It is often difficult to determine whether problems with the newborn were the result of negligence by the neonatologist or if the underlying condition was present before birth. Many hospitals that deliver babies do not have a neonatologist on staff or have the medical equipment or staff to provide specialized care to newborns who are born with complications. Often they must be transferred to tertiary care centers to receive care by a neonatologist. Many times the obstetrician caring for the mother may have an indication that the mother should deliver the baby at a tertiary care facility due to the likelihood of a condition that will be present at birth that would require intervention by a neonatologist. Frequently the obstetrician will consult with the neonatologist to make a collaborative decision about the need for transfer. Failure of the neonatologist to recommend transfer of the mother in a case with clearly defined parameters may constitute malpractice. Upon admission of a neonate into the neonatal intensive care unit, failure of the neonatologist to order appropriate monitoring, and failure to intubate, or provide appropriate supervision may also constitute malpractice. Failure to treat sepsis in a patient in which it was suspected, such as fever, poor feeding, lethargy, or seizure-like activity. Failure to detect congenital abnormalities, serious heart disease, and congenital hip dislocation may be cause for malpractice action.
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