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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
A proposed model for managing cases of neurologically impaired infants
Richard L Berkowitz1, Gary Hankins, Richard Waldman
1From the Columbia University College of Physicians & Surgeons, New York, New York; University of Texas Medical Branch, Galveston Texas and American College of Obstetricians and Gynecologists Task Force on Neonatal Encephalopathy and Cerebral Palsy; American College of Obstetricians and Gynecologists District II/New York and Associates for Women's Medicine, Syracuse, New York; American College of Obstetricians and Gynecologists' Department of State Legislative & Regulatory Activities, Washington, DC; and American College of Obstetricians and Gynecologists District II/New York, Albany, New York.
Insights
Current systems for supporting families with neurologically impaired infants are flawed. A proposed New York program aims to improve financial aid and medical negligence assessment for these children.
Area of Science:
- Medical Law and Ethics
- Pediatric Neurology
- Public Health Policy
Background:
- The existing system for financial support of neurologically impaired infants relies on the tort system, alleging medical negligence.
- This system is inefficient, costly, and inequitable for families and physicians.
- High malpractice premiums threaten obstetric practice in the U.S.
Purpose of the Study:
- To address inequities in financial support for families with neurologically impaired infants.
- To propose a new system for assessing medical negligence in these cases.
- To introduce the Neurologically Impaired Program for New York State (S7748).
Main Methods:
- Description of a two-pronged program submitted to the New York State legislature.
- The program aims to correct inequities and assess medical negligence.
- Proposed bill: Neurologically Impaired Program for New York State (S7748).
Main Results:
- The proposed program seeks to create a fairer and more efficient system.
- It aims to reduce the burden on families and protect physicians from unjust accusations.
- The program is designed to ensure appropriate financial support and accurate negligence assessment.
Conclusions:
- The current tort-based system for supporting neurologically impaired infants is fundamentally flawed.
- A new legislative program (S7748) offers a more equitable and efficient solution.
- This initiative could safeguard obstetric practice while supporting affected families.
Abstract:
The current mechanism for obtaining financial support for families with neurologically impaired infants is seriously flawed. It relies on payment awarded through the tort system based on a claim that medical negligence was responsible for the infant's condition. The system is extraordinarily inefficient and expensive, as well as being unfair to many families with affected children and to physicians who are unjustly accused of contributing to outcomes they could not have prevented. Furthermore, the exorbitant malpractice premiums necessary to support the system are threatening the future of obstetric practice in the United States. This article describes a two-pronged program designed to correct these inequities and to assess each case for the occurrence of medical negligence, which has been submitted to the New York State legislature as a proposed bill entitled the Neurologically Impaired Program for New York State (S7748).
