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A Proposed Model for Managing Cases of Neurologically Impaired Infants

Berkowitz, Richard L. MD; Hankins, Gary MD; Waldman, Richard MD; Montalto, Donna MPP; Moore, Kathryn

doi: 10.1097/AOG.0b013e318198a65e
Current Commentary

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).

A two-pronged proposal is presented for the financial support of families with neurologically impaired children and the assessment of medical negligence in these cases. Supplemental Digital Content is available in the text.

From the 1Columbia University College of Physicians & Surgeons, New York, New York; 2University of Texas Medical Branch, Galveston Texas and American College of Obstetricians and Gynecologists Task Force on Neonatal Encephalopathy and Cerebral Palsy; 3American College of Obstetricians and Gynecologists District II/New York and Associates for Women’s Medicine, Syracuse, New York; 4American College of Obstetricians and Gynecologists’ Department of State Legislative & Regulatory Activities, Washington, DC; and 5American College of Obstetricians and Gynecologists District II/New York, Albany, New York.

See related editorial on page 576.

Corresponding author: Richard L. Berkowitz, MD, Columbia University Medical Center, Division of Maternal Fetal Medicine, 622 West 168th Street, PH 16-66, New York, NY 10032; e-mail:

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2009 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.