to reduce the need for a shunt and improve motor function. They can plan a controlled cesarean instead of risking the lesion in a vaginal delivery. They can arrange the specialized neonatal care a child with myelomeningocele needs from the first minute of life.^[2]

Missed, all of that disappears. A misread anatomy ultrasound forecloses fetal surgery. An unplanned vaginal delivery of a known lesion turns a controllable injury into a sepsis emergency in the NICU. A buried AFP result turns a manageable, surgically corrected defect into permanent paraplegia and lifelong bowel and bladder dysfunction.

The legal term for some of these claims is a loss-of-chance or wrongful-birth claim. In plain English: the diagnosis was there to be made, the provider failed to make it, and that failure took away the family's chance to prepare, intervene, or plan a safer birth. Whether that claim is available, and what it covers, depends on your state's law.

The first thing we do is pull the actual ultrasound images and read them with our own specialist. The report tells you what the radiologist saw. The images tell you what was there to see. The lesion is either visible on the 20-week scan or it is not.

Lifelong Effects of Spina Bifida from Negligent Care

The effects of spina bifida depend on the level of the spinal lesion and how quickly, and how well, it was diagnosed and treated. The higher the lesion on the spine, the greater the neurological deficit.^[3]

Spina bifida does not manifest as a single problem. It cascades across motor, urological, neurological, and cognitive systems for life. Children may face lower-extremity paralysis, hydrocephalus, tethered cord syndrome, neurogenic bladder and bowel, latex allergy, learning disabilities, and repeated surgeries across decades. Roughly 80 to 90 percent of children with myelomeningocele develop hydrocephalus from a Chiari II malformation, which requires serial head-circumference monitoring, neuroimaging, and timely shunt placement. A missed or delayed shunt causes additional, preventable brain injury on top of the underlying condition.

What the medical charts do not capture is the rest of it: the therapy appointments stacked into every week of childhood, the catheter routines, the orthopedic surgeries, and the cost of raising a child whose care needs never end. When that burden traces to a provider's failure to meet the standard of care, the family deserves compensation that funds the care the child actually needs.

How a Spina Bifida Lawyer Proves the Case

These cases are won in the records. The proof is usually sitting in the ultrasound images, the lab reports, and the delivery notes the family has never seen.

Record and Image Review:   The anatomy ultrasound images (not just the radiologist's report), the AFP and serum screening results, the prenatal chart, the maternal-fetal medicine notes, the delivery records, and the neonatal surgical records.

Expert Review:   A maternal-fetal medicine specialist and a radiologist on whether the lesion was detectable and the screening was handled to standard, and a pediatric neurosurgeon on whether delivery and closure were managed correctly. Most states require a certificate or affidavit of merit signed by a qualified expert before suit can be filed.

Causation Proof:   The defense in these cases argues the defect was congenital and nothing could have changed the outcome. Strong cases answer with the specific window that was lost: what the imaging showed, what an earlier diagnosis would have made possible, and how the mismanaged delivery or delayed treatment worsened the injury.

Yes, the defect is congenital. The question we answer is whether your child is worse off than the medicine required, because the diagnosis was missed or the delivery was mishandled.

For the broader picture of how malpractice claims are built and valued, see our explanation of how medical malpractice claims are investigated.